[Dermatologic disorders of the athlete: a report of 30 cases?]. / Les dermatoses du sportif: a propos de 30 athletes.

BACKGROUND: Participation in athletic activities is associated with a variety of skin problems. We aimed to precise the most important sports related dermatoses in athletes. METHODS: We conducted transversal study on 30 athletes of 2 teams: one of soccer and the other of basketball players. For each athlete dermatological exam was practiced. RESULTS: 18 soccer players and 12 basketball players were enrolled; the mean age was about 25.3 years [18-35 years]. The results suggest that athletic activity seems to be a predisposing factor for cutaneous infections (87%) especially fungal infections (90%). Traumatic lesions were also frequent in our athletes (20/30), dominated by calluses and nail disorders (80%). CONCLUSION: Sports-related dermatoses include infections, traumatic entities, allergic contact dermatitis, environmental encounters, exacerbation of preexisting dermatoses, thus regular dermatological screening of athletes is critical for rapid identification and treatment of dermatoses distrusting sport performance.

Generalized cutaneous morphea in a patient with post-hepatitis C cirrhosis.

A case of generalized cutaneous morphea in a a 55-year-old female patient known to have suffered 10 years from post-hepatitis C virus cirrhosis is reported. Anti-HCV antibodies were present, whereas screening for HBs antigen and anti-HBc antibodies was negative.

[Porokeratosis. A study about 6 cases]. / Porokeratoses: etude de 6 cas.

BACKGROUND: Porokeratoses (PK) represent a less common group of dermatoses that are acquired or hereditary, of unknown pathogenesis, characterized by keratinization disorder. Different clinical forms have been identified and the most frequent are the Mibelli's porokeratosis (MP) and the Disseminated Superficial Actinic Prokeratosis (DSAP). AIM: In this retrospective study, we analysed the observations of PK collected in the Dermatology Department of La Rabta Hospital over a 16-year period. METHODS: Six cases of PK were collected: 4 females and 2 males, with no medical history with a mean-age of 42.7. RESULTS: Only a female patient had (PK) familial history. All our patients had typical clinical aspects with lesions in annular plaques, of atrophic center, surrounded by keratotic border. The histological aspect was consistent with PK, showing the typical cornoid slide. In our series, there are 3 cases of (MP) and 3 cases of (DSAP). PK lesions usually appear during the childhood and the third and fourth decades for the DSAP. In MP, there is one or some large, unilateral, annular plaques. DSAP is characterized by numerous small annular lesions of the photo-exposed regions. Their prognosis is on the whole, favourable but remains conditioned by malignant transformation. Treatment is difficult aiming at reducing that risk of degeneration.

[Nasosinusal sarcoidosis: 2 cases. A report of 2 cases]. / Sarcoidose naso-sinusienne. A propos de deux cas.

INTRODUCTION: Nasosinusal sarcoidosis is a rare non caseating granulomatous disease. It may be inaugural, isolated or associated with multisystemic sarcoidosis. MATERIAL AND METHODS: [corrected] We report two cases of nasosinusal sarcoidosis associated to multisystemic sarcoidosis. Both patients were females aged over 43 years. In one case, the primary symptom was a nasal obstruction. Tomodensitometric and guided biopsy findings provided the main diagnostic criteria. Anti-malaric treatment was prescibed in both cases. Stabilisation of the lesions was noted. DISCUSSION: we tried to reveal through this study the diagnostic an therapeutic difficulties of nasosinusal sarcoidosis.

[Pseudoxanthoma elasticum: a report of 11 cases]. / Pseudoxanthome elastique: a propos de 11 observations.

INTRODUCTION: Pseudoxanthoma elasticum (PXE) is an inherited disorder of elastic tissue with many systemic manifestations PATIENTS AND METHODS: We performed a retrospective study from all the patients diagnosed with PXE at the department of dermatology of La Rabta hospital of Tunis, between 1986 and 2003. RESULTS: During the observation period, we identified 11 patients with PXE, 5 males and 6 females with a mean age of 28 years (10-47 years). Family history was found in 5 patients. Exhibit yellowish, pigskin, and popular lesions on the sides of the neck were observed in all cases. Systematic ophthalmologic examination revealed angioïd streaks in 4 patients. No abnormalities were found in cardiovascular and metabolic explorations. DISCUSSION: Diagnosis of PXE is based on clinical, histological and genetic criteria. Ocular and cardiovascular damage make all the gravity of the disease, from where interest of an ophthalmologic and cardiovascular examination systematic.

[Eccrine poroma of the scalp: A study of three cases]. / Porome eccrine du cuir chevelu. A propos de trois observations.

