[Periungual trichilemmal cyst of the big toe].
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Adult↗
Biomedical subjects
S Azzouzi
Publications and source records attributed to S Azzouzi.
[Intertoe space cutaneous epidermoid carcinoma].
BACKGROUND: Localisation of epidermoid carcinoma in the intertoe space is very rare. We report a case occurring in a setting of chronic intertoe intertrigo. CASE: A 66 year-old woman presenting intertoe intertrigo for 30 years consulted for painful ulceration of the 3rd intertoe space of the left foot present for 4 years and refractory to antifungal treatment. The examination revealed ulceration with infiltrated edges occupying the entire 3rd intertoe space, with no satellite adenopathy. Histological examination of the skin biopsy sample revealed epidermoid carcinoma. Wide excision of the lesion was performed with a safety margin of 5 mm, with removal of the 3rd and 4th left toes. The outcome was favourable with no relapse after 12 months. DISCUSSION: A single publication reported a series of 22 cases of intertoe epidermoid carcinoma in which the key aetiological feature of tumour was continual maceration. In this patient, maceration was maintained by a number of factors, including cultural factors: ritual ablutions performed 5 times daily, with no drying of the intertoe spaces, and domestic cleaning involving large quantities of water several times weekly.
Aged↗
[Axillary basal cell carcinoma: a rare localization].
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Axilla↗
[Fahr syndrome associated to hypoparathyroidy, revealed by dermatologic manifestation].
BACKGROUND: Fahr syndrome is defined by the presence at the brain base of strio-pallido-notched non-arteriosclerotic bilateral and symmetric calcifications. We report an observation of Fahr syndrome revealed by a growing pyodermitis in direct relation with hypocalcemia. OBSERVATION: A 17 year-old girl was admitted to the Dermatology Department for a growing pyodermitis of the large folds. The patient was known to be epileptic and had undergone surgery for a left eye cataract a year before. Microbiologic and mycologic examinations of the pus and of the cutaneous fragments were negative. During hospitalization, the patient had an attack of tetany, a laryngeal spasm and a generalized erythema thrust studded with pustules. The phosphocalcic assessment showed severe hypocalcemia and hyperphosphoremia. Parathormone serum rate was decreased. The brain tomodensitometry conveyed bilateral calcifications of the central gray nucleus. The diagnosis of a growing amicrobial pustulosis secondary to an idiopathic hypoparathyroidism and responsible for the Fahr syndrome was maintained. Treatment was composed of calcium (2 g/day) and vitamin D3. The evolution was favorable with a relapse at 2 years. DISCUSSION: We report an idiopathic hypoparathyroidism associated with Fahr syndrome conveyed by growing amicrobial pustulosis. We discuss the dermatologic manifestations of Fahr syndrome associated with hypoparathyroidism and the physiopathologic mechanisms of the dermatologic lesions during hypocalcemia.
Adolescent↗
[Solitary fibrous mediastinal tumor. A case report].
Solitary fibrous tumor is a rare tumor, generally located in the pleura. Recently, new sites have been described in the literature, particularly involving the peritoneum and mediastinum, as wekk as te-the bronchopulmonary and orbital regions. The diagnosis is established at pathology, but in some cases may be difficult to differentiate from other tumors. We report the case of a 60-year-old women who had undergone surgery 25 years ago for right pulmonary hydatid cyst and who presented inspiratory dyspnea and dry cough for four months. Physical examination revealed a right cervical tumefaction in the supraclavian region. The AP chest x-ray disclosed an opacity in the right laterotracheal upper cervicomediastinal zone laminating the trachea which was displaced to the left. Thoracic computerized tomography showed a tissular process in the superior and middle mediastinum. Surgical tumor resection was performed and pathology confirmed the diagnosis of solitary fibrous tumor. The postoperative period was uneventful. Frequency of the mediastinal localisation is the same in men and women. The tumor generally develops between the 5th and 7th decades, and is most often asymptomatic. Fortuitous discovery is the rule. The clinical course is unforeseeable.
Female↗
[Extramembranous glomerulonephritis and myelodysplastic syndrome].
Membranous glomerulonephritis (MGN) is the main cause of nephrotic syndrome in adults and is usually idiopathic. We report a case of nephrotic MGN associated with a myelodysplastic syndrome (MDS) in a 43 year old man. The initial treatment consisted of oral corticosteroids (1 mg/kg/day). Within 3 months proteinuria decreased from 22.4 g/day to 3.96 g/day and the blood cell count was normalized. Renal biopsy disclosed type I MGN. Ponticelli's protocol was started with a favorable effect: negative proteinuria, normal blood cell count and normal bone marrow cellularity. The association between MGN and MDS is quite rate. The possible links between the two conditions are reviewed.
Adrenal Cortex Hormones↗
[Juvenile hyaline fibromatosis: 2 twin brothers affected].
