[Occipital sinus pericranii: About an unusual situation and review of the literature]. / Sinus pericranii occipital : à propos d'une situation inhabituelle et revue de la littérature.

The sinus pericranii refers to a set of clinical presentations that share a pathological communication between the scalp veins and the underlying cranial venous sinus. The nature of this connection ranges from the simple dilatation of the emissary veins, to wide connections through a calvarial bone loss leaving almost the cranial venous sinus in direct contact with the subcutaneous tissue. The authors present the case of an occipital pericranii sinus of intraoperative discovery. Congenital, post-traumatic or spontaneous, this anomaly is most often frontal and located on or close to the midline. The usual clinical presentation is that of a soft mass that empties to the pressure while standing, while it fills in all situations that increase the intracranial pressure (Valsalva maneuver …). The diagnosis is not always easy to establish, and relies on a bundle of clinical and radiological arguments. Through a review of the literature we propose to focus on the clinical features, diagnostic means and therapeutic options of this rare entity.

Epithelioid hemangioendothelioma, an uncommon tumor of the eyelid: A case report.

Epithelioid hemangioendothelioma (EHE) is an infrequent vascular tumor that has an intermediate prognosis between the prognosis of the angioma and that of the angiosarcoma. Its evolution is characterized by a tendency to recurrence and metastases. EHE has been reported in locations such as: lungs, liver, bone and soft tissues. There are very few reports of cases involving the head and neck region. The occurrence of EHE in the orbital region and/or the eyelid is extremely rare. The authors report a case of EHE in the right upper eyelid. Surgical excision has been performed resulting in a good local control of the disease after a 5-year follow up.

Toxic epidermal necrolysis in a female with metastatic breast cancer treated with vinorelbine.

Vinorelbine is an anticancer agent with high clinical efficacy for the treatment of metastatic breast cancer. Toxic epidermal necrolysis is a rare but serious cutaneous adverse reaction associated with drug therapy. We hereby present a case report of a patient with metastatic breast cancer, treated with vinorelbine, who developed toxic epidermal necrolysis. To the best of our knowledge, ours is the second case report describing this exceptional dermatologic emergency associated with vinorelbine. In June 2014, a 33-year-old female was treated for localized breast cancer. In December 2016, a brain magnetic resonance imaging revealed cerebral and cerebellar recurrence of the breast cancer. Whole brain radiation therapy was administered and treatment with vinorelbine was subsequently initiated. On day 3 of the first cycle of chemotherapy, she presented a general malaise and an itchy rash with conjunctivitis, oral ulcers and diffuse alopecia. The clinical diagnosis was toxic epidermal necrolysis due to vinorelbine. The patient was transferred to the burn unit. Treatment with intravenous steroids, topical steroids and desloratadine was initiated. She subsequently developed Staphylococcus aureus bacteremia and died of multi-organ failure. Toxic epidermal necrolysis is an extremely rare, acute hypersensitivity reaction involving the skin and mucous membranes. Features more suggestive of toxic epidermal necrolysis are acute onset and rapid worsening of painful lesions of the skin and mucous membranes. Specific treatment with active interventions should be practiced in the context of an international and multicentre clinical study in order to give sufficient power for such trials in this rare disease.

La vinorelbine est un agent anticancéreux très efficace dans le cancer du sein métastatique. La nécrolyse épidermique toxique est un effet indésirable médicamenteux cutané rare mais grave. Nous présentons le cas d'une patiente avec un cancer du sein métastatique traité par vinorelbine, qui a développé une nécrolyse épidermique toxique. A notre connaissance, c'est le deuxième cas de la nécrolyse épidermique toxique due à la vinorelbine. En juin 2014, une femme de 33 ans a été traitée pour un cancer mammaire localisé. En décembre 2016, elle a présenté des métastases cérébrales et cérébelleuses. Une radiothérapie encéphalique a été administrée puis un traitement par vinorelbine a été initié. Au troisième jour du premier cycle de chimiothérapie, elle a présenté un malaise général et une éruption cutanée avec démangeaisons accompagnée de conjonctivite, d'ulcères buccaux et d'alopécie diffuse. Le diagnostic était en faveur de la nécrolyse épidermique toxique à la vinorelbine. La patiente a été transférée à l'unité de brûlure et a reçu des stéroïdes intraveineux et locaux et la desloratadine. Elle a ensuite développé une bactériémie à Staphylococcus aureus et est décédée d'une défaillance multiviscérale. La nécrolyse épidermique toxique est une réaction d'hypersensibilité aiguë extrêmement rare touchant la peau et les muqueuses. Elle est évoquée devant l'apparition aiguë et l'aggravation rapide de lésions douloureuses de la peau et des muqueuses. Un traitement spécifique avec des interventions actives doit être recherché dans le cadre d'une étude internationale et multicentrique, afin de donner assez de puissance à de tels essais dans cette maladie rare.

Epidemiological analysis of burn patients in the military hospital, Rabat, Morocco.

A retrospective study was conducted of burn patients admitted to the military hospital in Rabat, Morocco, in the 6-yr period from 2004 to 2009. This is the first multivariate study to be performed in Morocco. The epidemiological data from the 291 patients hospitalized were collected and studied. The type of burn was indicated in 284 of the patients: 94% of the injuries were thermal burns, 4% were electrical burns, and 1.5% chemical burns. In 261 cases the exact aetiology was noted: 56% of accidents were caused by flames, 38% by hot liquids, 4% by electric current, and 2% by chemicals. The distribution of the Moroccan population is as follows: 0-4 yr, 7%; 5-l4 yr, 8%; 15-19 yr, 8%; 20-59 yr, 70%; over 60 yr, 7%. The male/female sex ratio was 1.63. The mean duration of hospitalization stay was 42 ± 62 days. The mean body surface area burned was 21 ± 18%. Total mortality was 5%; 57% of deaths were due to septic shock. Our results were similar to data from other studies in the literature, with certain characteristics in our series, especially the age bracket most affected, the body surface area burned, and the mechanisms of injury.

[Burns by electric scalpel blade: four cases]. / Brulure par Plaque de Bistouri Electrique: a Propos de Quatre Cas.

A burn due to the plate of a diathermy knife is a rare but serious accident owing to the depth of the lesion and its localization, especially when it occurs in a surgical context that creates difficulties for both the patient and the surgeon. Such burns are unpredictable and also serious not only because of their location but also because they occur during a surgical operation in patients who are already ill. Such burns have to be dealt with by specialists. Prevention is the only way of avoiding this kind of accident.

[Not Available]. / Brulures par Bouillottes Chez les Diabetiques.

Diabetic neuropathy is a frequent complication of diabetes. The most frequent clinical form is known as "sock polyneuritis", with loss of sensitivity to pain in the feet. Hot water bottle burns are the prerogative of diabetic patients suffering from a form of sensitive polyneuropathy. Such burns are deep. It is difficult to take therapeutic responsibility and decisions must be multidisciplinary. We underline the importance of the education of diabetic patients and of arousing their awareness to the possible risks involved in the use of hot water bottles.