[Erythema nodosum: profile in a Tunisian teaching hospital]. / Erythemes noueux: etude d'une serie hospitaliere.

BACKGROUND: Erythema nodosum (EN) is the most frequent acute nodular hypodermatitis. Etiologies of EN are varied although a similar clinical presentation. The aim of our study is to establish epidemio-clinical characteristics of EN in 103 patients. METHODS: (62 in care (january 1980-december 2005) and 41 consultants (january 1991-december 2005) were seen on the dermatology unit of the Rabta hospital. We have only included patients that had done: blood count, chest X-Ray, ASLO, tuberculin intradermoreaction, transaminase, inflammation marker. RESULTS: We had 86 women and 17 men with a mean age of 36,5 years. Lesions were located in lower limbs in 88 cases. The main etiologies were: post streptococcal infections (42 cases), tuberculosis (8 cases), Crohn disease (8 cases), Behçet disease (7 cases) and sarcoidosis (5 cases). EN was idiopathic in 23 patients. The most common provoking agent of EN varies from a country to another and even in the same country from a study to another. In Tunisia, post streptococcal infections and Behçet disease still frequent etiologies for EN, sarcoidosis and inflammatory colites are more and more found unlike tuberculosis which is less incriminated than before. In case of EN it is reasonable to begin etiological enquiry by common causes.

[Erysipelas after osteoarticular prosthesis]. / Erysipèle après prothèses ostéoarticulaires.

OBJECTIVE: The occurrence of erysipelas after implantation of osteoarticular prosthesis is rarely reported in literature except when it may indicate infection of the implant. PATIENTS AND METHODS: We studied retrospectively 77 files of patients that had been hospitalized for erysipelas from January 1999 to December 2003. RESULTS: We included 3 patients (3.8%) 2 women and a man (average age: 61 years) with a history of osteoarticular prosthesis implantation on the same side as erysipelas. The period between implantation of the prosthesis and erysipelas varied from 6 months to 30 years. The 3rd patient also presented with chronic venous insufficiency and was treated for legs ulcers of venous origin. There were neither clinical nor radiological signs of prosthesis infection. The clinical schedule was typical. The initial outcome was favorable under intravenous penicillin G and local care. Antibiotic prophylaxis was recommended for all the patients, however, 2 patients relapsed.

[Pemphigoid gestationis: a study of 20 cases]. / Pemphigoïde gravidique: étude de 20 cas.

INTRODUCTION: Pemphigoid gestationis is a bullous autoimmune sub-epidermal dermatosis, occurring during pregnancy and/or postpartum. The objective of our study was to define the epidemio-clinical profile, the histopathological and immunopathological features, the treatment and the course of pemphigoid gestationis in Tunisian patients. PATIENTS AND METHODS: This was a retrospective study concerning the cases of pemphigoid gestationis recorded between 1989 and 2003 in the dermatology department in La Rabta Hospital in Tunis. The patients were included according to clinical, histopathological and immunopathological criteria. RESULTS: We retained 20 patients: 15 multiparae and 5 primiparae. The average age at onset was 29. The first clinical signs appeared in the 3rd trimester in 60 p. 100 of all cases. Clinically, the urticarial patches were noticed in 90 p. 100 of all cases and blisters in 65 p. 100 of the cases. The eruption was located mainly on the trunk and the limbs. The face was affected in 7 cases, the mucous membranes in 3 cases, the palms in 2 cases and the soles in 1 case. Cutaneous histologic examination revealed a sub-epidermal blister in 11 cases and a lymphohistiocyte infiltrate in all cases. Direct immunofluorescence showed a linear deposition of the third component of the complement along the basement membrane zone in all cases. Fetal prognosis was assessed in 13 cases: 1 fetal death, 1 still-born, 3 miscarriages, 1 anencephaly and 2 cases of transit bullous affection in the new-born. DISCUSSION: Our results are similar to those in the literature, but with some particular aspects: the late onset of the pemphigoid gestationis in the course of the 3rd trimester of pregnancy, the frequent involvement of the face and the mucous membranes and the absence of the two main fetal risks: prematurity and hypotrophy. Moreover, we underline the efficiency of topical class I corticosteroids in the treatment of pemphigoid gestationis.

Photo-onycholysis: two cases induced by doxycycline.

Photo-onycholysis is a phototoxic reaction, which is usually drug-induced. It consists of the separation of the nail from the nail bed due to ultraviolet radiation. We report two cases of female patients who developed distal onycholysis while receiving doxycycline. Among the drugs that cause photo-onycholysis, the most frequently cited are tetracyclines, psoralens and fluoroquinolones. Photo-onycholysis is often distal, half-moon shaped and can be surrounded by pigmentation. Spontaneous recovery follows within a few months of discontinuing the drug.

[Kaposi's sarcoma in Tunisia. Review of 91 cases]. / La maladie de Kaposi en Tunisie. A travers une serie de 91 observations.

The sickness of Kaposi's sarcoma (KS) knows, currently, a renewal of interest since the emergence of 2 new forms: the iatrogenic KS and the epidemic KS. Through a retrospective study on 21 years (1978 to 1998) we have tried to specify the epidemiologic and clinical characters of KS in Tunisia. Our study interests 91 patients: 85 cases of classic KS (94%), 4 cases of iatrogenic KS and 2 cases of epidemic KS. The incidence of iatrogenic KS in renal transplant recipients in our study is 1.9%. A male predominance is found in the 3 forms. The mean age of beginning was 60 years in classic KS and more lower in the 2 other forms (31 years in iatrogenic KS and 46 years in epidemic KS). A predominance of lesions in the lower limbs was found in the 3 forms. The visceral locations was more frequent in iatrogenic KS (3 cases) while it has been found in only 1 case of classic KS. In Tunisia, the classic KS is the most frequent form. In iatrogenic and epidemic KS, visceral lésions are frequent and must be researched systematically.

[Epidemiologic/clinical profile of condyloma acuminata in a dermatology service. Report of 232 cases]. / Profil epidemio-clinique des condylomes genitaux dans un service de dermatologie. A propos de 232 cas.

The incidence of condylomata acuminata is increasing in all countries. They are one of the most frequent sexually transmitted disease (STD). The authors reported the experience of the department of Dermatology of charles Nicolle's hospital between the year 1979 and 1998. This HPV infections were in the third position of the STD and occurred mainly in young males. The clinical lesions are genital condylomata. They were successfully treated with electrodessication or cryotherapy.