Roland Tomb

Saint Joseph University, Lebanon | USJ · Faculty of medicine

Background Telogen effluvium (TE) is the most common cause of alopecia in women. Treatment should address the etiological factors and may include adjuvant therapies. In practice, physicians may employ modified approaches and utilize various combinations of topical and oral molecules. Aims In this real-life observational study, the aim was to evalu...

Introduction Data from the Levant regarding pediatric dermatoses are limited. The objective was to estimate the prevalence of pediatric dermatoses in a health-care system that allows every patient to directly reach a specialist. Patients and Methods It is a single-center, chart review, epidemiological study of patients who consulted, between 2010...

Oral isotretinoin remains the most effective treatment for acne. The aim of this retrospective single-center cohort study was to estimate the prevalence of adverse events with the different oral isotretinoin brands used in acne treatment. The population consisted of all patients who consulted for acne between January 2015 and January 2020. The incl...

Objectives: To explore the short- and long-term effects of UVB phototherapy preceding a fractional CO2 laser-UVB protocol in patients with resistant nonsegmental vitiligo. Materials and methods: This single-center, prospective, split-face/body, evaluator-blinded study included adult patients with stable vitiligo refractory to conventional treatm...

Oral isotretinoin remains the most effective treatment for acne. The aim of this retrospective single-center cohort study was to estimate the prevalence of adverse events with the different oral isotretinoin brands used in acne treatment. The population consisted of all patients who consulted for acne between January 2015 and January 2020. The incl...

Résumé Les troubles moteurs fonctionnels liés à l’AVC sont associés à l’incoordination segmentaire et à l’altération de la proprioception. L’objectif était d’évaluer l’efficacité des techniques de facilitation proprioceptive neuromusculaire (PNF) sur la marche par augmentation de la force musculaire et de la coordination. Deux groupes de 16 sujets...

Basal cell carcinoma (BCC) data coming from the Levantine coast of the Mediterranean Sea are limited. The study aimed to primarily analyze the demographic, clinical, pathological, and prognostic characteristics of BCC in this region of the world and secondarily identify features associated with high-risk, recurrent, or multiple BCCs. Patients with...

Aim: Assess the knowledge and behavior of Lebanese parents when it comes to melanoma and its prevention in children. Methods: A survey, to be completed by parents, was sent through children from three schools. Results: During sun exposure only 23.5% of 1012 respondents were always covering enough areas of their children's skin and 74.1% did no...

Introduction Les maladies inflammatoires peuvent affecter la fertilité et compliquer la grossesse. L’objectif était d’estimer, chez les femmes atteintes de psoriasis, le taux d’hypofertilité et de complications obstétricales et d’identifier les facteurs associés à ces complications. Matériel et méthodes Cette étude de cohorte rétrospective analyti...

Introduction La pemphigoïde bulleuse (PB) se caractérise classiquement par des bulles tendues se développant sur un fond érythémateux, urticarien, ou eczémateux. Cependant, les présentations non bulleuses peuvent représenter 20 % des PB. Les IgE semblent jouer un rôle dans les phases initiales de la PB et dans les cas atypiques de PB, telles que le...

Introduction Le syndrome de Netherton (SN) est une forme rare d’ichtyose congénitale à transmission autosomique récessive qui affecte profondément la qualité de vie du malade et de sa famille. Jusqu’à ce jour, les traitements du SN étaient souvent décevants. Le sécukinumab a été récemment utilisé dans le cadre du traitement de ce syndrome avec d’ex...

Sézary syndrome (SS) is an aggressive leukemic variant of cutaneous T-cell lymphomas (CTCL) in which the human Telomerase Reverse Transcriptase (hTERT) gene is re-expressed. Current available treatments do not provide long-term response. We previously reported that Histone deacetylase inhibitors (HDACi, romidespin and vorinostat) and a DNA methyltr...

Cutaneous T‐cell lymphomas (CTCL) are telomerase‐positive tumors expressing hTERT, although neither gene rearrangement/amplification nor promoter hotspot mutations could explain the hTERT re‐expression. As the hTERT promoter is rich in CpG, we investigated the contribution of epigenetic mechanisms in its re‐expression. We analyzed hTERT promoter me...

Basal cell carcinoma (BCC) is one of the most frequent and most curable tumors at its early stages. BCC rarely metastasizes and its treatment in this setting is still challenging. Hedgehog inhibitors showed an activity in advanced or metastatic disease. However, there is an unmet need for new agents. Immune checkpoint inhibitors have been assessed...

