Les dermites du siège chez le nourrisson à Dakar: Etude de 205 cas [Diaper dermatitis among the infant in Dakar: Study of 205 cases]

Background: Diaper dermatitis in infant is a common reason for dermatological consultation. The aim of this study was to describe the epidemiological, clinical, etiological and evolutionary aspects of diaper dermatitis in infant. Materials and Methods: A cross-sectional descriptive study was conducted in three dermatology departments in Dakar. All infants [1-30 months] who are followed from October 1, 2015 to April 30, 2016 for diaper dermatitis was included. Results: We collected 205 cases, a hospital frequency of 22.18%. The sex ratio was 1.02 and the mean age was 8.49 months. Diaper dermatitis was inflammatory in 67%, irritative in 18%, infectious in 12% and associated with general disease in 3%. Dermatitis was seborrheic in 51.7%, mycotic in 14.6% and associated with: acrodermatitis enteropathic in 4 cases and granuloma gluteale infantum in one case. Baby diapers were used in 93.7% by moms with a change of less than 6 times a day in 84.9%. The clinical outcome was favorable in 56.1%. Conclusion: Diaper dermatitis in infant is a common infant dermatosis in Dakar. The multiple causes necessitate a rigorous diagnostic approach. Severity is related to association with general diseases. RÉSUMÉ Introduction: Les dermites du siège du nourrisson est un motif fréquent de consultation dermatologique. L’objectif de notre étude était de décrire les aspects épidémiologiques, cliniques, étiologiques et évolutifs des dermites du siège du nourrisson. Matériels et Méthodes: Une étude descriptive a été menée dans trois services de dermatologie à Dakar. Tous les nourrissons [1-30 mois] suivis du 1er Octobre 2015 au 30 Avril 2016 pour une dermite du siège étaient inclus. Résultats: Nous avons colligé 205 cas, soit une fréquence hospitalière de 22,18%. Le sex- ratio était de 1,02 et l’âge moyen de 8,49 mois. Les dermites du siège étaient inflammatoire dans 67%, irritative dans 18%, infectieuse dans 12% et associée à une maladie générale dans 3%. La dermite était séborrhéique dans 51,7%, mycosique dans 14,6% et associée à : une acrodermatite entéropathique dans 4cas et un granulome glutéal dans un cas. Les couches étaient utilisées dans 93,7% par les mamans avec un changement de moins de 6 fois par jour dans 84,9%. L’évolution clinique était favorable dans 56,1%. Conclusion: Les dermites du siège du nourrisson sont des dermatoses fréquentes chez le nourrisson à Dakar. Les causes multiples rendent nécessaire une démarche diagnostique rigoureuse. La gravité est liée à l’association avec des maladies générales

Evaluation de la rigidité artérielle par la vitesse de progression de l’onde pouls doigt-orteil mesuré par pOpmetre® chez des sujets noirs africains atteints de sclérodermie systémique [Evaluation of arterial stiffness by finger-toe pulse wave velocity measured by pOpmetre® in black africans patients with systemic scleroderma]

