[Phototherapy and hemodialysis pruritus]. / Photothérapies et prurit des hémodialysés.

The renal failure-related pruritus is frequent (10-30%) and this frequency increases in dialysed patients (60-80%). Its physiopathology remains badly known. The prurit is variable in intensity and surface. It predominates on the forehead, the back and the forearms. The skin is normal on it presents non specific lesions. The best treatment would be the renal graft. When it can't be done, phototherapy represents a good therapeutic alternative. We report the experience of our patients from December 1993 to January 2002. The patients could benefit from a steady treatment and be well followed-up. The mean age of our patients was 51 years with a masculine predominance (12 men to 7 women). The mean duration of hemodialysis was 3 years and the one of prurit was 10 months. Between December 1993 and January 2001, UVB phototherapy with a spectrum was used in 14 cases. After this period a phototherapy with a narrow spectrum was used. The mean dose was 2 Joules with a number of sessions. Eventually, the total body irradiation with UVB was the most regularly effective therapy of the hemodialysed prurit. It allows an important reduction, which is a significant result in comparison with UVA irradiation.

[Tabetic arthropathy: "a forgotten disease"]. / Arthropathie tabétique: "une maladie oubliée"

INTRODUCTION: With the current sparcity of syphilitic manifestations, the once obvious aspects of the affection have been forgotten or are little known. We report 4 cases of tabetic arthropathy admitted to the Dermatology Department Ibn Rochd University Hospital of Casablanca. OBSERVATIONS: The mean age of the patients was 50 years, all were males. The diagnosis was based on clinical, radiological, and biological criteria. There was a large contrast between the extent of the articular malformation and the indolence. The radiological aspect associated destructive and constructive lesions. The syphilis serology was positive in the articular liquid, the blood and/or the cerebro-spinal fluid. Treatment was essentially medical. DISCUSSION: Tabetic arthropathy, an exceptional affection, is one of the complications of the tabes dorsalis. Its prevention relies on the treatment of the syphilis at an early stage, before the onset of the articular and neurologic forms, the management of which remains very difficult.