Evaluation of HIV Non-occupational Post-exposure Prophylaxis Utilisation in a Tertiary Health Facility in Nigeria

Background The Sub-Saharan Africa accounts for more than 70% of the global burden of HIV infections. Non-occupational post-exposure prophylaxis, when initiated within 72 hours of HIV exposure for 28 days, can prevent seroconversion in 80% of HIV exposures. Objectives To evaluate the characteristics, prevalence and outcome of non-occupational HIV post-exposure prophylaxis utilization in a tertiary hospital. Method This was a retrospective study that involved the medical records of 143 patients who sought HIV non-occupational post-exposure prophylaxis between 1st June 2011 and 31st May 2021. A questionnaire was used to collect information about the socio-demographic data, profiles of both the source and exposed persons, antiretroviral completion rate and outcome at follow-up. Results Females accounted for 125 (87.4%). Sexual assaults were the main reasons for seeking non-occupational post-exposure prophylaxis in 119 (83.2%). High-risk exposures were observed in 134 (93.7%). HIV status of the sources was unknown in 126 (88.1%). 123 (86.0%) initiated antiretroviral within 72 hours of exposure and antiretroviral completion rate was 70.6%. Only 28 (19.6%) reported for follow-up scheduled HIV screening and were all negative. Conclusion Early initiation of postexposure prophylaxis, improvement in baseline HIV testing of the source, and follow-up HIV screening, will significantly improve services and outcomes. Rwanda J Med Health Sci 2022;5(3):264-27

Atopic Dermatitis in Adults: Epidemiology, Risk Factors, Pathogenesis, Clinical Features, and Management

Atopic dermatitis (AD) is an itchy chronic relapsing inflammatory skin condition mostly affecting children than adults. Eczematous conditions are common worldwide with increase in the prevalence in both developed and developing countries. AD in adults is of two types – the first type starts as AD in childhood and gradually progresses to adulthood (Persistent AD) and the second type results from AD developing in adulthood (Adult-onset AD). The article reviews and discusses this condition in adults considering the epidemiology, risk factors, pathogenesis, diagnostic criteria, and management of this condition

A Retrospective Review of Chronic Non-Communicable Dermatoses Among Older Adults at a Tertiary Healthcare Facility in Southwestern Nigeria

Introduction: Aging is a ubiquitous human trait that predisposes older persons to chronic diseases. Compared with systemic non-communicable diseases, a significant gap exists in literature on the burden of non-communicable dermatoses (NCDs) amongst older adults, particularly in low and middle-income countries. Objectives: The aim of this study was to document the epidemiology and clinical pattern of non-communicable skin diseases among older adults in Nigeria. Methods: We conducted a retrospective review of medical records of ambulant adults aged ≥60 years referred for dermatological care at a teaching hospital in Southwestern Nigeria between February 2017 and February 2022. The frequency and pattern of NCDS were recorded for descriptive statistical analysis using SPSS 20 statistics software.  The level of statistical significance was set at 0.05. Result : A total of 553 medical records were reviewed with a female: male ratio of 1.3:1 The mean age of the study population was 68.85 ±7.87. Six out of every 10 patients (60.6%) had at least one chronic NCD. The incidence of chronic NCDs declined with increasing age. Chronic eczemas (22.4%), pigmentary dermatoses (9.4%), and skin tumors (8.7%) were the most frequent chronic non-communicable dermatoses recorded. Older males had a significantly higher incidence of chronic eczemas while chronic urticarias and skin tumors demonstrated significant female preponderance. Conclusion: There is a high burden of Chronic NCDs with significant gender disparities among older adults with skin problems in Nigeria. Pre-emptive planning and resource allocation towards specialist geriatric-dermatology services are needed to address the skin-health needs of the growing geriatric population

Vitiligo on tribal mark: A demostration of Wolf’s isotopic response

Background: Wolf’s isotopic response is the development of new lesions on old scar. Although this phenomenon is uncommon, most of the reported cases have been associated with development new lesions on the previously healed scar of herpes zoster infections. Case Report: Our patient is 74 year old woman with generalized vitiligo who demonstrated Wolf’s isotopic response by developing new lesions of vitiligo along the track of old scar (tribal mark). Conclusion: The exhibition of Wolf’s Isotopic response on old tribal mark, may transform a benign, asymptomatic tribal mark into a clinically significant feature which may aid the diagnosis of vitiligo

Fixed drug eruption induced by Fixed drug eruption induced by Moringa oleifera Moringa oleifera leaf leaf extracts - A case report extracts - A case report

Fixed drug eruption (FDE) is a commonly encounter cutaneous drug reaction at the dermatology clinics. The diagnosis is made when a characteristic lesion occurred repeatedly at the same site following re-exposure to the precipitating agent. We are presenting Moringa oleifera as a cause of FDE in a 55 year old man making the plant part of the growing list of implicating agents causing FDE. The mechanism by which it causes the lesion may not be completely understood but may probably be due to high sulphur content in the leaf extracts. The sulphur may serve as hapten and activate CD 8+ effector/memory T- cell leading to generation of proinflammatory cytokines such as interferon-gamma which causes tissue damage

Psychodermatological Disorders in Patients With Primary Psychiatric Conditions: Cross-Sectional Study

BackgroundPsychodermatological disorders (PDs) and their associations with mental health problems are one of the most frequent research themes in dermatology outpatient settings. Surprisingly, very few studies have been conducted to evaluate PDs among patients with primary psychiatric conditions. As such, the relationship between preexisting psychiatric conditions and comorbid PDs is underrepresented in the literature. ObjectiveThis study examined the prevalence and distribution of PDs among adults with primary psychiatric conditions and determined their association with underlying psychiatric diagnoses. MethodsWe conducted a cross-sectional analysis at a tertiary health care facility in southwestern Nigeria. Comorbid PDs were identified and classified using preexisting classification systems. A bivariate analysis was conducted to determine the association between PDs and underlying psychiatric conditions. The level of statistical significance was set at P<.05. ResultsThe study included 107 patients with mental health disorders, of whom 64 (59.8%) were female. The mean age of the patients was 40.73 (SD 13.08) years. A total of 75 (75/107, 70%) patients had at least one comorbid PD. The prevalence of PDs was highest in patients with affective disorders (15/20, 75%) and least in those with schizophrenia (45/66, 68%). PDs associated with delusions or hallucinations and somatoform symptoms were 9 and 13 times more frequent in patients with anxiety disorders compared to those with other psychiatric conditions (P=.01; odds ratio [OR] 9.88, 95% CI 1.67-58.34 and P=.003; OR 13.13, 95% CI 2.34-73.65), respectively. In contrast, patients with schizophrenia were significantly less likely to be diagnosed with dermatoses resulting from delusions or hallucinations (P=.002; OR 0.04, 95% CI 0.00-0.75). A weak but significant negative association was also found between psychophysiological PDs and anxiety disorders (ϕ=–0.236; P=.02). ConclusionsThis study provides important insights into the overwhelming burden of psychodermatological conditions in patients with mental health disorders and specific associations with underlying psychiatric diagnosis