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Biomedical subjects

A Ben Osman Dhahri

Publications and source records attributed to A Ben Osman Dhahri.

16 recordsLinked to original sources

[Leiomyosarcoma of the lip].

BACKGROUND: Superficial leiomyosarcomas are rare malignant tumors that may be subdivided into cutaneous and subcutaneous cases. CASE-REPORT: A 58 year-old man was seen for a lower lip tumor that appeared 3 years earlier. Histopathologic and immunohistochemical examinations showed features of cutaneous leiomyosarcoma. DISCUSSION: Cutaneous leiomyosarcoma may derive from the arrector pili, smooth muscle of sudoral glands or genital dartoic muscle. The subcutaneous form arises from smooth muscle wall of blood vessels. Superficial leiomyosarcomas occur frequently in the extensor surface of the lower extremities and involve the mucosal area in rare cases. Only five cases arising in the lips have been described. Lip cutaneous leiomyosarcoma may derive from ectopic sweat glands of the lips or from a hypodermic tumor that extends to the lip.

Humans↗

[Superficial fungal infections. Epidemiologic, clinical and mycologic study over a three year period].

The object of our study is to release the epidemiological, clinical and mycological characteristics of superficial fugal infections. A retrospective study was carried out during three years (1996-1998). Direct microscopy was positive in 86% cases, the culture in 62% cases. Trichophyton rubrum accounts for 85% of the dermatophytic flora. The superficial fugal infections account for 15% of the reasons for consultation in our service. They would touch according to data's of literature 2 to 13% of the general population. Trichophyton rubrum in accordance with the various series published, is the fungi most frequently insulated with variable rates between 46 and 82% of the superficial fungal infections. Any time, Candida albicans is prevalent on the level of the hands.

Adult↗

[Dermatofibrosarcoma protuberans. About 18 cases].

Dermatofibrosarcoma protuberans (DFSP) is a rare mesenchyma skin tumor. It is characterized by a slow growth with a high rate of recurrence but limited potential for metastasis. We report the result of a retrospective study of 18 cases of DFSP collected over 16 years in the dermatology department of La Rabta Hospital. The mean age was 32 years with a sex ratio of 1.57. The site of predilection was the trunk (77.5%). Histological features were typical in all cases with positivity for CD34 in 14 cases. Treatment was surgical in 13 cases. DFSP is a tumor of intermediate malignancy, which can have aggressive course. This tumor is best treated with surgery in which large excision are necessary to reduce the risk of recurrence.

Adult↗

Congenital lower lip pits: a case report.

The Van der Woude syndrome is a rare autosomal-dominant condition typically comprising cleft lip or cleft palate and distinctive pits of the lower lips. The degree to which individuals carrying the gene are affected varies widely, even within families. The variable manifestations include lip pits alone, absent teeth, and isolated cleft lip and palate of varying degrees of severity. Other associated anomalies have also been described. We report a case of Van der Woud syndrome manifesting with isolated lower lip pits in an adolescent female with similarly affected family members.

Adolescent↗

[Extraskeletal osteosarcoma of the forearm: a case report].

Extraskeletal osteosarcoma is a rare soft tissue tumor. We report an exceptional case located in the forearm. A 62-year-old woman consulted for a tumor of the right forearm which she had noticed for six months. Physical examination revealed a 10 x 12 cm tumor with an ulcerated center. MRI demonstrated a heterogeneous mass exhibiting no connection with the bone or subjacent periosteum. Wide surgical resection was performed. The pathology study of the operative specimen confirmed the diagnosis of soft tissue osteosarcoma. The patient was given postoperative chemotherapy and was free of local recurrence or metastasis eighteen months after surgery. We discuss the present case and review data reported in the literature.

Female↗

[Adenocarcinoma of the umbilicus].

INTRODUCTION: Most of the umbilical neoplastic processes are metastatic whereas primary adenocarcinoma is scarce and hard to distinguish from a secondary process. Our observation illustrates this difficulty. OBSERVATION: A fifty year-old woman had developed chronic omphalitis over several years. She consulted for a multinodular, erythemato-violine, oozing and deep infiltrating tumor of the umbilicus which had been developing for two months. The anatomopathological exploration of a biopsy of the lesion suggested a clearly differentiated adenocarcinoma whose digestive origin was the most likely. Investigations for a primary neoplasm were negative. Polychemotherapy was efficient with eight months recline. DISCUSSION: Umbilical metastases are referred to as Sister Marie Joseph nodule. They essentially correspond to a metastatic localization of an intra abdominal adenocarcinoma. The major problem consists in distinguishing a Sister Marie Joseph nodule where the neoplasm remains indefinite from an adenocarcinoma developed from an embryonic remainder. The existence in our patient's case history of a chronic omphalitis developing for Years and the negative tests for a primary neoplasm suggest a primary adenocarcinoma of the umbilicus.

Abdominal Neoplasms↗

[Pemphigoid gestationis: a study of 20 cases].