Background: The purpose of this study was to assess the arterial stiffness (AS) in black africans patients with systemic scleroderma. Patients and Methodology: A prospective cross-sectional hospital survey has been performed over a 6-month period, including 55 black african individuals, aged over 16 years and consenting, consisting of 29 patients with systemic scleroderma and 26 hospitalized controls. The finger-toe pulse wave velocity (ft-PWV) was recorded by popmetre® and comparaison between the 2 groups has been performed with statistical analysis. Results: The mean ft-PWV was 9,56 m/s ± 3,09 in the patient group and 7,71 m/s ± 2,63 in control group. The ft-PWV was significantly higher in patients with scleroderma compared to controls (p<0.0145). The study of the relationship between AS and independent variables in multivariate analysis demonstrated that having scleroderma increase by 1.81 times the value of the ft-PWV after adjustment for age and systolic blood pressure. Discussion: To our knowledge, this is the first assessment of the AS in black african patients with scleroderma. It shows that ft-PWV was significantly higher in patients with scleroderma compared to controls. Also, this high AS was imputable to the scleroderma. Conclusion: In Africa, the measurement of the AS by popmetre® could be a simple, rapid, non invasive and pratical early detection and follow-up of cardio-vascular involvments in the course of scleroderma. RÉSUMÉ Introduction: L’objectif de notre étude était d’évaluer la résistance artérielle (RA) chez les patients noirs africains atteints de SS. Patients et Méthode: Une enquête hospitalière prospective transversale a été réalisée sur une période de 6 mois, portant sur 55 sujets noirs africains, âgés de plus de 18 ans, consentants, composé de 29 malades atteints de SS et 26 témoins hospitalisés. La vitesse de progression de l’onde pouls doigt-orteil (VOPdo) a été mesuré par Popmètre dans les 2 groupes et une étude comparative a été effectué grâce à des analyses statistiques. Résultats: La moyenne de la vitesse de progression de l’onde pouls doigt-orteil (VOPdo) au popmètre® était de 9,56 m/s ± 3,09 chez les malades contre 7,71 m/s ± 2,63 chez les témoins. La vitesse de propagation de l’onde de pouls était significativement plus élevée chez les malades comparés aux témoins (p<0.0145). L’étude de la relation entre la RA et les variables indépendantes en analyse multivariée, après régression linéaire montrait qu’avoir une SS augmentait de 1.81 fois la valeur de la VOP (p=0.022) après ajustement sur l’âge et la PAS. Discussion: A notre connaissance, cette étude est la première qui évalue la RA au cours de la SS chez le sujet noir africain. Notre étude montre que la VOPdo était significativement plus élevée chez les malades sclérodermiques comparés aux témoins (p<0.0145). En analyse multivariée, après régression logistique, la RA était imputable à la SS. Conclusion: En Afrique, la mesure de la RA par popmètre pourrait être une méthode non invasive, rapide, simple et pratique de dépistage précoce et de suivi des atteintes cardio-vasculaires au cours de la sclérodermie

Maladie de Rosaï-Dorfman a presentation cutanee tumorale [Rosaï-Dorfman disease with tumoral skin lesions]

Rosai-Dorfmann disease manifests on the skin commonly as papules, nodules or rarely as infiltrated plaques. Authors report the case of a 27 year-old-man, presenting diffuse, budding and pediculated tumoral skin lesions associated with superficial and deep lymphadenaopathies and fever. The histopathological examination showed caracteristic features of emperipolesis. The Rosaï-Dorfman disease is remarkable in our case by its tumoral and profus presentation, as well as its pseudo-xanthomatous aspect. RÉSUMÉ Les lésions cutanées de la maladie de Rosai-Dorfman sont le plus souvent à type de papules, nodules ou plus rarement de plaques infiltrées. Les auteurs rapportent l’observation d’un homme de 27 ans, présentant des lésions tumorales cutanées bourgeonnantes, pédiculées, diffuses, associées à des polyadénopathies superficielles et profondes fébriles, avec des images caractéristiques d’empéripolèse à l’histologie. La maladie de Rosaï-Dorfman est remarquable dans notre observation par sa présentation cutanée tumorale et profuse, ainsi que l’aspect pseudo-xanthomateux

Aspects epidemiologiques et cliniques des pemphigus au Senegal [Epidemiological and clinical aspects of pemphigus in Senegal]

