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Biomedical subjects

Hamida Turki

Publications and source records attributed to Hamida Turki.

11 recordsLinked to original sources

[Cutaneous metastasis of Crohn's disease].

INTRODUCTION: Involvement of the skin in Crohn's disease is rare. We report the case of a young woman presenting cutaneous nodules revealing a Crohn's disease. CASE REPORT: R. K. a 19 year old woman was admitted the impatient clinic for a 2 week history of nodular lesions of the extremities. Simultaneously, she had watery diarrhoea and abdominal pain associated with a bad general condition and fever. Skin examination showed ulcerated lesions with a non infiltrated inflammatory bader of the left food and the right calf associated with an abscess of the left forearm. Skin biopsy showed an inflammatory infiltrate of the deep dermis with tuberculoid noncaseating granulomas. Colonoscopy demonstrated multiple ulcers, a "globlestone appearance" of the glow and segmental glitis. Colonoscopy was followed by a peritonitis which made steroid therapy questionable. Meanwhile, the patient underwent a colonostomy and was fed intravenously, the skin lesions resolved. A follow up colonoscopy demonstrated colon polyps, and the biopsy of the colon showed features of colitis and "follicular" duodenitis which was in concordance with the diagnosis of Crohn's disease. COMMENTARIES: Usually, cutaneous lesions in Crohn's disease are consistent with nodules and granulomatous fissures of the grain. Involvement of the mucosa is rare. We report the case of "metastatic" localisation of nodular abscesses in Corhn disease. Improvement of cutaneous lesions might be explained by the nonuse of the digestive track allowed by the parenteral supplementation.

Adult↗

[Cutaneous manifestations of chronic hemodialysis. Prospective study of 363 cases].

OBJECTIVE: Chronic hemodialysis patients experience frequent and varied cutaneous manifestations, of often hypothetical pathogenesis. The aim of this work is to assess the prevalence and nature of these cutaneous lesions and discuss some pathogenic mechanisms. METHODS: This prospective study was conducted from 1 February through 30 April 1996. It included 363 hemodialysis patients in seven centers. Each patient was interviewed and examined. RESULTS: There were 210 men and 153 women. Their mean age was 50.6 years. The total duration of hemodialysis ranged from 1 to 192 months, with a mean of 52.4 months. 88% of the patients had cutaneous manifestations. Pruritus was reported by 44.8%. It appeared after hemodialysis began for 82.1% of them. Cutaneous xerosis was observed in 69%. Changes in pigmentation were observed in 17% of cases, primarily involving hyperpigmentation of photo-exposed areas. In 6 patients, skin, hair, and exoskeleton began to turn lighter 10 months to 8 years after hemodialysis. Follicular hyperkeratosis was observed in 15%. One patient had a confirmed case of perforating follicular dermatosis. Disorders of the exoskeleton (18.5% of cases) were represented mainly by thin nails and subungual hemorrhages. Other cutaneous manifestations included petechiae and ecchymoses (66%), folliculitis-type infections (9%), subcutaneous calcifications (2 cases), cutaneous pseudoporphyria (2 cases), and eczema around the fistula (11.5%), due essentially to locally-applied products. CONCLUSION: Cutaneous manifestations in chronic hemodialysis patients are frequent and polymorphous. While most have long been known, lightening of skin, in particular, others have been discovered more recently. Their pathogenesis is most often poorly elucidated. Treatment is often symptomatic. Dialysis and renal transplantation constitute the best treatment.

Female↗

[Ocular manifestations of pseudoxanthoma elasticum].

BACKGROUND: Pseudoxanthoma elasticum (PXE) is a hereditary disease characterized by skin, ocular, and cardiovascular lesions. Its prognosis depends mainly on the ocular and vascular lesions. METHODS: This study included 11 patients with PXE. All patients had an ophthalmologic examination. RESULTS: All patients had ocular lesions. Seven (63%) had angioid streaks and two, macular lesions. One patient had bilateral intrapapillary drusen (of the optic nerve head). CONCLUSION: Ocular lesions in PXE had substantial diagnostic value. Ocular complications affect functional prognosis. These patients must undergo routine ophthalmologic examinations to look for ocular manifestations and their complications.

