[Prevalence of syphilis and HIV infection in female prison population in Morocco]. / Prévalence de la syphilis et de l'infection à VIH dans une population carcérale féminine au Maroc.

We studied the prevalence of syphilis and HIV infection in 217 female prisoners at Oukacha prison, Casablanca and associated risk factors. The mean age was 32.0 years and mean length of imprisonment 22.8 months. As regards risk factors, 9% of the women said they used condoms, homosexuality was not admitted, 1.8% were intravenous drug users and the average number of sexual partners was 5.17. Fifty-one women (23%) were positive for syphilis and 4 (2%) were HIV-positive. Multivariate analysis found that being married was protective (OR = 0.75, 95% CI: 0.57-0.97), while high number of partners was a positive risk factor (OR = 2, 95% CI: 1.2-3.51).

[Prevalence of syphilis and HIV infection in female prisoners in Morocco]

We studied the prevalence of syphilis and HIV infection in 217 female prisoners at Oukacha prison, Casablanca and associated risk factors. The mean age was 32.0 years and mean length of imprisonment 22.8 months. As regards risk factors, 9% of the women said they used condoms, homosexuality was not admitted, 1.8% were intravenous drug users and the average number of sexual partners was 5.17. Fifty-one women [23%] were positive for syphilis and 4 [2%] were HIV-positive. Multivariate analysis found that being married was protective [OR = 0.75, 95% CI: 0.57-0.97], while high number of partners was a positive risk factor [OR = 2, 95% CI: 1.2-3.51]

[Intertoe space cutaneous epidermoid carcinoma]. / Carcinome épidermoïde interorteil.

BACKGROUND: Localisation of epidermoid carcinoma in the intertoe space is very rare. We report a case occurring in a setting of chronic intertoe intertrigo. CASE: A 66 year-old woman presenting intertoe intertrigo for 30 years consulted for painful ulceration of the 3rd intertoe space of the left foot present for 4 years and refractory to antifungal treatment. The examination revealed ulceration with infiltrated edges occupying the entire 3rd intertoe space, with no satellite adenopathy. Histological examination of the skin biopsy sample revealed epidermoid carcinoma. Wide excision of the lesion was performed with a safety margin of 5 mm, with removal of the 3rd and 4th left toes. The outcome was favourable with no relapse after 12 months. DISCUSSION: A single publication reported a series of 22 cases of intertoe epidermoid carcinoma in which the key aetiological feature of tumour was continual maceration. In this patient, maceration was maintained by a number of factors, including cultural factors: ritual ablutions performed 5 times daily, with no drying of the intertoe spaces, and domestic cleaning involving large quantities of water several times weekly.

[Terbinafine-induced Stevens-Johnson syndrome and aggravation of systemic lupus erythematosus]. / Syndrome de Stevens-Johnson et aggravation d'un lupus systémique induits par la terbinafine.

BACKGROUND: There have been published reports of induction and aggravation of subacute systemic lupus erythematosus of lupus by terbinafine. We report the case of female patient with systemic lupus erythematosus who, after treatment with terbinafine, presented a Stevens Johnson syndrome eruption, together with renal exacerbation of her connective tissue disease. OBSERVATION: A 25 - year-old woman was followed for 4 years for systemic lupus erythematosus was no renal involvement. The patient was stable under corticosteroids (20 mg/d) and chloroquine (200 mg/d). She was treated with terbinafine onychomycosis caused by Trichophyton rubrum. Seven days after trunk and limbs, with cheilitis affecting the mucous membrane and bilateral conjunctivitis. This rash was followed by epidermolysis involving 10% of the cutaneous area. Stevens-Johnson syndrome was diagnosed. Laboratory tests indicated massive hematuria and proteinuria, and the renal needle biopsy sample showed signs of class III lupus glomerulonephritis. The anti-histone antibodies were highly positive. The patient was treated with systemic corticosteroids (1 mg/kg/d), chloroquine was recommenced and cyclophosphamides were given in a bolus. The outcome of the patient's eruption and lupus was favorable. DISCUSSION: Although induction and worsening of lupus by terbinafine have already been reported, the present case differs through the concomitant occurrence of eruption on treatment with terbinafine and severe relapse of lupus, thus suggesting the involvement of a shared immunological mechanism.

[Quality of life and pemphigus]. / Qualité de vie et pemphigus.

INTRODUCTION: Pemphigus is a frequent chronic bullous dermatosis in Morocco that predominantly affects young women. It requires serious therapeutic management and often repeated hospitalizations. The purpose of this study was to assess the particular impact of pemphigus on quality of life by comparing the quality of life in patients suffering from pemphigus with that of the general population using a generic instrument of measure of health related quality of life: the SF-36, in association with a questionnaire exploring the impact of the disease on self perception, social relationship and behaviour. PARTICIPANTS AND METHODS: A French version of the SF-36 underwent 2 translations from French to Moroccan dialect, then two retrograde translations. After a pre-test, the questionnaire survey was administered by the same investigator to 30 patients who suffered from pemphigus, followed-up in the Ibn Rochd UHC in Casablanca and to 60 healthy adults. The two samples were paired according to age and sex. RESULTS: In the pemphigus group, there was a significant decrease of mean scores of all the SF-36 dimensions, except for physical pain and alteration in general status of health. The greatest alteration concerned the impact on physical and emotional status (p<0.00001) and the smallest alteration concerned the perception of general health (p=0.02). The factors influencing this impact were: profession, face involvement and extent of lesions. Other results concerning the psychosocial impact of pemphigus are presented. CONCLUSION: Our study confirmed that pemphigus is responsible for great alterations in health related quality of life. Therefore, the management of this disease must take into account its impact on various fields of life of the patients.