Background: The purpose of this study was to specify the epidemiological and clinical characteristics of pemphigus in the Department of Dermatology of the University Hospital of Dakar. Patients and Methodology: All medical records of patients seen for pemphigus in our department over a 11-year period were analyzed retrospectively. Results: We collected 105 cases of pemphigus, corresponding to a frequency of 10 cases/year and a hospital prevalence of 2.7%. Thus, pemphigus held the second rank of blistering autoimmune bullous diseases after bullous pemphigoid. The mean age of patients was 47.62 years and the age group [40-59 years] was predominantly affected (28 cases; 45 %). There were 41 femeles and 21 men (F/M ratio: 2). We did not find an endemic focus in our country. Clinical forms were dominated by pemphigus foliaceus (30 cases; 48.5 %), followed by pemphigus vulguaris (19 cases; 30.6 %) and finally by pemphigus erythematosus (13 cases; 21%). In 16 cases (25 %), the pemphigus had begun after the consumption of a traditional medicinal plant (8 cases). An associated toxidermia was found in12 cases. Pruritus was present in 43 patients (69.35%). Discussion: In Senegal, pemphigus are common diseases, but without however an endemic focuc. They occur in young women, with a predominance of superficial forms, especially pemphigus foliaceus. The presence of pruritus and associated toxidermia to traditional medicinal plants are common. RÉSUMÉ Introduction: L’objectif de cette étude était de préciser les aspects épidémiologiques et cliniques des pemphigus au CHU de Dakar. Patients et Méthodes: Tous les dossiers des malades admis pour pemphigus ont été analysé de façon rétrospective sur une période de 11 ans. Résultats: Nous avons colligé 105 cas de pemphigus, correspondant à une fréquence de 10 cas/an et une prévalence hospitalière de 2,7 %. Les pemphigus occupaient le 2° rang des dermatoses bulleuses auto-immunes après la pemphigoide bulleuse. L’âge moyen des patie nts était de 47,62 ans et la tranche d’âge [40-59] ans était la plus concernée (28 cas; 45 %). Il s’agissait de 41 femmes et 21 hommes, soit un sex-ratio F/H de 2. Il n’existait pas de foyer endémique. Les formes cliniques étaient dominées par le pemphigus foliacé (30 cas; 48,5 %), suivi du pemphigus vulguaire (19 cas; 30,6 %) et enfin du pemphigus séborrhéique (13 cas; 21%). Dans 16 cas (25 %), le pemphigus avait débuté au décours d’une phytothérapie orale (8 cas). Une toxidermie surajoutée était retrouvée dans 12 cas. Le prurit était noté chez 43 patients (69,35%). Discussion: Au Sénégal, les pemphigus sont des affections fréquentes, mais sans toutefois de foyer endémique et surviennent chez des femmes jeunes, avec une prédominance des pemphigus superficiels, notamment du pemphigus foliacé. La présence d’un prurit et d’une toxidermie surajoutée aux plantes traditionnelles sont fréquentes

The characteristics of severe forms of psoriasis on pigmented skins: A retrospective study of 102 cases in Dakar, Senagal

Background: Severe forms of psoriasis can be life-threatening for patients. Our objective was to determine the epidemiological, clinical, therapeutic aspects and outcome of severe forms of psoriasis. Methodology: A 18 years retrospective study conducted in the department of Dermatology at Le Dantec hospital listed all the severe forms of psoriasis. Results: We have collected 102 cases of severe forms. The sex ratio was 1.55 and the average age of 47 years. The family histories of psoriasis were reported in 5 patients. Arterial hypertension was noted in 10 patients, diabetes in 4 patients and obesity in 6 patients. Smoking and alcoholism were found respectively in 10 cases and 7 cases. The average duration of the lesions was 2 years. Phytotherapy was reported in 62 patients (62%). Pruritus was present in 86 patients (84%). The clinical forms of psoriasis were: erythroderma in 76 cases (74.5%), psoriatic arthritis in 14 cases (13.7%) and a pustular form in 12 cases (11%). HIV serology was positive in 12 patients. All patients had received a treatment with topical corticosteroids and emollients. Methotrexate was initiated in 57 patients and retinoids in 27 cases. The outcome was favorable in 67 patients (65%). We recorded 6 deaths (6%). Conclusion: The large use of oral phytotherapy medicines and inappropriate treatment precipitated or speeded up the occurrence of severe forms of psoriasis among our patients