Adolescent↗

[Ophthalmic manifestations of lipoid proteinosis].

INTRODUCTION: Lipoid proteinosis (LP), also known as hyalinosis (or lipoidosis) cutis et mucosae or Urbach-Wiethe disease, is a rare autosomal recessive disorder. It is associated with deposits of protein-lipid complexes in various tissues including the skin and mucous membranes. Ophthalmologic manifestations are frequent and can affect visual prognosis. CASE: This 28-year-old patient presented vesiculobullous lesions of the face that developed into varioloid scars associated with hoarseness. Ophthalmologic examination revealed unilateral lesions including hyaline deposits on the palpebral margins, iris, and trabecular zone, complicated by uveitis, cataract, and glaucoma, which caused the functional loss of the left eye. Histological examination of a cutaneous biopsy confirmed the diagnosis. DISCUSSION: Involvement of the eyelids is characteristic, and moniliform blepharosis is pathognomonic and frequent. This case featured a rare intraocular form (uveitis). Deposits may be found on the conjunctiva, cornea, trabecula and Bruch membrane. Conjunctival or cutaneous biopsy confirms the diagnosis. Available treatment is quite limited.

Adult↗

[Beneficial effects of antimalarials in the treatment of generalized granuloma annular in children].

Granulma annulare is a polymorphic granulomatous disease of the skin. It has a chronic course and affects mainly children and young adults. We report two cases of generalized granuloma annulare in children successfully treated with antimalarials. Two children, 6 and 12 years of age, without clinical history, presented with multiple granuloma annulare lesions which did not respond to potent topical steroids. Blood glucose level was normal. These lesions responded to small doses of antimalarials. No side effects were noticed. Compared with other drugs, with potential important side effects for children. Small doses of antimalarials might be beneficial in the treatment of generalized granuloma annulare.

Antimalarials↗

[Mal de Meleda. 16 cases].

Mal de Meleda is a recessive transgression palmoplantar keratoderma. We report the epidemiological, clinical and progressiveness aspects of the disease in 16 patients of a large consanguineous tunisian family. The age ranged from 3 to 90 years. Nine were male and 7 female patients. Onset in early infancy was characterized by erythema of the palms and soles, followed by a diffuse yellowish hyperkeratosis. Thickness of the dorsal aspect of the fingers started in childhood. Extension of hyperkeratosis to the dorsal of the hand were reported only in adults and usually precede the involvement of the feet Palmoplantar hyperhidrosis with fetid odor between the toes was frequently seen as well as conical distal phalanges. In some adults keratoderma gave contracture of the fingers leading to limitation of movements Mal de Meleda must be differentiated from other recessive palmoplantar keratoderma such as Papillon-Lefévre syndrome and Mal de Naxos. the remaining inherited palmoplantar keratoderma being autosomal dominant. Mal de Meleda is a rare disease but is still relatively frequent in some tunisian regions, due to the high rate of consanguinity Mal de Meleda remains an afflicting and disabling disease.

Adolescent↗

[Fluconazole and treatment of onychomycosis. About 86 cases].

Systemic treatment of onychomycosis is based these last years on the new drug utilization aiming to decrease the length of the treatment and secondary effects particularly with fluconazole. The aim of our study is to determine the efficiency and the tolerance of the fluconazole (Funzol) managed to the dose of 150 mg per week in the treatment of onychomycosis. It is a multicentric and prospective study done to different department of dermatology in Tunisia. Are included adult patients with clinical and mycologic documented onychomycosis. They are treated during 12 to 24 weeks for the fingernail and 24 to 36 weeks for the toenail. The assessment of the efficiency and the tolerance of the drug was clinic and biologic. During this survey, 86 patients are included, 55 female and 31 male with mean age of 43.5 years. Onychomycosis seat to hands in 30 cases (34.8%) with a predominance of Candida species (73%), to toes in 68 cases (79%) witch due in 85% of cases to dermatophytic agent (85%). At 6 months, clinical cure rate is observed in 51% of cases. After 9 months, at the end of therapy, 84% of patients were judged clinical successes and culture was negative in 82% of cases. Some minimal secondary effects are signalled in 11% of cases to 6 weeks and 10% to 12 weeks not justifying the stop of the treatment. So this study confirms the efficiency and the good tolerance of fluconazole in the treatment of onychomycosis.