Background Lichen planus (LP) is a chronic inflammatory disorder usually occurring in middle-aged adults. Data are scarce in the pediatric population. Objective To describe the patients’ characteristics, clinical presentation, and management of pediatric LP. Methods A systematic literature review of pediatric LP was performed in the Medline and C...

Background Basal cell carcinoma (BCC) represents by far the most common non-melanoma skin cancer (NMSC) in the world with an increasing incidence of 3% to 10% per year, especially in patients under the age of 40. While variants in the sonic Hedgehog and cell cycle regulation pathways account for the majority of BCC cases in adults, the molecular et...

In the sectoral frame of family and personal religious jurisdiction, each pathway impacts and has important ramifications for the other and is therefore representing a duality within the child protection system; it is therefore not possible to develop an accurate picture of the national child protection system by analyzing any of these pathways in...

Child marriage is a formal marriage or informal union entered into by an individual before reaching the age of 18. The legally prescribed marriageable age in some jurisdictions is below 18 years, especially in the case of girls; and even when the age is set at 18 years, many jurisdictions permit earlier marriage with parental consent or in special...

Arab countries provide a range of services accessible health care before entering the hospital or in emergency situations. There are a range of programs and pilot projects in this area, such as developing procedures and protocols governing the coordination between the actors and the provision of specialized units fixed or mobile to deal with issues...

Honor killings are directed mostly against women and girls. Although rarely, men can also be the victims of honor killings by members of the family of a woman with whom they are perceived to have an inappropriate relationship. The loose term “honor killing” applies to killing of both men and women in cultures that practice it. There is a strong pos...

Key elements of the definition of CSA typically include an act against a child including sexual touching or fondling, intrusion or penetration (genital contact), indecent exposure, or other forms of sexual acts in which children are used to provide sexual gratification for the perpetrator (English 1998). Child sexual abuse or child molestation is a...

Attempts to examine patterns of child sexual abuse internationally has been limited for many reasons. Outside of the US, Canada and England, few countries have research on child sexual abuse published in scholarly-refereed venues, and regardless of source, comparability is difficult with respect to methods and measurement. This reflects in part the...

Many services to children are available in Lebanon; however, there is a need to review the role of government welfare structures, specifically in the spectrum of protection services. This review should consider:

Within the sphere of international development, the move towards developing a more comprehensive approach to child welfare has been gathering pace in recent years. There is increasing global recognition that a more integrated and systems-based approach is required at the national level to prevent and protect children from all forms of violence, abu...

In undertaking investigations and planning interventions, it is important to recognize that there are a range of different kinds of abusive and sexually harmful behaviors towards children, including:

Many Arab states are suffering from the devastating effects of political conflicts, occupation and wars within the region, and particularly in the last 3 years of disturbances. The region also faces challenges of decades-long political conflicts, including the on-going Arab-Israeli conflict, which have resulted in multiple occupations and wars and...

Sexual violence against children is a form of child abuse. It includes harassment and rape, as well as the use of children in prostitution or pornography.

Sadly, in the context of numerous uprises and social conflicts, many countries halted the implementation of child protective acts and procedures, in relation with armed conflicts and social instability. Cases of child sexual abuse, trafficking and exploitation have increasingly been reported in media and an expanding social network in the Arab regi...

A 4‐year‐old boy of consanguineous parents, with a Fitzpatrick skin phototype IV, presented to our dermatology department for a diffuse chronic skin eruption. Lesions first appeared at the age of 5 months on his cheeks, and then extended to extremities and buttocks. The skin did not improve neither after the repetitive use of topical corticosteroid...

International professional organizations have contributed to the global effort for the prevention of child abuse and neglect: identification of efficient procedures in respective backgrounds, increasing the knowledge base, reducing the acceptance threshold of CAN, thus enhancing the quality of national visions in terms of child oriented policies. I...

The prohibition of violence has also been included in laws for civil service (e.g. Jordan, Bahrain) and stipulated in laws, regulations and ministerial decrees. There is considerable progress with regards amending penal codes and child protection acts, and the enactment of new laws to ensure effective protection for children.

This book collates and brings together the available information on CSA in the Arab region, as well as efforts to address the multiple types of CSAET and respond to the expanding burden of its diverse presentations. The purpose of the book is to show the quality of the work already done and the terrible plight of CSAET on children.

