Lichen planus pemphigoides in a child

AbstractIntroductionLichen planus pemphigoides (LPP) is a rare autoimmune subepidermal blistering disease characterized by evolution of vesico-bullous skin lesions in patients with active lichen planus. We describe a case of LPP in a 12-year-old girl with clinical, histological and direct immunofluorescence findings.Case reportA 12-year-old Moroccan girl presented, after sun burn, pruritic violaceus papules on hands and feet complicated by the apparition of bullous lesions on apparent normal skin and on lichenoid eruption. A white reticulated pattern was present on the oral mucosa. Histopathology of lichenoid papule and bulla was consistent with the diagnosis of LPP. Direct immunofluorescence of peribullous skin showed linear deposits of IgG and C3 at the basal membrane zone. Treatment with Dapsone was successful.DiscussionLPP is exceptional in children; just fifteen cases were reported in the literature. This condition seems to be idiopathic. However, in rare cases it has been associated with some drugs or after PUVA therapy. In our patient, it was probably induced by prolonged sun exposure

An optimal energy management system for real-time operation of multiagent-based microgrids using a T-cell algorithm

The real-time operation of the energy management system (RT-EMS) is one of the vital functions of Microgrids (MG). In this context, the reliability and smooth operation should be maintained in real time regardless of load and generation variations and without losing the optimum operation cost. This paper presents a design and implementation of a RT-EMS based on Multiagent system (MAS) and the fast converging T-Cell algorithm to minimize the MG operational cost and maximize the real-time response in grid-connected MG. The RT-EMS has the main function to ensure the energy dispatch between the distributed generation (DG) units that consist in this work on a wind generator, solar energy, energy storage units, controllable loads and the main grid. A modular multi-agent platform is proposed to implement the RT-EMS. The MAS has features such as peer-to-peer communication capability, a fault-tolerance structure, and high flexibility, which make it convenient for MG context. Each component of the MG has its own managing agent. While, the MG optimizer (MGO) is the agent responsible for running the optimization and ensuring the seamless operation of the MG in real time, the MG supervisor (MGS) is the agent that intercepts sudden high load variations and computes the new optimum operating point. In addition, the proposed RT-EMS develops an integration of the MAS platform with the Data Distribution Service (DDS) as a middleware to communicate with the physical units. In this work, the proposed algorithm minimizes the cost function of the MG as well as maximizes the use of renewable energy generation; Then, it assigns the power reference to each DG of the MG. The total time delay of the optimization and the communication between the EMS components were reduced. To verify the performance of our proposed system, an experimental validation in a MG testbed were conducted. Results show the reliability and the effectiveness of the proposed multiagent based RT-EMS. Various scenarios were tested such as normal operation as well as sudden load variation. The optimum values were obtained faster in terms of computation time as compared to existing techniques. The latency from the proposed system was 43% faster than other heuristic or deterministic methods in the literature. This significant improvement makes this proposed system more competitive for RT applications

An Optimal Energy Management System for Real-Time Operation of Multiagent-Based Microgrids Using a T-Cell Algorithm

The real-time operation of the energy management system (RT-EMS) is one of the vital functions of Microgrids (MG). In this context, the reliability and smooth operation should be maintained in real time regardless of load and generation variations and without losing the optimum operation cost. This paper presents a design and implementation of a RT-EMS based on Multiagent system (MAS) and the fast converging T-Cell algorithm to minimize the MG operational cost and maximize the real-time response in grid-connected MG. The RT-EMS has the main function to ensure the energy dispatch between the distributed generation (DG) units that consist in this work on a wind generator, solar energy, energy storage units, controllable loads and the main grid. A modular multi-agent platform is proposed to implement the RT-EMS. The MAS has features such as peer-to-peer communication capability, a fault-tolerance structure, and high flexibility, which make it convenient for MG context. Each component of the MG has its own managing agent. While, the MG optimizer (MGO) is the agent responsible for running the optimization and ensuring the seamless operation of the MG in real time, the MG supervisor (MGS) is the agent that intercepts sudden high load variations and computes the new optimum operating point. In addition, the proposed RT-EMS develops an integration of the MAS platform with the Data Distribution Service (DDS) as a middleware to communicate with the physical units. In this work, the proposed algorithm minimizes the cost function of the MG as well as maximizes the use of renewable energy generation; Then, it assigns the power reference to each DG of the MG. The total time delay of the optimization and the communication between the EMS components were reduced. To verify the performance of our proposed system, an experimental validation in a MG testbed were conducted. Results show the reliability and the effectiveness of the proposed multiagent based RT-EMS. Various scenarios were tested such as normal operation as well as sudden load variation. The optimum values were obtained faster in terms of computation time as compared to existing techniques. The latency from the proposed system was 43% faster than other heuristic or deterministic methods in the literature. This significant improvement makes this proposed system more competitive for RT applications