INTRODUCTION: Pemphigoid gestationis is a bullous autoimmune sub-epidermal dermatosis, occurring during pregnancy and/or postpartum. The objective of our study was to define the epidemio-clinical profile, the histopathological and immunopathological features, the treatment and the course of pemphigoid gestationis in Tunisian patients. PATIENTS AND METHODS: This was a retrospective study concerning the cases of pemphigoid gestationis recorded between 1989 and 2003 in the dermatology department in La Rabta Hospital in Tunis. The patients were included according to clinical, histopathological and immunopathological criteria. RESULTS: We retained 20 patients: 15 multiparae and 5 primiparae. The average age at onset was 29. The first clinical signs appeared in the 3rd trimester in 60 p. 100 of all cases. Clinically, the urticarial patches were noticed in 90 p. 100 of all cases and blisters in 65 p. 100 of the cases. The eruption was located mainly on the trunk and the limbs. The face was affected in 7 cases, the mucous membranes in 3 cases, the palms in 2 cases and the soles in 1 case. Cutaneous histologic examination revealed a sub-epidermal blister in 11 cases and a lymphohistiocyte infiltrate in all cases. Direct immunofluorescence showed a linear deposition of the third component of the complement along the basement membrane zone in all cases. Fetal prognosis was assessed in 13 cases: 1 fetal death, 1 still-born, 3 miscarriages, 1 anencephaly and 2 cases of transit bullous affection in the new-born. DISCUSSION: Our results are similar to those in the literature, but with some particular aspects: the late onset of the pemphigoid gestationis in the course of the 3rd trimester of pregnancy, the frequent involvement of the face and the mucous membranes and the absence of the two main fetal risks: prematurity and hypotrophy. Moreover, we underline the efficiency of topical class I corticosteroids in the treatment of pemphigoid gestationis.

Administration, Topical↗

[Cutaneous blastomycosis: description of two cases in Tunisia].

Blastomycosis is an uncommon mycotic infection in Africa. Isolated cutaneous disease is extremely rare. The purpose of this report is to describe 2 cases of cutaneous blastomycosis. The first case Involved a 70-year-old rural woman who presented papulonodules associated with scars on the upper extremities and right leg, ongoing for 2 months. The second patient was a 47-year-old woman who presented 2 vegetating plaque areas above the left knee and on the left shoulder, ongoing for 4 months. In addition a bow-shaped scar resulting from a dog bite was observed. Histologic examination and culture on Sabouraud's medium and brain heart agar confirmed diagnosis of cutaneous blastomycosis in both patients. No visceral involvement was found. Blastomycosis is uncommon in Tunisia with only 6 previously published cases. The two cases reported here are interesting because involvement was confined to the skin suggesting cutaneous inoculation of Blastomyces dermatitidis.

Aged↗

Photo-onycholysis: two cases induced by doxycycline.

Photo-onycholysis is a phototoxic reaction, which is usually drug-induced. It consists of the separation of the nail from the nail bed due to ultraviolet radiation. We report two cases of female patients who developed distal onycholysis while receiving doxycycline. Among the drugs that cause photo-onycholysis, the most frequently cited are tetracyclines, psoralens and fluoroquinolones. Photo-onycholysis is often distal, half-moon shaped and can be surrounded by pigmentation. Spontaneous recovery follows within a few months of discontinuing the drug.

Journal Article↗

[Multiple keratoacanthoma centrifugum marginatum].

INTRODUCTION: Keratoacanthoma centrifugum marginatum is a rare variety of commonly isolated keratoacanthoma. The size of the lesions and prolonged evolution often raise therapeutic problems. CASE REPORT: A 63-year-old man presented with multiple keratoacanthoma centrifugum marginatum evolving for 6 months and predominating on the lower limbs. Because of the multiplicity and size of the lesions, the patient was treated at acitretine at the dose of 1 mg/kg/day for five months, leading to the regression of all the lesions. DISCUSSION: Keratoacanthoma centrifugum marginatum has rarely been reported in the literature. Our observation remains exceptional in the multiplicity and size of the lesions. The efficacy of retinoids, previously reported in the treatment of solitary giant keratoacanthoma, multiple keratoacanthoma and keratoacanthoma centrifugum marginatum, was demonstrated even in this handicapping form of keratoacanthoma.

Humans↗

[Leprosy revealed by oedema of the hands].

BACKGROUND: We reported a case of lepromatous leprosy in a Tunisian woman revealed by a potentially misleading clinical picture involving isolated infiltration of the hands. PATIENTS AND METHODS: A 37 year-old woman consulted in October 2000 for bilateral edema of the hands associated with paraesthesia that had been present for one month. Screening for Hansen's bacilli confirmed the diagnosis of multibacillary leprosy. Daily therapy with triple anti-leprosy treatment was initiated. DISCUSSION: The occurrence of edema, which is classically described as a symptom of a reactional state, can occur during the course of leprosy. Where it is a presenting symptom, this unusual heralding sign can be a source of diagnostic error and delay.

Adult↗