[Lyell's syndrome: a report of 16 cases]

Lyell's syndrome [SL] or toxic epidermal necrolysis is a rare mucocutaneous eruption, which is characterised by an acute necrosis of the totality of the epidermis +1-the mucosal epithelium. This is a serious affection considering the severity of systemic manifestations, the unprcdictable evolution, and the absence of specific therapy. To assess epidemiological and clinical features of this condition in our departments. This was a retrospective study concerning the cases of Lyell's syndrome carried in the dermatology and the intensive care department of Parhat Hached hospital over a 26 year period. Results: We listed 12 women and 4 with a mean age of 48,9 years. Epidermal detachmcnt varied between 26 and 80%of the body surface and mucus were involved in 87, 5%of cases. Systemic manifestatinns wcre noted in 11 patients. A drug etiology was found in 875%of cases, half of which was due to antibiotics. Our results are similar to those in the literature. Our study illustrates the severity of this toxiderma with a high mortality rate [43, 75%of cases], conformable with what was predicted by the severity-of-illness score "SCORTEN". Infectious complications wore the principal cause of death

[Norwegian scabies, a rare diagnosis in Tunisia]

Norwegian scabies is a particular form of scabies, rarely reported in Tunisia. It habitually occurs in immunocompromised hosts, with prolounged immunosuppressive therapy, congenital immune disease, HIV-1 infection or neoplasm. We report an observation of norwegian scabies, occuring in a woman with prolounged systemic corticosteroid therapy

Observation: a 65-year old woman, with a long history of obstructive bronchoneumopathy and bronchiectasis, treated with systemic corticosteroids for 5 years, was referred with a mild pruriginous and scaly erythroderma. This dermatosis developed within 5 months, with fever and impairing of heal-th. Skin parasitological exams showed a massive infestation by sarcoptes. Histologic findings revealed multiple sarcoptes scabiei and eggs in the stratum corneum. The patient was treated with benzyl benzoate during 48 hours. She died rapid-ly with acute respiratory distress

Discussion: basing on this observation of norwegian scabies occuring in an old immunocompromised woman, we put the accent on this particular form of scabies, often misappreciated, and incite to practice skin and nail parasitological exams in case of mild pruriginous, chronic scaly erythroderma, developing in immunocompromised patients