INTRODUCTION: Juvenile hyaline fibromatosis is a rare hereditary genetic disease characterized by a cutaneous tumoral fibroblastic proliferation with joint involvement. CASE-REPORT: We report the case of 2 homozygous twin brothers both presenting a diffuse and invalidating form of juvenile hyaline fibromatosis. The 2 boys' born of a twin pregnancy' presented at the age of 2 months a clinical picture made up by the classic association: infiltrated papulo-nodules, gingival hyperplasia and joint contracture. The diagnosis of juvenile hyaline fibromatosis suggested clinically was confirmed by the histological study of the skin. DISCUSSION: These observations of juvenile hyaline fibromatosis's are particular in the involvement of 2 twin brothers, which to our knowledge has never been reported, the resemblance of the clinical features, and the severity of the functional handicap.
Diseases in Twins↗
[Diffuse xanthogranulomatous pyelonephritis: clinical, anatomopathologic, and therapeutic features. Report ot 9 cases and review of the literature].
Diffuse xanthogranulomatous pyelonephritis is a rare chronic pyelonephritis. This study permitted us to notice the various histological, clinical, radiological, and the different means diagnoses of this affection. Retrospectively series of nine patients is reported. The median age was 43 years. The commonest clinical presentation was urinary tract infection, and lumbar pain. Urine culture identified a bacteria in seven cases (77%). Intravenous urography recovers silent kidney (five cases), hydronephrosis (two cases), chronic pyelonephritis (one case) and renal stones in six cases (67%). Treatment consisted of nephrectomy. No specific biological or radiological signs of this affection can be identifying this lesion in preoperative. The diagnosis was revealed by the histological examination of the removed kidney. The outcome is favorable after a follow-up of six months to four years. The clinical features of the pyelonephritis xanthogranulomatous is not specific. Magnetic resonance imaging can give a specificity to this affection. Only histological examination is able to established the definitive diagnosis.
Adolescent↗
[Loose anagen hair syndrome: a familial case with fetal hair in meconium].
INTRODUCTION: Loose anagen hair syndrome is a recently described hair disorder. We report a familial case. CASE REPORT: Two sisters were examined, 4 years-old and 8 months old, from a consanguineous marriage. At birth, they presented diffuse alopecia of the scalp; the meconium contained black and silky hair. Clinical examination noted the short, fine hair with easy and painless uprooting. No clinical associated symptoms were observed. The trichogram showed 70 p. 100 of anagen hair and 30 p. 100 of telogen hairs. DISCUSSION: Our familial case is original by this clinical symptom: discharge of probably dystrophic foetal hair in the meconium. Loose anagen hair is characterised by easily pluckable hair. The trichogram confirms the diagnostic. It is composed of anagen hairs (80 to 100 p. 100) devoid of sheaths. The loose anagen hair is usually isolated, but associations have been reported. It may occur in families. The precise pathogenesis and treatment of this hair disorder are not known.
Alopecia↗
[Herpetic superinfection of pemphigus: 6 cases].
BACKGROUND: Herpes simplex infection should be searched for in patients who experience unexplained aggravation of acantholytic dermatosis. Epidermal alterations appear to play an important favoring role. PATIENTS AND METHODS: We report 6 cases of Herpes simplex infections in patients with pemphigus observed at the Ibn Rochd hospital dermatology unit, Casablanca, over a 3-year period (1995-1998). RESULTS: There were 4 men and 2 women, age range 27-76 years. Superficial pemphigus was observed in 5 cases and pemphigus vulgaris in 1. In all cases, histology showed cytopathogenic Herpes simplex infection. The Herpes simplex infection appeared when the patients were given general corticosteroid therapy at doses from 1 to 1.5 mg/kg/d for 15 days to 1 month. In two cases, the corticosteroids were associated with an immunosuppressor (azathioprine, cyclophosphamide). Cure was rapid with systemic aciclovir, achieved in 5 to 20 days. Recurrence was observed in 2 cases. DISCUSSION: Herpes simplex superinfection in patients with pemphigus is classically described but uncommonly observed. In our experience, it has become more frequent over recent years since, before 1990, we observed no cases. Its prevalence may be underestimated. The diagnosis of Herpes simplex superinfection is sometimes difficult and should be suggested in case of relapse or resistance to treatment. The Herpes virus simulates most cases of pemphigus relapse, with a preferential localization on the bullous lesions. The painful nature of the eruption is highly suggestive of Herpes simplex infection as is the presence of vesicles grouped in bouquets. Both type 1 and type 2 viruses are observed. Cure is rapidly achieved with aciclovir in 5 to 15 days. Spontaneous cure has been reported in the literature as well as recurrent herpetic infection. In two cases in the literature, the Herpes eruption was fatal due to severe herpetic hepatitis and disseminated intravascular coagulation. Herpes simplex infection must be rapidly recognized in pemphigus patients so curative aciclovir treatment can be given early.
Acyclovir↗