Morbihan disease: treatment difficulties and diagnosis: a case report.

Morbihan disease (MD) is a rare entity. Its nosography is unclear and its therapeutic management is difficult. We report a new case of MD. We report a case of a 51-year-old patient consulted in our department for a one year facial edema, erythema and papules reported by him, for which the patient was treated with cyclins, local and general corticotherapy, without improvement. The clinical examination found an important edema of the front and eyelids with an erythema of the cheeks covered with a few telangiectasias. The clinical, biological and histological findings lead to a diagnosis of Morbihan disease after excluding other diseases. Due to previous therapeutic failures, the patient was put on isotretinoin and furosemide with slight improvement. The particularity of our observation lies in the rarity and especially in the therapeutic difficulties encountered during this disease.

[Fonsecaea pedrosoi-induced chromoblastomycosis: about a case]. / Chromomycose cutanée à Fonsecaea Pedrosoi: à propos d'un cas.

We report the case of a 13-year old female patient from rural areas presenting with papulonodular lesion of 4/3cm in the lower third of the right leg, evolving over the last two years. Skin biopsy showed papillomatous hyperplasia with neutrophilic microabscess and spores. Direct mycological examination showed fumagoid bodies and Fonsecaea pedrosoi was isolated from culture. The patient underwent medico-surgical treatment (terbinafine 250mg/day for 6 months + resection and then skin graft) with good evolution and a follow-up period of 2 years without recurrences. Chromoblastomycosis is a chronic fungal skin infection, common in tropical and subtropical areas and rare in North Africa. In Morocco, only seven cases have been reported in the literature until June 2014. It is contracted from inoculation of germ after contact with the soil or organic matters. Responsible officers are pigmented fungi belonging to the dematiated group. Given its rarity, it can mimic other dermatoses such as leishmaniasis or tuberculosis. Despite the rarity of this infection, clinicians should suspect it in patients with chronic skin lesions (verrucous, vegetative, nodular and grouped in patches), especially if they occur in areas exposed to potential plant injuries, such as the lower limbs. Mycological examination is necessary to confirm the diagnosis. Surgery or the association between surgery and systemic antifungal drugs are the treatments of choice because antifungal drugs alone may result in resistances or recurrences.