[Localized scleroderma: a retrospective study. about 92 cases]

Sclerodermas are rare affections which can be located or generalized Localized form is the most frequent. The purpose of this study was to describe epidemiologic, clinics, biological, immunological, therapeutic, evolutionary characteristics of the localized scleroderma through a personal series and the data of the literature We have performed a retrospective study on all patients followed in the department of dermatology of the Hospital Charles Nicole during 14]ears period. Our study was about 92 cases of localized scleroderma [73 were females and 19 males]. The mean age was 35 years [between 2 and 72 years]. The majority of localised sclerodermas [66 2%of the cases] appeared before 40 years with a maximum of frequency between 10 and 30 years [41,6%]. Only 11.9%of the cases were observed before 10 years. They were 51 cases [55%] of morphea, 35 cases [38%] of scleroderma in bands including 32 linear scleroderma and 3 scleroderma en coup de sabre, 5 cases [5,5%] of generalized morphea and 1 case [0,15%] of deep morphea. Average therapeutic was specified among 63 patients [87%], and the evolution could be appreciated among 45 patients. The epidemiologic data observed in our series are comparable with those reported in the literature. Therapeutic difficulties and risks of functional after-effects, particular in scleroderma in bands, remain the principal concern for all the authors

[Bullosis diabeticorum: ten cases report]

Bullosis diabeticorum is a rare characteristic complication of diabetes mellitus; it affects 0.5%of diabetics. Bullosis diabeticorum is a manifestation of complicate and longstanding diabetes mellitus. Of our study was to describe particularities of diabetes in patients suffering of this disease. We have led a retrospective study covering a 5 year-period [January 2001-December 2007] in the dermatology department of the Charles Nicolle's hospital in Tunisia. We selected for this study all cases of bullosis diabeticorum. During the studied period, 10 cases have been collected. They were in all cases about complicate and long-standing diabetes. Bullosis diabeticorum has a favourable outcome in all cases with symptomatic treatment. The different cases of bullosis diabeticorum reported in our series were associated to complicate diabetes mellitus what lets suggest that vascular deteriorations led to cutaneous fragility responsible for the skin cleavage

[Orf of the hand]

The orf is a z0000tic infection which can be transmitted to humans. The aim of our report is to describe this often misdiagnosed viral infection in a man with an orf of the hand appearing after the feast of the sacrifice. A 40-year-old man with no past medical history, presented with a nodular lesion on the fifth right finger evolving for 3 weeks which had appeared 2 weeks after the feast of the sacrifice. Histology showed a vacuolar degeneration of keratinocytes probably of viral origin. Both histological aspect and the contact with sheep, led to the diagnosis of hand orf. Three weeks later the lesion had spontaneously resolved. Orf is an infectious mucocutaneous disease due to a parapoxvirus. It is more frequent in professionally exposed persons [veterinary, butchers]. But, in our country, the frequency of the orf increases after the feast of the sacrifice and remains undiagnosed because patients do not consult. The diagnosis may be confirmed by electron microscopy, conventional histopathology or by isolation of the virus by PCR. Information on the benign character of the disease and reassurance of the infected patient are very important because lesion usually resolves spontaneously

[What is new in the treatment of vitiligo]

Vitiligo is a frequent hypomelanosis that affects 1% of the world population, and 0,95% of the Tunisian population. The objective of our study is to describe through a recent review of the literature, the different therapeutic modalities, now used in vitiligo. We have used a clinical approach to guide therapeutic indications. We have performed a review of the articles, dealing with the treatment of vitiligo and published during the 10 previous years. We have used a Medline research with these key-words: "vitiligo and treatment". Randomized studies were privileged and 29 articles were analysed. We have initially presented all validated therapeutic means now used in vitiligo. We have then proposed, according to this recent review of the literature, clinical indications according to vitiligo type, extension of lesions and if vitiligo involves adults or children. We dispose of multiple chemical, physical and surgical treatments of vitiligo. Vitiligo with partial melanocyte defect can be treated especially by the different modalities of phototherapy [PUVA therapy, PUVASOL, UVB therapy TL01, Laser excimer]. Surgical treatments were also described, with there principal indications. Ethiopathgenic treatments [local steroids, Tacrolimus, Calcipotriol, Vitix] were especially indicated in vitiligo with complete epidermic and follicular achromy. Finally, different therapeutic associadons were reported in the litterature, showing synergic effect of some treatments. Phototherapy remains the best treatment of vitiligo type I. In vitiligo type II and III, ethiopathogenic treatments may be efficient, alone or associated with phototherapy

