[Porokeratosis. A study about 6 cases]

Porokeratoses [PK] represent a less common group of dermatoses that are acquired or hereditary, of unknown pathogenesis, characterized b keratinization disorder. Different clinical forms have been identified and the most frequent are the Mibelli's porokeratosis [MP] and the Disseminated Superficial Actinic Prokeratosis [DSAP]. In this retrospective study, we analysed the observations of PK collected in the Dermatology Department of La Rabta Hospital over a 16-year period. Six cases of PK were collected: 4 females and 2 males, with no medical history with a mean-age of 42.7. Only a female patient had [PK] familial history. All our patients had typical clinical aspects with lesions in annular plaques, of atrophic center, surrounded by keratotic border. The histological aspect was consistent with PK, showing the typical cornoid slide. In our series, there are 3 cases of [MP] and 3 cases of [DSAP]. PK lesions usually appear during the childhood and the third and fourth decades for the DSAP. In MP, there is one or some large, unilateral, annular plaques. DSAP is characterized by numerous small annular lesions of the photo-exposed regions Their prognosis is on the whole, favourable but remains conditioned by malignant transformation. Treatment is difficult aiming at reducing that risk of degeneration

Intralesional and anatomopathologic features of psoriatic erythroderma

Psoriasis is a chronic inflammatory cutaneous disorder. It is marked by aberrant epidermal and dermal expression of cytokines. Evaluate the expression of proinflammatory cytokines in a particular severe form of psoriasis the psoriatic erythroderma. We focused on intra-lesional cytokine gene expression in cutaneous biopsies of lesional site and their correspondent non lesional skin. On the whole, four healthy volunteers and thirty six patients were included in this study. Among these, three had a psoriatic erythroderma. Assuming that local production of cytokines may be approached by mRNA cytokine quantification, the expression of a tumour necrosis factor [TNFalpha] and interleukin-8 [IL-8] was analyzed by reverse transcription and real time quantitative polymerase chain reaction. Under expression of all selected molecules in psoriatic erythroderma lesions was contrasted with the data obtained in the other psoriatic lesion forms witch revealed that ratios had significantly increased in lesional skin compared with non lesional one. However, at anatomy-pathology analysis, inflammatory infiltrate in psoriatic erythroderma was classical poor and no specific of this disease, such as the case of our three patients. This could explain the drop of intra-lesional inflammatory mediators. The paradoxal low levels of proinflammatory cytokines in psoriatic erythroderma are an original and important result

[Eccrine poroma of the scalp: a study of the three cases]

The eccrine poroma is a rare bening sudoral tumor, which creates a fleshy formation. The diagnosis is made according to the anatomopathological study. The usual site is the sol, but in rare cases, other sites have also been reported. The authors report three cases of eccrine poroma localized in the scalp with literature review

[Nasosinusal sarcoidosis: 2 cases. a report of 2 cases]

Nasosinusal sarcoidosis is a rare non caseating granulomatous disease. It may be inaugural, isolated or associated with multisystemic sarcoidosis. We report two cases of nasosinusal sarcoidosis associated to multisystemic sarcoidosis. Both patients were females aged over 43 years. In one case, the primary symptom was a nasal obstruction. Tomodensitometric and guided biopsy findings provided the main diagnostic criteria. Anti-malaric treatment was prescribed in both cases. Stabilisation of the lesions was noted. We tried to reveal through this study the diagnostic and therapeutic difficulties of nasosinusal sarcoidosis

[Pseudoxanthoma elasticum: a report of 11 cases]

Pseudoxanthoma elasticum [PXE] is an inherited disorder of elastic tissue with many systemic manifestations. We performed a retrospective study from all the patients diagnosed with PXE at the department of dermatology of La Rabat hospital of Tunis, between 1986 and 2003. During the observation period, we identified 11 patients with PXE, 5 males and 6 females with a mean age of 28 years [10-47 years]. Family history was found in 5 patients. Exhibit yellowish, pigskin, and popular lesions on the sides of the neck were observed in all cases. Systematic ophthalmologic examination revealed angioid streaks in 4 patients. No abnormalities were found in cardiovascular and metabolic explorations. Diagnosis of PXE is based on clinical, histological and genetic criteria. Ocular and cardiovascular damage make all the gravity of the disease, from where interest of an ophthalmologic and cardiovascular examination systematic

[Cryosurgery for nose basal cell carcinoma]

Basal cell carcinoma [BCC] is the most common malignant tumour of the skin frequently located on the head and chiefly on the nose. Cryosurgery is one of the methods to treat BCC

Object: To determine the efficacy of cryosurgery of 17 BCC of the nose in terms of recurrence rates and cosmetic results. Results: 15 patients were included with a median age of 73 years and a photo type III or IV in 86% of cases. Mean size of tumours was 12 mm. Lesions were chiefly located on the alae nasi [70.5%]. Complications were few and minor. After an average follow-up of 13.5 months. recurrence rate was about 5.8% [one case]. Cosmetic results were good or excel-lent in 14 cases/17; only one patient had developed a notch of the nose

Conclusion: Cryosurgery is a rapid. of a low cost technique and chiefly with good oncological and cosmetic results

Erythema elevatum diutinum: etude anatomo-clinique de 5 cas

Erythema elevatum diutinum is a rare condition of unknown etiology listed with cutaneous vasculitis or neutrophilic diseases. Medical records and histopathologic slides of 5 patients with erythema elevatum diutinum were studied to better understand the disease. Lesions were clinically characteristic. All biopsy specimens showed leucocytoclastic vasculitis. The most significant finding is the association of erythema elevatum diutinum with seronegative rheumatoid arthritis

[Childhood linear psoriasis]

Linear distribution of psoriasis is rare. This presentation offers to physicians some diagnostic difficulty, especially in the absence of a history of preexisiting psoriasis or in the presence of any other linear dermatosis. In the study we report the cases of 3 girls aged repectively 45 yr and 10 yr admitted in our dermatology department. The clinical features and differential diagnosis of this skin disease which, in the children, can be easily mistaken for inflammatory verrucous epidermal nevus, are discressed