Publications by authors named "Mohamed Denguezli"

64 Publications

Verrucous sarcoidosis: a diagnosis to keep in mind.

Pan Afr Med J 2020 29;36:228. Epub 2020 Jul 29.

Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia.

Skin manifestations of sarcoidosis occur in up to 30% of cases, and may be the sentinel sign of the disease, with the skin being sometimes exclusively affected. While this may facilitate an early dermatologic diagnosis, heterogeneity in the cutaneous morphologies of sarcoidosis complicates recognition and affirms its reputation as a "great imitator". Here, we present a case of a verrucous version of sarcoidosis that may be misdiagnosed because it can mimic other inflammatory and neoplastic skin disorders. Although it is a rare variant, its presence should alert clinicians to the likelihood of systemic involvement of cutaneous sarcoidosis.
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http://dx.doi.org/10.11604/pamj.2020.36.228.21487DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908315PMC
March 2021

Pyogenic Granuloma-Like Kaposi Sarcoma: A Diagnostic Challenge.

Skinmed 2020 1;18(6):378-379. Epub 2020 Dec 1.

Department of Dermatology Farhat Hached University Hospital, Sousse, Tunisia.

An 81-year-old woman presented with a 2-month history of a painless nodule on the left foot that bled easily after minor trauma. She had no medical history and did not report any preexisting lesion. Physical examination revealed a 2 cm × 3 cm, exophytic and reddish-colored nodule, with an ulcerated and soft surface (Figure 1). There were no other skin lesions or abnormal physical findings. The diagnosis of a pyogenic granuloma (PG) was suggested. A biopsy specimen was obtained from the center of the lesion and stained with hematoxylin and eosin. Histopathologic examination revealed a marked proliferation of both capillary cells and spindle-shaped cells separated by slit-like vessels containing multiple erythrocytes (Figure 2A). Immunochemical analysis showed positivity for CD34 and (HHV)-8 in both endothelial and spindle cells (Figure 2B). Perls' staining showed abundant hemosiderin deposits in the tumor stroma (Figure 2C). These findings were consistent with the diagnosis of Kaposi sarcoma (KS). Laboratory tests eliminated a human immunodeficiency virus (HIV) infection, and no metastatic lesions were found on radiologic examinations. The lesion was treated with laser excision, with no recurrence at the 2-year follow-up.
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http://dx.doi.org/DOI Listing
December 2020

Two Erratic Cases of Tinea Capitis in Adults: Utility of Trichoscopy.

Int J Trichology 2020 May-Jun;12(3):118-120. Epub 2020 Aug 14.

Department of Dermatology, Farhat Hached Hospital, Sousse, Tunisia.

Tinea capitis (TC) is a common infectious disease throughout the world, mainly seen in children, but it can occur in adults. Even if mycological examination is essential to confirm the diagnosis, it has been proved that trichoscopy is a very effective useful tool in the screening of TC. Herein, we report two cases of adult TC with atypical clinical presentations causing a diagnostic delay of several years.
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http://dx.doi.org/10.4103/ijt.ijt_20_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7659736PMC
August 2020

Prurigo Pigmentosa Following Ketogenic Diet.

Am J Med 2021 04 11;134(4):e291-e292. Epub 2020 Nov 11.

Department of Dermatology, Farhad Hachad Hospital, Sousse, Tunisia.

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http://dx.doi.org/10.1016/j.amjmed.2020.10.016DOI Listing
April 2021

Acute Localized Exanthematous Pustulosis Induced by a Spider Bite.

Am J Trop Med Hyg 2020 09;103(3):937-938

Department of Dermatology, Farhat Hached Hospital, Sousse, Tunisia.

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http://dx.doi.org/10.4269/ajtmh.20-0138DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470554PMC
September 2020

Scalp Necrosis Revealing Severe Giant-Cell Arteritis.

Case Rep Med 2020 14;2020:8130404. Epub 2020 Aug 14.

Dermatology Department, Farhat Hached University Hospital, Sousse Medical Faculty, Sousse University, Sousse, Tunisia.

