Cutaneous metastases from internal cancers.

BACKGROUND: Cutaneous metastases (CMs) from carcinoma are relatively uncommon, being usually late events in the course of internal malignancies. CMs from internal tumors seen at a secondary dermatological centre in Tunis are reported. METHODS: A retrospective review of the available clinical records and histological material of all patients with CMs from internal malignancies was performed over a 14-year period. RESULTS: Fourteen cases of CMs were recorded: 8 males and 6 females. The age range was 53 to 96 years, with a mean of 63.5 years for males and 76.5 years for females. CMs represented the first indication of an internal malignancy in 64% of cases. Firm solitary or multiple nodules were the most relevant clinical presentation (93%). Preferred sites were the thorax (50%), the abdomen (29%), and the head and neck region (21%). The common sites of primary malignancy were the lungs (38%) in males and breast (33%) in females. Four out of 14 patients died within a short follow-up period (mean 9.5 months). DISCUSSION: CMs are relatively rare in patients with internal cancers, but they may be a presenting sign of such cancers.

[Adverse events related to systemic treatment using Glucantime for cutaneous leishmaniasis: a report from Tunisia]. / Effets indésirables du traitement systémique de la leishmaniose cutanée par Glucantime: expérience Tunisienne.

Glucantime is the firstline treatment for cutaneous leishmaniasis in Tunisia. Adverse effects related to systemic administration of Glucantime are frequent. The purpose of this retrospective study was to review the files of 53 patients who were treated for cutaneous leishmaniasis using meglumine antimoniate at a dose of 60 mg/kg/day for 15 days during the period between 1998 and 2007. Adverse effects were observed in 5 men and 4 women with an average age of 40.8 years. Antimony intolerance occurred in 8 patients and stibio-intoxication occurred in 4. Glucantime was considered as the most likely cause of adverse effects in 6 patients and as the plausible cause in 3 patients. Fever was the most frequent complication of antimony intolerance followed by cough, myalgia, and cutaneous lesions. Hepatic cytolysis was the most frequent sign of stibio-intoxication. Asymptomatic elevation of amylase level to 108 UI/l was observed in one case. The most serious complication was acute toxic kidney failure on the 15th day of treatment. The incidence of adverse events to Glucantime ranges from 16% to 59%. The most severe complication is acute renal failure on the 15th day of treatment, as observed in one patient in this series. Patient status must be monitored by performing laboratory tests at the beginning and end of the treatment. Since cutaneous leishmaniasis observed in Tunisia is a self-healing dermatosis that never results in sequels, treatment with Glucantime should be discontinued in any patient who develops suspicious symptoms.

Anti-aging activities of extracts from Tunisian medicinal halophytes and their aromatic constituents.

Six medicinal halophytes widely represented in North Africa and commonly used in traditional medicine were screened for pharmacological properties to set out new promising sources of natural ingredients for cosmetic or nutraceutical applications. Thus, Citrullus colocynthis, Cleome arabica, Daemia cordata, Haloxylon articulatum, Pituranthos scoparius and Scorzonera undulata were examined for their in vitro antioxidant (DPPH scavenging and superoxide anion-scavenging, ß-carotene bleaching inhibition and iron-reducing tests), antibacterial (microdilution method, against four human pathogenic bacteria) and anti-tyrosinase activities. Besides, their aromatic composition was determined by RP-HPLC. H. articulatum shoot extracts exhibited the strongest antioxidant activity and inhibited efficiently the growth of Salmonella enterica and Escherichia coli. P. scoparius and C. arabica inhibited slightly monophenolase, whereas H. articulatum was the most efficient inhibitor of diphenolase activity. Furthermore, H. articulatum exhibited the highest aromatic content (3.4 % DW), with dopamine as the major compound. These observations suggest that shoot extract of H. articulatum, and to a lesser extent of C. arabica, could be used as antioxidant, antibiotic as well as new natural skin lightening agents. Also, possible implication of aromatic compounds in anti-tyrosinase activity is discussed.

[Childhood cutaneous leishmaniasis in Tunisia: retrospective study of 60 cases]. / La leishmaniose cutanée de l'enfant en Tunisie: étude rétrospective de 60 cas.

Cutaneous leishmaniasis (CL) is a widespread parasitic disease that represents a major public health problem in several countries including Tunisia. The aim of this study was to determine the characteristics of childhood CL in a university hospital center in Tunis. The files of all children treated for of CL in the Dermatology Department of Habib Thameur Hospital over a 23-year period were reviewed. A total of 60 children were included. The mean age was 9.2 years and the sex ratio was 0.93. All patients lived or had stayed in an endemic area. Infectious risk was highest in autumn (41.6%). The most frequent clinical finding consisted of crusty nodules (53.3%) that were most often the only manifestation (63.3%) and usually located on the face (65%). Clinical diagnosis was confirmed by either peripheral blood smear (56.6%) or histological examination (35%). The treatment of choice was Glucantime administered by the intralesional route in 70% of patients or by intramuscular route in 30%. The outcome was favorable in all cases within 2 weeks to 6 months. Sequels were noted in 9 cases (18%) in the form of pigmented (7 cases) or atrophic (2 cases) residual scars. The frequency of childhood CL is relatively high especially during the second decade of life. Childhood CL is characterized by a generally favorable outcome and lack of distinguishing clinical characteristics form adult CL. If possible, therapeutic abstention is more widely in the children due to the high risk of adverse reactions.