BACKGROUND:Naevoid melanoma (NeM), a rare variant of melanoma, can be difficult to detect as its clinical and histopathological morphology can simulate a naevus.OBJECTIVES:To describe the clinical and dermoscopic features associated with NeM.METHODS:Lesions with a histopathological diagnosis of NeM were collected via an e-mail request sent to all members of the International Dermoscopy Society. All lesions were histopathologically reviewed and only lesions fulfilling a set of predefined histopathological criteria were included in the study and analysed for their clinical and dermoscopic features.RESULTS:Twenty-seven of 58 cases (47%) fulfilled the predefined histopathological criteria for NeM and were included in the study. Clinically, 16 of the 27 NeMs presented as a nodular lesion (59%), eight (30%) as plaque type and three (11%) as papular. Analysis of the global dermoscopic pattern identified three types of NeM. The first were naevus-like tumours (n = 13, 48%), typified by a papillomatous surface resembling a dermal naevus. In these lesions local dermoscopic features included irregular dots/globules (46%), multiple milia-like cysts (38%) and atypical vascular structures (46%). The second type were amelanotic tumours (n = 8, 30%), typified by an atypical vascular pattern (75%). The third type consisted of tumours displaying a multicomponent pattern (n = 4, 15%), characterized by classical local melanoma-specific criteria. Two lesions (7%) were classified as mixed-pattern tumours as they did not manifest any of the aforementioned patterns.CONCLUSIONS:While NeMs may be clinically difficult to differentiate from naevi, any papillomatous lesion displaying dermoscopically atypical vessels and/or irregular dots/globules should prompt consideration for the possible diagnosis of NeM.

Background. - Sneddon-Wilkinson disease (SWD) is a rare chronic neutrophilic dermatosis. The first-line treatment is dapsone but resistance to treatment may sometimes pose a challenge.Case Report. - We report a multidrug-resistant patient who responded dramatically before gradually losing response to infliximab and then etanercept. Complete remission was again obtained with adalimumab.Discussion. - Our case confirms the previously reported dramatic efficacy of anti-TNF biological agents in recalcitrant SWD but highlights the possibility of subsequent loss of response. Furthermore, it illustrates the efficacy of adalimumab in this indication. (C) 2013 Elsevier Masson SAS. All rights reserved.

El virus herpes humano tipo 8 (VHH-8) se descubrió en 1994 a partir de la biopsia de un sarcoma de Kaposi en un paciente con sida. Desde entonces se ha identificado en todas las variantes de sarcoma de Kaposi y en otros dos raros procesos: la enfermedad de Castleman multicéntrica y el linfoma primario de cavidades.Se presenta el caso de un paciente varón de 68 años de edad VIH-negativo con sarcoma de Kaposi de un año de evolución en seguimiento por Dermatología que consultó por astenia, anorexia y fiebre. A la exploración se detectaron múltiples adenopatías laterocervicales, axilares e inguinales. En la biopsia de una de dichas adenopatías se apreciaron hallazgos característicos de la variante de células plasmáticas de la enfermedad de Castleman. Se realizaron serologías para el VHH-8 y el VIH que resultaron positiva y negativa respectivamente (IgG anti-VHH-8 positivo, título 1/640, inmunofluorescencia indirecta).Mediante reacción en cadena de la polimerasa se amplificó VHH-8 en sangre periférica. El paciente recibió tratamiento con 8 ciclos de CHOP y rituximab con una completa resolución de las adenopatías y la sintomatología general sin observarse empeoramiento de su sarcoma de Kaposi. El paciente permanece en remisión completa 10 meses después de finalizado el tratamiento.Se presenta el caso de un paciente VIH-negativo y VHH-8-positivo, diagnosticado de sarcoma de Kaposi clásico que desarrolló una enfermedad de Castleman multicéntrica variante de células plasmáticas. La coincidencia de dos o más enfermedades relacionadas con el VHH-8 en un paciente VIH-negativo es un hecho descrito raramente en la literatura. El tratamiento con rituximab combinado con quimioterapia tipo CHOP ha demostrado ser eficaz en este caso sin que haya podido observarse un agravamiento de su SK.Human herpes virus 8 (HHV8) was discovered in 1994 in the biopsy of a Kaposi's sarcoma in a patient with AIDS. Since then it has been identified in all variants of Kaposi's sarcoma and in another two rare disorders: multicentric Castleman's disease and primary body-cavity based lymphomas.The case discusses a 68 year old, HIV-negative male patient, presenting Kaposi's sarcoma for one year and being monitored by dermatology, who presented for weakness, anorexia and fever. On examination, he was found to have adenitis of the lymph nodes in his neck, underarm and groin. A biopsy on one of the swellings led to findings characteristic of multicentric plasma cell variant Castleman's disease. Blood tests for HHV8 and HIV were carried out, resulting positive and negative respectively (IgG anti-HHV8 positive, title 1/640, indirect immunofluorescence). PCR amplification showed HHV8 in peripheral blood. Patient received 8 cycles of CHOP and rituximab, leading to complete disappearance of the adenitis and general symptoms, with no worsening of his Kaposi's sarcoma. Patient remained in complete remission for 10 months after treatment.This paper discusses the case of a HIV-, HHV8+ patient, diagnosed with classic Kaposi's sarcoma, who developed multicentric plasma cell variant Castleman's disease. The coincidence of two or more HHV8-related illnesses in a HIV-negative patient has rarely been described in medical literature. Treatment with rituximab combined with CHOP chemotherapy was effective in this case, and no worsening of the patient's KS was observed.

