Maladies auto-immunes systémiques dans les Services de Médecine Interne et de Dermatologie du Centre Hospitalier Universitaire de Bouaké: profil de 50 patients / Systemic autoimmune diseases in the Internal Medicine and Dermatology Departments of the University Hospital of Bouake: profile of 50 patients

Introduction Les maladies auto-immunes systémiques (MAIS) sont peu connues malgré les progrès diagnostiques et thérapeutiques réalisés ces dernières années. L'objectif de ce travail était de décrire le profil épidémiologique, diagnostique et thérapeutique des MAIS dans les services de Médecine Interne et de Dermatologie du Centre Hospitalier Universitaire de Bouaké (CHU). Méthodes Il s'agissait d'une étude transversale descriptive réalisée dans les services de Médecine Interne et de Dermatologie du CHU de Bouaké, sur une période de 10ans (janvier 2009- décembre 2018). Résultats : Sur 30906 patients, 50 présentaient une MAIS soit une prévalence hospitalière de 0,16%. Les MAIS les plus fréquentes étaient le lupus érythémateux systémique (50%) et la sclérodermie systémique (42%). L'âge moyen était de 39,5ans ±15ans et le sex-ratio de 0,19. Le délai moyen de consultation était de 26,2 mois. Le tableau clinique était dominé par les signes généraux (98%), les manifestations cutanéomuqueuses (96%) et les manifestations articulaires (90%). Chez 37 patients ayant réalisé l'hémogramme, l'anémie représentait 51,3% des cas. Le syndrome inflammatoire était objectivé chez 67% des 12 patients possédant un bilan inflammatoire. Les auto-anticorps réalisés chez 05 patients étaient contributifs chez 03 patients. Les corticoïdes par voie générale étaient prescrits dans 56% des cas et les perdus de vue étaient observés dans 90% des cas. Conclusion : Les MAIS étaient rares dans notre étude, dominées par le lupus érythémateux systémique et la sclérodermie systémique. L'amélioration du plateau technique et l'accessibilité du bilan immunologique et la sensibilisation paraissent indispensables afin d'améliorer la prise en charge des patients.

Introduction: Systemic autoimmune diseases (SAID) are little known despite the diagnostic and therapeutic progress made in recent years. The objective of this work was to describe the epidemiological, diagnostic and therapeutic profile of SAID in Internal Medicine and Dermatology departments of the university hospital of Bouake. Methods: This was a cross-sectional study carried out in the Internal Medicine and Dermatology departments of the university hospital of Bouake, over a period of 10 years (January 2009-December 2018). Results: Of 30,906 patients, 50 presented SAID with a hospital prevalence of 0.16%. The most common SAID were systemic lupus erythematosus (50%) and systemic sclerosis (42%). The mean age was 39.5 ± 15 years, and the sex ratio was 0.19. The average consultation time was 26.2 months. The clinical picture was dominated by general signs (98%), mucocutaneous manifestations (96%) and articular manifestations (90%). In 25 patients who performed the blood count, anemia represented 76% of cases. The inflammatory syndrome was objectified in 67% of the 12 patients with an inflammatory profile. The auto-antibodies made in 05 patients were contributory in 03 patients. Systemic corticosteroids were prescribed in 56% of cases and patients were lost to follow-up in 90% of cases. Conclusion: SAID were rare in our study, dominated by systemic lupus erythematosus and systemic scleroderma. Improvement of the technical platform and accessibility of the immunological assessment appears essential in order to improve patient's care.

Prise en charge des patients COVID-19 à l'hôpital de dermatologie de Bamako / Care of COVID-19 patients at the dermatology hospital of Bamako

Aim: To assess the COVID-19 patients' treatment duration according to the place of treatment at the Dermatology Hospital of Bamako (DHB). Methods: This was a cross-sectional study comparing the management of COVID-19 PCR-positive patients in the hospital to that of those managed at home from March 2020 to April 2021 until two consecutive negative PCR 48 hours apart. Results: Among the 1109 patients, 369 were hospitalized, 497 followed at home. As of April 31, 2021, 81.2% (900/1109) of the patients recovered, 1.3% (14/1109) were transferred to another health structure, and 2.5% (28/1109) died. No statisticallysignificant difference was observed between the meanduration of the treatment for patients treated at home (10 days) in (95% CI, 9.69-10.3) and those managedathospital (10 days95% CI, 9.76-10.23) (Mantel-Cox test, p= 0.060). Conclusion: These results suggest that the place of treatment do not influence the time to recovery. This is particularly important given the current burden of COVID-19 management on the health workforce