Child sexual abuse and exploitation (CSAE) is not a new phenomenon—it is documented in the written and verbal histories from all cultures.

Commercial sexual exploitation of children (CSEC) is defined by the Declaration of the First World Congress against Commercial Sexual Exploitation of Children, held in Stockholm in 1996, as “sexual abuse by an adult accompanied by remuneration in cash or in kind to the child or third person(s).” CSEC usually takes the form of child prostitution or...

States should build community confidence in the justice system by, inter alia, bringing all perpetrators of violence against children to justice and ensure that they are held accountable through appropriate “No matter whether violence against children occurs in the family, school, community, institution or workplace, health workers are the front li...

Islamic and other religion-based rules still lead legal frames and constitutions in Sudan and other countries within the MENA region. Christian and animist captives in the civil war are often enslaved and female prisoners are often used sexually, with their captors claiming that Islamic law grants them permission. According to CBS news, slaves have...

Despite many obstacles, the perspective of child protection is strongly developing within national systems and regional networks, in the presence of increasing levels of common values and universal understanding of child rights. In reality, child dedicated structures are grass rooting initiatives; they rely on political decisions, local and nationa...

FGM is a manifestation of violence on girls and a fundamental breach of their rights; this custom is still practiced in a number of Arab countries, but does not include all Arab communities. Female genital mutilation (FGM) is one of the major forms of violence against girls and constitutes a clear violation of their rights. This traditional practic...

Access to sexual and reproductive health in conservative communities and in the MENA region are particularly limited and, as such, increase women’s vulnerability to unwanted pregnancies, unsafe abortions, and sexually transmitted infections (STIs). The aim was to assess the prevalence of STIs, sexual practices, recreational drug-use and their possi...

Background: In hemiparetic patients, the skeletal muscle is mainly affected with a combination of abnormalities (denervation, remodeling, spasticity, and eventually muscular atrophy). Objective: This study examined the role of eccentric exercise in strengthening muscles of the lower extremity and ultimately improving autonomy in patients with po...

Sexual child abuse in the Arab world.

The aim of this paper is to give pediatricians and dermatologists a more precise idea of recurrent Gianotti–Crosti syndrome that occurs following vaccine administration to eventually prevent unnecessary investigations in future patients or vaccination restrictions.

Background : Acne is highly prevalent among teenagers and young adults with proven negative psychological and emotional impact. To our knowledge, no study has been conducted to quantify the repercussions of acne on quality of life (QoL) and self-esteem in Lebanon. Accordingly, this study aimed to highlight the effect of acne treatment on QoL and se...

Rosacea and cutaneous lupus erythematosus (CLE) are chronic inflammatory dermatoses. To our knowledge, no cases of granulomatous rosacea (GR) associated with CLE have been previously reported in the literature. We describe the case of a 38-year-old female patient who presented to our clinic with a diffuse scaly facial erythema, with the co-diagnose...

Background Human papilloma virus (HPV) infection is the most common sexually transmitted disease worldwide and the main cause of genital warts. Clear recommendations for the management of urethral warts, which are often hard to detect and difficult to treat, still lack. Objective To summarize all available data describing treatment modalities of u...

This book presents and brings together research on child sexual abuse from various countries and cultures in the Arab Region. It addresses the multiple types of Child Sexual Abuse Exploitation and Trafficking (CSAET) and responds to the expanding burden of its diverse presentations. The book identifies appropriate structures for efficient programs...

The myeloid zinc finger (MZF) protein family encompasses different transcription factors (TFs) including the myeloid zinc finger protein 1 (MZF-1), also known as zinc finger protein 42 (ZNF42) (Hromas et al., 1991). Assessing the role of MZF-1 in the granulocyte colony-stimulating factor (G-CSF)-induced differentiation of neutrophil in mice, Murai...

Introduction La griséofulvine pourrait être efficace dans le traitement de plusieurs dermatoses inflammatoires non infectieuses à cause de ses propriétés anti-inflammatoires et immunomodulatrices. Nous rapportons ici 2 cas de dermatose neutrophilique (DN) spectaculairement améliorés sous griséofulvine. Observations Cas 1 : une femme de 28 ans prés...

Lymphomas represent a heterogeneous group of cancers characterized by clonal lymphoproliferation. Over the past decades, frequent epigenetic dysregulations have been identified in hematologic malignancies including lymphomas. Many of these impairments occur in genes with established roles and well-known functions in the regulation and maintenance o...