Giant-cell arteritis (GCA), also referred to as temporal arteritis, is the most common primary vasculitis of the elderly involving the extracranial branches of the carotid arteries, in particular, the temporal artery. Patients usually present with temporal headaches, visual impairment, fever, and scalp tenderness. Scalp necrosis associated with GCA is a rare occurrence with approximately 100 cases reported in the literature to date. It is a therapeutic emergency requiring urgent management as it may lead to irreversible loss of vision. To increase awareness of this severe complication, we report a patient with a scalp necrosis revealing a GCA.
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http://dx.doi.org/10.1155/2020/8130404DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443249PMC
August 2020

Linear IgA bullous dermatosis: A rare manifestation of amoxicillin-clavulanic acid treatment.

Dermatol Ther 2020 11 9;33(6):e14187. Epub 2020 Sep 9.

Department of Dermatology, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia.

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http://dx.doi.org/10.1111/dth.14187DOI Listing
November 2020

An atypical presentation of lupus vulgaris.

Indian J Dermatol Venereol Leprol 2020 Sep-Oct;86(5):573-576

Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia.

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http://dx.doi.org/10.4103/ijdvl.IJDVL_707_18DOI Listing
August 2020

Nilotinib-induced pityriasis rubra pilaris: First case report.

Dermatol Ther 2020 11 17;33(6):e14085. Epub 2020 Aug 17.

Department of Dermatology, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia.

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http://dx.doi.org/10.1111/dth.14085DOI Listing
November 2020

Severe chronic actinic dermatitis treated successfully with Thalidomide.

Photodermatol Photoimmunol Photomed 2020 Nov 25;36(6):493-495. Epub 2020 Jul 25.

Dermatology Department, Farhat Hached University Hospital, Sousse, Tunisia.

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http://dx.doi.org/10.1111/phpp.12588DOI Listing
November 2020

Addictive behaviors, cardiovascular and metabolic comorbidities in North African psoriatic patients: case-control study.

Pan Afr Med J 2019 19;34:205. Epub 2019 Dec 19.

Farhat Hached Hospital, Dermatology Department, Sousse, Tunisia.

We propose to study the epidemiological aspects of North African psoriasis and determine the cardiovascular comorbidities and addictive behaviors associated with psoriasis. This is a North African case-control study which was conducted over a five year period (October 2008 through August 2013), involving 671 psoriatic patients and 1,242 controls identified in various Algerian, Tunisian and Moroccan university hospitals. For each patient, epidemiological characteristic, addictive behaviors, and cardiovascular pathologies associated with psoriasis were noted. Six hundred and seventy one psoriasis patients and 1,242 controls were included in this study. The average age was 47.24 years and the M/F sex-ratio was 1.11 (354 men and 317 women). Statistical analysis showed that psoriasis patients were more likely to develop addictive behaviors than controls (smoking p<10-5 and alcohol consumption: p < 10-5), together with dyslipidemia (30.1% of patients p < 10-5), obesity (23.8% of patients p < 10-4), hypertension (22.3% of patients p < 10-5), diabetes (21.7% of occurrences p < 10-5) and metabolic syndrome (37.4% of patients p<10-5). The relative risk for developing psoriasis was 1.9 in hypertensive patients, 1.7 in diabetic patients, 3.9 in dyslipidemic patients, 1.8 in obese patients, 2.6 in those with metabolic syndrome, 2.1 in smokers and 2.8 in alcoholics. Our work confirms the high incidence of addictive behaviors and of cardiovascular and metabolic comorbidities during the North-African psoriasis, hence the need for a multidisciplinary comprehensive care based on a guideline suited to the characteristics of North-African psoriatic patients.
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http://dx.doi.org/10.11604/pamj.2019.34.205.12883DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7060950PMC
August 2020

[Capecitabine aggravating lentiginosis].

Therapie 2020 Feb 21. Epub 2020 Feb 21.

Département de dermatologie, hôpital Farhat Hached, 4000 Sousse, Tunisie.

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http://dx.doi.org/10.1016/j.therap.2020.02.015DOI Listing
February 2020

Unilateral pityriasis rosea.

