The Early Detection and Case Management of Skin Diseases With an mHealth App (eSkinHealth): Protocol for a Mixed Methods Pilot Study in Côte d’Ivoire

Background: There is a high prevalence of skin diseases sub-Saharan Africa, including skin neglected tropical diseases (NTDs) that could lead to lifelong disabilities and deformities if not diagnosed and treated early. To achieve early detection and early treatment of these skin diseases, we developed a mobile health app, eSkinHealth.Objective: This paper outlines a protocol for evaluating the effect of our eSkinHealth app in the early detection and effective management of skin diseases in Côte d’Ivoire.Methods: A mixed methods pilot trial will be conducted in Côte d’Ivoire and will consist of 3 phases: (1) the development and improvement of the eSkinHealth app, (2) a pilot trial to evaluate the usability of the eSkinHealth app for local medical staff in Côte d’Ivoire, and (3) a pilot trial to evaluate the effectiveness of early detection and case management of targeted skin NTDs (Buruli ulcer, leprosy, yaws, and lymphatic filariasis) with the eSkinHealth app in Côte d’Ivoire. The pilot study will be implemented as a 2-arm trial with local health care providers and patients with skin NTDs over a 3-month follow-up period. The local health care providers will be assigned to an intervention group receiving the eSkinHealth app to be used in their daily practices or a control group. Training will be provided on the use and implementation of the app and the diagnostic pipeline to the intervention group only, while both groups will receive training on skin diseases. Our primary outcome is to evaluate the early detection and effective management of skin diseases using the eSkinHealth app in Côte d’Ivoire by the number of cases diagnosed and managed. Additionally, we will evaluate the eSkinHealth app with validated questionnaires and in-depth interviews. Procedures of our methods have been reviewed and approved by the Institutional Review Board of the Ministry of Health, Côte d’Ivoire and by Tulane University in 2021.Results: This study was funded in 2021. We started the enrollment of patients in February 2022, and data collection is currently underway. We expect the first results to be submitted for publication in 2023.Conclusions: Our eSkinHealth app is a field-adapted platform that could provide both direct diagnostic and management assistance to health workers in remote settings. The study will provide evidence for the usability and the effectiveness of the eSkinHealth app to improve the early detection and case management of skin NTDs in Côte d’Ivoire and, furthermore, is expected to contribute to knowledge on mobile health approaches in the control of skin NTDs

Epidemiological, Clinical, and Paraclinic Aspect of Cutaneous Sarcoidosis in Black Africans

The specific objectives were to identify the epidemiology of cutaneous sarcoidosis and describe the clinical and laboratory aspects of the disease. Materials and Methods. We performed a descriptive cross-sectional study involving 24 referred cases of cutaneous sarcoidosis in 25 years (1990–2014) collected at Venereology Dermatology Department of the University Hospital of Treichville (Abidjan) both in consultation and in hospitalization. Results. The hospital frequency was one case per year. The average age was 42 years, ranging from 9 to 64. The sex ratio was 1. The shortest time interval between the appearance of the skin lesion and consultation of Dermatology Department at CHU Treichville was 3 months. The elementary lesions were represented primarily by a papule (18 cases), placard (3 cases), and nodule (2 cases) and mainly sat on the face and neck in 8 cases (38%). Extra cutaneous lesions were dominated by ganglion and respiratory involvement with 5 cases each followed by musculoskeletal damage in 3 cases. Chest radiography showed abnormality in 13 cases (54%). The pulmonary function test performed in 13 patients found 7 cases (54%) having restrictive ventilatory syndrome and 6 cases (46%) being normal. A tuberculin anergy was found in 11 cases (61%)

Skin pathology of the elderly patients: Case of black African

Background: Skin diseases of the elderly subjects have clinical signs which are different from those of the young people. The purpose of this study was to determine the skin diseases that led elderly people to consult at the Department of Dermatology at the University Teaching Hospital in Bouaké, Côte d’Ivoire. Methods: That was a descriptive cross-sectional study conducting between January 1, 2015 and December 31, 2015 and including patients 65 years and older who were diagnosed with skin diseases the Department of Dermatology at the University Teaching Hospital in Bouaké, Côte d’Ivoire. Results: During the study period, 109 patients aged 65 years and older (1.8%) were recruited. These patients consulted for 227 diagnoses. The average age of the patients was 71.8 and sex ratio was 0.7. Mycoses were the major reason for consultation (18.7%) followed by pruritus (17.9%), eczema (13.1%), and (9.0%) tumors with 76.5% of benign tumors and (5.1%) disorders of keratinization. Leg ulcers were 2.1%. Mycoses were represented by intertrigo (52.9%) and dermatomycosis of the glabrous skin (25.7%). Kaposi sarcoma and keloid were the most frequent tumors. Conclusion: Our study shows a predominance of mycosis, eczema, and pruritus in the elderly subjects. Mycoses and pruritus could result from the weather and the skin aging, respectively

