Management of a Trichophyton tonsurans Outbreak in a Day‐Care Center

Trichophyton tonsurans is the leading cause of tinea capitis in the United Kingdom (UK) as well as causing tinea corporis. This organism has been linked to several outbreaks in the UK and abroad, and such outbreaks may be prolonged since T. tonsurans can be difficult to control. There remains an incomplete consensus in the literature on the optimal management of such outbreaks of this infection. Following notification that a child with T. tonsurans was identified at a day‐care center in the UK, initial investigations identified nine cases of fungal infection involving children and staff over the previous 7 months. We report on the management of an outbreak of T. tonsurans tinea capitis and tinea corporis among children and staff in a day‐care center. An outbreak control team with representatives from dermatology, microbiology, day‐care center management, and the Health Protection Agency initiated case ascertainment by scalp inspection and brushing of all children and staff at the nursery. Two complete rounds of screening were required before the outbreak was declared over. Infection control measures included antifungal shampoo use, exclusion of identified cases for a short period, removal of shared items from the center, and enhanced decontamination of fomites. The outbreak, which lasted longer than 12 months, involved 12 children and 7 staff members. Of these, 12 cases were confirmed by positive fungal culture. T. tonsurans is difficult to manage, especially in childcare settings, but case ascertainment, appropriate treatment with oral agents, and sustained infection control measures can be effective in controlling such outbreaks.     

Widely Metastatic Squamous Cell Carcinoma Originating from Malignant Transformation of Hypertrophic Lichen Planus in a 24‐Year‐Old Woman: Case Report and Review of the Literature

Hypertrophic lichen planus (HLP) is a T‐cell‐mediated process typically presenting with hypertrophic or verrucous plaques on the lower limbs. We report the case of a 24‐year‐old woman with a history of HLP since age 3 years presenting with rapid malignant transformation of one lesion into a large squamous cell carcinoma (SCC). Subsequent examination revealed progressive, widespread metastatic involvement, and the patient ultimately died from her disease. SCC associated with HLP is rare, with a review of the literature revealing fewer than 50 cases. This case highlights the need to be aware of suspicious changes in HLP and to educate patients as to when to be reevaluated.     

Troubles moteurs tardifs induits par antipsychotiques : mise au point

Antipsychotic-induced tardive movement disorders (ATMDs) constitute a set of late-onset involuntary movements, resulting from the blocking of dopamine receptors. ATMDs are generally underscreened by health professionals, though they may also occur with new generation antipsychotics. ATMDs encompass several specific clinical types: tardive dyskinesia, tardive dystonia, tardive akathisia, tardive tremor, tardive myoclonus, tardive stereotypy, tardive tourettism, tardive parkinsonism, and withdrawal emergent syndrome. The prevalence rates of ATMDs are high, and the outcome may be variable. The most evidenced risk factor for ATMDs is age. Primary and secondary prevention rely on systematically assessing the clinical risk factors before prescribing an antipsychotic medication, and regularly undertaking a neurological examination. Managing ATMDs requires decreasing, stopping, or changing the antipsychotic treatment. Specific reversing drugs, such as reserpine, can be used, though the levels of evidence of these drugs are low. Surgery can be considered in the case of severe and resistant ATMDs.     

An evaluation of kurtosis beamforming in magnetoencephalography to localize the epileptogenic zone in drug resistant epilepsy patients

Objective

Kurtosis beamforming is a useful technique for analysing magnetoencephalograpy (MEG) data containing epileptic spikes. However, the implementation varies and few studies measure concordance with subsequently resected areas. We evaluated kurtosis beamforming as a means of localizing spikes in drug-resistant epilepsy patients.