Adolescent↗

[Kaposi' s sarcoma. A series of 65 cases].

Kaposi sarcoma (SK) is characterized by proliferation of vascular and spindle-shaped cells with variable clinical presentations. The association with AIDS modifies the profile of this disease. The pathophysiology seems to be based on the major role HHV-8. The goal of this work was to specify the profile of this disease in our region through a retrospective study of 65 cases of SK over a 23-year period (1981-2003). In our series, the classic form prevailed 163 cases (96.9%)]. One patient had a secondary form due to steroid therapy and another patient had a KS associated with AIDS. A male prevalence was noticed (M/F: 2.8). Cutaneous lesions were dominated by papulo-nodular lesions (90.9%) of the lower limbs (92.3% of the cases). Mucous lesions were present in 15.4% of the cases. Therapeutic abstention was decided in 38.4%. Surgical excision was indicated in 35.4% of cases, radiotherapy in 4.6% of the cases and chemotherapy in 23% of the cases. The classic form of KS is the most frequent in our area; the other forms remaining rare.

Acquired Immunodeficiency Syndrome↗

Novel mutations in the gene encoding secreted lymphocyte antigen-6/urokinase-type plasminogen activator receptor-related protein-1 (SLURP-1) and description of five ancestral haplotypes in patients with Mal de Meleda.

Mal de Meleda is a recessive, transgressive palmoplantar keratoderma for which we previously identified mutations in the gene encoding secreted lymphocyte antigen-6/urokinase-type plasminogen activator receptor-related protein-1 (SLURP-1). In this report we describe two new mutations: (i) a founder mutation, which changes a conserved cysteine residue to tyrosine (C99Y) in a large inbred Tunisian pedigree, and (ii) a signal sequence mutation (W15R), which was homozygous in a German family and heterozygous in a Scottish patient. Four ancestral haplotypes were observed in 69 patients from countries around the Mediterranean basin, and an additional haplotype was found in the German and Scottish patients.

Aged↗

Possible relation of Tunisian pemphigus with traditional cosmetics: a multicenter case-control study.

Pemphigus is a severe, autoimmune, blistering disorder with a high incidence among young women in rural Tunisia. The authors investigated explanatory environmental factors. A multicenter case-control study was conducted prospectively from 1992 to 1996 in Tunisia. Sixty-eight incident female cases of pemphigus and 166 controls matched on age, hospital, and geographic area were included. Data collected concerned socioeconomic status, medical history, drug intakes, lifestyle, and environment. Several factors were significantly associated with pemphigus in multivariate logistic regression analyses: traditional cosmetics (odds ratio (OR) = 4.0, 95% confidence interval (CI): 1.1, 14.8); Turkish baths (OR = 3.2, 95% CI: 1.4, 7.3); cutting up raw poultry (OR = 5.1, 95% CI: 1.3, 19.4); contact with ruminants (OR = 2.7, 95% CI: 1.3, 5.8); and wasp, bee, and spider stings (OR = 3.1, 95% CI: 1.5, 6.4). A dose-dependent relation was observed for traditional cosmetics. All risks except insect bites were higher when analysis was restricted to younger women, the demographic group with higher incidence. The strength of the associations, the dose-dependent relation for traditional cosmetics, and the increase of risk estimates for younger women support a causal relation. Traditional cosmetics widely used by Tunisian women could play a major role in excess of cases of pemphigus.

Case-Control Studies↗