Objectif: Evaluer la durée du traitement des patients COVID-19 selon le lieu de pris en charge à l'Hôpital de Dermatologie de Bamako (HDB). Méthodologie : Il s'agissait d'une étude transversale comparant la prise en charge des patients COVID-19 PCR-positifs à l'hôpital à celle à domicile de mars 2020 à avril 2021 jusqu'à l'obtention de deux tests PCR négatifs consécutifs à 48 heures d'intervalle. Résultats : Parmi les 1109 patients, 369 ont été hospitalisés, 497 suivis à domicile. Au 31 avril 2021, 81,2% (900/1109) des patients se sont rétablis, 1,3% (14/1109) ont été transférés dans une autre structure de santé et 2,5% (28/1109) sont décédés. Aucune différence statistiquement significative n'a été observée entre la durée moyenne du traitement pour les patients traités à domicile (10 jours) en (IC 95 %, 9,69-10,3) et ceux pris en charge à l'hôpital (10 jours IC 95 %, 9,76-10,23) (test de Mantel Cox, p= 0,060). Conclusion: Ces résultats suggèrent que le lieu de traitement n'influence pas le temps de récupération. Ceci est particulièrement important étant donné la charge actuelle de la gestion des COVID-19 sur le personnel de santé

Assessment of the effect of treatment on the quality of life of adult Keloid

Background: Documentations of the effect of treatment on the quality of life of keloid patients are few. This study assessedimprovement in quality-of-lifefollowing keloid treatment. In addition, to assess which of the offered four modalities of treatment improved quality of life more.Methods:Thisquasi-experimentalstudy was conducted on 32 adults who had treatment for keloid disease in the clinic from February 2019 to January 2020. This was part of a comparative study of four different modalities of keloid treatment. The quality of life was assessed before and after treatment using the Dermatology Life Quality Index questionnaire (DLQI). Data was analyzed using SPSS version 23.0Results:Quality of life significantly improved after treatment with the mean ± SD DLQI score improving from 7.75 ± 6.15 to 4.16 ± 4.93, p=0.001. Quality of life before treatment was impaired in 93.7% and improved to 65.6%. Before treatment, 2 patients had no QOLimpairment but this improved to 11 patients after treatment. Prior to treatment, severely impaired QOLwas in recorded 28.1% of thepatient's and in 9.4% after treatment. Quality of life improved more in patients who had the combined intralesional triamcinolone acetonide and 5-flourouracil treatment. Significant improvement in the DLQI items of symptomatology, embarrassment, social activity and choice of clothing was noted.Conclusion:Treatment of keloid improves quality of life and this is dependent on the modality of treatment. The items of quality of life improved include; embarrassment, choice of clothing, interference with socialactivities, symptoms of pain and pruritus.

Management of skin diseases among community pharmacists in Lagos, Nigeria

amongst others. Pharmacists play an important role in identifying and managing skin problems, especially in Nigeria and other developing countries with few dermatologists found mainly in tertiary centres. This study aimed to evaluate and document community pharmacists' role in managing skin diseases in Lagos, Nigeria.Methods: Questionnaires were administered to 140 community pharmacists (70 each in Lagos Island and Lagos Mainland chosen from the zonal list of community pharmacists obtained from Association of Community Pharmacists of Nigeria (ACPN) Lagos State Branch. Data generated were collated and analyzed using SPSS (Statistical Package of Social Sciences) version 20.0. The results were presented as frequency tables and charts.Results: One hundred and twenty (120; 85.7%) questionnaires were returned for analysis. The results revealed that community pharmacists mainly treat patients with dermatological complaints with triple combination creams. The study shows that though pharmacists manage many patients with skin problems, their knowledge base is poor and treatment sub-optimal. The survey also shows that the most common skin problems encountered by community pharmacies are acne, bacterial infections and eczema.Conclusion: It can be concluded from this study that pharmacists need to undergo training in management of skin diseases to help the many patients that approach them. It is recommended that community pharmacists undergo appropriate training programmes to improve their output

