Blistering eruptions following isotretinoin therapy for hidradenitis suppurativa: a case report

A 33-year-old male was treated with isotretinoin (20mg daily) for hidradenitis suppurativa. After 6 weeks on the medication, he developed symmetrical erythematous tense blisters on the lower legs. Report of biopsy done was of intraepidermal blisters with superficial dermal lymphohistiocytic infitrates. He was commenced on oral prednisolone 30mg daily and Isotretinoin was withdrawn. The blisters resolved over a 2week period. The lesions of hidradenitis suppurativa were noticed to have improved with the short course of isotretionoin

Community Based Study of the Influence of Social class on the Prevalence and Clinical Profile of Adolescent Facial Acne Vulgaris

Background: Facial acne vulgaris is the most common disease of the skin in adolescents. In Nigeria, studies of the prevalence of  dolescent facial acne vulgaris, lesion type and distribution, and influence of social class on prevalence are few. The aim of this study was to determine the prevalence of adolescent facial acne vulgaris, clinical characteristics, and the influence of social class on this prevalence. Methods: This was a community‑based cross‑sectional study. One thousand and seventy‑nine students from four secondary schools (two private and two public) were assessed. Students were clinically examined for facial acne vulgaris, and acne severity was graded. A structured questionnaire for sociodemographic variables was administered to the students. Data were analyzed using SPSS 16. Results: One thousand and seventy‑nine students were studied; 52% were male, and 47.9% were female. The students were aged 9–20 years with a mean age of 14 ± 2.1 years. The prevalence of facial acne vulgaris was found to be 53.2%. More females (56.7%) had acne than males (50%), the prevalence was found to increase from 28% in the 9–11 years age group to 71.1% in the 18–20 years age group and more prevalent in adolescents from the high social class (60.7%). The severity of acne was mild in 67.2%, moderate in 28.9%, and severe in 4.9%. Conclusion: Prevalence of adolescent facial acne vulgaris increases with age, more prevalent in adolescents from a high social class. Male gender, age, a family history of acne, and previous treatment of acne contribute to the severity of acne. Keywords: Acne vulgaris, adolescent, clinical profile, prevalence, severity, social class&nbsp

Epidemiology and clinical profile of vitiligo in Ibadan, Nigeria

Background: Vitiligo patients are seen routinely in the Dermatology Outpatient Clinic of the University College Hospital Ibadan, Nigeria. However, the epidemiologic and clinical profile of these patients is not documented. The aim of this study was to document the clinical (age of onset, location, severity, class of vitiligo) and sociodemographic characteristics of these patients.Methods: This is a retrospective descriptive study of patients treated for vitiligo from January 2005 to December 2009 at the University College Hospital (UCH) Ibadan dermatology outpatient clinic. Patient records were retrieved and a study proforma was used to assess patient’s information. Data was analyzed using SPSS version 16.Results: Over the study period, 130 vitiligo patients seen but only 111 case notes were retrieved. The mean age at onset in children was 7.8±4.0 and 34.6±17.1 in adults, M:F was 1:1. The commonest type of vitiligo was acrofacial, area of onset was the face/scalp in 59.2%, re-pigmentation was reported in 66%, active lesions in 59.7%, severity of vitiligo was <9% in 90%, Vitiligo was in visible (exposed) parts of the body 84.7% and asymptomatic in 92.7%.Conclusions: The clinical profile of vitiligo in Ibadan, Nigeria is similar to that observed in other places with only females having a genital onset and acrofacial vitiligo being the dominant type seen. Also, treatment modality varies between children and adults

Case series: eruptive xanthomas and hyperlipdaemia

Eruptive xanthomas are uncommon with only case reports documented making it difficult to have a prevalence figure. These asymptomatic eruptions are usually a clue to an underlying metabolic disorder with associated cardiovascular risk. Early diagnosis and treatment prevent its associated morbidity and mortality. We present a case series of 2 males (29 and 40 years) and 3 females (14, 28 and 40 years old). They presented with lesions clinically consistent with eruptive xanthomas.  Laboratory and histologic investigations revealed dyslipidemia and lipid laden macrophages. They were placed on statins with an improvement of skin lesions and improvement in lipid levels. Dermatologists should be aware of skin lesions as a marker of severe dyslipidemia and its attendant cardiovascular risk. Early treatment leads to resolution of xanthomas and prevention of cardiac related morbidity and mortality.

Clinical, epidemiological characteristics and associated factors of hair greying in Lagos, Nigeria

Objective: To document the epidemiological, clinical characteristics, believed triggers and associated behaviour in hair greying.Design: A community based cross-sectional descriptive study was conducted in February 2020 following ethical ap-proval and written informed consent from participants. All participants were clinically evaluated for hair greying, its pattern and location on the scalp. Socio-demographic data were documented. Data was entered and analyzed using the IBM statistics software version 22. Numerical and categorical variables are presented.Setting: The study was conducted at an urban market in Lagos, Nigeria.Participants: The study participants comprised 307 adult traders.Results: The mean age of the 307 participants studied was 42.7±12.8 years. The prevalence of hair greying was 47.6% (51% in males and 45.9% in females). The median (IQR) age of those with grey hair was 52 (44, 59) years. The prevalence of hair greying was 14.8% in those aged 30-34 years and 97.2% in those aged 60 years and above. The prevalence of premature greying was 17.7% and greying before friends and family members was reported at 19.9% and 13%, respectively. Grey hair was diffuse in 81.5%; localized to the frontal area of the scalp in 55.5%. Use of hair dye was noted in 15.8%.Conclusion: Hair greying is common in the study population. The age at onset is 30 years. Premature hair greying is uncommon in Nigeria. More epidemiological studies of hair greying especially of premature hair greying are needed

Histopathological Analysis of Psoriasis

Background: Treatment of psoriasis results in alteration in clinical and histopathology findings with resultant inconclusive histopathology findings and a diagnostic dilemma in resource poor settings. Objective: To document the histopathology of clinically correlated psoriasis, compare with other studies and observe any differences in features.Methodology: A retrospective cross-sectional evaluation of 60 cases histopathologically diagnosed as psoriasis was conducted at the ClinaLancet laboratory in Lagos, Nigeria over a 2-week period. Slides of 60 dermatology clinic treatment naive cases diagnosed by dermatologists with histopathological correlation as psoriasis were retrieved, observed under the microscope and the features of psoriasis were documented in a pre-designed proforma. Data was entered into a Microsoft Excel Spreadsheet. Simple means and frequencies were presented.Results: There were 35 females (58.3%) and 25 males (41.7%). The mean age of the patients was 41.55 ± 19.03 years; age range was 1-83 years. The commonly observed features of psoriasis were hyperkeratosis (100%), acanthosis (100%), perivascular infiltrates (100%), parakeratosis (95%), absent granular layer (83.3%), suprapapillary plate thinning (86.7%) and Munro microabscess (45%). The findings were comparable to other studies.Conclusion: The findings from this study are similar to the findings from other histopathology study of psoriasis. Iatrogenic intervention does not significantly change the histopathology features of psoriasis to the extent that a conclusive diagnosis cannot be made