La démodécie, ou démodécidose, est une parasitose cutanée due à des acariens du genre Demodex, saprophytes habituels du follicule pileux. Nous présentons ici, pour son intérêt didactique, un cas typique de démodécie rosacéiforme permettant de discuter les manifestations cliniques de cette affection chez l'homme, son diagnostic et son traitement.Une femme de 37 ans se présentait dans notre service pour une blépharite chronique. L'examen physique confirmait la blépharite et montrait une éruption papulo-vésiculeuse finement squameuse du visage. Il n'y avait pas de télangiectasies. La patiente ne rapportait pas d'épisodes de bouffées vasomotrices ni de photosensibilité. Le diagnostic de la démodécie rosacéiforme et celui de blépharite à Demodex folliculorum étaient posés sur la mise en évidence de plusieurs D. folliculorum au niveau des cils et du prélèvement cutané. La patiente était traitée par métronidazole oral pendant deux mois et pommade ophtalmique à base d'oxyde jaune de mercure pendant 15 jours. L'évolution était marquée par la disparition des lésions cliniques et la négativation de l'examen parasitologique.Demodex étant un parasite du follicule pileux à l'état physiologique, les limites de l'entité pathologique « démodécie » sont parfois difficiles à préciser, voire controversées. Ce cas clinique illustre bien les caractéristiques de la démodécie rosacéiforme et ses différences avec la rosacée. Le prélèvement parasitologique est essentiel pour établir un diagnostic correct.Demodicidosis is a parasitic skin disease caused by the follicle mites Demodex sp. In this article, we present a case of rosacea-like demodicidosis, discuss the clinical features of Demodex infestation in man and review their diagnosis and therapeutic modalities. A 37-year-old woman presented in our department with chronic blepharitis present for one year. On physical examination, the patient presented blepharitis and papulovesicles with fine scaling limited to the face. There was no telangectasia. The patient did not report flushing episodes or any kind of photosensitivity. A diagnosis of rosacea-like demodicidosis and Demodex blepharitis was based on the presence of numerous Demodex folliculorum in the eyelashes and scrapings of skin lesions. The patient was put on topic and oral metronidazole for 2 months and on yellow mercury ointment for 15 days. The course involved disappearance of the facial mites and complete remission without recurrence. Screening for Demodex sp is essential to establish the correct diagnosis and ensure suitable treatment.

This chapter discusses the neotectonics of the Alps. The distribution of earthquakes on both sides of the Mediterranean defines the diffuse boundary between the Eurasian and African plates with other microplates. The technique of direct measurement of active deformation of rocks is based on different methods of varying accuracy such as the contraction of tunnel diameters and the ellipticity of circular boreholes. In regions of strong relief, the interpretation of the results is beset by the difficulty of determining the role of gravity slides on mountain flanks. Present-day relative uplift and lowering of ground level have been measured directly over historical time with respect to the fixed reference of sea level. For periods of geological time, the vertical movement of rocks—that is, their burial or exhumation—is estimated with respect to ground level, which is variable with time. The spatial variation in horizontal movements can be derived from a comparison of repeated geodetic triangulation networks over several decades. The chapter describes the late faults in the field. Measurements of vertical and horizontal movements and a better knowledge of active deep structures are required for an integrated and explanatory model of the neotectonism, which is the subject of the research presented in the chapter.

