[Chronic lupus erythematosus: 104 Tunisian cases]

Chronic lupus erythematosus is a cutaneous form of lupus eryhematosus, usually involving photoexposed areas. The aim of our study is to evaluate the epidemio-clinical trends, therapeutic features and outcome of patients with chronic lupus erythematosus, through a Tunisian hospital series. We have tried to compare our results with those of other African and western series. It is a retrospective study, concerning all patients with chronic lupus erythematosus, attending the Dermatology department of Charles Nicolle Hospital over an 11 years period. The patients' age, sex, clinical features, explorations results, treatment and evolution were recorded. A total of 104 patients were included. Chronic lupus erythematosus represented 0,1% of all the dermatitis seen over 11 years. Chronic lupus erythematosus affects young women with a ratio F/M of 1,97 and an average age of 42 years. The discoid form was the most frequent clinical shape, observed in 73% of cases [76 patients]. The face was the most frequent localization of the lesions [91%]. Five patients [4.8%] presented a generalized chronic lupus erythematosus. The direct immunofluorescence in stick skin was positive in 54% of cases. Treatment included sun avoidance and oral antimalarials drugs in the majority of cases [95%]. The progression from chronic lupus erythematosus to systemic lupus erythemetosus was observed in two cases [2%]. Chronic lupus erythematosus is a relatively are disorder in Tunisia, compared to other African countries, where prevalence is 7 to 10 times more frequent. As shown in our study, the most common clinical feature is the discoid form. The diagnosis can be confirmed by histopathological and direct immunofluorescence examination. Progression of chronic lupus erythematosus to systemic lupus erythematosus is possible, as observed in tow of our patients. Thus, patients with chronic lupus erythematosus should be continually followed up

Fixed drug eruption: about 13 cases

To discuss, through a retrospective study, the epidemiological and clinical aspects and the causative agents of fixed drug eruption. Thirteen cases were collected retrospectively during 11 years. There were 10 females and 3 males with a mean age of 44 years. The lesions correspond to erythematous plaques which fade to leave slate-brown macules in all cases. The most frequent localizations were limbs [12 cases], trunk [6 cases], face [3 cases] and external genitals [3 cases]. Sulfonamides were the most frequent responsible drugs in our series [7 cases]. Fixed drug eruption is characterized by one or more erythematous plaques which recur in the same places after challenge. Sulfonamides are actually the most frequent causative drugs in the different series

[Profile of bullous pemphigoid, 47 cases reported]

We report forty-seven cases of bullous pemphigoid recorded in the dermatology department of Charles Nicolle hospital in Tunis during 16 years. In Tunisia, bullous pemphigoid is at the second rank of aquired autoimmune bullous skin diseases, differ pemphigus. The profile of bulbous pemphigoid in our series difere from that reported in the literature by the more young age [67,2 years] and the male predilection but don't present any clinical an epidemiological particularity. Three atypicals forms were observed: a vesicular form, a localized form and an infantile form. Systemic corticosteroids were choice treatment for our patients