PubMed Health⌕ Search

Biomedical subjects

M Zghal

Publications and source records attributed to M Zghal.

16 recordsLinked to original sources
PubMed2004

Intramuscular bipenicillin vs. intravenous penicillin in the treatment of erysipelas in adults: randomized controlled study.

The objective of the study was to evaluate the efficacy of intramuscular penicillin: mixture of benzyl penicillin and procain penicillin (2 MU x 2 times daily) and intravenous benzyl penicillin (4 MU x 6 times daily) in the treatment of hospitalized adult patients with erysipelas. A prospective randomized unicentric trial was conducted. In total, 112 patients entered the study; 57 in the intramuscular group and 55 patients in the intravenous group completed the trial. The failure rate was 14% for intramuscular group and 20% for the intravenous group (P = 0.40). Local complications such as of the leg abscesses were observed in the two groups (intravenous 9.1%, intramuscular 7%; P = 0477). Of the patients treated with intravenous benzyl penicillin, 25.5% presented complications related to the route (venitis). Intramuscular penicillin should be considered an effective and well-tolerated treatment of erysipelas in adult patients.

Adult↗
PubMed2003

[A whole family affected by xeroderma pigmentosum: clinical and genetic particularities].

INTRODUCTION: Xeroderma pigmentosum is a relatively frequent genodermatosis in North Africa. It is characterized by abnormal sensitivity to ultraviolet light, responsible for the early occurrence of multiple cutaneous neoplasms. We present the results of the clinical and biological investigations in a family in which all its members exhibited xeroderma pigmentosum. PATIENTS AND METHODS: Since 1962, the father, mother, the 5 children and the maternal uncle were all followed-up in the dermatology department in Tunis for a variant of xeroderma pigmentosum. Clinical (dermatological, neurological and ophthalmologic), biological, photobiological and molecular biology investigations were carried out. RESULTS: Diagnosis of a variant of xeroderma pigmentosum was established on the delayed appearance (after the age of 4) of poikiloderma and the early onset of multiple carcinomas, without neurological disorders. Fifty-eight squamous cell and 3 basal cell carcinomas were diagnosed and treated by surgical exeresis or radiotherapy. The third child, treated with etretinate for 6 years, had developed 38 carcinomas. Contrary to the parents, whose first carcinomas had appeared at the age of 34 and 40 years, the cutaneous cancers in the children appeared early, between the ages of 17 and 24. The minimal erythematous dose was normal in all these patients. Conversely, the phototest revealed persistent erythema and the delayed appearance of multiple dyskeratosis cells. Molecular biology confirmed the diagnosis of xeroderma pigmentosum with the presence of a low level DNA repair. The third child, the father and the uncle respectively exhibited DNA repair rates of 32, 57 and 72%, compared with normal controls. The results of the complementarity tests conducted in the third child suggested that this family belonged to the genetic F group. Discussion The clinical and molecular data confirmed the diagnosis of xeroderma pigmentosum in this family and their genetic F group profile. However, this family exhibited clinical (the cutaneous involvement was more severe in the children) and molecular heterogeneity and the level of DNA repair was high in comparison with the levels (between 12 and 15%) reported by Japanese authors in group F xeroderma pigmentosum. The third child exhibited 10-fold more carcinomas that his siblings. This high rate of carcinoma may be explained by excessive exposure to sun and/or the retinoid treatment, particularly since his DNA repair rate (32%) was relatively high compared with that of severe (0-5%) and moderate (5-15%) forms of the disease.

Follow-Up Studies↗
PubMed2003

[Cutaneous tuberculosis: anatomoclinical features and clinical course (26 cases)].