[Hereditary ichthyosis in Tunisia: epidemiological study of 60 cases]

Ichthyosis are a group of inherited keratinizing disorders. The cutaneous abnormalities may be isolated or associated with extra-cutaneous symptoms. To report the epidemiological and clinical profiles of patients with these genodermatoses from a hospital Tunisian study. A retrospective study of all cases of ichihyosis referred during a period of 5 years to the department of dermatology of Charles Nicole's hospital of Tunis. Sixty cases of hereditary ichihyosis were seen. The sex-ratio was of 0.5. Parental consanguinity was noted in 36 patients [60%]. Seventeen patients [25.7%] had a positive familial history of ichthyosis. The clinical form of ichthyosis was determined in 52 cases. The nonbullous ichthyosiform erythroderma was observed in 25 patients [41.6%]. Sixty patients presented an ichihyosis vulgaris [26.6%]. The other forms of ichthyosis were rarely observed: 4 cases of X-linked recessive ichthyosis, 2 cases of lamellar ichthyosis and 2 cases of bullous iclithyosiform erythroderma. Two patients were born with collodion-like membranes. Two cases presented a complex syndrome. The NBIE, commonly considered as a rare form of ichthyosis, was the most frequently form seen in our study [41.6%], probably because of the high frequency of consanguineous marriages in Tunisia. The IV represents the most frequent form reported in the litterature and was observed in 25% of our patients. The classification of some ichthyosis associated with other extra-cutaneous abnormalities [found in 2 of our patients] remains difficult

[Diabetic dermopathy: epidemioclinical characteristics]

Diabetic derruopathy is a common cutaneous marker of diabetes mellitus. Our purpose was to investigate the association of diabetic dermopathy and diabetic degenerative complications. We conducted a retrospective study in an outpatient diabetes clinic during a 6-month period. Diabetic were examined for the presence of diabetic denuopathy and diabetic degenerative complications. The data of 414 diabetic seen at National Institut of Nutrition were collected retrospectively. DO was present in 9 patients middle aged 46 years. Eight patients had type II diabetes, 5 of whom were insulindependant. The diabetic duration was over 10 years for 7 patients. Microangiopathy complications were present in 6 patients. DO may serve as a clinical sign of internal complications in diabetic patients

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

[Scleredema of Buschke. A case report]

Scleredema of Buschke is a rare disease whose aetiology remains unknown. It is characterized by symetric skin induration of the upper part of the body which usually resolve spontaneously. It can be associated with extra-cutaneous symptoms. We report a new case in a 55 year old women

[Xeroderma pigmentosum: Cutaneous, ocular, and neurologic abnormalities in 49 Tunisian cases]

This is a retrospective study about 49 cases of xeroderma pigmentosum [XP]. The goal was to determine the clinicalfeatures of XP in Tunisia. Our study revealed the predominance of a moderate form. Malignant skin tumors showed early. Squamous cell carcinoma [SCC] remained the most frequent skin malignancy in all clinical forms. Neurological abnormalities were more frequent in the moderate form. Mental retardation and peripheral neuropathy were the most common signs

[Dermatofibrosarcoma protuberans of darier and ferranda study of 28 cases in adult]

Dermatofibrosarcoma protuberans of Darier and Ferrand is a mes‚nchymatous skin tumor of intermediate malignant potential, characterised by slow growth, local malignancy and a high rate of recurrence. It is a rare tumor, accounting for approximately 0.1% to 0.18% of all malignant skin tumors. Peak incidence of the disease is between 20 to 40 years of age. We report a retrospective study of 28 cases of dermatofibrosarcoma protuberans. We reviewed the clinical features, histopathological and immunohistochemical aspects of this tumor