Introduction. Pulse dye laser (PDL) appears an attractive method to treat warts. However, data concerning the efficacy of this approach are based chiefly upon open clinical studies or case reports and results vary widely from one study to another. The purpose of this study was to compare the efficacy and safety of PDL with a placebo in the treatment of a homogeneous group of patients presenting palmoplantar warts.Methods. This was a randomized, prospective, placebo-controlled, single-blind study conducted between December 2004 and July 2005 in patients consulting for palmoplantar warts at the Dermatology Department of the University Teaching Hospital of Nice. The treatment settings used for the 595-nm PDL were as follows: spot diameter 5 mm, pulse duration 0.45 ms, fluence 9 J/cm(2) with 5 passes at a frequency of 1 Hz. Cryogen spray cooling (system incorporated in the machine) was given at a rate of 50 spurts Of 40 ms prior to each laser pulse. In patients in the placebo group, cooling pulses alone were given. For the plantar warts (in both groups), hyperkeratosis was removed manually with a scalpel before each session. A maximum of three sessions was administered at 3-week intervals. The type and number of warts was counted and recorded in a treatment schedule before the start of therapy, at each session and 5 weeks after the final session. The global safety of the treatment was evaluated using a visual analog scale between 0 (intolerable) and 10 (completely safe).Results. Nineteen patients were included in the laser group and 16 were included in the placebo group. Sixty-four per cent (48/75) of warts in the laser group resolved completely compared with 13% (4/30) in the placebo group (p < 0.001). In the PDL group, 6 of 19 patients (31.5%) no longer had warts by the end of the study compared with 3 of 16 patients (18.75%) in the placebo group (P = 0.46). The global safety score of the treatment as assessed by the patients themselves was 8.31 in the laser group and 9.81 in the placebo group.Discussion. Pulse dye laser appears to be an effective treatment in palmoplantar warts but the efficacy of this method seems to be only equivalent to that of standard treatments (cryotherapy or salicylic acid preparations). Safety is excellent and constitutes one of the major advantages of this technique. The absence of any proven superiority over the standard treatments in terms of efficacy, coupled with the high costs involved, means that PDL should only be used second-line therapy in patients wishing to avoid constraints affecting their professional activity.

INTRODUCTION:Pulse dye laser (PDL) appears an attractive method to treat warts. However, data concerning the efficacy of this approach are based chiefly upon open clinical studies or case reports and results vary widely from one study to another. The purpose of this study was to compare the efficacy and safety of PDL with a placebo in the treatment of a homogeneous group of patients presenting palmoplantar warts.METHODS:This was a randomized, prospective, placebo-controlled, single-blind study conducted between December 2004 and July 2005 in patients consulting for palmoplantar warts at the Dermatology Department of the University Teaching Hospital of Nice. The treatment settings used for the 595-nm PDL were as follows: spot diameter 5 mm, pulse duration 0.45 ms, fluence 9 J/cm2 with 5 passes at a frequency of 1 Hz. Cryogen spray cooling (system incorporated in the machine) was given at a rate of 50 spurts of 40 ms prior to each laser pulse. In patients in the placebo group, cooling pulses alone were given. For the plantar warts (in both groups), hyperkeratosis was removed manually with a scalpel before each session. A maximum of three sessions was administered at 3-week intervals. The type and number of warts was counted and recorded in a treatment schedule before the start of therapy, at each session and 5 weeks after the final session. The global safety of the treatment was evaluated using a visual analog scale between 0 (intolerable) and 10 (completely safe).RESULTS:Nineteen patients were included in the laser group and 16 were included in the placebo group. Sixty-four per cent (48/75) of warts in the laser group resolved completely compared with 13% (4/30) in the placebo group (p<0.001). In the PDL group, 6 of 19 patients (31.5%) no longer had warts by the end of the study compared with 3 of 16 patients (18.75%) in the placebo group (p=0.46). The global safety score of the treatment as assessed by the patients themselves was 8.31 in the laser group and 9.81 in the placebo group.DISCUSSION:Pulse dye laser appears to be an effective treatment in palmoplantar warts but the efficacy of this method seems to be only equivalent to that of standard treatments (cryotherapy or salicylic acid preparations). Safety is excellent and constitutes one of the major advantages of this technique. The absence of any proven superiority over the standard treatments in terms of efficacy, coupled with the high costs involved, means that PDL should only be used second-line therapy in patients wishing to avoid constraints affecting their professional activity.

