Facial actinic lichen nitidus successfully treated with hydroxychloroquin: a case report.

INTRODUCTION: Lichen nitidus is an unusual condition with chronic evolution. It arises as multiple tiny, shiny papules with a flat surface. Many clinical variants have been reported. We describe a new case of facial actinic lichen nitidus. Our patient responded rapidly to corticosteroids and hydroxychloroquine. CASE REPORT: A 23-year-old woman with photodistributed eruptions recurring during the summer with improvement during the winter presented to our institution. Clinical exam revealed pinhead sized flat and flesh-colored papules on her face. Koebner phenomenon was not observed. Palms, soles, nails, and mucosa were normal. Histologic examination of a cutaneous biopsy showed a well circumscribed lymphohistiocytic infiltrate in the papillary dermis in a "claw clutching a ball" pattern suggestive of lichen nitidus. The diagnosis of actinic lichen nitidus was made. Treatment included photoprotection, topical corticosteroids once daily for 6 weeks, and hydroxychloroquine for 6 months. Remission of lesions was obtained after 4 weeks. CONCLUSION: Actinic lichen nitidus is rare. The true prevalence of this disease and the effectiveness of its various therapies is difficult to evaluate because it is usually asymptomatic and resolves without squelae.

Clinical and molecular characterization of colorectal cancer in young Moroccan patients.

BACKGROUND/AIMS: Early-onset colorectal cancers are relatively rare. About 20% of colorectal cancers are familial or hereditary. Two autosomal dominantly inherited cancer syndromes are more studied: Lynch syndrome accounts for 2-5% of colorectal cancers and familial adenomatous polyposis represents 1% of total colorectal cancers. Unlike the familial adenomatous polyposis syndrome, there are no clinical features that help in easily recognizing Lynch syndrome. The young age of cancer occurrence could be a criterion that should raise a suspicion of Lynch syndrome. In Morocco, the average age at diagnosis of colorectal cancers according to the register of cancers of Casablanca is 56 years, which is 10 years earlier than in European countries. Our study aimed to assess the frequency and molecular characteristics of the Lynch syndrome in Moroccan early-onset colorectal cancers patients. MATERIALS AND METHODS: The population analyzed included 70 patients. The criteria for inclusion of patients in this study were a colorectal cancers before age 50 and the exclusion of familial adenomatous polyposis. We started by searching for microsatellite instability, first by immunohistochemistry of 3 mismatch repair proteins (MLH1, MSH2 and MSH6) and with second confirmation using 4 monomorphic markers (BAT25, BAT26, NR21, and CAT25). RESULTS: We found instability in 10/70 (15%) of the cases. The loss of expression affects more often the MLH1 protein, with 8 cases, versus 2 cases of altered MSH2. None of the 70 patients of the series fulfilled the Amsterdam II criteria, indicative of Lynch syndrome. CONCLUSIONS: Further work needs to be done to discriminate hereditary cases from sporadic ones, but testing for microsatellite instability as a first step is important.

[Cutaneous manifestations of male breast cancer]. / Manifestations cutanées du cancer du sein chez l'homme.

OBJECTIVE: The appearance of skin symptoms in male breast is the main reason for consultation in our context. The aim of this study is to describe the various cutaneous manifestations of male breast cancer through a series of cases collected in a dermatology department. METHODS: A retrospective study was conducted in the dermatology department at the CHU Ibn Rochd January 1988 to December 2009. All cases of male breast cancer initially diagnosed in dermatology were included. The various epidemiological, clinical, histological and therapeutic data were collected from medical records. RESULTS: Twenty cases were collected. The mean age was 61.25 years. Skin invasion by tumor was found in all patients, and it was the reason for consultation. It was a cutaneous involvement at the nipple and areola (17 cases) and at the periareolar skin (three cases). The clinical appearance of skin involvement was vegetative type in 12 cases, infiltrating with nipple retraction in five cases and nodule with skin change in three cases. The average period of consultation was 25 months. The axillary lymph nodes were noted in 11 patients and distant metastases in eight patients. The cutaneous metastases outside breast were noted in six patients. The histological types were: infiltrating ductal carcinoma in 15 cases (75%), papillary carcinoma in two cases (10%) and non-specific carcinoma in three cases (15%). The treatment was surgery in 14 patients and consisted of radical mastectomy with complete axillary nodal dissection according to Patey. Complementary therapies, chemotherapy or radiotherapy, were indicated in 14 patients. CONCLUSION: Our single-center study with dermatological recruitment illustrates the frequency and variety of skin disease in male breast cancer and demonstrates that they are still the main reason for consultation in our context. Better information for public and practitioners would allow earlier diagnosis and a more favourable prognosis.