[Cutaneous chondroid syringoma]. / Syringome chondroïde cutané.

INTRODUCTION: Chondroid syringoma (CS) is a rare cutaneous tumor characterized by mixte epithelial and mesenchymal component. The confident histological diagnosis can be obtained by immuno-histochemistry study. Here we present 10 new cases with their clinico-hystological characteristics. METHODS: The 10 cases were observed between January 2000 and august 2013, in Fort-de-France and Louis-Mourier universitary hospitals. For all the cases a controlled histological study was performed by a dermatopathologist expert and immuno-histochemistry was added. Clinical and immuno-histological data were analyzed. RESULTS: The lesions were almost localized on the face (3/10) and the extremities (3/10). The size was about 1.2 to 5.2cm. Every case was treated by surgery, no malignant case was diagnosed. Histologically, all the 10 cases presented as a well-limited dermic tumor with a mixte epithelial and mesenchymal component. The stroma was myxo-chondroid, and the epithelial component consisted in epithelial cavities lined by one or two cell layers with eccrine (4/10) or apocrine (5/10) features. Immuno-chemistry study reveals positivity for EMA, ACE and CK7 for the internal cells, and positivity for S100 protein and vimentin of the extern cell layer. DISCUSSION: Chondroid syringoma is characterized by a mixte epithelial with eccrine and apocrine cells and a myxo-chondroid stroma. Our study has some clinical and histological particularities (lesions on the extremities, epidermic connecting…). The main differentials diagnoses are the other annexial tumors. The treatment is surgical. CONCLUSION: The histological diagnosis of CS is quite easy, but in case of doubt, immuno-chemistry will help, showing a double mesenchymal and epithelial differentiation.

Paradoxical response preceding control of Scedosporium apiospermum mycetoma with posaconazole treatment.

Mycetoma is a chronic granulomatous infection that is difficult to treat, notably when due to fungi such as Scedosporium apiospermum. Recent antifungal agents could be an option, but cases are rarely reported, and none with posaconazole. Paradoxical responses, defined as initial clinical worsening despite appropriate treatment, are common in tuberculosis but rare in deep mycoses in non-immunocompromised hosts. Hence, paradoxical responses in context other than mycobacterial infection in an immunocompromised host could provide insights into the pathophysiology and the optimal strategy for treatment. We report the first case of a mycetoma caused by S. apiospermum with bone involvement treated with posaconazole, and the paradoxical response observed at the beginning of the treatment. As with mycobacterial infections, a paradoxical response in deep mycosis could represent the earliest marker of therapeutic efficacy.

[Evolution in the prevalence of intestinal parasitosis in the Fort de France University Hospital (Martinique)]. / Evolution de la prévalence des parasitoses digestives au CHU de Fort-de-France (Martinique).

OBJECTIVE: Determine the prevalence of intestinal parasitosis between January 1, 1997 and December 31, 1999 in the microbiology laboratory of the Fort de France University Hospital. METHOD: Retrospective study of the results of 4684 parasitological examinations of stools performed in 2704 patients between January 1, 1997 and December 31, 1999 in this laboratory. RESULTS: This survey showed the high prevalence of anguillulosis, found in 51.69% of infested patients and in 4.56% of the population studied, the ever high prevalence of non or scarcely pathogenic amoebas (Endolimax nanus, Dientamoeba fragilis, Entamoeba coli) found in 27.19% of infested patients and 1.88% of the population studied, together with that of hookworms (12.80% of infested patients and 1.13% of the population), and the persistence of lambliasis. This study also revealed the presence of cryptosporidies (7 cases) and microsporidies (4 cases) in the patients infected by the human immunodeficiency virus. DISCUSSION: These results confirm the trend of the past twenty Years and the results of surveys initiated by the national statistics board (INSERM) in 1978, 1988 and 1995-1995, with the regression of bilharziosis and the persistence of anguillulosis and hookworms. CONCLUSION: The improvement in living conditions and hygiene, the combined efforts of the health care workers and Authorities in Martinique over the past 30 Years in the fight against parasites have led to a great reduction in the prevalence of classical intestinal parasitosis. However, new parasites associated with HIV infection have appeared.

Leishmania (Leishmania) martiniquensis n. sp. (Kinetoplastida: Trypanosomatidae), description of the parasite responsible for cutaneous leishmaniasis in Martinique Island (French West Indies).

The parasite responsible for autochthonous cutaneous leishmaniasis in Martinique island (French West Indies) was first isolated in 1995; its taxonomical position was established only in 2002, but it remained unnamed. In the present paper, the authors name this parasite Leishmania (Leishmania) martiniquensis Desbois, Pratlong & Dedet n. sp. and describe the type strain of this taxon, including its biological characteristics, biochemical and molecular identification, and pathogenicity. This parasite, clearly distinct from all other Euleishmania, and placed at the base of the Leishmania phylogenetic tree, is included in the subgenus Leishmania.

Professional skippers' sun-protection knowledge and behavior in the tropics.

A preliminary inquiry, conducted on Martinique Island, sought to determine professional skippers' sun-protection knowledge and behavior. Fifty-two skippers (mean age: 41 years) completed a questionnaire; 39 (75 %) had a simple sunburn over the last 6 months and 3 (6%) severe sunburn; 54 (64%) declared achieving sun protection by wearing clothes during >90% of the day. Only 17% had used sun protection >90% of the time.