Omphalolith: a rare entity but important to recognize

Omphalolith (umbolith) is an uncommon entity under normal circumstances. However, in a deeply retracted umbilicus in an obese individual, the accumulation of sebum and keratin may lead to the formation of a stone. This calculus may remain undiagnosed for many years until revealed by secondary infection or ulceration. We report an interesting case of an omphalolith in a young woman.  In our literature search, very few cases of omphalolith have been reported

Omphalolith: a rare entity but important to recognize

Omphalolith (umbolith) is an uncommon entity under normal circumstances. However, in a deeply retracted umbilicus in an obese individual, the accumulation of sebum and keratin may lead to the formation of a stone. This calculus may remain undiagnosed for many years until revealed by secondary infection or ulceration. We report an interesting case of an omphalolith in a young woman.  In our literature search, very few cases of omphalolith have been reported

Giant congenital melanocytic nevus with neurofibroma-like lesions and onset of vitiligo

Giant congenital pigmented nevus and neurofibromatosis type 1 may rarely occur together. We reported here an unusual case where giant congenital melanocytic nevus was associated with neurofibroma-like lesions and vitiligo, emphasizing the clinical and histological diagnostic difficulties posed by this presentation, the signification of vitiligo which can testify of a possible malignant transformation of the giant nevus to a melanoma, and highlights the importance of an accurate diagnosis and a close follow-up of such patients

Cutaneous leukocytoclastic vasculitis revealing multifocal tuberculosis

Cutaneous leukocytoclastic vasculitis (CLV) is an inflammatory vascular disorder rarely reported to be associated with tuberculosis. The following report describes the case of a young man with multifocal tuberculosis revealed by CLV. Diagnosis was confirmed by the presence of tuberculoid granuloma with caseous necrosis on pleural and perianal biopsy, and a rapid improvement in anti-tuberculous quadritherapy. Although rarely seen, Mycobacterium tuberculosis should be considered as a potential cause of CLV

Pemphigoid gestationis: A Moroccan study

Introduction: Pemphigoid gestationis (PG) is a rare autoimmune skin disorder that occurs during pregnancy. Materials and Methods: Prospective study including all cases of PG diagnosed between 2010 and 2015. Results: We reported 16 patients: 12 multiparous and 4 primiparous, the average age was 30.43 years. The onset of the disease was done in 43.75% of cases at 3 trimester, and 25% of the 2 trimester with three cases of early post partum and post abortum cases. All patients had urticarial papules, vesicule were found in 85.7%. The beginning was done in periumbilical 62.5%. Histology objectified in all cases a sub epidermal detachment, and the IFD performed in 8 cases, objectified in 6 patients a linear deposit of C3 along the dermoepidermal junction. All patients were treated with Bethametasone at 30 g/d with a progressive degression over several months. Concerning the fetal prognosis we found two cases of prematurity, and one case of fetal death. One patient had a choriocarcinoma complicated molar pregnancy. Conclusion: All our patients evolved well under topical corticosteroids of very strong class, even with extensive lesions, so suggesting their first-line use, avoiding the recourse to the oral corticotherapy

Syndrome de Sweet: étude clinique et natomopathologique sur 5 ans

Le syndrome de Sweet ou dermatose aiguë fébrile neutrophilique est une maladie inflammatoire rare à expression cutanée prédominante,  appartenant au groupe des dermatoses neutrophiliques. Il est caractérisé par le polymorphisme de son expression clinique et la diversité des  maladies qui peuvent lui être associées. Le but de ce travail était d'étudier les particularités cliniques, anatomopathologiques, thérapeutiques et évolutives du syndrome de Sweet. Nous rapportons une étude rétrospective et descriptive de 25 cas de syndrome de Sweet observés dans les services de dermatologie et d'anatomie pathologique du centre hospitalier  universitaire de Fès sur une période de 5 ans. Notre série était constituée de 5 hommes et de 20 femmes avec un sex-ratio (hommes/femmes) de 0,25. L'âge moyen des patients était de 47 ans avec des extrêmes allant de 11 à 75 ans. Des maladies associées étaient retrouvées chez 17 patients : hémopathies (deux cas), tumeur solide (1cas), maladie chronique de l'intestin (1cas), tuberculose (1 cas), diabète (trois cas) et infections (9 cas). Deux patientes étaient enceintes au moment du diagnostic. Les manifestations cutanées étaient polymorphes avec atteintes muqueuses dans deux cas. Les lésions siégeaient le plus souvent au niveau acral. Histologiquement, le derme était le siège d'un infiltrat dense et diffus riche en polynucléaires neutrophiles dans tous les cas. Une inflammation de la paroi des vaisseaux étaient observées dans trois cas. Le syndrome de Sweet peut être révélateur ou précéder des maladies associées, ce qui impose une surveillance rigoureuse et prolongée