Biomedical subjects

Mohamed Ridha Kamoun

Publications and source records attributed to Mohamed Ridha Kamoun.

At least 19 recordsLinked to original sources

PubMed2006

[Multiple basal cell carcinomas following radiation therapy for nasopharyngeal cancer].

INTRODUCTION: Basal cell carcinoma (BCC) is a cutaneous, generally primary malignancy, most common among the elderly. We report the case of a patient presenting numerous BCCs several years after radiation therapy for nasopharyngeal cancer and discuss the risk factors for this tumor and the role played by radiation in its genesis. CASE: A 30-year-old woman presented with pigmented facial lesions that had been developing over the past year. Eleven years earlier, she had had an undifferentiated nasopharyngeal carcinoma (T3N2M0), which was treated by neoadjuvant chemotherapy and then external radiation therapy. Initial cutaneous examination noted two lesions that were identified as BCC after biopsy. The tumors were excised surgically. Neither clinical nor radiological check up showed signs of basal cell nevus syndrome. DISCUSSION: BCC is the most frequent malignant tumor. It is observed mainly among those aged 45-60 years. Disorders that might promote or complicate BCC should be systematically sought in young patients, especially basal cell nevus syndrome. While our patient may have had this syndrome, we found none of the other clinical or radiographic elements often observed with it. The occurrence of BCC within the irradiation area, the multiplicity of lesions, and the sufficient latency period are consistent with radiation-induced tumors. We found no reports in the literature of BCC following radiation treatment for nasopharyngeal cancer, but the occurrence of these tumors in our patient suggests the need for close supervision in such cases.

Adult↗

PubMed2006

Risk factors for erysipelas of the leg in Tunisia: a multicenter case-control study.

BACKGROUND: Risk factors for erysipelas (cellulitis) were rarely evaluated in controlled studies. Regional variations of these risk factors have never be assessed. OBJECTIVE: To assess risk factors for erysipelas of the leg in Tunisia. SUBJECTS AND METHODS: Case-control study in seven hospital centers in Tunisia. Cases were 114 consecutive patients with erysipelas of the leg [sudden onset (<24 h) of a well-demarcated dermo-hypodermatitis with fever or chills]. Two controls were matched to each case for age, sex, and hospital (n = 208). Main outcome measures are local and general suspected risk factors for erysipelas of the leg. RESULTS: In multivariate analysis, disruption of the cutaneous barrier (i.e. traumatic wound, toe-web intertrigo, excoriated leg dermatosis or plantar squamous lesions) and leg edema were independently associated with erysipelas of the leg, with respective odds ratios of 13.6 (95% confidence interval: 6.0-31) and 7.0 (1.3-38). No association was observed with diabetes, alcoholism, or smoking. CONCLUSIONS: We confirmed the major role of local risk factors and the minor role of general risk factors for erysipelas of the leg, in a setting different than the one previously studied. Detecting and treating toe-web intertrigo and traumatic wounds should be considered in the prevention of erysipelas of the leg.

Case-Control Studies↗

PubMed2006

[Foot and diabetic neuropathy: about 205 cases].

Diabetic neuropathy is a serious and disabling complication of diabetes mellitus. It occurs in all types and at any moment of the evolution of diabetes. It can be worsened by arteriopathy or an associated cutaneous infection. Our study is about 205 diabetic patients with a peripheral neuropathy. In 27 patients (14% of cases) there are also trophic disorders: callus in zones of support (17 cases), mal perforant (6 cases) and burns (5 cases). Arteritis of the lower limbs was present in 50 % of cases. The authors discuss the physiopathology and management of diabetic neuropathy.

Adult↗

PubMed2006

[Pemphgoid gestationis. A report of 30 cases].

Pemphigoid gestationis is an acute autoimmune subepidermal bullous dermatosis which occurs during pregnancy and post partum. It is a rare disease which incidence vary from 1/1700 to 1/60000 pregnancy. It occurs in young woman aged between 20 to 40 years. The authors try throughout a retrospective study of 30 cases of pemphigoid gestationis to drave the epidemiological and clinical profile and the immunopathological characteristics of this affection.

Adult↗

PubMed2006

[Fluconazole and treatment of onychomycosis. About 86 cases].

