Supernumerary nipple in a young woman Salim, Salma; Hassam, Badreddine
The Pan African medical journal,
09/2019, Volume:
34, Issue:
36
Journal Article
Peer reviewed
Open access
We report the case of a 24 year old woman, without significant past medical history, who consulted for an asymptomatic and pigmented lesion of the breast evolving from infancy. Dermatological ...examination showed a brown plaque localized on the milk line in the underside of the right breast, measuring 1 cm, firm in consistency, with a non infiltrated base.
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Topical minoxidil, the only approved treatment for female pattern hair loss (FPHL), has been associated with scalp allergic contact dermatitis (ACD). We report the case of a female patient who ...developed ACD from minoxidil solution. A 30-year-old women presented with pruriginous and pustular lesions over an erythematous area on the scalp and forehead. These lesions had appeared after 1 week of treatment with 5% minoxidil solution (Foligan )minoxidil 5%, ethanol, propylene glycol and purified water, for androgenetic alopecia. Physical examination revealed multiple millimetric papulovesicles and papulopustules over an erythematous oedematous area on the frontal scalp and forehead. The patient refused to have a biopsy taken. With these clinical lesions a diagnosis of pustular contact dermatitis was made. Minoxidil solution was stopped and topical corticosteroid therapy twice a day was started. A complete clearance of the lesions could be observed after 5 days. Topical 2,6-diamino-4-piperidinopyrimidine 1-oxide (minoxidil) has been shown to be effective in the treatment of androgenetic alopecia for over 15 years. Minoxidil 5% solution has a favorable safety profile, with adverse effects limited to the site of application (5.7% of patients) and signed by pruritus, erythema, scaling and dryness. The most common causes of these symptoms include irritant contact dermatitis, allergic contact dermatitis, or exacerbation of seborrheic dermatitis. Although cases of pustular allergic contact dermatitis have been anecdotally reported. We conclude that our case is interesting in that it represents an uncommon reaction to a drug used very frequently in dermatology.
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Kaposi of the penis: about a case Asmaa, Sqalli Houssaini; Hassam, Badreddine
The Pan African medical journal,
2019, Volume:
32, Issue:
137
Journal Article
Peer reviewed
Open access
Kaposi sarcoma (KS) is a multicentric angioproliferative disorder of endothelial origin. It predominantly affects mucocutaneous sites but may also affect visceral organs. We are reporting a case of ...KS with unusual presentation. A 45-year-old male presented violaceous macules on the glans which appeared 3 weeks ago. Otherwise he reported fever and loss weight. Histological examination detected the presence of spindle cells and the positivity for Kaposi-associated Herpes virus-8 confirmed the lesions as Kaposi's sarcoma. Visceral sarcoma lesions were also present in the oesophagus and gastric fundus. HIV viral serology was positive. Treatment with antiretroviral therapy and bleomycine was initiated. Sarcomas of the penis are very uncommon, representing less than 5% of malignant tumors in this area. KS is the most common sarcoma of the penis and the second most common is leiomyosarcoma. Primary presentation of KS on the penis is not common but more often observed in patients with AIDs, whose lesions are the aggressive form, and only approximately 2-3% cases have shown penile KS lesions as first manifestation of disease as our patient. This case is important as it illustrates that disseminated KS was not to be predicted by the number or the external lesions.
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We report the case of a 56-year-old man who presented with locally advanced giant condyloma acuminatum (Buschke-Löwenstein tumor) after approximately 15 years of neglect due to hospital phobia. ...Clinical examination showed an extensive, erosive, exophytic and cauliflower-like growth involving his suprapubic, external genitalia and perianal region.
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Image en médecineDermocorticoids (DC) are the first line treatment for mild to moderate psoriasis. Despite their relative safety, long-term use and most of all self-medication practice could expose ...them to a risk of skin atrophy. We report the case of a 50-year old female patient, treated for psoriasis with chronic application of topical dermocorticoids over several years. Her skin appeared to be very thin, displaying the underlying venous network, telangiectasias as well as stretch marks which are manifestations of dermo-epidermal atrophy. Skin atrophy is the most common adverse effect of dermocorticoids and it is due to their strong antiproliferative effect on keratinocytes, melanocytes and fibroblasts which synthesize the collagen. It may be associated with delayed wound healing and various infectious complications; hence the importance of providing proper patient education.
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Le henné est un produit utilisé pour colorer les cheveux, mais aussi pour dessiner des tatouages labiles sur la peau. Le henné est souvent mélangé avec de la paraphénylènediamine (PPD). Nous ...rapportons l'observation d'une patiente qui a présenté un eczéma de contact à un tatouage labile contenant la PPD. Une jeune femme de 23 ans se fait tatouer sur le dos de la main et sur l'avant-bras des dessins esthétiques à base de henné noir. Ce tatouage labile contenait de la PPD. Deux jours plus tard, elle développe des lésions érythématovésiculeuses et édémateuses très prurigineuses avec une sensation de cuisson. Les lésions siégeaient au site de tatouage et suivaient exactement le dessin initial. Elles étaient améliorées par un traitement à base de dermocorticoïdes de classe 4. La patiente refuse l'exploration allergologique par patch-tests et aucun test allergologique n'est effectué. Actuellement, le henné est très en vogue dans les pays occidentaux. La PPD est ajoutée pour diminuer le temps de fixation ou pour obtenir une coloration plus foncée. Elle peut entrainer de graves réactions systémiques. La réaction allergique la plus fréquente est la dermatite de contact. Le traitement repose sur la corticothérapie locale. Une meilleure législation sur la pratique du tatouage temporaire et le contrôle des préparations ainsi qu'une Information régulière annuelle du grand public sont indispensables. L'intérêt de notre observation est de montrer l'importance d'informer surtout les jeunes sur les risques d'un tatouage labile.
