[Dual localisation of ischaemic fasciitis with local relapse at one site]. / Une double localisation de fasciite ischémique avec récidive locale sur un des sites.

INTRODUCTION: Ischaemic fasciitis (IF) is a rare pseudosarcomatous proliferation initially described on the pressure points of long-term bedridden patients. Healing is the rule after surgical excision. No multifocal localisations have been reported to date. Herein, we describe the case of a patient with FI affecting two sites and having recurred at one of them. OBSERVATION: A 50-year-old woman with scoliosis and mental retardation consulted for a hard skin lesion next to her right scapula. Elastofibroma was diagnosed on the basis of a surgical biopsy sample. Early local recurrence led to a second resection four months later. Histologically, central fibrinoid necrosis was observed, surrounded by collagenous tissue containing occasionally atypical fibroblasts and numerous capillaries. The diagnosis of ischaemic fasciitis was made by a national expert. Six months later, we observed a 13-cm purplish erythematous infiltrated mass with a 6-cm ulceration at the surgical site. A second 6-cm non-ulcerated indurated purplish lesion was visible next to the right greater trochanter. The scan showed deep soft-tissue infiltration with subfascial extension and contact with the greater trochanter. Superficial biopsies of both lesions showed only an appearance of granulation tissue. MRI performed after five months showed an extension of lesions at the two sites with an appearance evocative of ischaemic fasciitis. Surgical excision was refused by the patient and her family. DISCUSSION: We report a rare case of ischaemic fasciitis at two separate sites with local relapse after surgical excision.

[Outbreak of dermatophytosis in a high-level French judo team: prospective study 2006/2011. Efficacy of a therapeutic protocol introduced in 2004/2005]. / Épidémie de dermatophytoses chez les judokas du pôle France d'Orléans : étude prospective 2006/2011 et évaluation de l'efficacité des mesures instaurées en 2004/2005.

BACKGROUND: Outbreaks of dermatophytosis have been reported more and more frequently in combat sports such as wrestling and judo. Such outbreaks are difficult to treat due to the involvement of numerous actors and structures. The main aim of our study was to determine whether the use of a standardized treatment in a high-level judo team could successfully reduce the outbreak. Our secondary objectives were to study the topography of lesions and ascertain whether consultations for suspected dermatophytosis were significantly more frequent during the 4 weeks following a judo training course. MATERIALS AND METHODS: We conducted a prospective follow-up study from October 2004 to the end of June 2005 (series 1) and then from September 2006 to June 2011 (series 2) during which all new suspected cases of dermatophytosis in a judoka from Pôle France Orléans were examined at the Orléans Dermatology Department. For each consultation, we prepared a map of lesions and mycological samples, and patients received standardized treatment. RESULTS: We compared the two series and a considerable decrease was noted in dermatophytosis outbreaks after the introduction of these measures. The mean number of visits per training season was 97 for series 1 and 21.6 per training season for series 2. The mean numbers of episodes of cutaneous lesions clinically active per training season were 74 for series 1 and 16.8 for series 2. Lesions were localized mainly on the forearms, face and neck (40% for series 1 and 73% for series 2). "Waves" of visits (at least two visits per week) occurred significantly more frequently (68%) during the 4 weeks following a training period than during the rest of the year. CONCLUSION: Standardized management of this outbreak reduced the number of infectious episodes.