Rosai-Dorfman Disease Involving Multiple Organs: An Unusual Case with Poor Prognosis

Rosai-Dorfman disease is a rare, benign histiocytic proliferative disorder that usually affects the lymph nodes. Although extranodal involvement has been reported in diverse sites, manifestation in the cardiovascular system is extremely rare. Specifically, cardiac involvement in Rosai-Dorfman disease is an extraordinarily infrequent event. We describe a case of a 36-year-old female who presented Rosai-Dorfman disease of multiple organs including the heart, with poor prognosis

Pulmonary Tuberculosis and Lepromatous Leprosy Coinfection

Simultaneous occurrence of leprosy and pulmonary tuberculosis is reported infrequently in the modern era. We report a case of pulmonary tuberculosis diagnosed in patient being treated with glucocorticoids for complications of leprosy (type II reaction). Physicians should recognize that the leprosy patients treated with glucocorticoid may develop tuberculosis

Cutaneous Manifestations of Lupus Erythematosus in Antananarivo (Madagascar)

Introduction: Lupus erythematosus is a serious autoimmune inflammatory disease. Mucocutaneous manifestations are themain clinical manifestations, so our aim is to determine the different cutaneous manifestations of lupus erythematosus in Antananarivo.Methods: A retrospective study was conducted over a period of 5 years from January 2007 to December 2011 in the medical derpartment of Joseph Raseta Befelatanana University Hospital.. All patients who presented lupus erythematosus were included.Results: Among 57,509 patients seen in Joseph Raseta Befelatanana University Hospital, sixty seven cases of lupus erythematosus were included. The mean age was 35.08 years [minimum: 9; maximum: 69 years]. The sex ratio was 0.06. Among these 67 patients, forty six presented cutaneous manifestations (68, 65%). As specific lesions in lupus, chronic cutaneous lupus was observed in 47.82%, acute cutaneous lupus in 30.43% and subacute cutaneous lupus in 06.52% of patients. The other dermatological manifestations found were alopecia in 52.17%, photosensitivity in 43.47%, Raynaud's phenomenon in 17.39% and bullous lesions in 06.52% of patients.Conclusion: A little difference was found in epidemiological, clinical and paraclinical aspects in lupus Malagasy patients and Africans. Lupus erythematosus is still a under-diagnosed disease in Madagascar. A deeper understanding of the cutaneous manifestations of SLE is essential for diagnosis and prognosi

Misuse of Topical Corticosteroids for Cosmetic Purpose in Antananarivo, Madagascar

This cross-sectional study was conducted in Antananarivo, Madagascar, from June to September 2012. We aim to evaluate the misuse of TC on the face for cosmetic purpose and the adverse effects due to its application. A questionnaire-based analysis was done among females who use topical corticosteroids on the face for cosmetic purpose. Of the 770 women questioned, 384 (49,8%) used topical corticosteroids for cosmetic purpose whose mean age was 38 years (range 16–73 years). Two hundred and sixty-one females (68%) used TC combined with handcrafted cosmetics, and 123 (32%) used TC alone. “Pandalao,” which contains salicylic acid, peppermint oil, lanolin, powder of Juanes de Vigo (mercury powder), and Vaseline, is the most handcrafted cosmetic combined with TC in our study (used by 29,4% respondents). Only one (0,26%) had obtained the TC by physician’s prescription, 234 (61%) from cosmetic retailers, 92 (23%) directly from local pharmacies, 49 (12%) from beauticians, and 15 (4%) from unspecified sources. Lightening of skin color was the main reason for using TC in 44,8% of respondents in the absence of any primary dermatosis. Pigmentation disorders (63,2%) and cutaneous atrophy (52,1%) were the most adverse effects noted

