Nail dystrophy: a rare sign of sarcoidosis

A 29-year-old woman presented to our clinic for subungueal hyperkeratotic lesion of the fourth left toenail. In 1997, she developed systemic sarcoidosis with lung and cutaneous lesions. The patient required gradually tapered systemic corticosteroids for 4 years and methotrexate for 1 year to control lung disease. A few months previously a hyperkeratotic verrucous lesion developed beneath the distal portion of the forth left toenail plate. There was no history of trauma. A biopsy specimen of the nail bed revealed epithelioid granulomas in the dermis without central necrosis. An X-ray of the feet showed severe osteolysis of the terminal phalanx of the forth left toenail. After 2 weeks application, once daily, of hight potency topical steroids, the subungueal hyperkeratosis rapidly improved without relapse after eight months. Nail dystrophy in sarcoidosis is rare. The most common nail changes described in sarcoidosis include thickening of the nail plates associated with fragility and longitudinal ridging , brown discoloration of the nail bed , convex nails and layering, splinter hemorrhage also occur. Such changes are usually associated with lupus pernio and cystic bone change of the phalanx. Our patient did not show lupus pernio like lesions, but radiological examination of the left foot showed bone cyst of the terminal phalanx. Treatment options for nail dystrophy in sarcoidosis include systemic treatment with 10mg/day of prednisone and 200mg/day of hydroxychlorochine sulphate, hight- potency topical steroids application once daily and steroid injections into the nail fold

SARS-CoV-2 virus genome structure and evolution

Late December 2019, a new virus outbreak was detected in Wuhan, Hubei province China and later spread all over the world.The virus is a new strain of the β-Coronavirus (SARS-CoV-2) with a single strand positive sense RNA, and a genome size of 29,890 kb that codes for 9744 amino acids. Not many mutations are depicted in the SARS-CoV-2 genome, However, most of them are detected in the ORF8 regionand the spike. The latter exhibits higher affinity with the Human ACE2 receptor than the SARS-CoV.Alignment of SARS-CoV-2 genome with other Corona viruses shows a high similarity to the Bat-CoV,but this latter was not enough to conclude that the Bat is the origin of the Human SARS-CoV-2. This review aimed to provide an overview of the viral genome structure and its origin

Traitement chirurgical conservateur du genu varum.

Notre étude concerne 68 observations d’ostéotomie tibiale haute de valgisation, chez 68 patients présentant une gonarthrose sur genu varum, traités au service de traumatologie-orthopédie de l’hôpital Ibn Sina de Rabat entre 2005 et 2009. L’âge moyen de nos malades était de 52 ans, 74% d’entre eux étaient de sexe féminin. Le diagnostic clinique constituait l’indication chirurgicale dans la majorité des cas. Les examens radiologiques fondamentaux réalisés pour confirmation du diagnostic sont : La radiographie fémoro-tibiale,le pangonogramme bipodal,et les incidences fémoro-patellaires. L’acte opératoire a consisté en une ostéotomie tibiale haute de fermeture externe dans 66 cas et une ostéotomie tibiale haute d’ouverture interne dans 2 cas. Le foyer d’ostéotomie était fixé par des agrafes dans 76,5% des cas, pour les cas restants, on note l’utilisation des plaques en T et en L. Les résultats basés sur la douleur, la mobilité articulaire, la correction axiale et la réapparition de l’interligne articulaire interne du genou sur les Radiographies ont été satisfaisants avec : - Très bons résultats : 30%. - Bons résultats dans : 44% - Résultats moyens dans : 26%