Radiation-induced morphea: autoimmunity as a risk factor.

Radiation-induced morphea (RIM) is a rare complication of radiotherapy of unknown etiology. We report the case of a woman with a history of vitiligo and Hashimoto's thyroiditis, who developed RIM following radiotherapy for breast carcinoma. We suggest that a history of autoimmune disease is a possible risk factor for the development of RIM.

[Survival in HIV-1 patients receiving antiretroviral therapy in Morocco]. / Survie des patients vivant avec le VIH-1 sous thérapie antirétrovirale au Maroc.

BACKGROUND: The purpose was to study factors associated with the survival of HIV-1 patients receiving antiretroviral therapy in Morocco. MATERIAL AND METHOD: This was a retrospective study of a cohort of 182 HIV-1 patients receiving antiretroviral therapy in the department of dermatology venereology at the Military Instruction Hospital Mohamed V in Rabat during the period from 1 January 2006 to 1 January 2017. Death of any cause during the study period was considered to be the result of HIV infection. The log-rank test was used to compare the survival curves based on determinants. The Cox regression model analyzed the determinants of survival since induction of antiretroviral therapy. RESULTS: The median follow-up time was 4.7 years (IQR: 1.97-8.18). The mortality rate was 75 deaths per 1000 person-years. Advanced clinical stage CDC C (RR: 2.72; CI 95%: 1.33-5.56) and treatment with indinavir (RR: 1.41; CI 95%: 0.77-2.59) were significantly associated with death. CONCLUSION: Initiation of antiretroviral therapy in the early stage of the disease and use of less toxic molecules are recommended to reduce mortality.

[Dermatological experience at the Moroccan mobile field hospital in Brazzaville, Congo]. / Expérience dermatologique de l'hôpital marocain de campagne a Brazzaville (Congo).

As part of a humanitarian relief mission, Morocco set up a mobile field hospital in Brazzaville Congo from February 22, 2006 to March 23, 2006. Analysis of data collected at a cost-free outpatient dermatology clinic demonstrated local characteristics in comparison with conventional dermatologic practice. A total of 1217 patients including 473 women, 451 men, and 293 children were examined. The five most frequent disorders affecting children were infectious disease, atopic eczema, keloids, toxidermias, and genodermatosis. In addition to these diseases, adults presented sexually transmitted infections, benign and malignant tumors, lichen, leg ulcers, elephantiasis of the external genitalia and lower extremities, and complications related to the use of skin lighteners. Historical pathology was found in 1% of the general population.

[Tularaemia outbreak in Kosovo]. / Epidémie de tularémie au Kosovo.

BACKGROUND: The occurrence of a first case of tularaemia in Kosovo in 2000 and the subsequent appearance of other cases provided us with an opportunity to study this infection, seen at the Moroccan medical-surgical field hospital set up in Mitrovica during our stay in Kosovo. PATIENTS AND METHODS: This was a prospective study involving all patients with suspected tularaemia consulting at the hospital and subsequently referred to dermatologists and the ENT practitioners between 3 January and 27 August 2002. For each patient, clinical and treatment history data were studied using a preset form. Investigations were requested to confirm the diagnosis or examine the consequences and individual characteristics for all patients. Diagnosis was based upon clinical findings and epidemiological context, and was confirmed by serology. RESULTS: Seven cases were seen and all involved women, two of whom were pregnant. Two cases were familial. Three patients lived in the country and 4 in towns. The clinical picture consisted of suppurative adenitis preceded by pharyngitis. Six patients required surgical drains due to late consultation and after failure of antibiotic therapy. All patients were successfully cured. DISCUSSION: Our 7 cases are original since they occurred in a specific context of ecological upset resulting from war. Our study confirms the reality of tularaemia in Kosovo. Control of this epidemic depends upon improvement of living conditions for the population.

[Acute alveolo-interstitial pneumopathies in HIV-negative patients treated with antineoplastic chemotherapy]. / Pneumopathies alvéolo-interstitielles aiguës chez des patients VIH négatif traités par chimiothérapie anticancéreuse.

INTRODUCTION: Treatment of malignant tumors can delay some opportunistic infections. In this paper, we report three cases of alveolo-interstitial pneumonia among HIV negative patients who received chemotherapy. EXEGESIS: All three patients received corticotherapy for a long time. In two cases, it was pneumocystis-tuberculosis coinfection. Evolution was favourable for two patients with sulfaméthoxazole-triméthoprime (one with corticotherapy). CONCLUSION: The possible role of chemotherapy, corticotherapy and malignant tumor in the pathogenesis of opportunistic infections will be discussed.

[Parvovirus B19 infection mimicking drug-induced hypersensitivity syndrome]. / Primo-infection à Parvovirus B 19 mimant un syndrome d'hypersensibilité médicamenteuse.

BACKGROUND: Clinical manifestations of primary parvovirus B19 infection vary greatly. Epidermal megalerythema is the most common feature. We report a particular form resembling a drug-induced hypersensitivity reaction. CASE REPORT: A 19-year-old man had a scarlatiniform eruption associated with multiple node enlargement, elevated liver enzymes and a abnormal white cell count with mononucleosis and lymphopenia, similar to that observed in hypersensitivity reactions. Seroconversion and positive PCR search for viral DNA established the diagnosis of primary parvovirus B19 infection. The spontaneous course was favorable with no recurrence at one month. DISCUSSION: The clinical features and laboratory findings in this case of parvovirus B19 infection closely resembled drug-induced hypersensitivity syndrome. The role of viral agents in the development of hypersensitivity reactions have been suggested. It is important to look for viral infections in clinical presentations mimicking drug-induced hypersensitivity.

[Delayed appearance of maculopapular eruptions induced by tamoxifen]. / Eruption maculopapuleuse d'apparition retardée induite par le tamoxifène.

BACKGROUND: Prescriptions of tamoxifen can be expected to increase over the next few years, particularly for primary prevention of breast cancer. We report a case of a delayed tamoxifen-induced skin reaction. CASE REPORT: A 50-year-old woman was hospitalized for a diffuse maculopapulous eruption which developed four months after beginning a tamoxifen regimen instituted to prevent recurrence of breast cancer after surgery, chemotherapy and radiotherapy. The eruption resolved rapidly after withdrawal of tamoxifen. The same skin reaction occurred 9 hours after rechallenge with tamoxifen. Patch tests performed later with Nolvadex tablets crushed in vaseline were negative. DISCUSSION: Tamoxifen-induced skin reactions are uncommon. The likelihood that tamoxifen was the cause in this case was very high (C3S3 = I4, B2). The late onset (4 months) in this case is remarkable and misled us to look for another cause which could not be found. Challenge with tamoxifen confirmed its causal role. Once again, negative patch tests were found in this type of skin reaction.