Mycobacterium ulcerans

Objective. The usual preferential site of BU is in the limbs. In our experience, we noticed atypical and often misleading sites which pose serious issues for the diagnosis and often for the treatment. Methods. This is a retrospective study conducted over a period of ten years of BU treatment at the Department of Dermatology of the University Teaching Hospital of Treichville (Abidjan, Côte d’Ivoire). We included in this study all BU cases with atypical site diagnosed clinically and confirmed either by the histology, by smear, or by PCR. Results. Epidemiologically, the age of patients ranged from 3 to 72 years with a median age of 14.2 years. Children aged less than 15 years were affected in almost 80% of case. The clinical table was dominated by ulcerated forms in 82.1% of cases. The unusual topography mostly observed was that of the torso (thorax, back, and abdomen) in 76.8% of cases. Conclusion. BU is an endemic disease in Côte d’Ivoire where it constitutes a serious public health issue. Several years following its first cases, BU still is little known. This dermatosis may present atypical misleading clinical aspects which must be ignored

Case Report Multifocal Buruli Ulcer Associated with Secondary Infection in HIV Positive Patient

Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV) positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune reconstitution inflammatory syndrome (IRIS) occurrence and Mycobacterium dissemination. The deep immune depression, the underline biological, and clinical disorders of the patient might contribute to IRIS occurrence and Buruli ulcer dissemination. Future investigations have to be conducted on the mechanism of IRIS on set and on Mycobacterium ulcerans dissemination after ARV drugs initiation and the patient related underline clinical or biological disorders

Disseminated granuloma annulare-like presentation of juvenile Wells' syndrome

A 5-year-old boy was referred because of urticarial flares with angioedema. Antihistamines and systemic steroids were not useful to prevent flares. At examination, at distance of a flare, chronic red-brownish plaques were found on the legs, trunk, and back, resembling granuloma annulare. The skin biopsy showed epithelioid and giant-cell granulomas, elastophagia, and “flames figures” surrounded with many eosinophils. A diagnosis of disseminated granuloma annulare-like variant of Wells' syndrome as described earlier by Caputo was made. A treatment with dapsone was initiated and enabled to stop flares. Wells' syndrome is a rare clinicopathologic entity with a chronic benign course and often misleading clinical presentation. Our case illustrates the clinical polymorphism and benefit of dapsone therapy

Atopic dermatitis in children: Epidemiological and clinical aspects in Côte d'Ivoire

Few studies have been devoted to atopic dermatitis in children in sub-Saharan Africa. We therefore make this study in Côte d’Ivoire in order to contribute to a better knowledge of atopic dermatitis in children on black skin. In our study the prevalence was 9.2%. The duration of the disease before the consultation ranged from 3-45 days. Atopic dermatitis occurs more frequently in children from2 to 5 years old. More than half of the patients had a history of atopy and the lesions generally were localized in the folds. 60% of the lesions were dry and were trigged by dust. The pruritus was often insomnia and the scratching leads to hyperpigmentation of the lower eyelid; a characteristic sign on black skin not often reported in the literature

Confluent and Reticulated Papillomatosis of Gougerot-Carteaud on Black Skin: Two Observations

Confluent and reticulated papillomatosis of Goujerot-Carteaud is a rare and benign skin disease characterized by flat papules taking a reticulated appearance. It is a skin disease of unknown etiology and nosology that is always discussed. This disease preferentially involves the chest and interscapular regions. It is a condition probably underdiagnosed in black skin because it generally simulates a pigmented tinea versicolor. This pathology withstands antifungal treatment but has a particular sensitivity to cyclines thus constituting a distinguishing criterion, useful for diagnosis which should be evoked in front of these reticulated confluent papules

Confluent and Reticulated Papillomatosis of Gougerot-Carteaud on Black Skin: Two Observations

Confluent and reticulated papillomatosis of Goujerot-Carteaud is a rare and benign skin disease characterized by flat papules taking a reticulated appearance. It is a skin disease of unknown etiology and nosology that is always discussed. This disease preferentially involves the chest and interscapular regions. It is a condition probably underdiagnosed in black skin because it generally simulates a pigmented tinea versicolor. This pathology withstands antifungal treatment but has a particular sensitivity to cyclines thus constituting a distinguishing criterion, useful for diagnosis which should be evoked in front of these reticulated confluent papules

Dépigmentation cutanée cosmétique des femmes noires: résultats d’une enquête CAP à Abidjan (Côte d’Ivoire)

Introduction: la dépigmentation cutanée cosmétique est une pratique largement répandue chez les femmes noires en Afrique. Elle comporte de nombreuses complications bien décrites depuis des décennies. Cependant, les motivations des pratiquantes ne sont pas bien connues. Notre étude avait pour objectif d'appréhender les raisons et les motivations de ces femmes afin de pouvoir mener une action de communication en vue d'un changement de comportement. Méthodes: nous avons mené une étude transversale qui a consisté en une enquête CAP (Connaissances/Attitudes/Pratiques) au centre de Dermatologie du CHU de Treichville d'Abidjan. Les données ont été analysées par les logiciels Epi Info 3.5.1. et 6.04. Résultats: les pratiquantes étaient surtout des femmes urbaines jeunes (20-40 ans), célibataires, lettrées et professionnellement actives. La dépigmentation cutanée et ses conséquences étaient connues des femmes Cependant, elles désiraient être plus belles grâce à un teint plus clair et étaient influencées par les médias et leurs amies proches. Les complications les plus fréquemment observées étaient l'ochronose exogène et les vergetures. Les moyens de communication de proximité étaient les plus souhaités par les utilisatrices pour les aider à changer de comportement. Conclusion: l'élaboration de stratégies de communication de proximité visant un changement de comportement semble nécessaire pour enrayer le phénomène de dépigmentation cosmétique des femmes à Abidjan. The Pan African Medical Journal 2016;2

Multifocal Buruli Ulcer Associated with Secondary Infection in HIV Positive Patient

Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV) positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune reconstitution inflammatory syndrome (IRIS) occurrence and Mycobacterium dissemination. The deep immune depression, the underline biological, and clinical disorders of the patient might contribute to IRIS occurrence and Buruli ulcer dissemination. Future investigations have to be conducted on the mechanism of IRIS on set and on Mycobacterium ulcerans dissemination after ARV drugs initiation and the patient related underline clinical or biological disorders

Allergy to Red Meat: A Diagnosis Made by the Patient and Confirmed by an Assay for IgE Antibodies Specific for Alpha-1,3-Galactose

We report the first case of allergy to red meat observed in Ivory Coast. A 49-year-old male presented with pruritus. The diagnosis of allergy to red meat was confirmed by an assay for IgE antibodies specific for alpha-1,3 galactose. Interestingly, the disease was considered a spell to the patient who was suspected of being a sorcerer by the community