Background Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse drug reaction with systemic symptoms. This study aims to investigate clinical features, causative drugs, and available treatments for pediatric DRESS, particularly for relapsing cases. Methods A systematic search of the English and French literat...

Lichen planus (LP) is a chronic inflammatory disorder of uncertain etiopathogenesis usually occurring in middle-aged adults. It affects the skin, oro-genital mucosa, nails and scalp. Various clinical presentations have been described in adults. However, data is scarce for LP in children. This systematic review aims to describe the patient's charact...

1. Introduction & Objectives Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe rare adverse drug reaction presenting with cutaneous and systemic signs. The main objective of this paper is to investigate clinical features, causative drugs, and available treatments for pediatric DRESS, with a focus on relapsing cases. 2. Mate...

Background: Acquired ungual fibrokeratomas (AUFKs) are benign recurrent fibrokeratotic tumors of the nail unit of uncertain etiology. Little is known about the optimal modality to successfully treat these lesions. No systematic review addressing ungual fibrokeratomas has been published to date. Objectives: The aim of this study is to summarize a...

Dermatologists worldwide are engaged in the struggle against Covid-19. They limited their daily activity to priority cases, intending to reduce the exposure of patients in the waiting room. Teledermatology was recommended as an efficient alternative to assure patients’ needs and safety. At the same time, dermatologists had to manage the skin injuri...

Background: Keratosis pilaris (KP) is a common hereditary keratinization disorder. Keratosis pilaris rubra and KP atrophicans faciei are less frequent variants of the disease. Topical treatments often yield ineffective and temporary results. Objective: The objective of this article is to review and assess all the studies that used light and lase...

First described in 1901, Schamberg disease or progressive pigmentary purpuric dermatosis (PPPD) is the most common clinical pattern among recognized pigmented purpuric eruptions, a group of relapsing capillaritis. The pathogenesis of PPPD has not been well elucidated and treatment has not been standardized.

Lichen nitidus (LN) is a rare cutaneous disorder characterized by the presence of multiple, usually asymptomatic, small papules, most commonly localized on the neck, chest, forearms, abdomen and genitalia. Rare cases of generalized LN and of palmoplantar LN have been reported, and to our knowledge, no cases of concomitant generalized and palmoplant...

Introduction L’aspergillose cutanée primaire est une affection rare, principalement décrite chez des patients immunodéprimés. Les exceptionnels cas survenant chez des sujets immunocompétents se présentent de façon constante sur un site de lésion cutanée préalable. Observation Nous rapportons ici le cas clinique d’une patiente de 84 ans hémodialysé...

UNAIDS report documents 95% increase in new HIV infections among key populations in Eastern Europe and Middle East and North Africa region. Data on HIV and STIs among MSM in Lebanon is still scarce. Therefore, the aim was to assess prevalence of HIV and sexually transmitted infections (STIs) among men who have sex with men (MSM) in Lebanon and asso...

Background: Erythema multiforme (EM) is an acute inflammatory mucocutaneous condition. EM is rarely described in children and infants. Objective: To investigate the triggers, clinical manifestations, and treatment of pediatric EM. Methods: Systematic literature review of pediatric EM. Results: After full-text article review, we included 113...

Background: Nontuberculous mycobacterium (NTM) infection following cosmetic procedures usually results from inadequate sterile techniques and contamination from nonsterile water. These infections are difficult to diagnose and treat. Objective: This study aimed to describe the characteristics of NTM infections acquired after an aesthetic procedur...

Introduction La réaction du greffon contre l’hôte (GVH) représente la principale complication après une allogreffe de cellules souches hématopoïétiques. La GVH a rarement été décrite après transplantation d’organes solides. Lors d’une GVH, les manifestations cutanées sont très fréquentes et polymorphes, allant d’un érythème maculeux au stade précoc...

Introduction Les hidrocystomes eccrines sont des tumeurs kystiques bénignes de rétention sudorale, pouvant être solitaires (type Smith) ou multiples (type Robinson), de localisation surtout centro-faciale, avec prédilection pour les zones malaires et périorbitaires. Ils se caractérisent par leur variabilité saisonnière avec une recrudescence en pér...

Background Stigma refers to the wounds reproduced on the human body, similar to the ones inflicted on the Christ during his crucifixion, on the palms, soles, and head, as well as the right or the left side of the chest, the lips and, the back. Whether they are genuine or fabricated, stigmata are still considered a medical enigma. Objective To summ...