Int J Dermatol 2020 Feb 24;59(2):e27-e28. Epub 2019 Oct 24.

Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia.

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http://dx.doi.org/10.1111/ijd.14682DOI Listing
February 2020

Temporal Triangular Alopecia: Trichoscopic Diagnosis.

Skinmed 2019;17(3):219-220. Epub 2019 Sep 9.

Dermatology Department, Farhat Hached University Hospital, Sousse, Tunisia.

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May 2020

Bowen disease of the nailfold: dermoscopic diagnosis.

Int J Dermatol 2019 Dec 4;58(12):e252-e253. Epub 2019 Sep 4.

Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia.

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http://dx.doi.org/10.1111/ijd.14624DOI Listing
December 2019

An unusual photodistributed acute generalized exanthematous pustulosis induced by terbinafine.

Therapie 2019 09 28;74(4):502-504. Epub 2019 Feb 28.

Dermatology Department, Farhat Hached University Hospital, Faculty of Medicine, 4002 Soussse, Tunisia.

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http://dx.doi.org/10.1016/j.therap.2019.02.004DOI Listing
September 2019

Alopecia areata in Tunisia: epidemio-clinical aspects and comorbid conditions. A prospective study of 204 cases.

Int J Dermatol 2019 Jul 24;58(7):811-815. Epub 2019 Jan 24.

Dermatology Department, Farhat Hached University Hospital, Sousse, Tunisia.

Background: Alopecia areata (AA) is an autoimmune condition that usually presents as patchy, nonscarring hair loss. Autoimmune disorders and atopy are reported as comorbid conditions. We aimed to investigate the demographics, clinical characteristics, and associations of AA in Tunisian patients.

Methods: Demographic data, pattern of alopecia, age of onset, and associations were evaluated in 204 patients from January 2012 to June 2016.

Results: Two hundred and four cases of AA were seen. The male to female ratio was 0.68. The mean age at presentation was 23 years old. Positive family history was noticed in 22.1% of patients. Personal history of atopy was associated with AA in 18.1%. Associated autoimmune diseases were thyroid disorders (12.7%), vitiligo (1.5%), psoriasis (three cases), type 1 diabetes (two cases), autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) syndrome (two cases), lichen sclerosus atrophicus (one case), and pemphigus vulgaris (one case). Patchy AA was the most common manifestation (49.5%) followed by alopecia universalis (27.5%), alopecia ophiasis (12.7%), and alopecia totalis (10.3%). Nail changes consisting of pitting, trachyonychia, and longitudinal ridging were reported in 24.8%. AA patterns were more severe in females (P = 0.049). Severe forms showed more persistent disease duration (P = 0.005), earlier onset (P = 0.001), and more recurring episodes (P = 0.002) and were significantly associated with nail involvement (P < 0.001).

Conclusions: Our study aimed to review epidemio-clinical characteristics and comorbid conditions of AA in Tunisian patients. More severe cases with a pejorative value of early-onset AA, long disease duration, and nail involvement were seen in our study.
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http://dx.doi.org/10.1111/ijd.14381DOI Listing
July 2019

A Case of Nail Psoriasis Successfully Treated with Intralesional Methotrexate.

Dermatol Ther (Heidelb) 2018 Dec 25;8(4):647-651. Epub 2018 Sep 25.

Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia.

Psoriasis is a chronic inflammatory disease affecting the skin, nails, and joints. About 61% of psoriatic patients have nail involvement that can cause a significant social problem. Treating nail psoriasis is challenging but can improve the health outcomes and quality of life of patients. Treatment options available for nail psoriasis including topical therapy, intralesional injections, and systemic and biologic agents have various side effects and some benefits. Management is currently inconclusive. Intralesional injection of methotrexate in nail psoriasis was previously documented in few cases. We present a case of nail psoriasis successfully treated with low-dose intralesional methotrexate with no significant side effects in a 48-year-old psoriatic patient. Given the various side effects of conventional topical and systemic therapies limiting their use, we conclude that intralesional methotrexate injection seems to be a safe and effective treatment option for nail psoriasis. However, large controlled studies are needed.
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http://dx.doi.org/10.1007/s13555-018-0261-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261120PMC
December 2018

Amelanotic melanoma arising in an area of SLURP-1 mutated Mal de Meleda.