The eccrine poroma is a rare benign sudoral tumour, which creates a fleshy formation. The diagnosis is made according to the anatomopathological study. The usual site is the sol, but in rare cases, other sites have also been reported. The authors report three cases of eccrine poroma localised in the scalp with literature review.

[Cryosurgery for nose basal cell carcinoma. Series of 17 tumors]. / Place de la cryochirurgie dans le traitement des carcinomes basocellulaires du nez. A propos d'une série de 17 tumeurs.

UNLABELLED: Basal cell carcinoma (BCC) is the most common malignant tumour of the skin frequently located on the head and chiefly on the nose. Cryosurgery is one of the methods to treat BCC. OBJECT: To determine the efficacy of cryosurgery of 17 BCC of the nose in terms of recurrence rates and cosmetic results. RESULTS: 15 patients were included with a median age of 73 years and a photo type III or IV in 86% of cases. Mean size of tumours was 12 mm. Lesions were chiefly located on the alae nasi (70.5%). Complications were few and minor. After an average follow-up of 13.5 months, recurrence rate was about 5.8% (one case). Cosmetic results were good or excellent in 14 cases/17; only one patient had developed a notch of the nose. CONCLUSION: Cryosurgery is a rapid, of a low cost technique and chiefly with good oncological and cosmetic results.

[Nevus lipomatosus cutaneous superficialis: a clinico-pathological study of 13 cases]. / Naevus lipomateux cutane superficiel : étude anatomoclinique de 13 cas.

Nevus lipomatosus cutaneous superficialis (NLCS) is a rare hamartomatous skin lesion histologically characterised by the presence of mature fat tissue within the dermis. Clinically, two types of NLCS can be distinguished: a multiple type of Hoffmann-Zurhelle and a solitary type. We report a retrospective study of 13 cases of NLCS seen in the Anatomopathological department of La Rabta hospital of Tunis during a period of 12 years (1992-2004). Two clinical forms were distinguished: the solitary form (11 cases) consisting of a unique papulo-nodular lesion and the multiple form (2 cases). Histologically, the tumor consisted in all cases on mature fat tissue.

[Warty dyskeratoma or "follicular dykeratoma": a clinicopathologic features of a new entity]. / Dyskeratome verruqueux ou "dyskeratome folliculaire": aspects anatomo-cliniques d'une nouvelle entité.

INTRODUCTION: Warty dyskeratoma is a rare, benign, epithelial tumor characterized by a variable clinicopathologic spectrum. In all cases, lesions revealed foci of acantholytic dyskeratosis. CASE REPORT: A 74-year-old man has for two year developped a single small nodule with a hyperkeratotic area on the scalp. Histopathology revelead a warty dyskeratoma. DISCUSSION: Warty dyskeratoma is an epithelial tumor. Histopathology is important for the diagnosis. On the basis of our findings and from the literature, we propose to discuss the nosologic problem of this entity.

[Acral acanthosis nigricans paraneoplastic: about one case]. / Acanthosis nigricans acral paranéoplasique: à propos d'un cas.

The paraneoplastic acanthosis nigricans occurs in association with visceral neoplasms. We report a case of acanthosis nigricans that seat at a dorsal face of the second, third and fourth right toe of a 63 year-old patient. The exploration has been put in evidence a carcinoma of the right lung. The acanthosis nigricans has been nearly disappeared after resection of the pulmonary lobe. The relapses of the acanthosis nigricans in a same sit after five years has been reveal a carcinoma of the bladder. The resection of the bladder tumour has been followed by disappearance of the acanthosis nigricans.

[Granuloma annulare: apropos of 18 cases]. / Le granulome annulaire: à propos de 18 observations.

Granuloma annulare is a benign skin disorder which cause is unknown. The aim of this work is to report the results of a retrospective study dealing with 18 cases of granuloma annulare carried in the dermatology department of la Rabta hospital over a nine year period. We describe 3 clinical forms: localized granuloma annulare: 9 cases, generalized granuloma anulare: 7 cases and deep granuloma annulare: 2 cases. Diabetes mellitus was associated to granuloma annulare in 6 patients, from which 3 presented with multiple lesions. Corticosteroids were used topically in 11 cases. The outcome was marked by a partial resolution in 15 cases. In our study. We didn't found any malignancy with our granuloma annulare patients.

[Squamous cell carcinoma and discoid lupus erythematosus. Report of 2 cases]. / Lupus discoïde et carcinome épidermoïde. A propos de deux cas.

Some cases of skin cancer developping from chronic discoid lupus erythematosus were publied among the world. We make know our experience about two cases suffering with a chronic discoid lupus erythematosus from 16 and 11 years and developped a squamous cell carcinoma from the elbow and the lower lip.