Systemic treatment of onychomycosis is based these last years on the new drug utilization aiming to decrease the length of the treatment and secondary effects particularly with fluconazole. The aim of our study is to determine the efficiency and the tolerance of the fluconazole (Funzol) managed to the dose of 150 mg per week in the treatment of onychomycosis. It is a multicentric and prospective study done to different department of dermatology in Tunisia. Are included adult patients with clinical and mycologic documented onychomycosis. They are treated during 12 to 24 weeks for the fingernail and 24 to 36 weeks for the toenail. The assessment of the efficiency and the tolerance of the drug was clinic and biologic. During this survey, 86 patients are included, 55 female and 31 male with mean age of 43.5 years. Onychomycosis seat to hands in 30 cases (34.8%) with a predominance of Candida species (73%), to toes in 68 cases (79%) witch due in 85% of cases to dermatophytic agent (85%). At 6 months, clinical cure rate is observed in 51% of cases. After 9 months, at the end of therapy, 84% of patients were judged clinical successes and culture was negative in 82% of cases. Some minimal secondary effects are signalled in 11% of cases to 6 weeks and 10% to 12 weeks not justifying the stop of the treatment. So this study confirms the efficiency and the good tolerance of fluconazole in the treatment of onychomycosis.

Adolescent↗

PubMed2005

[Alternative medicine and dermatology].

Alternative medicine is more popular than ever before and Dermatology has not remained unaffected by this trend. The aim of this review was to summarise all surveys of dermatological patients regarding the usage of alternative medicine to assess the potential efficacy of alternative medicine and to understand the reasons for which patients use alternative therapies. Computarized literature search was performed in medline. The search terms were "alternative medicine", "skin" and the name of different alternative therapies. Numerous studies have been practiced and published but few randomised controlled trials have been carried out. Greater knowledge of alternative medicine and its philosophical background and practical uses should result in better care for our patients and stimulate clinical research that will allow further consideration of its appropriate use and better evaluation of its possible danger.

Complementary Therapies↗

PubMed2005

Scrotal calcinosis: pathogenesis and case report.

Scrotal calcinosis (SC) is a rare and benign condition defined as the existence of multiple calcified nodules within scrotal skin. We report the case of a 39-year-old male patient with a three-month history of scrotal tumours that increased rapidly in number and size. Histopathological and immunohistochemical investigations showed no evidence of epithelial structure. Whether SC is idiopathic or the result of the calcification of pre-existing cysts is still a controversial issue. In some cases, as well as in our case, no evidence of cystic structure was found around calcified material, despite minutely careful studies. This suggests that SC might be truly idiopathic.

Adult↗

PubMed2004

Childhood leishmaniasis: report of 106 cases.

In Tunisia there are three epidemic clinical forms of cutaneous leishmaniasis. They are associated with three different species of Leishmania and are observed in different geographical areas. We undertook a single-center retrospective analysis of childhood leishmaniasis in order to describe epidemio-clinical profile, therapeutic characteristics and clinical outcomes of affected patients. The study comprises 166 children with 132 lesions of cutaneous leishmaniasis. The subjects ages range from 5 months to 15 years (average 8.75 years). The F:M sex ratio is 1.3. Leishmaniasis affects grown-up children in 74.5 percent of the cases. All of our patients live in an endemic area. The face is affected in 76.5 percent of cases. Mucosal leishmaniasis is present in 9 children (6.8 %). Clinical diagnosis confirmed by the parasitologic smear or histopathological examination in 89.6 percent of the cases. Treatment with intralesional meglumine antimoniate is done for 67 patients; the treatment regimen is one local injection (1 ml/cm(2)) per week until recovery. Systemic meglumine antimoniate is the initial therapy for 25 patients. Meglumine antimoniate treatment is well tolerated with no side-effects. All leishmaniasis lesions heal within an average period of 2.18 months. Childhood cutaneous leishmaniais is common in Tunisia. It has the characteristics of sporadic leishmaniasis. Mucosal leishmaniasis has a favorable outcome with no destruction, nor scaring deformity. The standard treatment remains intralesional meglumine antimoniate.

Adolescent↗

PubMed2004

Radio-induced malignancies of the scalp about 98 patients with 150 lesions and literature review.

INTRODUCTION: - The induction of malignant diseases is one of the most concerning late effects of ionizing radiation. The topic of this study deals with skin tumors developed in the irradiated areas in children given X-ray therapy for tinea capitis. MATERIAL AND METHODS: - All patients with malignant tumors of the scalp referred to Salah Azaiz Institute between 1970 and 2001 have been questioned in order to determine if there had been a prior X-ray irradiation for tinea capitis, its modality, and its consequences. The first scalp irradiation goes back to 1922 and the last was performed in 1963. RESULTS: - Ninety-eight patients with 150 radio-induced cancers of the scalp following irradiation for tinea capitis are reported (1.5 lesion per patient). The patients were irradiated in various hospitals and dispensaries throughout the country. Eighty-one patients (82%) had only one session of radiation. The average age at irradiation was 12 (+/-6) years, the latent period for radiation-induced skin cancers was 36 (+/-14) years. In 61 patients (62%), the scalp appeared normal and in 38% radiodermatitis was noted. Patient age at diagnosis of malignancy varied from 20 to 83 years with an average of 47 years. Basal cell carcinomas (125 cases) and spinocellular carcinomas (16 cases) were the most common, three other cases of annexial tumors, two malignant non-Hodgkin's lymphomas and four melanoma lesions are also present. Radiotherapy was used for the treatment of 74 patients (alone in 42 and associated with surgery in 32 patients); 14 patients had exclusive surgical excision. CONCLUSIONS: - Basal cell carcinomas are the most frequent tumors arising on chronic radiodermatitis. In spite of the long latency period, patients' young age at irradiation explained the occurrence of these cancers at a relatively young age. Literature review is suggesting recessive mutation of tumor-suppressor genes as the characteristic abnormality in radio-induced cancer.

