Hailey-Hailey disease: the role of azathioprine an immunomodulator

Hailey-Hailey disease (HHD) is a rare autosomal dominant hereditary blistering and erosions disorder affecting the intertriginous regions of the body. There is still no treatment protocol for this disease thus clinicians are highly advised to draw up individualized treatment plan. In this case report we discuss a case of HHD in a 58-year-old Chinese man who was successfully treated with azathioprine in Hubei province

Cervical cancer and precancerous cervical lesions detected using visual inspection with acetic acid at Livingstone Teaching Hospital

Introduction: cervical cancer (CaCx) is the second most common malignancy in women world-wide. Precancer screening aided by visual inspection with acetic acid (VIA) is an early diagnosis method used to detect the lesions that are high indicators of cancer in women. cervical cancer is more prevalent in the developing world affecting mainly women in the reproductive age group and is the commonest cancer among Zambian women. Therefore, the study aimed to determine the prevalence and factors associated with a positive VIA at Livingstone Teaching Hospital (LTH). Methods: this was a cross-sectional study conducted at LTH among 329 women from Livingstone district aged 18 and above, who were coming for routine cervical cancer screening using VIA between 2019 and 2020. Demographic and clinical data were collected from the CaCx clinic. A positive VIA (precancerous cervical lesions) and cervical cancer were the primary and secondary outcome variables. A positive VIA was defined by presence of a dense ulcerative acetowhite area in the transformation zone of the cervix. Cervical cancer diagnosis was defined by presence of cancerous cells on histological examination by a qualified pathologist. Data were analyzed using Statistical package for social sciences (SPSS) version 22.0. Chi-square test, Mann-Whitney and logistic regression were the statistical methods used. Results: the participants had a median (interquartile range) age of 37 (29, 44) years. Prevalence of CaCx and positive VIA were 6% (95% confidence interval (CI) 4, 9) and 19% (95% CI: 15, 24) respectively. At multivariable analysis, the factors associated with a positive VIA were alcohol consumption [odds ratio (OR) 0.30 (95% CI: 0.12, 0.74)] and HIV infection [OR 0.37 (95% CI: 0.19, 0.70)]. Conclusion: the study showed that precancerous cervical lesions are common among our study participants and it was influenced by alcohol consumption and HIV status. There is therefore need to enhance the screening programs using VIA in order to identify cancerous lesions at an early stage for early intervention in resource limited settings

A Case Report of Tenofovir Alafenamide Induced Alopecia in a Zambian Teenager: A call for Pharmacovigilance

Adverse drug reactions continue to pose a global risk in the fight against HIV. In an attempt to attain the end AIDS pandemic by 2030, newer drugs are being formulated with better efficacy and fewer side effects. However, these new drugs still have Adverse Drug Reactions (ADRs), which may affect adherence and compliance. We present a rare case of Tenofovir Alafenamide (TAF) induced alopecia of a  Zambian teenager in the context of pharmacovigilance as a tool to identify ADRs, which may or may not have been identified during clinical trials. This is a wake-up call to all health care workers to identify and report ADRs and use the established channels to affect policy change. Key words: Tenofovir Alafenamide, Alopecia, Adverse Drug Reactions, pharmacovigilance, PLWHI

Hansen's disease: a neglected tropical infectious condition

This case of Hansen's disease reminds clinicians of all ages and era that leprosy is not a disease of the past as such a systematized multidisplinary approach and timely referral to specialists should be followed when evaluating any patient with chronic dermatoses of unknown cause. Early diagnosis of leprosy coupled with prompt treatment with Multi Drug Therapy (MDT) are the most important steps in preventing permanent debilitating deformity and disability.Keywords: Hansen's disease, Leprosy, Neglected Tropical Infectious Condition, Mycobacterium leprae, Mycobacterium lepromatosis, MDT, Armadillo contac

Onycholysis an early indicator of thyroid disease

Onycholysis is also referred to plummer's nails is a dermatological nail disorder characterized by spontaneous distal separation of the nail plate from the free margin and progressively proximally. We discuss a case of the 38-year-old man with onycholysis associated with hyperthyroidism due to Graves' disease. In this case review, we will discuss an association of onycholysis with thyroid disease and its diagnostic prognosis. Any unexplained onycholysis should prompt the clinician to investigate the client for asymptomatic hyperthyroidism

Dermatofibrosarcoma Protruberans A Locally Aggressive And Recurent Malignant Tumour Of The Skin: Review And Case Report

Dermatofibrosarcoma protuberans (DFSP) is uncommon but represents one of the most common dermal sarcomas, which is said to be a locally aggressive, low grade, and relatively uncommon cutaneous tumour, which has a high propensity for local relapse with low metastatic potential. Over 90% DFSPs are genetically characterized by chromosomal rearrangements (translocation t (17;22) (q22; q13), resulting in the collagen type-1 alpha 1 (COL1A1)-platelet-derived growth factor â (PDGFB) fusion gene with well-known risk factors for developing DFSP, some cases develop at the site of previous trauma and reports have included a burn scar and the site of vaccination.The mainstay mode of treatment of DFSPs is wide local excision with traditionally 3-cm gross margins excision surgery. Mohs Micrographic Surgery (MMS) is highly recommended surgery for DFSP and is very useful treatment choice for recurrent DFSP.This case report discusses two patients with confirmed DFSP and have received adequate therapy. It also reviews salient features of evaluation and prompt management of DFSP and much emphasis on long-term follow-up of patients.Key Messages:Early diagnosis of pediatric DFSP is critical to minimize surgical disfiguration. We emphasize early evaluation of any suspicious skin lesion should not be ignored and should be excised and sent for histopathology. Undertreating a DFSP is even more problematic, as the tumour is locally destructive, can metastasize, and can prove fatal without treatment. A full metastatic workup should be done and patient should be regularly followed up, if it turns out to be malignant