K. Jaber

Unilateral erythema nodosum and homolateral cutaneous leishmaniasis

OBJECTIVE The authors wanted to report an uncommon etiology of erythema nodosum. CASE REPORT A 45-year-old woman presented with numerous encrusted nodular lesions on the left leg and arm. Leishmania was identified after a parasitological examination. Subcutaneous erythematous nodules developed later on the same leg. Erythema nodosum was diagnosed with a biopsy of the nodules. The patient was treated with systemic meglumine 60 mg/kg per day for 13 days. All lesions improved under treatment. DISCUSSION This was the first reported case of unilateral erythema nodosum with cutaneous leishmaniasis. Clinical and laboratory exams were in the range of normal and led the authors to exclude common causes of erythema nodosum. Subcutaneous nodules occurred before the beginning of treatment with meglumine. Thus, drug allergy (previously reported) was excluded as an etiology of EN.

Multiple and giant perforating pilomatrixoma: a case report

Pilomatrixoma, also termed pilomatricoma, trichomatricoma or calcifying epithelioma of Malherbe, is a benign skin tumor that originates from the matrix of the hair root. It’s a relatively rare condition [1] which is frequently misdiagnosed clinically and the correct diagnosis is only histological [1,2]. This tumor presents as a solitary asymptomatic, firm, and skin-colored faint blue/red nodule in the deep dermis and subcutaneous tissue, with an average size of 0.5 to 3.0 cm [3]. However, giant pilomatrixomas (more than 5 cm) have been reported in a few cases [4]. Pilomatrixoma is most commonly seen on the head and neck region followed by the upper extremities [5]. Although it can be seen in all ages and sexes; it is most often encountered in first two decades of life and females [1,4-9].

P 18 : Leishmaniose cutanée pseudo-tumorale : à propos d’un cas

Introduction Nous rapportons une observation exceptionnelle d’une forme pseudo-tumorale de leishmaniose cutanee LC a Leishmania infantum chez un patient immunocompetent. Observations Un patient de 47 ans, non tare, nous a consulte pour un nodule du dos de la main droite evoluant depuis 2 ans, erythemateux, non ulcere, ferme, a surface lisse sans squames ni croutes, ayant recidivee a deux reprises apres une exerese chirurgicale complete. L’histologie des pieces d’exerese montrait des resultats differents : une maladie de Rosai Dorfman dans un cas, un granulome tuberculoide sans necrose caseeuse dans l’autre. Un frottis dermique a la recherche de corps de Leishman etait negatif. Une troisieme biopsie cutanee a ete pratiquee concluant a une leishmaniose cutanee dans sa forme granulomateuse avec un epiderme par place acanthosique et hyperkeratosique et un derme comportant un infiltrat inflammatoire dense riche en histiocytes realisant des granulomes epithelioides. Des corps de Leishman ont ete observes dans le cytoplasme des histiocytes. Le typage par PCR a permis d’identifier L. infantum. Le bilan biologiq ue ne montrait pas de signes d’immunodepression. Conclusion Cette observation elargit ainsi l’eventail des aspects cliniques de la leishmaniose cutanee due a L. infantum chez un patient immunocompetent.