[Management of severe psoriasis: about 50 cases]

Background: With its varied clinical presentation, psoriasis is actually considered as a public health care problem. Severe psoriasis remains difficult to treat

Methods: Our study was retrospective involving 50 patient with severe psoriasis treated in the dermatology unit of military hospital of Tunis from January 1990 to December 2003

Aim of our study was to evaluate actual different therapeutic attitudes and new treatments in case of severe psoriasis

Results: During the 14 years studied the frequency of severe psoriasis was about 19,5%. Extended psoriasis was noticed on 64% of the patients. Arthropatic psoriasis was found on only 6% of the patients. Erythrodermic psoriasis, pustular psoriasis and palmoplantar psoriatic keratoderma were equally noticed in 10% of the patients. PUVA-therapy was firstly prescribed on 96,6% of the patient with extended psoriasis, bettering was noticed on 71% of all them during the 3 first cures. From the 20 patients that have received acitretin, 65% have noticed improvement. Methotrexate and RE-PUVA was secondarily used [only for the cases of psoriasic arthritis amd methotrexate] on respectively 18% and 10% of the patients. All our patients reported worsening on them quality of life

Conclusion: Cyclosporin is more and more used initially in cases of rebellious psoriasis. Actually therapeutic hope leans on biological therapies

[Erythema nodosum: profile in a Tunisian teaching hospital]

Background: Erythema nodosum [EN] is the most frequent acute nodular hypodermatitis. Etiologies of EN are varied although a similar clinical presentation

The aim of our study is to establish epidemio-clinical characteristics of EN in 103 patients

Methods: [62 in care [January 1980-december 2005] were seen on the dermatology unit of the Rabta hospital. We have only included patients that had done: blood count, chest X-Ray, ASLO, tuberculin intradermoreaction, transaminase, inflammation marker

Results: We had 86 women and 17 men with a mean age of 36,5 years. Lesions were located in lower limbs in 88 cases. The man etiologies were: post streptococcal infections [42 cases], tuberculosis [8 cases], Crohn disease [8 cases], Behcet disease [7 cases] and sarcoidosis [5 cases]. EN was idiopathic in 23 patients. The most common provoking agent of EN varies from a country to another and even in the same country from a study to another. In Tunisia, post streptococcal infection and Behcet disease still frequent etiologies for EN, sarcoidosis and inflammatory colites are more and more found unlike tuberculosis which is less incriminated than before. In case of EN it is reasonable to begin etiological enquiry by common causes