Keloids are chronic progressive dermal pseudo-tumors that can grow considerably in volume and surface area but do not invade other tissues. They are usually triggered by dermal injury or inflammation, but they are not scars in the normal sense of the word, since they enlarge and progress over decades. The phenomenon usually referred to as "hypertrophic scars" represents a kind of keloidal process that does not extend beyond the initial site of injury and spontaneously regresses in 12–24 months. The multiplication of keloids and hypertrophic scars in a single patient is known as keloid disease. Keloid disease is due to a familial predisposition (autosomal dominant) that preferentially affects people of non-European ancestry, especially those of sub-Saharan African descent. Keloid disease has a deep impact on quality of life, not only because of disfiguring lesions, but also because of the frequency of associated intense neurogenic pruritus and pain, as well as recurrent bouts of suppuration. Diagnosis relies primarily on a good knowledge of the clinical characteristics of keloids, thus warranting the inclusion of a clinical atlas in the first part of the review. The second part will deal with the pathology, pathophysiology and treatment of keloid disease.

BACKGROUND:Cutaneous reactions may occur in patients receiving terbinafine therapy, mainly rash and urticaria. More exceptionally, development of psoriasis has been described. We describe the development of plantar pustular psoriasis in a patient who took oral terbinafine.CASE REPORT:A 70-year-old man, without previously known history of psoriasis, was treated with terbinafine, 250 mg/day, for onychomycosis. Ten days later, a plantar pustular psoriasis appeared. The psoriasis cleared up after discontinuation of terbinafine and institution of antipsoriatic therapy.DISCUSSION:Terbinafine is an antifungal agent widely use in the treatment of onychomycosis. A skin reaction occurs in 3 p. 100 of patients. Only 24 cases of flare-up of previous psoriasis or psoriasis de novo after terbinafine have been described. The psoriasis generally clears after discontinuation of terbinafine. So, terbinafine is perhaps not the best first line therapy for onychomycosis in patients with psoriasis.

Introduction. Parmi les effets secondaires cutanes de la terbinafine, l'exacerbation ou le declenchement de psoriasis a rarement ete decrit. Nous rapportons une observation de psoriasis pustuleux plantaire, apres prise de Lamisil®. Observation. Un homme de 70 ans, qui ne se savait pas atteint de psoriasis, recevait de la terbinafine pour une onychomycose des orteils. Au dixieme jour du traitement se declarait un psoriasis pustuleux plantaire. L'arret de la terbinafine, associe a un traitement specifique, permettait un traitement de la poussee. Discussion. La terbinafine est un antifongique utilise dans le traitement des onychomycoses. Les effets secondaires cutanes, qui surviennent dans 3 p. 100 des cas, sont essentiellement a type d'exanthemes ou d'urticaire. Plus recemment, 24 cas de psoriasis de novo ou d'exacerbation de psoriasis ont ete rapportes. Chez tous les malades, l'arret de la terbinafine a entraine une amelioration du psoriasis. La terbinafine doit vraisemblablement etre prescrite avec prudence au cours du psoriasis.

BACKGROUND:Acute generalized exanthematic pustulosis is a severe adverse drug reaction which occurs after taking antibiotics. Rare cases implicating psychotrops have been observed.CASE REPORT:A 71-year old women with schizophrenia was given closapine for six weeks when she developed an erythematopustular skin reaction and fever typical of acute generalized exanthematic pustulosis. The skin disease regressed one week after withdrawing clozapine.DISCUSSION:This is the first case of acute generalized exanthematic pustulosis observed after taking the neuroleptic drug, clozapine, used in severe schizophrenia.

Background. Acute generalized exanthematic pustulosis is a severe adverse drug reaction which occurs after taking antibiotics. Rare cases implicating psychotrops have been observed. Case report. A 71-year-old woman with schizophrenia was given clozapine for six weeks when she developed an erythematopustular skin reaction and fever typical of acute generalized exanthematic pustulosis. The skin disease regressed one week after withdrawing clozapine. Discussion. This is the first case of acute generalized exanthematic pustulosis observed after taking the neuroleptic drug, clozapine, used in severe schizophrenia.