INTRODUCTION: Despite prevention programs, tuberculosis is still progressing endemically in developing countries. The prevalence of cutaneous tuberculosis is estimated as 2.1 p. 100 and represents a rare localization among the extra-pulmonary forms. In order to study the epidemiology, the most frequent anatomoclinical forms and the progressive features of cutaneous tuberculosis, we conducted a study in the area of Tunis over a 20-year period. PATIENTS AND METHODS: All cases of cutaneous tuberculosis observed between 1981 and 2000 in the dermatology department of the Habib Thameur hospital were included in a retrospective study. Diagnosis of cutaneous tuberculosis was challenging and required the correlation of clinical, biological and progressive features. RESULTS: Twenty-six patients were observed in the study. There were 12 men and 14 women with a mean age of 30.4 years (range: 6-74) and 20 p. 100 of infantile cases. Of the various patterns of cutaneous tuberculosis seen, 11 (42 p. 100) had lupus tuberculosis, 10 (38 p. 100) had scrofuloderma, 4 (15 p. 100) had tuberculosis verrucosa cutis and 1 child had a perianal tubercular ulcer. The Mantoux test was positive in 20/24 patients. Histological tuberculoid granuloma was seen in 25 cases (96 p. 100) associated with caseating necrosis in 10 cases (38 p. 100). All patients were treated successfully with triple or quadruple anti-tubercular drugs for 6 to 10 months. One patient exhibited a squamous cell carcinoma on a lupus tuberculosis scar four years later. DISCUSSION: The progression of cutaneous tuberculosis remains stable, ranging from 1.4 cases/year between 1981 and 1990 to 1.2 cases/year between 1991 and 2000. In our study, females were slightly more affected than men with a M/F sex ration of 0.86. Before 1984, scrofuloderma was the most frequent form among the cutaneous tuberculoses. Now the frequency of lupus tuberculosis has reached that of scrofuloderma, demonstrating the increase in the incidence of clinical pattern of cutaneous tuberculosis with strong immunity probably related to the improvement in health conditions and generalization of vaccination programs.

Adolescent↗
PubMed2003

Trigeminal trophic syndrome: a report of two cases with review of literature.

Trigeminal trophic syndrome, a rare cause of facial ulceration, is the consequence of damage to the trigeminal nerve or its central sensory connections. We report two cases of trigeminal trophic syndrome, complications of cerebral vascular accidents. A 65-year-old woman complained of numerous and progressive ulcers of the right side of her face of 2 month's duration. A 67-year-old woman presented with an ulcer of the ala nasi of 10 week's duration. This syndrome most commonly occurs in women with an average age of 57 years. About 100 cases are reported in the literature. The diagnosis is made on clinical grounds, and is suggested when loss of sensation occurs in association with unilateral facial ulceration, especially involving the ala nasi. Once the ulcers appear, they are extremely persistent.

Aged↗
PubMed2001

[Melanoma in xeroderma pigmentosum: 12 cases].

BACKGROUND: Xeroderma pigmentosum is a rare genodermatosis, with a defect affecting recovery of ultraviolet-induced damages and characterized by a high rate of malignancies of the exposed skin areas. We studied melanoma features of patients with xeroderma pigmentosum. PATIENTS AND METHODS: A retrospective study of xeroderma pigmentosum patients admitted to the Charles Nicolle Hospital of Tunis between 1973 and 1998. RESULTS: Two hundred sixteen patients with xeroderma pigmentosum were registered. Melanoma was present in 12 patients, 7 females and 5 males. Two patients were sisters. Cutaneous melanoma was found in 8 patients. Four patients presented with metastatic melanoma. The median age for development of the first melanoma was 17.5 years. All of the cutaneous melanomas were found on the face. Lentigo malignant melanoma was reported in 3 cases. The tumors were treated with surgical excision. Except for a melanoma affecting the orbit, characterized by a fatal outcome, no metastases were detected at the different investigations. DISCUSSION: Melanoma occurs frequently in patients with xeroderma pigmentosum, it has been reported in 5.5 p. 100 of cases and 11.3 p. 100 of patients with cutaneous carcinoma. The age of onset was low: 17.5 years. It appeared later than the carcinoma. The location of cutaneous melanoma in face in xeroderma pigmentosum patients indicates that they were caused mainly by sunlight exposure. Lentigo malignant melanoma was the most frequent type. Prognosis is difficult to define owing to the large number of other cutaneous malignancies. Apart from one case of rapidly fatal orbital melanoma, we recorded long survivals even in cases of melanoma revealed by metastases.

