Adult discoid lupus erythematosus

BACKGROUND: Discoid lupus erythematosus is a particular form of systemic lupus in which manifestations are confined to the skin. AIM: Our purpose was to evaluate the epidemiology trends, presenting clinical manifestations, therapeutic features and outcome of patients with discoid lupus erythematosus (DLE). METHODS: It's a retrospective study, done in the dermatology department of Habib Thameur Hospital over an 8 years period. We included only the cases of DLE confirmed by the histology and/or the direct immunofluorescence. RESULTS: We identified 26 patients mean aged 46.19 years. All of them were adults. The lesions were localized on the face for 25 patients, neck (7 patients), scalp (6) and hands (6). Eleven patients presented a generalized DLE. The mean period of follow-up was 3 years raging from 1 month to 20 years. After a 15 year evolution, 1 patient presented degeneration in squamous cell carcinoma of 2 lesions. CONCLUSION: Unfortunately, there is still in our country a long delay before the first consultation, which, added to an absence of adequate photoprotection, can obscure the prognosis of DLE.     

A case of preserved fertility in an hemodialyzed patient with systemic lupus erythematosus

BACKGROUND: Pregnancy and child birth in haemodialysis remains a rare event, even more, when pregnancy occurs in patient with systemic lupus erythematosus (SLE). AIM: We report a case of a patient with end stage renal failure secondary to SLE and who carried out 3 pregnancies. CASE REPORT: She was a woman with proliferative and diffuse lupus glomerulonephritis since 1985 treated by corticosteroids and cyclophosphamide. In 1995, she developed chronic renal failure. In 1996, she underwent a 1st full term spontaneous pregnancy with normal birth weight. In 2001, she underwent a second spontaneous pregnancy while she was on periodic haemodialysis. She had a full term baby birth with a birth weight at 1 Kg 700 and who died 4 days later. In 2002, she had a third pregnancy with voluntary abortion at 8 weeks. CONCLUSION: Our patient had conserved fertility despite treatment by cyclophosphamide, chronic renal failure and haemodialysis. The two successful deliveries may be attributed to the control of SLE activity and to the adequacy of haemodialysis.     

Fermeture percutanée des communications interventriculaires congénitales par la prothèse Amplatzer Duct OccluderII: données préliminaire d’une étude Tunisienne monocentrique

Introduction . Percutaneous closure of congenital ventricular septal defects (VSDs) represents a promising alternative to surgery with lower rate of complications and shorter hospital stay. Its main limitation is the choice of the appropriate device for each type of defect. Aim. To report the experience of the service of cardiology (Sahloul hospital, Sousse, Tunisia) in percutaneous closure of congenital VSDs with Amplatzer Duct Occluder II (ADOII). Methods. This was a retrospective, monocentric study, conducted from January 2013 to December 2017. The study included patients treated by percutaneous closure of congenital VSDs with the ADOII device. Results. Twelve patients (6 boys; 6 girls) were included. The mean±SD of patients’ age and weight were 65±41 months and 23±10 kg, respectively. VSDs were peri-membranous (n=9) and muscular (n=3), and defects were restrictive (n=11) and non-restrictive (n=1). The mean (minimum-maximum) size of VSDs was 4.72 (3-6) mm. Eleven ADOII prostheses were successfully implanted. One failure procedure was noted with migration of the device into the pulmonary artery. A second child with perimembranous defect developed transient atrioventricular block. No deaths occurred. Conclusion. The present early experience shows that percutaneous closure with ADOII device of perimembranous and trabecular VSDs is safe and effective.     

Association lichen planus and ulcerative colitis. A case report

Ulcerative colitis is a frequent chronic inflammatory boxel disease. Its cutaneous manifestation are varied. Some of them are frequent like pyoderma gangrenosum, erethema nodosum and oral ulceration. We report the case of an exceptional association of ulcerative colitis with lichen planus in a 40-year old woman with a 2 year history of ulcerative colitis, who had lesions on the buccal mucosa and the lower lip for which the diagnosis of lichen planus was made and confirmed histologically.