Epidemic clinical profil of skin cancer in southern Tunisia

Skin cancer [SK] frequency is increasing all over the world. We report a clinical and epidemiological study of SK in the south of Tunisia through a 1476 cases series. On the basis of a retrospective study, we report the clinical and epidemiological data collected from files of patients with skin cancers seen during a 24-year-period [1979-2002]. Our series was composed of 1476 patients, with an incidence of 61.5 cases/year. The mean age was 55 years. Epithelial skin carcinomas were the most common [1288 cases, 87.3%]. Basal cell carcinomas were found in 890 patients [69%] and squamous cell carcinomas in 398 [31%]. The mean age was 60 years. The phototype III was the most common [52.8%] among these patients. Skin melanomas were found in 71 cases [4.8%]. The mean age was 54 years with a female predominance [60.6%]. Kaposi sarcoma was found in 4.5% of patients. The mean age was 64.3% and a male predominance was found [80% of cases]. Two patients with Kaposi sarcoma [3.3%] were HIV positive. Dermatofibrosarcoma protuberans was reported in 2% of patients and skin lymphoma in 1.7%.The mean age is relatively low in our series. The increase in the incidence of skin cancers is probably related to the climatic conditions, the ageing of the population and to the changes in the social, economic and cultural aspects in the country. The male predominance is changing toward an equal distribution between both sexes probably in relation to the present similarity in the life style and work conditions

Sexual disturbances secondary definitive colostomy

Sexual disturbances after colostomy are various. However, they probably remain underestimated in societies where sexuality is still a taboo issue. The aim of this prospective study was to evaluate the possible sexual behaviour and the post operative sexual disturbances in patients whome underwent colostomy. The group was devided in 10 male and 11 female patients. Seventeen patients [81%] were married, 3 widowed and 1 unmaried. Sexual disturbances were found in 47% of patients. There was a lack of interest in sexual relations in 2 women, a resolved premature ejaculation in one case, post operative dysparenia in 2 female patients, a retrograde ejaculation in a 60-year-old man, impotence in a 46 years old patient, and a premature ejaculation in a 36-year-old man. The frequency of sexual disturbances [47%] in our series was close to that reported in the literature [50%]. The sexual disorders are more common in male patients, the most frequent being ejaculatory dysfunction. In women, dyspareunia is the most common disorder. The particular case of colostomy in homosexuals remains a current issue

Beneficial effects of Antimalarials in the Treatment of Generalized Granuloma Annular in children

Granuloma annulare is a polymorphic granulomatous disease of the skin. It has a chronic course and affects mainly children and young adults. We report two cases of generalized granuloma annulare in children successfully treated with antimalarials.Two children, 6 and 12 years of age, without clinical history, presented with multiple granuloma annulare lesions which did not respond to potent topical steroids. Blood glucose level was normal. These lesions responded to small doses of antimalarials. No side effects were noticed.Compared with other drugs, with potential important side effects for children. Small doses of antimalarials might be beneficial in the treatment of generalized granuloma annulare

[Kaposi's sarcoma, a series of 65 cases]

Kaposi sarcoma [SK] is characterized by proliferation of vascular and spindle-shaped cells with variable clinical presentations. The association with AIDS modifies the profile of this disease. The pathophysiology seems to be based on the major role HHV-8 The goal of this work was to specify the profile of this disease in our region through a retrospective study of 65 cases of SK over a 23-year period [1981-2003]. In our series, the classic form prevailed 163 cases [96.9%]]. One patient had a secondary form due to steroid therapy and another patient had a KS associated with AIDS. A male prevalence was noticed [M/F: 2.8]. Cutaneous lesions were dominated by papulo-nodular lesions [90.9%] of the lower limbs [92.3% of the cases]. Mucous lesions were present in 15.4% of the cases. Therapeutic abstention was decided in 38.4%.Surgical excision was indicated in 35.4% of cases, radiotherapy in 4.6% of the cases and chemotherapy in 23% of the cases. The classic form of KS is the most frequent in our area; the other forms remaining rare