Int J Dermatol 2019 Aug 23;58(8):966-968. Epub 2018 Sep 23.

Dermatology Department, Farhat Hached University Hospital, Sousse, Tunisia.

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http://dx.doi.org/10.1111/ijd.14231DOI Listing
August 2019

[Drug-induced vasculitis].

Therapie 2019 Jun 24;74(3):347-354. Epub 2018 Jul 24.

Département de pharmacologie, faculté de médecine de Sousse, université de Sousse, avenue Md Karoui, 4002 Sousse, Tunisie.

Introduction: Drug-induced vasculitis is reported in almost 10-20 % of vasculitis. Several drugs may be incriminated in their occurrence. Our study aimed to study the epidemiological, clinical, histopathological and evolutionary characteristics of drug-indced vasculitis from a series of cases and to specify the different drugs involved.

Methods: We conducted a retrospective study during the period from January 2006 to December 2015 from the cases notified to the regional pharmacovigilance center of Sousse, Tunisia. The diagnosis was established according to the criteria proposed by the group of the American college of rheumatology (ACR).

Results: Our study included thirteen cases of drug-induced vasculitis over a ten-year period, with an mean incidence of 1.3 new cases per year. Mean age of patients was 40.84 years. The mean delay from the treatment onset was 14.46 days with extremes ranging from 5 days to six weeks. Most patients had pure skin involvement. Association with other extracutaneous complaints was present in five cases. Cutaneous biopsy was performed in all patients showing a pathological pattern of leukocytoclastic vasculitis, associated with fibrinoid necrosis, extravasation of red blood cells and allergic capillaritis. The outcome was favorable for all patients. The offending drugs in our series were amoxicillin, pristinamycin, rifampicin, fluconazole, metformin, glimepiride, phenobarbital, gabapentin, fenofibrate, ibuprofen, allopurinol, rituximab and tinzaparin.

Conclusion: Anamnestic, clinical, biological and histopathological findings allow the early recognition of drug-induced vasculitis. Adequate treatment prevents systemic spreading and a worse prognosis.
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http://dx.doi.org/10.1016/j.therap.2018.07.005DOI Listing
June 2019

[Oral squamous cell carcinoma of the mandibular region mimicking cervico-facial actinomycosis].

Presse Med 2018 Jul - Aug;47(7-8 Pt 1):702-704. Epub 2018 Jun 13.

Hôpital Farhat Hached, service de dermatologie, avenue Ibn Jazzar, 4000 Sousse, Tunisie.

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http://dx.doi.org/10.1016/j.lpm.2018.04.006DOI Listing
November 2018

Pristinamycin-induced leukocytoclastic vasculitis: First report of a case in Tunisia.

Therapie 2018 May - Jun;73(3):295-297. Epub 2017 Nov 7.

Department of pharmacovigilance, Sousse university, faculty of medicine, avenue Mohamed Karoui, 4002 Sousse, Tunisia.

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http://dx.doi.org/10.1016/j.therap.2017.10.002DOI Listing
September 2018

ENPP1 Mutation Causes Recessive Cole Disease by Altering Melanogenesis.

J Invest Dermatol 2018 02 28;138(2):291-300. Epub 2017 Sep 28.