Adolescent↗
PubMed2000

[Epidemiologic/clinical profile of condyloma acuminata in a dermatology service. Report of 232 cases].

The incidence of condylomata acuminata is increasing in all countries. They are one of the most frequent sexually transmitted disease (STD). The authors reported the experience of the department of Dermatology of charles Nicolle's hospital between the year 1979 and 1998. This HPV infections were in the third position of the STD and occurred mainly in young males. The clinical lesions are genital condylomata. They were successfully treated with electrodessication or cryotherapy.

Adult↗
PubMed1995

High prevalence of mutations in the p53 gene in poorly differentiated squamous cell carcinomas in xeroderma pigmentosum patients.

Mutations in the p53 gene were analyzed in 23 squamous cell carcinomas (SCCs) and five basal cell carcinomas from 10 xeroderma pigmentosum patients in Tunisia. Fourteen mutations were detected. Most occurred at the dipyrimidine sequences of DNA, suggesting that they were caused by ultraviolet light. A strong correlation was noted between the presence of the p53 mutations and clinical characteristics such as histology and growth of SCC. In well-differentiated grade 1 SCCs, three (27.3%) of 11 tumors had the p53 gene mutations, whereas in grade 2 and grade 3 SCCs, six (85.7%) of seven tumors had the p53 gene mutations (p < 0.05). Tumors less than 8.0 mm in diameter showed a relatively low frequency of mutation (two of 10 tumors, 20.0%), whereas most of the tumors larger than 8.1 mm (seven of eight tumors, 87.5%) had mutations of the p53 gene (p < 0.025). Multiple tumors in the same xeroderma pigmentosum patients also showed this relation. These results suggest that mutations in the p53 gene lead to the invasive and rapid-growing character of SCC.

Adolescent↗
PubMed1994

Far less frequent mutations in ras genes than in the p53 gene in skin tumors of xeroderma pigmentosum patients.

Mutations in Ha-ras, Ki-ras, and N-ras genes in squamous and basal cell carcinomas in patients with xeroderma pigmentosum (XP) were examined by the polymerase chain reaction followed by single-strand conformation polymorphism analysis and direct base sequencing. No mutation was detected in codons 12, 13, and 61 of the ras genes in XP skin tumors. This was in contrast with previous findings of a high frequency of mutation in the p53 gene in skin tumors in XP patients. A novel mutation in codon 6 of the Ki-ras gene was detected in a squamous cell carcinoma. The mutation was a C-->T transition at a dipyrimidine (5'-CT) sequence and could have been produced by solar ultraviolet light. The mutated ras gene did not have the ability to transform NIH/3T3 cells. In three tumors, multiple base substitutions were detected in exon 1 of the Ki-ras and N-ras genes. These results and our previous work on p53 gene mutations suggest that mutations in ras genes are far less frequent than in the p53 gene in the skin tumors in XP patients and that ras genes are less important in skin tumorigenesis in XP patients than is the p53 gene.

3T3 Cells↗
PubMed1994

Nuclear morphometry in xeroderma pigmentosum-associated malignant melanomas.

Previous clinical observations have indicated that the metastatic potential for thick malignant melanoma is lower for patients with xeroderma pigmentosum than for other patients. In a prospective study using computerized image analysis to measure the morphometric characteristics of nuclei in these neoplasms, we found that the nuclei of malignant melanoma cells were smaller and more ovoid in patients with xeroderma pigmentosum than in other patients. Objective evaluation and grading of these subtle histopathologic variables could provide a means of establishing prognostic factors unrelated to the thickness of the neoplasm.

Cell Nucleus↗
PubMed1994

Increased rate of spontaneous mitotic recombination in T lymphocytes from a Bloom's syndrome patient using a flow-cytometric assay at HLA-A locus.

