[Erythrasma: study of 16 cases]

Erythrasma is a chronic bacterial infection due to Corynebacterium minutissimum, affecting the interspaces of the toes, the axillary folds and the groin. Its impact is underestimated as it is often misdiagnosed ad wrongly taken as a dermatophytic infection. Through a hospital series, we report the epidemiologic and clinical features of erythrasma, as well as the therapeutic ways. A retrospective study over a 20 year period and including the patients diagnosed as having erythrasma after a Wood's light examination. There were 16 patients [6 males and 10 females] with an average age of 44.6 years-old. The majority of our patients consulted on hot season. Clinical examination showed macular plaques with clear limits, erythematous in 6 cases and yellowish in the remaining cases. The lesions were located at the axillary folds in 13 cases; the groin in 2 cases and at all folds in one case. Treatment with erythromycin [topical or general administration] was the most prescribed. Outcome was generally favourable, but recurrences have been noticed. Erythrasma is a frequent misdiagnosed infection and often confused with a mycosis [especially in the interspaces of the toes]; knowing that antimycotic agents are efficient in erythrasma. This is probably the reason of the small number of patients in our series

[Hyalinosis cutis et mucosae: 5 cases from Tabarka [Tunisia]]

Hyalinosis cutis et mucosae [HCM], is a rare autosomal recessive genodermatosis. Cutaneous features are characteristic and allow to suspect diagnosis. To report a series of HCM. A retrospective study of all cases of HCM, diagnosed in a dermatology department over a period of 25 years [1983-2007]. Over the considered period, 5 new cases of HCM were diagnosed. Patients were aged between 14 and 41 years. They were 3 females and 2 males. All patients were native of Tabarka [northwestern Tunisia]. The age of the onset of the disease varied from neonatal period to 5 years. Hoarseness was the first clinical manifestation in all cases. Skin lesions developed between the ages of 3 and 8 years. Vesiculobullous lesions were observed in 2 patients. Moniliform blepharosis was seen in all patients. Warty and hyperkeratotic papules were observed in 3 patients. Diffuse thickening of the skin was seen in 3 patients. Lesions were primarily distributed on the face. All patients presented diffuse scars. Linear palmoplantar keratoderma was seen in one patient. Asymptomatic endocranial calcifications were noted in 4 patients. A pituitary adenoma was noted in one patient. Histopathological examination of a skin lesion revealed a typical pattern of HCM. Two patients were treated with systemic retinoids without improvement. We reported five new cases of HCM. All patients were native from Tabarka. We report also one case of linear palmar keratoderma associated with HCM. This association was not reported in the literature. Finally, the association HCM-pituitary adenoma, seen in one patient, may be fortuitous

[Cutaneous schwannoma: study of 26 cases]

Schwannoma is generally a benign tumour developing from Schwann cells. To study epidemiological, clinical and pathological features of scwannoma. Retrospective study about 26 cases of cutaneous schwannoma collected in our department over 24 years. Our patients were 12 females and 14 males. Mean age was 30 years. Clinically, schwannoma was a subcutaneous tumour which was painful in 11 cases. Individual tumours were located on the limbs [10 cases], on the head [9 cases] and the trunk [5 cases]. Multiple tumours were seen in two patients. Histopathological examination confirmed the diagnosis of schwannoma in all cases. Treatment was complete surgical excision in all cases. Cutaneous location of schwannoma is not rare. Usually, and contrarily to our series, there is no sex predominance. Clinically, schwannoma is located on the limbs and head. The diagnosis is confirmed by histopathological examination. Malignant epitheloid schwannoma diagnosed in one of our patients is a rare tumour. Schwannomas usually grow slowly and are poorly invasive. Malignant degeneration is exceptional. Treatment is complete surgical excision

[Cutaneous sarcoidosis through a hospital series of 28 cases]

Sarcoidosis is a systemic disease, of unknown etiology, characterized by noncaseating epithelioid granulomas. It may affect many organs mainly lungs, lymph nodes and skin. The aim of our study is to evaluate retrospectively the epidemiological, clinical features and therapeutic particularities of cutaneous sarocidosis through a hospital series conducted in the dermatology department of Habib Thameur hospital. We have included 28 patients [23 females and 5 males] with a mean age of 45.5 years. The most frequent skin lesions were: papular sarcoidosis in 6 cases, nodular sarcoidosis in 8 cases and plaques in 6 cases. The other clinical types observed were: lupus pernio [2 cases], subcutaneous nodules [2 cases] and scar sarcoidosis [2 cases]. Three patients presented erythema nodosum. Tuberculin skin test was negative in 77% of cases. Lymph nodes were palpable in 4 patients. Investigative exams revealed intrathoracic involvement in 8 cases and anterior uveitis sequels in 2 cases. Cutaneous manifestations were treated by chloroquin in 13 cases, allopurinol in 3 cases and intralesional betamethasone injections in 1 case. Five patients, with systemic involvement, underwent a therapy with oral corticosteroids, Sarcoidosis is a rare affection in Tunisia that affects mainly females. Cutaneous manifestations incite physicians to carry out complete investigations and to uphold a regular follow-up in order to detect systemic involvement