[Extensive cutaneous chromomycosis: Efficacy of combined terbinafine and cryotherapy]. / Chromomycose cutanée étendue : efficacité de l'association terbinafine et cryothérapie.

BACKGROUND: Chromomycosis is a chronic fungal skin infection, mainly affecting the limbs. It is responsible for severe morbidity and its treatment remains long and disappointing. Rarely described in Morocco, we report a new observation that has evolved very well under treatment combining terbinafine and cryotherapy over a short duration. CASE REPORT: A 56-year-old patient, immunocompetent, had a pustular and crusty placard on both forearms that had evolved for a year. Mycological examination showed fumagoid bodies and cutaneous biopsy showed epithelioid granulomas and giant cells without necrosis. The PCR confirmed a chromomycosis at Fonsecaea pedrosoi. HIV serology was negative. Treatment with terbinafine 250mg/d for 6months combined to cryotherapy resulted in complete remission with initial clinical improvement after only 3 weeks. DISCUSSION: Chromomycosis occurs increasingly in non-tropical areas. If diagnostic methods become more effective, management remains difficult and poorly codified. Terbinafine-cryotherapy combination would bring a lot of benefits with a little risk to bothpractitioner and patient. CONCLUSION: This combined treatment would constitute an excellent therapeutic alternative because of its efficiency, feasibility, low cost, method of administration and aesthetic result.

[Malignant proliferating trichilemmal cyst of the scalp: A case report]. / Kyste trichilemmal proliférant malin du scalp : une nouvelle observation.

BACKGROUND: Proliferating trichilemmal cyst (PTC) is a rare adnexal tumor, generally benign, primarily sitting on the scalp of elderly women. About fifty cases are reported in the literature. Herein, we describe another one particularly aggressive. OBSERVATION: A 70-year-old woman had been showing an increase in the size of an occipital cyst for 6years. A cephalic scan and wide surgical excision had confirmed the diagnosis of a malignant PTC. Four months later, the tumor recurred with regional metastases and intracerebral invasion. DISCUSSION: Through our case and based on the literature analyzing, we discuss the nosology of PTC and its clinical and histological distinctive elements. CONCLUSION: Large studies are needed to better understand the specificities of PTC, specially malignant form, but it remains difficult because of its rarity.

[Histoid leprosy with erythema nodosum leprosum]. / Lèpre histoïde avec érythème noueux lépreux.

Histoid leprosy is a particular variant of lepromatous leprosy presenting as cutaneous or subcutaneous nodular and/or plaque-like lesions arising form apparently normal skin. It is characterized histologically by spindle-shaped histiocytes in interlacing bundles and whorls, containing numerous intact and rod-shaped Mycobacterium leprae. It can occur de novo or secondary in patients treated for a long course by dapsone alone. We describe a case of lepromatous leprosy treated according to the national Moroccan protocol who developed histoid lesions during his treatment by dapsone. The patient responded well to fluoroquinolone, rifampicin and clofazimine, with however, the occurrence of erythema nodosum leprosum.