Fixed pigmented erythema due to cimetidine

Fixed pigmented erythema (EPF) is pathognomonic of drug-induced toxicity. Antisecretory drugs are among the most commonly not responsible drugs. EPF secondary to cimetidine administration has rarely been described. We report an EPF case during a cimetidine-based treatment in Bouake. A 43-year-old patient, HIV negative, consults for an EPF located on both sides of the breasts, on the 5th day of an antiulcer treatment comprising compressed cimetidine and gastric dressing based on phosphatase d ‘aluminum. The diagnosis is made in front of the characteristic aspect of the lesion of EPF and the early reappearance of lesions recurring exactly in the same places, after the reintroduction of cimetidine. The discovery of an EPF imposes a strict etiological approach in search of the responsible drug. During anti-ulcer treatment, the practitioner should bear in mind the potential role of cimetidine

Tinea Capitis Caused by <i>Microsporum audouninii</i>: A Report of Two Cases from Côte D’Ivoire, West Africa

We report here two cases of tinea capitis caused by Microsporum (M.) audouinii in Côte d’Ivoire, West Africa. The patients were a three-year-old boy and a six-year-old girl who presented with scaly patches on the scalp. The causative fungus was isolated using an adhesive tape-sampling method and cultured on Sabouraud dextrose agar plates. It was identified as M. audouinii both by its macroscopic and microscopic features, confirmed by DNA sequencing. These are the first documented cases of M. audouinii infections confirmed with DNA sequencing to be reported from Côte d’Ivoire. The practicality of the tape-sampling method makes it possible to carry out epidemiological surveys evaluating the distribution of these dermatophytic infections in remote, resource-limited settings

Tinea Capitis Caused by Microsporum audouninii: A Report of Two Cases from Côte D’Ivoire, West Africa

We report here two cases of tinea capitis caused by Microsporum (M.) audouinii in C&ocirc;te d&rsquo;Ivoire, West Africa. The patients were a three-year-old boy and a six-year-old girl who presented with scaly patches on the scalp. The causative fungus was isolated using an adhesive tape-sampling method and cultured on Sabouraud dextrose agar plates. It was identified as M. audouinii both by its macroscopic and microscopic features, confirmed by DNA sequencing. These are the first documented cases of M. audouinii infections confirmed with DNA sequencing to be reported from C&ocirc;te d&rsquo;Ivoire. The practicality of the tape-sampling method makes it possible to carry out epidemiological surveys evaluating the distribution of these dermatophytic infections in remote, resource-limited settings

Tinea Capitis Caused by Microsporum audouninii: A Report of Two Cases from Côte D’Ivoire, West Africa

We report here two cases of tinea capitis caused by Microsporum (M.) audouinii in Côte d’Ivoire, West Africa. The patients were a three-year-old boy and a six-year-old girl who presented with scaly patches on the scalp. The causative fungus was isolated using an adhesive tape-sampling method and cultured on Sabouraud dextrose agar plates. It was identified as M. audouinii both by its macroscopic and microscopic features, confirmed by DNA sequencing. These are the first documented cases of M. audouinii infections confirmed with DNA sequencing to be reported from Côte d’Ivoire. The practicality of the tape-sampling method makes it possible to carry out epidemiological surveys evaluating the distribution of these dermatophytic infections in remote, resource-limited settings

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

First cases of Mycobacterium leprae (Hansen’s disease) detection in Côte d’Ivoire using molecular diagnosis (PCR)

International audienceBackgroundLeprosy is a skin disease caused by Mycobacterium leprae. It is the second mycobacterial disease after tuberculosis still presenting a public health problem in many countries today. With the advent of multidrug therapy in 1982, much progress has been made in the fight against this disease, which causes severe social consequences. Côte d’Ivoire, like many African countries, reached the elimination threshold of disease and MDT is available throughout the country. However, Côte d’Ivoire has not managed to break the chain of transmission of M. leprae. Thus, in the country where leprosy is endemic, the number of Grade II disabilities observed remains significant.Methods and resultsThe diagnosis of infection is often made by default, based only on clinical and microscopic evidence; we are committed to implementing PCR, a previously unavailable diagnostic tool, to help confirm suspected leprosy cases. Samples consisting of nasal mucus and slits skin smears were collected from 39 suspect cases for confirmation by PCR. DNA was extracted and amplified, targeting M. leprae repeated elements (RLEP). Results showed a PCR positivity rate of 38.5%. PCR products of the repetitive elements were sequenced and BLASTn analysis confirmed that the amplified products obtained were part of the M. leprae genome.PCR is now available for confirmation of leprosy cases in Côte d’Ivoire. This will help to reduce the consequences of leprosy and promote its elimination

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