Observance Thérapeutique Au Cours Des Dermatoses Chroniques A Madagascar

Introduction: Therapeutic compliance is the adequacy of the patient's behavior regarding medical recommendations. In Madagascar, No survey has not yet been published in that regard. Thus, our purposes are to determine the compliancy rate of patients with chronic diseases in dermatology and to identify the factors affecting their therapeutic compliance.Methods: Monocentric descriptive and retrospective study performed in the dermatology department of Joseph Raseta Befelatanana University Hospital center, On a 6 months duration, among patients with chronic dermatoses.Results: We counted 133 patients with a compliancy rate of 35.34%. Several parameters particularly age, gender, educational level, salary, understanding of pathology and treatment, duration of follow-up, were considered and correlated with the rate of compliance to assess factors of good and bad compliance.Conclusion: In order to improve the therapeutic observance in care unit, It is necessary to intervene on the standard of living of the patients suffering from chronic dermatoses and to promote the therapeutic education accompanied by psychological support to make them understand their pathology as well as the appropriate treatment

A Case of Fluoroquinolone-Resistant Leprosy Discovered after 9 Years of Misdiagnosis

We report a case of misdiagnosed leprosy in a 21-year-old Malagasy male, who, improperly treated, developed secondary mycobacterial resistance to fluoroquinolone. The patient contracted the infection 9 years prior to the current consultation, displaying on the right thigh a single papulonodular lesion, which progressively spread to the lower leg, back, and face. Initial administration of ciprofloxacin and prednisolone led to temporary and fluctuating improvement. Subsequent long-term self-medication with ciprofloxacin and corticosteroid did not heal the foul and nonhealing ulcers on the legs and under the right sole. Histopathological findings were compatible with lepromatous leprosy. Skin biopsy was positive for acid-fast bacilli and PCR assay confirmed the presence of a fluoroquinolone-resistant strain of Mycobacterium leprae (gyrA A91V). After 6 months of standard regimen with rifampicin, clofazimine, and dapsone, clinical outcome significantly improved. Clinical characteristics and possible epidemiological implications are discussed

Quality of Life in Patients with Psoriasis Seen in the Department of Dermatology, Antananarivo, Madagascar

Background. Psoriasis is a chronic, inflammatory, and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision-making along with the effectiveness and the harmlessness of the treatments. Objective. To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales. Methods. A cross-sectional study from January to June 2018 was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, including patients more than 18 years old with mild to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales. Results. 80 patients were included, their mean age was 36.5 years, and the male to female was 1.5 : 1. The mean DLQI score was 13.8. Symptoms, feelings, and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0.36). Furthermore, the clinical presentation of psoriasis did not influence the patient’s QoL (p=0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0.2). The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0.002). Furthermore, the higher the PASI, the more QoL is altered (p=0.002). Conclusion. Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis

Chromoblastomycosis and sporotrichosis, two endemic but neglected fungal infections in Madagascar

International audienceChromoblastomycosis and sporotrichosis are endemic fungal infections of tropical and subtropical regions, including Madagascar. The causal fungi develop in the soil or on plants and infect humans through wounds, either directly (wounding by the plant, through thorns, for example), or through the contact of an existing wound with contaminated soil. For this reason, the lesions predominantly occur on the limbs, and these fungi principally infect people working outside with bare hands and/or feet. The subcutaneous lesions of chromoblastomycosis are initially nodular, subsequently becoming warty, tumoral, cauliflower-like and pruriginous, which promotes dissemination. The chronic nature of the infection and its progression over long periods lead to highly disabling lesions in essentially rural and agricultural populations. The lesions of sporotrichosis are also nodular, but more ulcerous, and they form an extended chain following the route of the lymph vessels. Pus, squamous or skin biopsy specimens are used for the mycological examination of these mycoses. Treatment depends on the severity and form of the lesions and is based on antifungal drugs sometimes combined with physical methods. There has been no study of these infections for more than two decades in Madagascar, despite the large numbers of cases seen by doctors in all parts of the island. The nature, diversity and distribution of the plants responsible for contamination have not been described in Madagascar. In this review, we described these two endemic mycoses in terms of their epidemiological, mycological, clinical and therapeutic characteristics, focusing particularly on Madagascar, which is one of the leading foci of these two infections worldwide

Clinical aspects of previously treated chromoblastomycosis: A case series from Madagascar

International audienc