Papular acantholytic dyskeratosis (PAD) is a challenging diagnosis for both dermatologist and pathologist. It predominantly affects female patients, but men can present less frequently the disease. Histopathology is required to confirm the diagnosis and to exclude other acantholytic dermatoses. We present a rare case of PAD in a young male patient,...

Introduction Les verrues constituent la manifestation dermatologique la plus fréquente de l’infection par le virus du papillome humain (VPH). Il existe une grande variété de traitements locaux mais aucun n’a prouvé une supériorité en termes d’efficacité ou d’effets secondaires. Nous rapportons le cas d’une patiente ayant des verrues cutanées multip...

Background The “Nefertiti lift” consists of injecting the platysmal bands and the inferior border of the mandible with botulinum toxin. No clinical trial has evaluated its effect on the different lower face and neck aging components, and little is known about the clinical characteristics that predict treatment success. Methods Patients were inject...

Characteristics of autoimmune bullous diseases (AIBDs) show wide geographic variation. The aim of this study was to determine retrospectively the characteristics of patients with AIBD admitted to Hôtel-Dieu de France Hospital in Beirut, Lebanon, between 1999 and 2014 and to compare them with those from other areas in the Middle East, the Far East,...

Characteristics of autoimmune bullous diseases (AIBDs) show wide geographic variation. The aim of this study was to determine retrospectively the characteristics of patients with AIBD admitted to Hôtel-Dieu de France Hospital in Beirut, Lebanon, between 1999 and 2014 and to compare them with those from other areas in the Middle East, the Far East,...

Tyrosine kinase enzymes are an attractive target for anticancer therapies. Tyrosine kinase inhibitors (TKI) are well tolerated; somehow severe systemic side effects are rarely seen during treatment. Toxicities of skin and appendages may lead to poor compliance, psychosocial inconvenience, and drug interruption. Changes of the hair can arise followi...

Pyoderma gangrenosum (PG) is a sterile neutrophilic disorder that rarely affects children. Clinical, epidemiological, and therapeutic data on pediatric PG is poor as there are many newly reported associated diseases and drugs. This paper aims to review all recent available data on pediatric PG. A systematic review of the literature was conducted us...

Digital mucous cysts (DMC) are benign, highly recurrent lesions of the digits. To date, there is still no treatment agreement on the treatment of DMC. Herein, we review available data on treatment modalities, including both surgical and nonsurgical techniques, and to provide a practical algorithm for the management of DMC. A systematic review was c...

Introduction L’ « osteoma cutis » miliaire est une entité rare avec moins de 60 cas décrits dans la littérature. Elle est caractérisée par l’émergence de multiples fragments d’os mature dans le derme. Cliniquement, le patient se présente avec des papules monomorphes, indurées, infiltrées, touchant surtout la face avec une prédominance pour le sexe...

Background: Chondrodermatitis nodularis helicis (CNH) is an idiopathic benign inflammatory painful condition of the ear. Still, to date, no study has yet evaluated nor compared treatments regarding their safety and efficacy. Objective: The objective of this study is to review all available treatment modalities of CNH that were described in the l...

Splinter hemorrhages (SHs) of the nails represent a frequent although not specific clinical finding that has been associated with conditions of varying severity. However, to date, there is no single report of their characteristics and etiologies. The aim of this study is to guide clinical practice by reviewing all of the data concerning SH of the n...

Background Screening psoriatic arthritis remains a challenge. A few dedicated tools have been developed in different settings however direct comparative data is limited. Objectives To compare screening properties of a new instrument [PsoQ], inspired by both ASAS recommendations for early diagnosis of spondyloarthritis and ACR criteria for rheumato...

Le syndrome de Maffucci est une affection congénitale non héréditaire rare qui se caractérise par une dysplasie du mésoderme qui induit de diverses malformations vasculaires et cartillagineuses. L’association avec une atteinte vicérale et des nevi épidermique n’a jamais été rapporté dans la litérature. Il s’agit du premier cas du Syndrome de Maffuc...

Introduction Le syndrome de Comèl-Netherton est une génoder- matose rare caractérisée par une desquamation prématurée et un amincissement de la couche cornée. Nous rapportons le cas d’un syndrome de Netherton diagnostiqué suite à l’apparition d’une ichtyose linéaire circonflexe précoce. Observation Il s’agit d’une fille de 4 mois admise à l’hôpita...