Squamous Cell Carcinoma in African Children with Xeroderma Pigmentosum: Three Case Reports

Introduction: Xeroderma pigmentosum is a rare autosomal recessive genetic disease. This disease predisposes patients to early-onset skin cancers, particularly squamous cell carcinoma. Here, we report 3 pediatric cases, including 2 deaths. Observation: The subjects included 2 boys and 1 girl with skin type VI. All subjects were from consanguineous marriages, and the average age was 7.6 years. The patients all had ulcerative budding tumor lesions in the cephalic region, and the mean disease duration was 18 months. In all 3 cases, the diagnosis of xeroderma pigmentosum was made before the poikilodermal appearance of sun-exposed areas and photophobia. Neurological-type mental retardation was noted in 1 case. Histology confirmed squamous cell carcinoma in all 3 cases. The evolutions were marked by the death of 2 children (cases 1 and 3). In one case, the outcome was favorable following cancer excision and subsequent chemotherapy with adjuvant radiotherapy. Conclusion: Squamous cell carcinoma is a serious complication related to xeroderma pigmentosum in Sub-Saharan Africa. Prevention is based on the early diagnosis of xeroderma pigmentosum, black skin photoprotection, screening and early treatment of lesions, and genetic counseling

Epidemiologic and clinicopathologic aspects of Leprosy in Dakar; evaluation of 73 new cases

Hundreds of new leprosy cases are still diagnosed in Dakar despite all the efforts in the struggle by the national program for elimination of leprosy by the Institute of Applied Leprosy in Dakar. The aim of our study was to evaluate the epidemiological, clinicopathological and outcome of new cases of leprosy. A prospective study was conducted over a period of one year listing all new cases of leprosy based on clinical diagnosis, bacteriology and histology. 73 new cases were recorded. The sex ratio was 1.5 and the mean age of 39.5 years. Children aged from 0 to 15 years old represented 12%. The clinical forms were rated in order of decreasing frequency Borderline 47.94%, 30.13% lepromatous lepromatous, indeterminate 8.21, borderline lepromatous 6.84, TT: 5.47%, 1.36 and neurological bb%. Neurological signs were enlarged nerve in 50 cases, a neurological deficit in 16 cases and a sensitive deficit in 16 cases. The complications were burns and ulcerations in 10 cases, a claw in 7 cases, a reversal reaction in 7 cases, erythema nodosum in 4 cases and neuritis in 8 cases. The number of new cases mutilated was 24.65%. The smear was positive in 42% and histology contribution in 91.37% of cases. Our study highlights the significant number of patients with multibacillary contagious, affected children, the high proportion of disability grade 2/OMS reflecting the delay in diagnosis. This delay is due to ignorance, to traditional treatments and low socio-economic status and lack of trained diagnostic teams in different areas apart from referral centres

Pyoderma gangrenosum among children in Senegal: 6 cases

The pyoderma gangrenosum (PG) is a chronic ulcerative neutrophilic dermatosis rare in children. It is often associated with chronic inflammatory bowel disease, some systemic diseases and leukemias. We report six cases in children. We collected six cases, the average age was 10 years (4-15 years), the sex ratio was 0.16 (5 boys and 1 girl). The ulcerated clinical form of PG was noted in all children. The topography was in the lower limbs in five cases and in the cephalic extremity in three cases. The mean duration of evolution was 2 years (15 days-7 years). PG was associated with ulcerative colitis in one case. Oral corticosteroids were administered in all cases at a dose of 0.5 to 1 mg/kg. The complete healing of the cutaneous lesions was obtained. Two children were lost to sight. Our study reports a male predominance of PG in children with ulcerative clinical form of the limb and association with ulcerative colitis. Corticosteroids appear to be efficient, but may be limited by their complications