Dermatologic manifestations in inflammatory bowel disease in Tunisia

Cutaneous manifestations are the most common extra intestinal manifestations associated with inflammatory bowel disease [IBD]. To assess the epidemio-clinical profile of skin manifestations in IBD. A prospective and descriptive study was conducted. We have examined skin, mucosa, hair and nails, of all patients with an IBD during one year. One hundred-ninety-five patients were included. Crohn's disease [CD] was noted in 154 cases [79.8%], ulcerous rectocolitis [UC] in 39 cases [21.2%] and inclassable IBD in 2 cases. Cutaneous manifestations were found in 91% of Crohn's patients and in 92% of UC patients. Granulomatous perianal skin lesions were the main cutaneous manifestations of CD [53%]. The most common affected sites were ano-perineal fistulae, perianal and perineal fissures and oedematous and infiltrated perianal and genital plaques. Reactive lesions [Erythema nodosum, Pyoderma gangrenosum, Aphthous stomatitis] were noted in 14 cases. Skin manifestations due to malabsorption were also frequently observed [101 cases: 51.7%].Other dermatoses implicating various mechanisms such as psoriasis, alopecia areata, vitiligo, rosacea, lichen planus, were also noted. Adverse skin manifestations due to treatment [folliculitis, acne, macula-papular rash and DRESS syndrome] were present in 16 cases. Our series is characterized by a high frequency of cutaneous manifestations associated to IBD. A better recognition of these skin manifestations by the physician may improve their management

Etiological spectrum of sporadic malabsorption syndrome in northern Indian adults at a tertiary hospital.

BACKGROUND: The etiology of malabsorption syndrome (MAS) may differ in different geographical regions. Limited data are available on the etiological spectrum of MAS among Indian adults. METHODS: Ninety-nine consecutive adult patients with MAS (urine d-xylose <1 g/5 g/5 h with or without increased fecal fat (> or =7 g/24 h) were evaluated for cause of MAS using standard criteria. Past medical records were examined to know the nature of treatment received. RESULTS: The etiology of MAS was: tropical sprue 39, celiac disease 9, Crohn's disease 9, giardiasis 8, small intestinal bacterial overgrowth in absence of another cause of MAS 8, panhypogammaglobulinemia 2 (one with strongyloidiasis), intestinal lymphangiectasia 1, intestinal tuberculosis 4, idiopathic 15, acquired immunodeficiency syndrome 2, and amyloidosis 2. Twenty-eight patients had received anti-tubercular treatment earlier. CONCLUSIONS: Tropical sprue, celiac disease and Crohn's disease are common causes of MAS in Indian adults. Inappropriate anti-tubercular treatment is common in them and needs to be discouraged.

Estudo de doenças de má absorçäo intestinal como causa de baixa estatura monossintomática / Study of intestinal malabsorption diseases as cause of monosymptomatic short stature

Objetivo: Este estudo foi realizado com o objetivo de avaliar causas de baixa estatura monossintomática na infância, enfatizando causas de má-absorçäo intestinal, especialmente doença celíaca. Métodos: Foram avaliadas, em um desenho transversal, crianças com estatura abaixodo terceiro percentil ou taxa de crescimento inferior a 5cm/ano. A seguinte propedêutica foi realizada: avaliaçäo hematológica, bioquímica, endocrinológica, idade óssea, pesquisa sorológica de anticorpos antigliadina, gordura fecal, dosagem de cloretos no suor e biópsia jejunal. Resultados: Um total de 51 crianças foi estutado, sendo que a maioria foi incluída no grupo dos variantes da normalidade. Näo foram encontradas portadoras de doença celíaca, mas identificaram-se 4 crianças com provável fibrose cística, assintomáticas em relaçäo ao trato respiratório e gastrintestinal. Conclusäo: Além da doença celíaca, a fibrose cística deve ser incluída no diagnóstico diferencial de baixa estatura na infância...