Background Some cases of dermatofibrosarcoma protuberans (DFSP) do not protrude above the skin.Objectives To assess the prevalence of these DFSPs and further to describe their presentation and course.Methods One hundred and forty-three patients were retrospectively collected. They were asked to complete a standardized questionnaire indicating the history and appearance of the DFSP from the first skin changes identified to the time of diagnosis.Results Eighty-one DFSPs were described as protuberant ab initio, and 62 as initially nonprotuberant (npDFSP). The latter remained at this stage for a mean period of 7.6 years. Twenty-nine per cent of npDFSPs were 'morphoea-like', 19% were 'atrophoderma-like' and 42% were 'angioma-like'. Age at diagnosis was similar for both initial presentations. npDFSPs were most often misdiagnosed by physicians.Conclusions Nearly half the patients first identified their early DFSP-related skin changes as patches. Both this frequency and the long duration at this preprotuberant stage should prompt dermatologists to consider the diagnosis of DFSP earlier, in order to make surgical treatment easier.

We report a case of necrotizing fasciitis with probable in vivo transfer of a TEM-24 plasmid-borne extended-spectrum β-lactamase (ESBL) gene from Enterobacter aerogenes to Aeromonas hydrophila. The patient was an 87-year-old female with a leg lesion following a trauma. She had a history of rheumatoid polyarthritis treated by 10 mg of prednisone per day, refractory anemia, and chronic venous insufficiency of the lower limbs. Within 5 days, the infection grew worse and the initial amoxicillin-clavulanic acid antibiotic therapy was replaced with ceftriaxone-metronidazole (1 to 1.5 g daily). Surgical debridement revealed extensive necrosis, and 3 days later, the lesion evolved toward typical necrotizing fasciitis (1, 6), leading to a second surgical intervention for above-knee amputation followed by complete healing. Routine bacteriological procedures revealed (i) Escherichia coli NI-202 susceptible to most β-lactam compounds, (ii) E. aerogenes NI-203 resistant to all β-lactam antibiotics except imipenem, (iii) A. hydrophila NI-204 resistant to ceftazidime, and (iv) A. hydrophila NI-205 susceptible to ceftazidime (Table ​(Table1).1). Pulsed-field electrophoresis confirmed that A. hydrophila NI-204 and NI-205 derived from a single clone. For β-lactamase analysis, the E. aerogenes isolate was grown in brain heart infusion broth with and without cefoxitin or ceftazidime induction (10 μg/ml) at 37°C before analytical isoelectric focusing with crude sonic cell extracts on polyacrylamide gels (2, 4). Two bands of β-lactamase activity were detected with iodine gel with cefazolin (500 μg/ml) as the substrate, which was suggestive of the production of an inducible cephalosporinase (pI 8.8) and an ESBL (pI 6.5). Aeromonas isolates were grown at 30°C with cefoxitin (10 μg/ml), imipenem (1 μg/ml), or tobramycin (1 μg/ml) induction (5). Analytical isoelectric focusing with penicillin and cefazolin as substrates revealed three bands (pI 7, 7.8, and 8.2) probably corresponding to previously described cephalosporinase-, imipenemase-, and oxacillinase-type inducible β-lactamases (5, 11, 12). A. hydrophila NI-204 produced an additional enzyme similar to E. aerogenes NI-203 ESBL (pI 6.5). TABLE 1. β-Lactamases, plasmid content, and MICs (μg/ml) of the clinical isolates and transconjugant strains Taking into account resistance to ceftazidime, pI determination, and local epidemiology, the ESBL was presumed to be the plasmid-mediated TEM-24 βlactamase (2-4, 7). The plasmid was transferred from E. aerogenes NI-203 to A. hydrophila NI-205 and to E. coli C1a at a high frequency (10−4). Recipient strains (NI-206 and NI-207, Table ​Table1)1) presented the same acquired resistance pattern. After plasmid extraction and gel electrophoresis, both wild-type strains (E. aerogenes NI-203, A. hydrophila NI-204) and recipient strains (A. hydrophila NI-206, E. coli C1a NI-207) showed a common 180-kb band, as previously characterized with Enterobacteriaceae, Pseudomonas aeruginosa, and recently A. caviae (4, 7-9). The capacity of Aeromonas salmonicida to maintain either or both of the Pseudomonas and Enterobacteriaceae R factors has already been observed (10). PCR amplification with TEM family-specific primers was applied to E. aerogenes NI-203 and A. hydrophila NI-204 and showed a deduced protein sequence with 100% identity to that of TEM-24 (3, 7). This report demonstrates probable in vivo transfer of ESBL TEM-24 from E. aerogenes to the genus Aeromonas. It was observed in a wild-type strain of A. hydrophila simultaneously producing the class A, B, C, and D β-lactamases.