The Prevalence of Paediatric Skin Conditions at a Dermatology Clinic in KwaZulu-Natal Province over a 3-Month Period

Background. Skin conditions are common in children; and studying their spectrum in a tertiary dermatology clinic will assist in quantifying skin diseases associated with greatest burden. Objective. To investigate the spectrum and characteristics of paediatric skin disorders referred to a tertiary dermatology clinic in Durban; KwaZulu-Natal (KZN) Province; South Africa. Methods. A cross-sectional study of children attending the dermatology clinic at King Edward VIII Hospital; KZN; was carried out over 3 months. Relevant demographic information and clinical history pertaining to the skin conditions were recorded and diagnoses were made by specialist dermatologists. Data were analysed with EPI Info 2007 (USA).Results. There were 419 children included in the study; 222 (53%) were males and 197 (47%) were females. A total of 64 diagnosed skin conditions were classified into 16 categories. The most prevalent conditions by category were dermatitis (67.8%); infections (16.7%) and pigmentary disorders (5.5%). For the specific skin diseases; 60.1% were atopic dermatitis (AD); 7.2% were viral warts; 6% seborrhoeic dermatitis and 4.1% vitiligo. Dermatitis was significantly more common in males (p0.05). AD was the most common condition below 12 years of age; while the presence of viral warts was the most prevalent disorder among HIV-infected children. Approximately one-third (37.5%) of the disorders referred by other medical practitioners were misdiagnosed. Conclusions. AD constituted the highest burden both numerically and economically. Viral infections were a major contribution from HIV infection. The diverse spectrum and characteristics of skin diseases referred will assist in modifying the dermatology educational curriculum and bridge knowledge gaps among healthcare providers treating children

Evaluation du traitement antiretroviral chez l'adulte infecte par le VIH au service de dermatologie venereologie de l'hopital national Donka

Si l'utilisation des multitherapies antiretrovirales (ARV) a grandement ameliore la survie; la morbidite et la qualite de vie des PVVIH dans les pays du Nord; dans les pays du Sud; et notamment en Afrique; de nombreux obstacles ont freine leur utilisation. C'est ainsi que le suivi des patients sous ARV dans certains pays en voie de developpement est encore timide voir inexistant. Objectif : L'objectif de ce travail etait de rapporter les reponses therapeutiques obtenues apres une periode minimale de six mois de suivi chez des patients VIH+ admis en consultations externes ou a la suite d'hospitalisations. Materiel et methodes : Il s'agissait d'une etude retrospective de type descriptif concernant les patients suivis dans la periode du 1er janvier 2004 au 31 decembre 2008; soit 5 ans. Resultats : Notre etude a concernee 275 patients dont 61;41 de femmes avec un sex-ratio (H/F) de 0;62. L'age moyen de nos patients etait de 36;83 [18 70]. Le poids moyen initial de nos patients etait de 59;88 kg [30 -107] avec la majorite (66;91) au stade III de la classification clinique de l'OMS. Le profil serologique etait domine par le VIH1 (97;0) de femmes avec un sex-ratio (H/F) de 0;62. L'age moyen de nos patients etait de 36;83 [18 70]. Le poids moyen initial de nos patients etait de 59;88 kg [30 -107] avec la majorite (66;91) au stade III de la classification clinique de l'OMS

Dermatological Malignancies at a University Teaching Hospital in North-Western Tanzania: A Retrospective Review of 154 Cases

"Abstract:Dermatological malignancies are among the most common form of cancers and the global incidence has been increasing at an alarming rate. A retrospective study was conducted to determine the prevalence; histopathological pattern; anatomical distribution and treatment outcome of dermatological malignancies at Bugando Medical Centre in North-western Tanzania. Data were collected from patients' files kept in the Medical record department; the surgical wards; operating theatre and histopathology laboratory and analyzed using Statistical package for social sciences system. A total of 154 patients with a histopathological diagnosis of dermatological malignancy were studied. Generally; males outnumbered females by a ratio of 1.4:1. The majority of patients were in the 5th and 6th decades of life. Malignant melanoma was the most common dermatological malignancy (67.5) followed by Kaposi's sarcoma (10.4); Squamous cell carcinoma (8.4) and Basal cell carcinoma(7.8). The lower limbs were the most frequent site accounting for 55.8. Wide local excision was the most common surgical procedure performed in 79.2 of cases. Post-operative wound infection was the most common complication in 58.3 of patients. Mortality rate was 3.8. Dermatological malignancies are more prevalent in our setting. A high index of suspicion is needed to avoid labelling malignancies ""chronic ulcers"" and all suspected lesions should be biopsed."