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Tuberculosis is a bacterial disease caused by mycobacterium tuberculosis. It's cutaneous form accounts for 2% of all extrapulmonary tuberculosis. We report a case of 30-year-old woman with nodules ...evolving for two years. Examination showed gums of genital and inguinocrural location, and scrofulous scars. Several diagnoses were discussed including tuberculosis, syphilis, actinomycosis, or cutaneous lymphoma. Skin biopsy revealed an epithelial giganto-cellular granuloma with caseating necrosis; the culture of a cutaneous fragment was positive for Mycobacterium Tuberculosis. Our case is original and unusual due to the uncommon clinical appearance and location of the nodules grouped in the inguinocrural region. The multiplicity of the clinical forms of cutaneous tuberculosis sometimes makes the diagnosis difficult. Gums and scrofulodermas remain the most frequent forms of cutaneous tuberculosis in Morocco. According to the immuno-anatomo-clinical classification, tuberculous gum is part of the multi-bacillary forms and is seen mostly in immunocompromised patients.
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Type B lymphomatoid papulosis Bouhamidi, Ahmed; Hassam, Badreddine
The Pan African medical journal,
2018, Volume:
30, Issue:
138
Journal Article
Peer reviewed
Open access
A 28-year-old woman with no notable medical history. Who presented with a 3-month history of pruritic erythematous purplish papules at the axilla, elbow folds, flanks, inner thigh and popliteal. On ...physical examination, there were multiple papular lesions with irregular pigmentation at the axilla (A), associated with maculopapular erythematous plaques on elbow folds, flanks, inner thigh and popliteal (B). There was no lymphadenopathy or mucosal involvement. Skin biopsy was in favor of type B lymphomatoid papulosis with the presence of rare large cells, with CD30 expression confined to the cell membrane and Golgi region (C, D). All the staging investigations were normal. The diagnosis of type B lymphomatoid papulosis was retained and the patient treated with topical corticosteroids with a good improvement, she is under regular monitoring. Lymphomatoid papulosis is characterized by erythematous papulonodular lesions, often evolving into a crust and spontaneously disappear in a few weeks, leaving a depressed and sometimes pigmented scar. Type B lymphomatoid papulosis histology consists of an infiltrate of lymphocytes with cerebriform nuclei, the infiltrate includes large cells that can express the CD30 antigen. lymphomatoid papulosis has a good prognosis but can be associated with or progress to malignancy. Therefore, it is important to monitor these patients.
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La miliaire sudorale est une manifestation cutanée bénigne liée à l'obstruction sudorale généralement témoin d'une exposition excessive à la chaleur, à l'humidité ambiante ou d'une hyperthermie. Nous ...rapportons le cas d'une patiente de 70 ans, diabétique sous insuline, hospitalisée au service de réanimation pour un coma acidocétosique secondaire à une pyélonéphrite. La patiente a présenté des lésions vésiculeuses diffuses au niveau de tout le corps de contenu clair, fermes à la palpation, reposant sur une peau saine, correspondant à une miliaire cristalline. La miliaire sudorale est une manifestation cutanée bénigne liée à une rétention sudorale secondaire à une obstruction des canaux sudoraux. Selon le niveau d'obstruction, on distingue la miliaire cristalline par obstruction dans le stratum cornéum; la miliaire rouge par obstruction dans le stratum malpighi et la miliaire profonde par obstruction au niveau ou en dessous de la jonction dermo-épidermique. La miliaire cristalline guérit spontanément en quelques heures en laissant une desquamation, comme c'était le cas chez notre patiente après régression du syndrome fébrile.
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Patient de 68 ans, tabagique chronique, consultait pour une tuméfaction cutanée au niveau de la paroi thoracique antérieure évoluant depuis 05 mois, augmentant progressivement de taille, associée à ...une dyspnée d'effort d'aggravation progressive, évoluant dans un contexte d'altération de l'état général et d'amaigrissement chiffré à 15kg. L'examen cutanéo-muqueux objectivait Une tuméfaction cutanée mesurant 5cm sur 5cm, arrondie, bien limitée, à bordure érythémateuse et à surface ulcérée (A). L'examen des aires ganglionnaires montrait deux adénopathies axillaires bilatérales, mesurant 2cm chacune, de consistance ferme, indolores, mobiles. La biopsie cutanée montrait un profil histologique et immuno-histochimique d'un adénocarcinome compatible avec une origine pulmonaire (B et C). La TDM thoracique avait confirmé la présence d'un processus pulmonaire lingulaire gauche (D). La décision thérapeutique était de démarrer une poly-chimiothérapie à base de sel de platine et pemetrexed. L'évolution était marquée par le décès du malade après 4 mois du diagnostic de la maladie.
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