Bloom's syndrome (BS) is an autosomal recessive disorder conferring high propensity for cancer and displaying a high degree of genetic instability; the frequency of sister chromatid exchange is characteristically 10 times above background. The symmetrical four-armed chromatid interchanges are much more readily detected in peripheral blood lymphocytes of BS patients, suggesting that the frequency of somatic recombination is also increased. In the present study, the rate of spontaneous loss of HLA-A allele expression was estimated following fluctuation analysis in cultured T lymphocytes using a flow-cytometric assay. It was found to be 10 times or more higher than normal in lymphocytes from a BS patient. Molecular and chromosome analyses showed that all 13 independent variants from the patient were most likely derived from somatic recombinations. Further tests for loss of heterozygosity at a closely linked proximal locus, HLA-DQA1, showed that as many as half of the recombinants retained heterozygosity irrespective of the donor. The results suggest that the HLA region is hyperrecombinogenic in somatic cells and that the elevated recombination rate in BS cells results from the general increase at ordinary sites and not from random creation of unusual sites for recombination.

Adult↗
PubMed1993

Ultraviolet-specific mutations in p53 gene in skin tumors in xeroderma pigmentosum patients.

Mutations in the p53 gene were identified in five of eight non-melanoma skin tumors in the sun-exposed areas of xeroderma pigmentosum patients by the polymerase chain reaction and single strand conformation polymorphism analysis followed by sequencing of the DNA. All mutations occurred at the dipyrimidine sites, indicating that they were caused by UV irradiation. Two tumors had multiple mutations, and four tumors had nonsense mutations. Since xeroderma pigmentosum patients are extremely sensitive to UV, the solar UV should have caused the mutations in the p53 gene and the mutations must have played a significant role in UV tumorigenesis.

Adolescent↗
PubMed1993

High prevalence of the point mutation in exon 6 of the xeroderma pigmentosum group A-complementing (XPAC) gene in xeroderma pigmentosum group A patients in Tunisia.

Xeroderma pigmentosum (XP) patients in Tunisia who belong to the genetic complementation group A (XPA) have milder skin symptoms than do Japanese XPA patients. Such difference in the clinical features might be caused by the difference in the site of mutation in the XP A-complementing (XPAC) gene. The purpose of this study is to identify the genetic alterations in the XPAC gene in the Tunisian XPA patients and to investigate the relationship between the clinical symptoms and the genetic alterations. Three sites of mutation in the XPAC gene have been identified in the Japanese XPA patients, and about 85% of them have a G-->C point mutation at the splicing acceptor site of intron 3. We found that six (86%) of seven Tunisian XPA patients had a nonsense mutation in codon 228 in exon 6, because of a CGA-->TGA point mutation, which can be detected by the HphI RFLP. This type of mutation is the same as those found in two Japanese XPA patients with mild clinical symptoms. Milder skin symptoms in the XPA patients in Tunisia than in those in Japan, despite mostly sunny weather and the unsatisfactory sun protection in Tunisia, should be due to the difference in the mutation site.

Adolescent↗
PubMedDate not supplied

[Evaluation of the frequency of oncogenic HPV in venereal condyloma. Prospective study of 24 patients].

UNLABELLED: Human papillomavirus (HPV) infection tend to be the most prevalent sexually transmitted disease (STD), and "high-risk" HPV types are correlated to intra-epithelial neoplasia, especially cervical cancer. The aim of this study was to evaluate the frequency of "high risk" HPV types in condyloma. PATIENTS AND METHODS: A non randomised prospective study was performed, including 24 patients with condyloma examined in the department of Dermatology of Charles Nicolle's hospital. Molecular hybridisation method was realised for all patients to identify HPV type. RESULTS: Mean age of the 24 patients was 37.8 years Ratio (male/female): 1.4 In 21 patients HPV DNA was detected 2 women had "high risk" HPV type (9.5%).

Adult↗