[Extensive cutaneous chromomycosis: Efficacy of combined terbinafine and cryotherapy]. / Chromomycose cutanée étendue : efficacité de l'association terbinafine et cryothérapie.

BACKGROUND: Chromomycosis is a chronic fungal skin infection, mainly affecting the limbs. It is responsible for severe morbidity and its treatment remains long and disappointing. Rarely described in Morocco, we report a new observation that has evolved very well under treatment combining terbinafine and cryotherapy over a short duration. CASE REPORT: A 56-year-old patient, immunocompetent, had a pustular and crusty placard on both forearms that had evolved for a year. Mycological examination showed fumagoid bodies and cutaneous biopsy showed epithelioid granulomas and giant cells without necrosis. The PCR confirmed a chromomycosis at Fonsecaea pedrosoi. HIV serology was negative. Treatment with terbinafine 250mg/d for 6months combined to cryotherapy resulted in complete remission with initial clinical improvement after only 3 weeks. DISCUSSION: Chromomycosis occurs increasingly in non-tropical areas. If diagnostic methods become more effective, management remains difficult and poorly codified. Terbinafine-cryotherapy combination would bring a lot of benefits with a little risk to bothpractitioner and patient. CONCLUSION: This combined treatment would constitute an excellent therapeutic alternative because of its efficiency, feasibility, low cost, method of administration and aesthetic result.

[Malignant proliferating trichilemmal cyst of the scalp: A case report]. / Kyste trichilemmal proliférant malin du scalp : une nouvelle observation.

BACKGROUND: Proliferating trichilemmal cyst (PTC) is a rare adnexal tumor, generally benign, primarily sitting on the scalp of elderly women. About fifty cases are reported in the literature. Herein, we describe another one particularly aggressive. OBSERVATION: A 70-year-old woman had been showing an increase in the size of an occipital cyst for 6years. A cephalic scan and wide surgical excision had confirmed the diagnosis of a malignant PTC. Four months later, the tumor recurred with regional metastases and intracerebral invasion. DISCUSSION: Through our case and based on the literature analyzing, we discuss the nosology of PTC and its clinical and histological distinctive elements. CONCLUSION: Large studies are needed to better understand the specificities of PTC, specially malignant form, but it remains difficult because of its rarity.