Haplotypic classification of dystrophic epidermolysis bullosa in Tunisian consanguineous families: implication for diagnosis.

Dystrophic epidermolysis bullosa (DEB) is a rare genodermatosis caused by mutations in the type VII collagen gene COL7A1. Clinical diagnosis of DEB should be confirmed by histopathological and electron microscopy analysis, which is not always accessible. We report here a genetic investigation of DEB consanguineous families in Tunisia. A total of 23 EB families were genotyped with 5 microsatellite markers overlapping the COL7A1 gene. Among these families, 19 presented with the dystrophic form of EB, 9 were diagnosed by histopathological examination, 2 had the simplex form, 1 had a junctional EB, and 1 was affected by an unclassified form of EB. The informativeness of the markers was studied and allowed us to select three markers for genetic testing of DEB in Tunisian families at risk. Haplotype analysis and homozygosity by descent suggest that all families classified clinically as having DEB and the patient who presented with an unclassified form of EB are likely linked to the COL7A1 gene, and showed evidence for exclusion for the simplex and junctional cases. For COL7A1 linked families, two main haplotypes were shared by eight families. For all the other cases, haplotypic heterogeneity was observed, thus suggesting a mutational heterogeneity among Tunisian DEB families. The genetic results matched with the ultrastructural analysis in all the DEB families and with the clinical examination in 94.7% of all studied DEB families. This study is to our knowledge the first genetic investigation of DEB in the Maghrebian population. We propose a selection of informative markers and show the importance of haplotype analysis as a relatively easy and cost and time effective method for carrier screening and prenatal diagnosis of DEB in consanguineous families at risk.

Risk factors for erysipelas of the leg in Tunisia: a multicenter case-control study.

BACKGROUND: Risk factors for erysipelas (cellulitis) were rarely evaluated in controlled studies. Regional variations of these risk factors have never be assessed. OBJECTIVE: To assess risk factors for erysipelas of the leg in Tunisia. SUBJECTS AND METHODS: Case-control study in seven hospital centers in Tunisia. Cases were 114 consecutive patients with erysipelas of the leg [sudden onset (<24 h) of a well-demarcated dermo-hypodermatitis with fever or chills]. Two controls were matched to each case for age, sex, and hospital (n = 208). Main outcome measures are local and general suspected risk factors for erysipelas of the leg. RESULTS: In multivariate analysis, disruption of the cutaneous barrier (i.e. traumatic wound, toe-web intertrigo, excoriated leg dermatosis or plantar squamous lesions) and leg edema were independently associated with erysipelas of the leg, with respective odds ratios of 13.6 (95% confidence interval: 6.0-31) and 7.0 (1.3-38). No association was observed with diabetes, alcoholism, or smoking. CONCLUSIONS: We confirmed the major role of local risk factors and the minor role of general risk factors for erysipelas of the leg, in a setting different than the one previously studied. Detecting and treating toe-web intertrigo and traumatic wounds should be considered in the prevention of erysipelas of the leg.

Dermatomyositis and malignancy in Tunisia: a multicenter national retrospective study of 20 cases.

OBJECTIVE AND METHODS: The aim of our study was to report the epidemiologic, clinical, and biologic profiles of dermatomyositis (DM) associated with malignancy in patients from Tunisia. From January 1982 to January 2000, we collected retrospectively 20 case reports of DM associated with cancer from the different university hospital centers of Tunisia. Initial workup included anamnesis, clinical examination, cancer staging and classification, serum muscle enzymes (creatine phosphokinase, lactate dehydrogenase, aldolase, and transaminases), electromyography, and muscular biopsy. We calculated the median survival and mean value of all the variables. Comparisons of statistical tests were done with the Kruskal-Wallis test. RESULTS: Among the 130 DM cases of our study, 20 were associated with cancer (15.38%). The mean age of our patients was 49.6 years and the sex ratio (female/male) was equal to 3. Cancers were mainly those of the breast (35%) and nasopharynx (25%). DM followed a paraneoplastic course in 90% of the cases. The profile of seric muscular enzymes showed a significant statistical difference (P =.05) between a group of patients with severe muscular weakness and a group with moderate muscle weakness only for creatine kinase. The median survival was 36.5 months after diagnosis of DM and 48.6 months after that of cancer. The 5-year actuarial survival was 38% as related to cancer and 16% as related to DM. Mortality was 45%, in 90% as a result of cancer. CONCLUSIONS: In our study, nasopharyngeal carcinoma represents the second cancer associated with DM, after breast neoplasm, demonstrating the frequency of these 2 cancers in our country. Despite our reduced number of study samples, our study also suggests a relationship between severe muscle weakness and high seric muscle enzymes.