Bowen's disease: epidemioclinical study of 9 tunisian cases

Bowen's disease [BD] is a form of in situ SCC, characterized by chronic and progressive course, with low potential for invasive malignancy. To assess epidemiology and clinical features of BD in a Tunisian cohort. A retrospective study of 9 cases of BD managed in a Tunisian dermatology department. There were 7 males [77.8%] and 2 females [22.2%]. The mean age of patients was about 68.8 years [46-89]. Lesions were solitary in 7 cases and occurred in various sites: face [1 patient], trunk [2 patients], limbs [6 patients]. The mean diameter of the tumour was about 3.4 cm. Lesions presented clinically as an enlarging well demarcated erythematous plaque with irregular borders and crusted or scaling surface. Histological examination showed in all cases abnormal keratinocytes with disordered maturation and loss of polarity replacing the epidermis in its whole thickness. The main treatment was surgery [N=5]. Only one patient had radiotherapy [case 1]. Outcome was mentioned in 2 patients who remained free from recurrence respectively after a follow-up of 1 and 12 years. Our series outlines epidemiological and clinical features of BD in Tunisia through a small but representative sample. As in the literature, this condition prevailed mainly over 60 years. In our study, BD occurred predominantly in men and affected nonexposed sites in 8 cases. This profile is uncommon in a sunny country in Tunisia, in the absence of other aetiological agents

[Pruritus in the elderly: an epidemic-clinical study [about 208 cases]]

Pruritus is an unpleasant cutaneous feeling causing the desire to scratch. Few epidemiologic studies were interested in this symptom which relates to the old subject particularly. To study the epidemiological and clinical features as well as the treatment of pruritus in this age bracket. A retrospective study over 10 years and 5 months at the dermatology department of Habib Thameur hospital concerned 208 patients, 65 years old and more presenting a pruritus without specific dermatological lesion. The frequency of pruritus in the old subject was 5.14 per 1000 new consultants. Pruritus had revealed an ignored affection in 36.36% of the cases: an iron deficiency in 10 cases, a type 2 diabetes in 6 cases, a hypereosinophilia over 1000 elements/mm3 in 4 cases, a chronic renal failure in 2 cases, a hepatic cytolysis in 2 cases, a cholestasis in one case, a polycythemia vera in one case and hepatitis B one a case. Skin lubricants and antihistamines associated to topical corticosteroids in 25 cases and UVB therapy in a case were prescribed. These treatments brought an attenuation of pruritus in 62% of the cases. Iron deficiency anemia was the principal cause of pruritus in our series, followed by the type 2 diabetes. Our results contrast with the data of the literature considering that the traditional prevalence of the hepatic cholestasis was not noted and that diabetes is not regarded as inductive factor of pruritus

Sweets syndrome: about of 8 cases

Sweet's syndrome is a dermatosis classically determined by painful erythematous plaques or nodules associated with fever, neutrophilia and dense neutrophilic dermal infiltrate. In most cases, Sweet's syndrome may occur in the absence of other diseases. However, it can be associated with an inflammatory disease and essentially with malignant conditions in 20% of cases requiring a careful investigation. We report herein, the epidemiological, clinical, therapeutic and evolutive features of a hospital serie. We retrospectively reviewed all the files of patients conforming with the diagnosis of SS, seen at the dermatology departement of Habib Thameur hospital during a 7-year period [from 1997 to 2003]. All patients fulfilled at least two major criteria and two minor criteria of Su et Liu's diagnostic criteria modified by Von Den Driesch. 8 cases of .Sweet's syndrome were diagnosed. All patients were females. The mean age was 51.62 years. The lesions occurred on the upper limbs in 7/8 cases. SS was isolated in 6 cases and para-inflammatory in one case corresponding to an associated Sjogren's syndrome. Besides the st and ard therapy using oral corticosteroids [3 patients], non steroidal inflammatory agents has been efficient in 4 cases. In our serie, we report an exclusive female involvement and a lower frequency of associated diseases compared with the relevant literature. Association of SS and Sjogren's syndrome is exceptional. To our knowledge, only 6 cases have already been reported

Histiocytome fibreux angiomatoide: Une tumeur rare a malignite intermediaire

Angiomatoid fibrous histiocytoma is a rare humour affecting young adults. Unlike conventional malignant fibrous histiocytoma, it's extension is only local thus giving a good prognosis. We report the cases of a 9 years-old girl and a 1 6 years-old boy presenting respectively, with an axiliary tumour 5cm of diameter and a paravertebral subcutaneous tumour 1,5cm of diameter. In both cases, the diagnosis was not initially suspected. The treatment consisted in surgical resection