Introduction. We report an unexpected cenesthetic hallucination-type neuropsychiatric side effect with hydrochloroquine (Plaquenil (R)) in a ptient treated for an erosive plantar lichen planus.Observation. A 75 year-old woman was hospitalized for a handicapping erosive plantar lichen. Treatment with hydrochloroquine (400 mg/day) was initiated, associated with topical corticosteroids and a short course of oral acorticosteroids (0-5 mg/kg/day of methylprednisolone). After 10 days of treatment, a short episode of temporo-spacial disorientation occurred, followed by a feeling of depersonalization and cenesthetic hallucinations with feelings in the body. These manifestations were preceded by nightmares. Hydrochloroquine was spontaneously stopped by the patient one week later and led to the progressive disappearance of the hallucinations and a return to a normal mental state within one month. Two and a half years later, no relapse of the psychiatric manifestations has been noted.Discussion. Chloroquine and hydrochloroquine may be at the origin of severe psychosis-like psychiatric side effects. Such manifestations are exceptional, little known and principally described during treatment of malaria. The clinical presentation of the psychosis induced by synthetic ani-malarials is fairly homogenous from one case to the next: onset in a patient without psychaitric past of manifestations such as delirium, hallucinations, maniac episodes or depression after an interval of a few hours to 40 days, usually regressing one week after suspension of the synthetic antimalarial. There is no relationship between the dose of synthetic anti-malarial administered and the onset of psychiatric problems. The triggering-off mechanism is unknown and appears to be an idiosyncratic reaction. Our case report draws the dermatologists' attention to the possibility of the occurrence of potentially severe psychiatric side effects.

INTRODUCTION:We report an unexpected cenesthetic hallucination-type neuropsychiatric side effect with hydrochloroquine (Plaquenil) in a patient treated for an erosive plantar lichen planus.OBSERVATION:A 75 year-old woman was hospitalized for a handicapping erosive plantar lichen. Treatment with hydrochloroquine (400 mg/day) was initiated, associated with topical corticosteroids and a short course of oral acorticosteroids (0.5 mg/kg/day of methylprednisolone). After 10 days of treatment, a short episode of temporo-spatial disorientation occurred, followed by a feeling of depersonalization and cenesthetic hallucinations with feelings in the body. These manifestations were preceded by nightmares. Hydrochloroquine was spontaneously stopped by the patient one week later and led to the progressive disappearance of the hallucinations and a return to a normal mental state within one month. Two and a half years later, no relapse of the psychiatric manifestations has been noted.DISCUSSION:Chloroquine and hydrochloroquine may be at the origin of severe psychosis-like psychiatric side effects. Such manifestations are exceptional, little known and principally described during treatment of malaria. The clinical presentation of the psychosis induced by synthetic ani-malarials is fairly homogeneous from one case to the next: onset in a patient without psychiatric past of manifestations such as delirium, hallucinations, maniac episodes or depression after an interval of a few hours to 40 days, usually regressing one week after suspension of the synthetic antimalarial. There is no relationship between the dose of synthetic anti-malarial administered and the onset of psychiatric problems. The triggering-off mechanism is unknown and appears to be an idiosyncratic reaction. Our case report draws the dermatologists' attention to the possibility of the occurrence of potentially severe psychiatric side effects.

