[Large gastric diverticulum]

Gastric diverticula are infrequent anatomic abnormalities that are usually asymptomatic. We report a case of large gastric diverticulum and discuss disgnostic and therapeutic challenges. A 63-year-old man was admitted with vague epigastric discomfort. Physical examination and laboratory investigations were normal. Endoscopy revealed and erosive gastropathy and a pouch arising from the posterior aspect of the greater curve, 8 cm form the hiatus. Barium meal confirmed the presence of a 5 cm diameter diverticulum arising from the gastric fundus. Careful examination of the whole stomach at gastroscopy is recommended for not missing a diverticulum

[Amelanotic spitzoid melanoma of the digit: a case report]

Melanomas of digit is rare, accounting for 1% of all cutaneous melanomas. We report a new case. Our purpose is to discuss the clinicopathological characteristics and the difficulties encountred in establishing diagnosis of this rare tumor. We report the case of a 25 years old woman, who consulted for nodular and ulcerated lesion of the right index, located in the external face of the metacrapo-phalangial joint. The nodule was biopsied and histopathologic exam concluded to spitzoid melanoma. The surgical margins were involved. The patient refused surgical recovery. She consulted 3 years later with axillary lymph nodes. A wide excision of the tumor with lymph node biopsy were made. Histological study concluded to a tumoral residu incompletely excided with lymph node metastases. Amputation of the second digit with dissection of the axillary lymph nodes was made. The surgical margins were tumor free. Lung metastases appeared with a follow up of two months. The patient died early after starting chemotherapy with Deticen. In our report, clinical presentation was misleading causing a diagnosis and therapeutic delay. Pathologically, all the histological types of melanoma were described in the digit except spitzoid melanoma

Feasibility of quality of life assessment in routine clinical oncology practice: a Tunisian study

Limited research has been devoted to quality of life [QOL] of cancer patients in developing countries. To assess the feasibility of QOL assessment in a cohort of Tunisian cancer patients, the EORTC QLQ-C30 questionnaire was administered to 23 women treated with adjuvant chemotherapy for early breast cancer on an outpatient basis at baseline and during the 3rd cycle of chemotherapy. We observed a significant deterioration in physical functioning, cognitive functioning and social functioning during chemotherapy. However, a wide range of methodological and practical obstacles to routine QOL evaluation were identified through this study. Further improvement of cancer care infrastructure and public education is still needed before reliable QOL studies can be performed

Giant lipoma of the transverse colon: a case report and review of the literature

Colonic lipomas are benign adipose tumors which are usually submucosal. Small lesions are asymptomatic and may be detected incidentally. Large lipomas can cause symptoms. We report a case of symptomatic giant colonic lipoma. A 67-year old woman was admitted to hospital with persistent abdominal pain, for which a barium enema showed a large polypoid mass occluding the lumen of the transverse colon. Colonoscopy revealed a tumor narrowing the bowel lumen of about 5 cm in diameter with a sessile appearance and ulcerated overlying mucosa. The possibility of colonic malignancy could not be precluded and an operative resection was performed. Pathological examination revealed a colonic lipoma. Twelve months after the surgery, the patient was free of symptoms. Awareness of the possibility of colonic lipomas is important for clinicians in terms of evaluation of therapeutic regimen

[ cutaneous leishmaniasis: comparative study between herbal essences preparation in the green clay and intralesional injection of glucantime [R] about 8 cases]

The cutaneous leishmaniasis [CL] is increasing in our country. The conventional treatment is the Glucantime. However, many alternative treatments modalities of the CL have been proposed and one these modalities has been the use of herbal extract applied topically on the lesions. The aim of the study was to compare the efficacity of a preparation based on herbal extracted essences with green clay excipient, and the intralesional injection of Glucantime. Eight patients have been included in our trial having an ulcerated CL with a number of lesions per person lower than 5. Two lesions were treated by two different protocols: one based on topical herbal extract, the other based on intralesional injection of Glucantime. Three lesions were infected and no lesion has been healed after application of our preparation, against 5 lesions that healed by intralesional injection of Glucantime. This preparation seems inefficient in the treatment of the CL in spite of the healing effect known of the herbal essences

[Sweet's syndrome in an infant. a new pediatric observation]

Introduction: Sweet's syndrome was described for the first time in 1964. It is usually described in adults and remains rare in children. We report a case in a 18 month-old infant

Observation: A 18 month-old boy presented with multiple round erythematous papules and plaques involving the extremities, face and ears. Laboratory examinations revealed neutrophilic polynuclear hyperleukocytosis, anemia and inflammatory syndrome. Physical examination and skin biopsy led to diagnosis of Sweet's syndrome. The boy was treated by oral corticosteroids. Because he developed rectorragia and hematemesis we change to dermocorticoides class II and colchicine that led to spectacular improvement

Conclusion: Sweet's syndrome is exceptional in infants. The frequent association with a malignant blood disease should prompt appropriate investigations and prolonged survey. Systemic corticosteroids therapy is the reference

[Cutaneous infection in geriatric patients - about 656 cases]

Skin disorders in elderly people are frequent, numerous and variable. The goal of this study was to describe the distinctive features of cutaneous diseases in aged people in an outpatient clinic of dermatology. Two thousands and twelve patients files were studied. The age varied from 65 to 99 years [mean 72 years]. Most of the patients [47.5%] were in the age section 65-70 years with a predominance of male patients [55.1%]. The most common skin conditions were infectious diseases [32.6%]. Superficial mycoses were diagnosed in 30% of cases. Dermatophytoses were the commonest infections [52%]. Erysipelas was the leading cause of bacterial infections [26% of all cases]. Parasitic diseases [6.6%] were dominated by scabies. Skin disorders are certainly underestimated in our study. The low frequency of elderly seeking health care in dermatologic clinic in our series, could be explained by the predominance of young people in the general population. Cutaneous disorders in elderly are dominated by infectious and malignant tumoral conditions, the latter increasing with age

[Diabetes mellitus cutaneous manifestations]

Diabetes mellitus cutaneous manifestations are numerous. The aim of this case control study [200 diabetic patients and 100 controls]. was to estimate the frequency of these manifestations, their clinical particularities and their relationship to the duration of the disease, the equilibrium and degenerative complications of the diabetes. Cutaneous manifestations were found in 84,5% of the diabetic patients and in 49% of controls. Diabetic dermopathy [DD] was found in 11,5% of patients and necrobiosis lipoidica in 1 case. Diabetic bullosa was reported in 6% of cases. It was more commune in ancient and poorly controlled disease. Diabetic rubeosis was found in 3% of diabetic patients and cheiroarthropathy in 7%. Cutaneous infections, mainly due to fungus [47%], were found in 63% of patients and 44% of controls. Side effects of antidiabetic medications were noted in 11% of cases. The high frequency of cutaneous manifestations in diabetes mellitus, in our study, could be explained by the inclusion of all skin diseases, in particular, cutaneous infections. The manifestations were significantly more frequent in diabetic patients. DD, diabetic bullosa and cheiroarthropathy are the most specific manifestations. Skin infections are common but non specific. They are favorised by poorly controlled diabetes. Complications of the diabetic foot are frequent