Clinical and histological patterns and treatment of pyoderma gangrenosum.

Pyoderma gangrenosum (PG) is a rare inflammatory neutrophilic dermatosis for which accurate epidemiological data are limited and therapy remains a challenge. The primary study's aim was to examine all cases of PG observed in our department over a 6-year period in order to describe the relevant characteristics and outcome under therapy. Fourteen patients were included (5 women, 9 men). The average age of our patients was 40,15 years. The classical, ulcerative form was found in 10 cases (71.42%), the pustular form in 4 cases (27.57%) and PG was multifocal in 4 cases. The PG was located preferentially to the lower limbs. Histological examination was realized in all patients and objectified inflammatory infiltrate composed of polymorphonuclear neutrophils in all cases with vasculitis in 4 cases. Six patients (42.85%) had associated disease at diagnosis of PG, including inflammatory bowel disease in two cases (14.28%), a blood disease in 2 cases (14.28%), lymph node tuberculosis and inflammatory arthritis in 1 case (7%). The most frequent first-line treatments were oral corticosteroids (7 cases) and other treatments used were colchicine in 2 cases, topical corticosteroids in 3 cases with good clinical evolution. Our study confirms that PG is a rare disease, associated in almost half of cases with systemic disease already present at diagnosis; in our Moroccan background, it is most often inflammatory bowel disease, hematological or solid cancer and tuberculosis.

[Pityriasis lichenoides: not always a clear-cut diagnosis!] / Pithyriasis lichénoïde: diagnostic pas toujours aussi facile!

Pityriasis lichenoides is a rare inflammatory dermatosis occurring in young subjects. It evolves into rashes on the trunk and the limbs which regress spontaneously. We here report a particular case of pityriasis lichenoides whose diagnosis was adjusted due to the scar appearance of the lesions. The patient was treated with cyclin and phototherapy, with a favorable outcome.

[Localized scleroderma: about 24 cases]. / Sclérodermie localisée: à propos de 24 cas.

Morphea, also known as localized scleroderma, is defined as a sclerosus skin condition that can extend to the subcutaneous tissue but with no Raynaud's phenomenon or visceral involvement. Some clinical forms may have a functional and aesthetic impact, hence the interest of treatment of early stage inflammation. We here describe the epidemio-clinical, therapeutic and evolutionary features of different forms of morphea, by reporting a series of 24 cases.

Validation of the Skindex-16 questionnaire in patients with skin diseases in Morocco.

OBJECTIVE: The aim of the study was to translate and adapt the original version of the Skindex-16 questionnaire from English to Moroccan Arabic language, refining its terms and adapting it to Moroccan culture. METHODS: After translation and cross-cultural adaptation, the questionnaire was tested on skin diseases patients. Internal consistency was tested using Cronbach's α coefficient, the test-retest reliability using intraclass correlation coefficient (ICC). Construct validity was assessed by examining item convergent and divergent validity. RESULTS: The questionnaire was administered to 120 patients. The mean age of patients was 39 years (SD: 16), 49.6% were married. 76.9% of all participants lived in an urban area. The average time to complete the Skindex-16 questionnaire was 5 min. Questionnaire reliability was assessed using Cronbach's α coefficient, in which the values were all > 0.7. All items exceeded the 0.4 criterion for convergent validity. CONCLUSION: In general, the findings of this study indicated that the authors have developed a semantically equivalent translation of Skindex-16 into Moroccan Arabic. It is a reliable and valid measure of the effects of skin disease on the quality of life in Moroccan patients.

Hereditary spherocytosis with leg ulcers healing after splenectomy.

Hereditary spherocytosis (HS) is a familial hemolytic disorder with marked heterogeneity. A refractory chronic leg ulcer is an uncommon complication of HS, reported in fewer than two percent of patients. We present the case of a 28-year-old man who was suffering from a leg ulcer and was unresponsive to treatment of two years' duration with various conservative modalities. He had been suffering from repeated attacks of jaundice, pallor, and splenomegaly since he was 10 years old. Upon admission, physical and laboratory findings revealed moderate HS. However, complete clearance of the leg ulcer was not achieved until two months after a splenectomy.