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La Presse Medicale - In Press.Proof corrected by the author Available online since vendredi 19 decembre 2014

Objective The appearance of skin symptoms in male breast is the main reason for consultation in our context. The aim of this study is to describe the various cutaneous manifestations of male breast cancer through a series of cases collected in a dermatology department. Methods A retrospective study was conducted in the dermatology department at the CHU Ibn Rochd January 1988 to December 2009. All cases of male breast cancer initially diagnosed in dermatology were included. The various epidemiological, clinical, histological and therapeutic data were collected from medical records. Results Twenty cases were collected. The mean age was 61.25 years. Skin invasion by tumor was found in all patients, and it was the reason for consultation. It was a cutaneous involvement at the nipple and areola (17 cases) and at the periareolar skin (three cases). The clinical appearance of skin involvement was vegetative type in 12 cases, infiltrating with nipple retraction in five cases and nodule with skin change in three cases. The average period of consultation was 25 months. The axillaries lymph nodes were noted in 11 patients and distant metastases in eight patients. The cutaneous metastases outside breast were noted in six patients. The histological types were: infiltrating ductal carcinoma in 15 cases (75%), papillary carcinoma in two cases (10%) and non-specific carcinoma in three cases (15%). The treatment was surgery in 14 patients and consisted of radical mastectomy with complete axillary nodal dissection according to Patey. Complementary therapies, chemotherapy or radiotherapy, were indicated in 14 patients. Conclusion Our single-center study with dermatological recruitment illustrates the frequency and variety of skin disease in male breast cancer and demonstrates that they are still the main reason for consultation in our context. Better information for public and practitioners would allow earlier diagnosis and a more favourable prognosis.

La Presse Medicale - In Press.Proof corrected by the author Available online since samedi 13 septembre 2014

La Presse Medicale - In Press.Proof corrected by the author Available online since lundi 20 janvier 2014

Resume Introduction La glomerulonephrite extramembraneuse (GEM) lupique pure expose a un risque de developper une insuffisance renale terminale, et peut etre fatale. Son traitement immunosuppresseur est peu codifie. Nous decrivons la forme initiale de la GEM lupique dans notre centre et precisons son evolution en fonction du traitement immunosuppresseur choisi. Methodes Etude retrospective incluant toutes les GEM lupiques pures hospitalisees dans le service de nephrologie de Rabat entre 1994 et 2005. Resultats La GEM lupique pure est retrouvee chez 18 patients, soit 16,7 % de nos 108 cas de nephropathies lupiques. L’âge moyen des patients etait de 29 ± 2,1 ans (17–52), avec un sex ratio de 2H/16F. Le suivi moyen etait de 54 ± 31 mois (3–130). La presentation clinique initiale etait marquee sur le plan renal par la presence d’une proteinurie, nephrotique dans 11 cas. La creatininemie etait de 18,6 ± 3,9 mg/L. Une leucocyturie etait observee dans 12 cas (67 %) et une hematurie microscopique dans 8 cas (44 %). Les atteintes extrarenales etaient cutanees (14 cas), articulaires (14 cas), hematologiques (8 cas), cardiaques (6 cas) et neurologiques (4 cas). Les patients ont ete traites par corticotherapie seule (groupe 1 : 7 cas) ou associee au cyclophosphamide en cas d’insuffisance renale ou d’atteinte neurologique (groupe 2 : 11 cas). Onze cas ont connu une remission complete, 7 une remission partielle. Quatre rechutes ont ete observees, dont 3 dans le groupe 2. La creatininemie moyenne a 3 ans etait comparable dans les 2 groupes. Quatre deces de cause extrarenale ont ete observes. Un seul cas d’evolution vers l’insuffisance renale chronique terminale a ete observe dans le groupe 2. Discussion La forme initiale de la GEM lupique est variable. Le cyclophosphamide permet une evolution favorable en cas d’insuffisance renale avancee d’emblee, mais il n’evite pas la survenue de complications letales, notamment neurologiques.

La Presse Medicale - In Press.Proof corrected by the author Available online since samedi 21 fevrier 2015

La Presse Medicale - In Press.Proof corrected by the author Available online since mercredi 4 mars 2015

La Presse Medicale - In Press.Proof corrected by the author Available online since vendredi 27 juin 2014