Carcinome basocellulaire pigmenté: à propos d’un cas malagasy. Pigmented basal cell carcinoma : malagasy case report.

Basal cell carcinoma (BCC) constitutes about 70 % of human skin cancer. This malignant neoplasia is characterized by the presence intercellular junction. BCC develop predominantly in fair-skinned human. Pigmented BCC is one of its rare form in subject with fair skin. We report a case of pigmented BCC in Malagasy patient.A 70 years-old woman, phototype IV, presented to us with pigmented, and painless lesion of the right nasolabial fold, appears 3 years before. She observed an increasing size of lesion after recent manipulation of the lesion. Ulceration occurred and alerted the patient. In clinical examination, we found a non-inflammatory, and brown ulceration which measured 1 cm x 0.4 cm. It was a no oozing ulceration, and there was no bleeding to the touch. We felt skin induration in its basis, which exceeded 0,5cm along the ulceration’s limit. Biopsy exeresis was made with a 0,5cm carcinological margins on all sides of lesion, and brought back operative piece which measured 2.2 x 1 x 0.3cm. Histopathologic examination showed a tumor proliferation in the outer layers of the epidermis, made up of confluent islets cells consisting of epithelial cells, moderately atypical, assuming a palisaded arrangement at their periphery. Melanin deposits were seen within tumor nodules, and gave the diagnosis of pigmented BCC with a complete exeresis.BCC mainly affects subject with light skin, at whose a BCC is rarely pigmented. For black skinned people, pigmented BCC is not exceptional.

Tétanos Céphalique : A Propos d’un Cas Malagasy

 [Cephalic Tetanus: A Malagasy Case Report]A 30-year-old man presented with a lockjaw and dysphagia for two days. He mentioned a history of supraorbital wound, due to bicycle accident, eighteen days before his presentation to our hospital. His vaccination status was not known. Initial assessment showed palsies of right cranial nerves VII and III. At thirty six hours after his arrival, painful contractions of the extensor muscle of the neck and back occurred. The patient progressed to the systemic muscular rigidity. A diagnosis of CT evolving towards generalized form. We administered antibiotics, intravenous antitoxin, muscle relaxant and a single dose of tetanus toxoid. His follow up visit after 1 month found improvement of lockjaw and dysphagia. His facial nerve palsy required reeducation.The diagnosis of CT is exclusively based on clinical findings. CT should be suspected in all cases who vaccination status is not updated or not known, presenting lockjaw with palsies of one or more cranial nerves. Early management improve the prognosis