[Adenocarcinoma of the umbilicus]. / Adénocarcinome de l'ombilic.

INTRODUCTION: Most of the umbilical neoplastic processes are metastatic whereas primary adenocarcinoma is scarce and hard to distinguish from a secondary process. Our observation illustrates this difficulty. OBSERVATION: A fifty year-old woman had developed chronic omphalitis over several years. She consulted for a multinodular, erythemato-violine, oozing and deep infiltrating tumor of the umbilicus which had been developing for two months. The anatomopathological exploration of a biopsy of the lesion suggested a clearly differentiated adenocarcinoma whose digestive origin was the most likely. Investigations for a primary neoplasm were negative. Polychemotherapy was efficient with eight months recline. DISCUSSION: Umbilical metastases are referred to as Sister Marie Joseph nodule. They essentially correspond to a metastatic localization of an intra abdominal adenocarcinoma. The major problem consists in distinguishing a Sister Marie Joseph nodule where the neoplasm remains indefinite from an adenocarcinoma developed from an embryonic remainder. The existence in our patient's case history of a chronic omphalitis developing for Years and the negative tests for a primary neoplasm suggest a primary adenocarcinoma of the umbilicus.

[Epidemiological and clinical profile of superficial mycoses in the Monastir region (Tunisia). Retrospective study (1991-1994) of 3578 cases]. / Profil épidémiologique et clinique des mycoses superficielles dans la région de Monastir (Tunisie). Etude rétrospective (1991-1994) a propos de 3578 cas.

Despite of socio-economical improvement in our population and the efficacy of available antifungal treatment, superficial mycoses remain a common condition in dermatologic practice. To determine the epidemio-clinical pattern of superficial mycoses in our region, a retrospective study of 3578 cases have been carried out in the Department of Dermatology of the University Hospital of Monastir during a 4 year-period. The mean age of patients was 33 years (range: 6 months-91 years). The male to female sex-ratio was 0.82. Rural origin, history of previous mycoses, diabetes, topic or systemic corticosteroids and the presence of animals in surroundings were the most predisposing factors. The most frequent clinical patterns were: tinea corcoris and pedis (40.3%), Tinea versicolor (21.6%), Tinea capitis (9.7%) dermatophytosis of hairless skin (9.6%) and onychomycosis (8.6%). Dermatophyte was the most frequent (55.5%). The occurrence of superficial mycose especially if it affects diffuse area of the body, or if it is relapsing and resistant to treatment, requires looking for predisposing factors.

[Tunisian pemphigus. Apropos of 70 cases. (Experience of the dermatology department of La Rabta Hospital 1974-1992)]. / Le pemphigus Tunisien. A propos de 70 cas. (Expérience du service de dermatologie de l'hôpital La Rabta, de 1974 à 1992).

INTRODUCTION: Pemphigus frequently seen in Tunisia has specific characteristics distinguishing it from the European or American forms. Between 1974 and 1992, we observed 70 cases in the dermatology unit of the La Rabta University Hospital in Tunis. Most patients were young (mean age 39 yr), predominantly women (80%). Deep pemphigus (pemphigus vulgaris and vegetans) occurred in 56% and superficial pemphigus (seborrheic and foliaceus) in 44%. High-dose corticosteroids were given as initial treatment (1.4 mg/kg/day). Infectious complications were frequent. Mortality was 14%. Pemphigus in Europe and North America usually occurs in adults in the 50-60 year age range. Superficial forms are rare (2-10%). In Tunisia, pemphigus is similar to Brazilian pemphigus with high frequency and predominant superficial forms (pemphigus foliaceus).