Laboratory of Human Genetics and Embryology, Institute of Medical Biology, A*STAR, Singapore, Singapore. Electronic address:

Cole disease is a genodermatosis of pigmentation following a strict dominant mode of inheritance. In this study, we investigated eight patients affected with an overlapping genodermatosis after recessive inheritance. The patients presented with hypo- and hyperpigmented macules over the body, resembling dyschromatosis universalis hereditaria in addition to punctuate palmoplantar keratosis. By homozygosity mapping and whole-exome sequencing, a biallelic p.Cys120Arg mutation in ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) was identified in all patients. We found that this mutation, like those causing dominant Cole disease, impairs homodimerization of the ENPP1 enzyme that is mediated by its two somatomedin-B-like domains. Histological analysis revealed structural and molecular changes in affected skin that were likely to originate from defective melanocytes because keratinocytes do not express ENPP1. Consistently, RNA-sequencing analysis of patient-derived primary melanocytes revealed alterations in melanocyte development and in pigmentation signaling pathways. We therefore conclude that germline ENPP1 cysteine-specific mutations, primarily affecting the melanocyte lineage, cause a clinical spectrum of dyschromatosis, in which the p.Cys120Arg allele represents a recessive and more severe form of Cole disease.
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http://dx.doi.org/10.1016/j.jid.2017.08.045DOI Listing
February 2018

[Cutaneous leukocytoclastic vasculitis: about 85 cases].

Pan Afr Med J 2017 14;26:138. Epub 2017 Mar 14.

Université du Centre, Tunisie.

Clinical manifestation, etiology and outcome of leukocytoclastic vasculitis are little studied. The aim of our study was to examine epidemiological, clinical etiological, and evolutionary characteristics of this entity. We conducted a cross-sectional data collection from medical records of 85 patients with leukocytoclastic vasculitis in the Department of Dermatology at the Farhat Hached University Hospital, Sousse between January 2000 and December 2013. Epidemiological, clinical, paraclinical, etiological data sheets had been completed for each patient. The average age of patients was 47.65 years, ranging between 10 and 78 years. Fifty-three women and 32 men were registered (sex ratio = 0.6). Cutaneous manifestations were dominated by vascular purpura (88.2%). The most common causes of leukocytoclastic vasculitis were systemic diseases (51%), infection (20%) and neutrophilic dermatoses (14.5%). Other causes were drugs (9.1%) and hematologic malignancies (5.4%). The cause of leukocytoclastic vasculitis was not detected in 30 patients (35, 3%). Two predictive factors associated with the acute outcome were retained: the presence of a recent infection (p= 0.014) and drug intake before the rash (p= 0.013). Chronic evolution was positively correlated with antinuclear antibodies (p= 0.009) and cryoglobulinemia (p=0.025). Our study highlights the multitude of causes of leukocytoclastic vasculitis. The search for an underlying disease is an imperative in order to ensure better therapeutic management.
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http://dx.doi.org/10.11604/pamj.2017.26.138.9721DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429439PMC
June 2017

[A particular type of cicatricial Pemphigoid with unique IgA deposit].

Pan Afr Med J 2017 13;26:136. Epub 2017 Mar 13.

Université de Sousse, Tunisie.

Cicatricial Pemphigoid is a subepithelial bullous dermatosis which essentially involves the mucous membranes with cicatricial evolution We report the case of a 66-year old patient hospitalized with erosive gingivitis associated with dysphagia, dyspnea and blurred vision. Dermatologic examination showed erosive lesions involving the palate and the pharynx. Ophthalmologic examination showed symblepharons, ectropion and bilateral cataract. Gingival biopsy revealed a necrotic detachment of the buccal epithelium. Direct immunofluorescence showed linear IgA deposit at the dermo-epidermal junction. Indirect immunofluorescence test was negative. The diagnosis of cicatricial pemphigoid was confirmed. Esophagogastroduodenoscopy objectified double stenosis of the esophagus. Nasopharyngeal and bronchial endoscopy showed ulceration of the epiglottis, hypopharynx, pharynx and bronchial tree. The patient was treated with Solumedrol bolus corresponding to 0.5mg/kg/day prednisone associated with 100mg/day disulone. The patient showed a favorable early clinical outcome complicated because of the aggravation of dysphagia and esophageal stenosis after 2 months. Our case study is singular due to the occurrence of a cicatricial pemphigoid in a male patient with a serious clinical picture due to lesions extending to conjunctival, oral, nasal, esophageal and bronchial mucous membranes associated with direct immunofluorescence only showing IgA deposit.
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http://dx.doi.org/10.11604/pamj.2017.26.136.9702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429461PMC
June 2017