[Dermatophytosis due to Trichophyton violaceum at the parasitology-mycology laboratory of the military hospital of Meknes (about twelve cases)]. / Dermatophyties à Trichophyton violaceum au laboratoire de parasitologie mycologie de l'HMMI de Mekhnès (à propos de douze cas).

INTRODUCTION: Trichophyton violaceum is an anthropophilic dermatophyte, common in Mediterranean and African countries, which causes particularly trichophytic tinea in school-aged children. The objective of this work is to study the clinical and epidemiological profile of T. violaceum infections. MATERIAL AND METHODS: This is a descriptive retrospective study of a series of twelve cases of T. violaceum dermatophytosis diagnosed among patients referred to our laboratory for suspicion of dermatomycosis during a period from January 2011 to December 2016. The diagnosis was based on the positivity of direct examination and culture, and the identification of our strains on the macroscopic and microscopic characteristics of the colonies. RESULTS: The mean age at diagnosis was 8.6 years with a sex ratio of 2. Tinea capitis (TC) was the most frequent clinical aspect (75 %), followed by onychomycosis (25 %). Among the TC, trichophytic tinea was predominant (66.7 %). Besides, we observed a case of pustulo-inflammatory tinea. Direct examination was positive and showed an endothrix pilar parasitism in all cases. DISCUSSION: The clinical expression of dermatophyties to T. violaceum is polymorphous. The TC is the most frequent as reported in the literature. However, kerion and onychomycoses of feet were rarely described in association with this dermatophyte, hence the importance of the mycological examination allowing to support the diagnosis of a misleading clinical lesion.

[Cutaneous leishmaniasis in the military hospital Moulay Ismaïl of Meknes (Morocco): about 49 cases diagnosed between 2005 and 2011]. / La leishmaniose cutanée à l'hôpital militaire Moulay Ismaïl de Meknès (Maroc) : à propos de 49 cas diagnostiqués entre 2005 et 2011.

An increase in the number of cases of cutaneous leishmaniasis has been observed, in recent years, in Morocco. We tried, through a series of 49 cases collected from the dermatology department at the military hospital Moulay Ismail of Meknes, to clarify the epidemiological, clinical and evolutionary aspects of the reported cases. We recorded for each patient: age, sex, geographic origin and the period before consultation. We have also noted the number of lesions, their location, and their clinical aspects. Finally, we recorded results of direct examination in search of the parasite, treatment and post treatment evolution. The sex ratio was 11. The average age was 35.6 years. The average period of consultation was 3.8 months. Eighty-six percent of cases (n=42) were from the region extending from south to south-east of the atlas. The average number of lesions per patient was 4.46 (from 1 to 40). Thirty-seven percent of cases (n=18) had single lesions and 63% (n=31) multiple lesions. There was a polymorphism of clinical aspects of lesions with predominant of ulcerative crusting aspects observed in 55.1% of cases (n=27). Face localization was observed in 20.4% of cases (n=10). Ninety-two percent of cases (n=45) had involvement of the upper limbs and/or lower. Direct examination was positive in 65% of cases (n=32). The treatment was based on meglumine antimoniate associated in three quarters of cases with cryotherapy using liquid nitrogen. The outcome was favorable for all patients. We observed an increase in the number of cases in 2011 and especially those with multiple lesions followed by a decline in 2011.

[Cutaneous filariasis Loa Loa: 26 moroccan cases of importation]. / Filariose cutanée à Loa Loa. 26 cas marocains d'importation.

INTRODUCTION: Loa Loa filariasis or loiasis is a subcutaneous and bloody vectorial parasitosis. It is endemic in forest and swamp areas of west and central Africa. PATIENTS AND METHODS: We reviewed 26 moroccan cases of importation. All patients had visited Equatorial Guinea. Transient and migratory edema with pruritus were described in all cases and seen in 5 cases. A history of eyeworm was reported in 13 patients and subcutaneous migration of adult Loa Loa in 19 patients. Other features including fever and asthenia were reported in 11 patients. Microfilaremia was positive in 8 patients and eosinophilia was present in 22 patients. Fifteen patients were treated with diethylcarbamazine alone and 9 patients with ivermectin and diethylcarbamazine. Two patients were treated with ivermectin alone. Relapses were noted in 8 cases. No visceral complications were noted excepting one case of terminal hematury. DISCUSSION: Loiasis is a filarial infection of man that occurs exclusively in central and West Africa. The most common symptoms being pruritus with temporary, localised edema, subcutaneous and subconjonctival eye passage of the adult worm, fever and fatigue. The biologic diagnosis of loaisis is made on peripheral microfilariae, filarial serology and eosinophil count. Travel and visits endemic areas were at the origin of the emergence of this pathology in Morocco. Filarial Loa Loa infection should be treated with diethylcarbamazine and/or ivermectin.

[Cutaneous blastomycosis revealing a corticoadenoma]. / Blastomycose cutanée révélant un corticosurrénalome.

BACKGROUND: Blastomycosis is an uncommon chronic granulomatosis caused by Blastomyces dermatitidis. We present a case with a skin localization that disclosed malignant corticoadenoma. CASE REPORT: A 32-year-old man consulted for inflammatory nodules of the face and lower limbs. The histological examination of a nodule biopsy was in favour of blastomycosis. Ketoconazole treatment was ineffective. Amphotericin B provided cure of the skin lesions. Search for extension disclosed a malignant corticoadrenoma. DISCUSSION: Blastomycosis is very rare in Morocco. The portal is usually the lung. Unique skin involvement is very exceptional. To our knowledge this is the first report of a blastomycosis-corticoadenoma association. The clinical situation may be alarming in immunodepressed subjects. Amphotericin B treatment is indicated.