Adult↗

PubMed2004

[Pustular psoriasis in childhood in 15 cases].

Psoriasis is a common, chronic and recurrent, inflammatory disease of the skin. Children were affected in 30% of cases. Severe form can be observed: pustular psoriasis (PP), psoriatic arthropathy and erythrodermic psoriasis. There were 15 children with PP, with an age range of 1-15.5 years, (mean age 7.56 years). Psoriasis constituted 5% of the total dermatological disorders in children. The severe forms of psoriasis were rare in children Annular PP was the most common form of PP in children. Juvenile PP had generally better prognostic than in adults, but the evolution is characterized by recurrences.

Adolescent↗

PubMed2004

[Erysipelas. Retrospective study of 647 patients].

We conducted a retrospective at the department of dermatology of Charles Nicolle hospital of Tunis between January 1994 and December 2000 to determine the epidemiological, clinical profile and the evolution of erysipelas. A total of 647 patients were studied. The mean age was 44.73 years and sex ratio about 1.55. Erysipelas predominately involved in the lower limbs (91.2%). Antecedents of erysipelas were found in 26.12 %. Portal of entry was found in 76.66% represented essentially by toe-web intertrigo. 26.6% of patients were hospitalised. Erysipelas can be controlled with antibiotics; treatment is essentially based on penicillin G 4 mega units intramuscularly every day (60.58%) for mean duration of 10.13 days. Satisfying results were observed in 87.78%. Erysipelas is common disease source of over-morbidity. Many predisposing factors were incriminated, account for the frequency of recurrence, justifying implement of primary and secondary prevention.

Adolescent↗

PubMed2003

Dermatomyositis and malignancy in Tunisia: a multicenter national retrospective study of 20 cases.

OBJECTIVE AND METHODS: The aim of our study was to report the epidemiologic, clinical, and biologic profiles of dermatomyositis (DM) associated with malignancy in patients from Tunisia. From January 1982 to January 2000, we collected retrospectively 20 case reports of DM associated with cancer from the different university hospital centers of Tunisia. Initial workup included anamnesis, clinical examination, cancer staging and classification, serum muscle enzymes (creatine phosphokinase, lactate dehydrogenase, aldolase, and transaminases), electromyography, and muscular biopsy. We calculated the median survival and mean value of all the variables. Comparisons of statistical tests were done with the Kruskal-Wallis test. RESULTS: Among the 130 DM cases of our study, 20 were associated with cancer (15.38%). The mean age of our patients was 49.6 years and the sex ratio (female/male) was equal to 3. Cancers were mainly those of the breast (35%) and nasopharynx (25%). DM followed a paraneoplastic course in 90% of the cases. The profile of seric muscular enzymes showed a significant statistical difference (P =.05) between a group of patients with severe muscular weakness and a group with moderate muscle weakness only for creatine kinase. The median survival was 36.5 months after diagnosis of DM and 48.6 months after that of cancer. The 5-year actuarial survival was 38% as related to cancer and 16% as related to DM. Mortality was 45%, in 90% as a result of cancer. CONCLUSIONS: In our study, nasopharyngeal carcinoma represents the second cancer associated with DM, after breast neoplasm, demonstrating the frequency of these 2 cancers in our country. Despite our reduced number of study samples, our study also suggests a relationship between severe muscle weakness and high seric muscle enzymes.

Adolescent↗

PubMed2003

[Epidemiologic profile of sexually transmitted diseases (STD) through a specialized consultation of STD].