Lasers in Surgery and MedicineVolume 34, Issue 3 p. 205-205 Letter to Editor Treatment of erosive oral lichen planus by the 308 nm excimer laser T. Passeron, Corresponding Author T. Passeron Department of Dermatology Hôpital de l'Archet Nice, FranceDepartment of Dermatology, Archet-2 hospital, BP 3079. 06202 NICE Cedex 3, France.Search for more papers by this authorW. Zakaria, W. Zakaria Department of Dermatology Hôpital de l'Archet Nice, FranceSearch for more papers by this authorN. Ostovari, N. Ostovari Department of Dermatology Hôpital de l'Archet Nice, FranceSearch for more papers by this authorF. Mantoux, F. Mantoux Department of Dermatology Hôpital de l'Archet Nice, FranceSearch for more papers by this authorJ.P.H. Lacour, J.P.H. Lacour Department of Dermatology Hôpital de l'Archet Nice, FranceSearch for more papers by this authorJ.P. Ortonne, J.P. Ortonne Department of Dermatology Hôpital de l'Archet Nice, FranceSearch for more papers by this author T. Passeron, Corresponding Author T. Passeron Department of Dermatology Hôpital de l'Archet Nice, FranceDepartment of Dermatology, Archet-2 hospital, BP 3079. 06202 NICE Cedex 3, France.Search for more papers by this authorW. Zakaria, W. Zakaria Department of Dermatology Hôpital de l'Archet Nice, FranceSearch for more papers by this authorN. Ostovari, N. Ostovari Department of Dermatology Hôpital de l'Archet Nice, FranceSearch for more papers by this authorF. Mantoux, F. Mantoux Department of Dermatology Hôpital de l'Archet Nice, FranceSearch for more papers by this authorJ.P.H. Lacour, J.P.H. Lacour Department of Dermatology Hôpital de l'Archet Nice, FranceSearch for more papers by this authorJ.P. Ortonne, J.P. Ortonne Department of Dermatology Hôpital de l'Archet Nice, FranceSearch for more papers by this author First published: 05 March 2004 https://doi.org/10.1002/lsm.20016Citations: 20AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume34, Issue3March 2004Pages 205-205 RelatedInformation

INTRODUCTION:Mycobacterium fortuitum skin infections are rare and usually iatrogenic. We report a case with cervical involvement following a facelift.OBSERVATION:A 65 year-old woman, without past history, underwent bilateral surgical facelift, complicated by cutaneous necrosis and treated with directed healing at home. Six weeks later, an abscessed nodule appeared under the left maxillary and was drained surgically. Then other pre-auricular and left cervical inflammatory nodules appeared without adenopathy or fever. M. fortuitum was isolated in bacteriological samples. The initially probabilistic antibiotherapy with carithromycin, subsequently adapted with amikacine and cirprofloxacine and then imipeneme for a total duration of 3 months, led to the clinical cure.DISCUSSION:Mycobacterium fortuitum is a rapidly growing, ubiquitous, mycobacteria responsible for nosocomial infections in immunocompetent patients, notably following plastic surgery. Contamination occurs where there has been a rupture in the skin barrier through contact with a vector (water, surgical material, antiseptic.). Treatment, which is not codified, consists in the association of surgery and antibiotics for several months.

Introduction. Myco bacterium fortuitum skin infections are rare and usually iatrogenic. We report a case with cervical involvement following a facelift.Observation. A 65 year-old woman, without past history, underwent bilateral surgical facelift, complicated by cutaneous necrosis and treated with directed healing at home. Six weeks later, an abscessed nodule appeared under the left maxillary and was drained surgically. Then other pre-auricular and left cervical inflammatory nodules appeared without adenopathy or fever. M. fortuitum was isolated in bacteriological samples. The initially probabilistic antibiotherapy with carithromycin, subsequently adapted with amikacine and cirprofloxacine and then imipeneme for a total duration of 3 months, led to the clinical cure.Discussion. Mycobacterium fortuitum is a rapidly growing, ubiquitous, mycobacteria responsible for nosocomial infections in immunocompetent patients, notably following plastic surgery. Contamination occurs where there has been a rupture in the skin barrier through contact with a vector (water, surgical material, antiseptic...). Treatment, which is not codified, consists in the association of surgery and antibiotics for several months.