[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.

Furuncular myiasis: unusual case of African Dermatobia hominis.

Human cutaneous myiasis is a common disease in endemic tropical zones. Increased international travel has produced increases in imported cases. We present an unusual patient with myiasis infestation of the leg caused by Dermatobia hominis, which manifested after returning from the Democratic Republic of Congo. This particular infestation has not been reported in Morocco prior to this case. Furuncular cutaneous miyasis must be considered when travellers exhibit draining nodules. Medical treatment consists of occlusion of the furuncular punctum with vaseline to stimulate extrusion of the larva or surgical debridement under local anesthesia.

[Severe rhabdomyolysis revealing a myopathy linked to autoimmune hypothyroidism]. / Rhabdomyolyse sévère révélant une myopathie hypothyroïdienne d'origine auto-immune A propos de deux cas.

While muscular manifestations are common of hypothyroidism, hypothyroid myopathy is most often limited to myalgia, muscular stiffness and cramps with, in some patients, elevated levels of muscle enzymes. We report two cases of rhabdomyolysis related to hypothyroid myopathy. One of the patients developed acute renal failure. Thyroid hormone replacement therapy improved thyroid and renal function with involution of rhabdomyolysis. Hypothyroidism appears to be an authentic cause of rhabdomyolysis and should be carefully ruled out in all patients with elevated serum levels of muscle enzymes.

[Glomus tumors: anatomoclinical study of 14 cases with literature review]. / Tumeurs glomiques: étude anatomoclinique de 14 cas avec revue de littérature.

BACKGROUND: Glomus tumor is a neuro-myo-arterial benign hamartoma. It is a relatively uncommon lesion. The aim of this study is to define all the unusual localizations of glomus tumor. PATIENTS AND METHODS: From January 1999 to December 2006, we included in this retrospective study all patients who had the classic triad of symptoms with histological exam. We analysed epidemiological, clinical and therapeutical features of our patients. RESULTS: Fourteen patients were found to have histopathologically-proven glomus tumors. The patients, eight men and six women, had mean of age around 42 years. Three unusual locations were found: forearm, sacred region and parasternal. Most glomus tumors occur in the toes and fingertips. They are difficult to diagnose, despite painful symptom, because of their unusual locations. CONCLUSION: Glomus tumors are rare vascular tumors. The usual presentation is a solitary nodule in the distal portion of a digit, but can also occur wherever, with localizations unaccustomed and disconcerting.

[Thalidomide in adult multisystem Langerhans cell histiocytosis: a case report]. / Efficacité du thalidomide dans le traitement de l'histiocytose langerhansienne multisystémique de l'adulte: à propos d'une observation.

BACKGROUND: Adult multisystem Langerhans cell histiocytosis is an excepted disorder, which have several treatments. The purpose of this study was to test the disease-controlling effect of thalidomide in a case of adult multisystem Langerhans cell histiocytosis with cutaneomucous and hypothalamic localizations at dermatology department, of Mohammed-V military hospital, Rabat. CASE REPORT: A 43-year-old women, presented multifocal chronic Langerhans cell histiocytosis confined to cutaneous, oral cavity, perianal, mastoid and hypothalamic areas, with severe disabling ulcers in intertriginous areas, diabetes insipid and amenorrhoea. We treated with thalidomide 200 mg/day after neurological examination. A rapid initial response with total diminution of the involved skin area, and diminution of diabetes insipid. She remained in remission for 1 year. No adverse effects from treatment were observed at clinical and electrophysiological examinations. CONCLUSION: Thalidomide treatment is an adequate therapeutic measure in adult Langerhans cell histiocytosis, which is rare and difficult to treat. Our case showed the efficacy of thalidomide at cutaneomucosal and hypothalamic manifestations.