INTRODUCTION: A confidential, free and specialised consultation of sexually transmitted diseases (STD) was initiated since 1993 in the department of Dermatology of hospital Charles Nicolle. We present the epidemiological and clinical features of this consultation. PATIENTS AND METHODS: It is a retrospective study including patients consulting during a period of 7 years (1993-1999). 546 patients were included. The mean age of our patients was 29 years and the sex-ratio 9. The diagnosis of urethritis was done for 242 patients. This diagnosis was clinic in the most cases. Urethral swabs was done for 71 patients. Neisseria gonorrhoeae was isolated in 56 cases and Chlamydia trachomatis in 15 cases. 41 patients were directed to our consultation for a positive syphilis serology. Condyloma were diagnosed in 23 cases and scabies in 12 cases. HIV serology was positive in 10 cases. In 3 cases, the diagnosis of HIV infection was done in this consultation. DISCUSSION: The epidemiologic profile showed a frequency of young men, bachelors and having multiple sexual partners. Clinically, urethritis was the principal STD observed.

Adolescent↗

PubMed2003

[Psoriasis: an update].

Psoriasis is a frequent dermatosis observed in 2 to 3% of people. It usually begin at the second decade of age but can also affect children. Diagnosis is often easily made by clinical exam. How ether many problems characterise this pathology and are not actually resolved: problems about epidemiology, etiology, treatment and psychological effects.

Humans↗

PubMed2003

[Epidemio-clinical profile of human scabies through dermatologic consultation. Retrospective study of 1148 cases].

We report a retrospective study of all scabies cases collected in the department of Dermatology of Charles Nicolle Hospital during a 8 year-period (1993-2000). 148 cases of scabies were collected with a mean incidence of 144 new cases/year (65-204). Diagnosis was made clinically in all cases. Parasitological exam was done in case of doubtful diagnosis. Our purpose is to try to define an epidemio-clinical profile of scabies in Tunisia and to estimate the incidence of this parasitosis through our dermatological consultation with reviewing the literature data.

Adolescent↗

PubMed2002

[Profile of leg ulcers. A review of a series of 70 Tunisian cases].

Leg ulcer often requires hospitalization in Dermatology and involves problems of therapeutic management. We intended to draw a clear epidemiological, clinical and therapeutic profile of leg ulcer through a series of 70 cases observed over a period of 46 months in the Dermatology department at Charles Nicolle Hospital in Tunis. Like other north african works, our survey stresses a particular epidemiological profile. In fact, leg ulcer affects young men at a ratio of 5 to 1 and an average age of 43.6 years. The vascular etiological factor accounts for 63.4% of all cases of leg ulcer whereas other etiologies make up a wade range owing to their multiplicity. Yet, they may reveal a potential pathology. Treatment is both symptomatic and etiological. Treatment with saccharose has been tried on 23 patients among whom 82% showed good tolerance and 47% complete healing. As they are carried out, our results are compared with the data of literature.

Adolescent↗

PubMed2002

[Dermatofibrosarcoma in children. Report of 7 Tunisian cases].

Dermatofibrosarcoma (DFS) protuberans is a rare mesenchyma tumor in childhood characterised by slow growth. We report the result of a retrospective study of 7 childhood (4 males) cases of through a fifteen year period. The mean age was 13 years. 4 Tumors were (DFS) located on the limbs: 2 on the trunk: and on the scalp. Clinical types were multinodular and infiltrated in 3 cases, nodular in two cases and ulcerated with budding also in two cases. The mean delay between diagnostic and the appearance of the tumor was about 24 months for 4 initial tumors. Histological features were typical in all cases. We report 3 recurrences of dermatofibrosarcoma arising few months after surgical excision of an initial tumor, in one case the tumor was diagnosed histocytofibroma. Six patient underwent surgical excision with wide margins, and in one case the margins were considered borderline. No recurrences were reported, the follow-up was between 17 months to 9 years. It's a rare tumor in childhood, 160 cases were reported. The clinical and evolutive mode were entirely comparable to the adult cases. However the initial appearance as benign atrophic or indurated plaque is more frequent in childhood, but this appearance wasn't noted in our series.

Adolescent↗

PubMed2002

[Cimetidine therapy for multiple warts in children].

Various treatment modalities are used to treat warts and this indicates that none is uniformly effective. Cimetidine, an H2-receptor antagonist, has been tried to treat warts because of its immunomodulatory effects. Sixty children with multiple and recalcitrant warts were included in a placebo-controlled, double-blind study. Patients were randomly allocated to treatment groups equally. The groups received cimetidine, 25 to 30 mg/kg daily, or placebo for 2 months. At the end of the therapy, only 10 cimetidine-treated and 9 placebo-treated were examined. Cure rates obtained were 60% in the cimetidie-treated group and 33% in the placebo-treated group. Among our data and the review of the literature, we believe that cimetidine is not appropriate as standard therapy for warts, but it may be an interested therapy for multiple and recalcitrant warts of children.

Adjuvants, Immunologic↗