Etiologies des hypochromies acquises en milieu dermatologique

Introduction : Parmi les troubles pigmentaires rencontres chez les sujets a peau noire; l'hypochromie encore appelee tache claire est sans doute la plus affichante. Peu d'etudes ont ete effectues en milieu specialise. Le but de ce travail est d'etudier les etiologies hypochromies en milieu dermatologique a Bamako. Methodes : Nous avons mene une enquete transversale descriptive sur les etiologies des hypochromies acquises dans le service de Dermatologie du centre National d'Appui a la lutte contre la Maladie (CNAM; Ex Institut Marchoux). L'hypochromie etait definie par la presence d'une lesion plus claire que la peau avoisinante et dont le diametre etait superieur a 1 cm. Le diagnostique etait essentiellement base sur l'examen clinique. Resultats : La prevalence des taches hypochromiques etait de 3;42.Les principales etiologies etaient la dermatite seborrheique (23;3); les eczematides (20;15); le vitiligo (18;9); le pityriasis versicolore (18;5) et la lepre (12;6). Conclusion : Les etiologies des taches claires sont multiples et peuvent en cacher parfois une lepre qui bien que de plus en plus rare; reste une maladie encore presente en milieu dermatologique

Digital Dermatoglyphics In students Of Delta State University; Nigeria

Dermatoglyphic studies have established that palmer and digital ridges form well defined patterns exhibiting traits that are genetically determined; appear to be conservative conservative in their evolution and are therefore very reliable for establishing and confirming the historical relationship and within populations. Unilateral thumbprints of 248 students were recorded; studied and classified using standard methods. The results obtained showed that loops were the most predominant pattern type in both sexes followed by whorls and arches. However; no significant differences occurred between sexes in the pattern types (p0.05). This study documents for the first time fingerprint patterns in undergraduates of Delta state university and further confirms findings in other parts of Africa

Les complications cutanees de la chimiotherapie antitumorale dans les services de dermatologie et cancerologie du CHU de Treichville

L'etude prospective portant sur 100 cas de complications cutanees de la chimiotherapie anticancereuse observee en 12 mois avec une prevalence de 18;18pour cent fait ressortir un accroissement regulier de l'emploi des chimiotherapies. Le developpement de la chimiotherapie oblige a mieux connaitre les effets secondaires de la chimiotherapie anticancereuse. Parmi ceux-ci; les complications cutanees tiennent une place importante. En effet; les medicaments anticancereux sont avant tout actifs sur les cellules en division rapide; et de ce fait la peau represente une excellente cible. Au cours de notre etude prospective; nous avons decrit et evalue les aspects cliniques des complications cutanees de la chimiotherapie et la toxicite des medicaments anticancereux inherentes a l'utilisation des protocoles usuels de la chimiotherapie anticancereuse. Sur l'ensemble des protocoles; nous avons observe une predominance des toxicites phaneriennes : alopecie (45pour cent); muqueuse (32pour cent); cutanee (23pour cent). Il n'a pas ete note de toxicite grave a type de syndrome de LYELL ni de deces. Selon notre etude; cette toxicite est liee a des facteurs tels t~ue l'age; le terrain; le choix des protocoles; le nombre de cures; la compliance. L'action pour l'amelioration de la prise en charge des malades atteints de cancer en matiere de chimiotherapie devrait s'orienter vers: -une identification des complications les plus frequentes. -en fonction du nombre de cures. -le suivi de tout cancer doit concerner: ola muqueuse ; oles cheveux (phaneres) ; ola peau. Cependant; les toxicites cutaneo-muqueuses et phaneriennes observees au cours de notre etude n'ont jamais constitue un facteur limitant du traitement

AIDS related conditions (ARCs) in dermatology - Q.E.C.H. experience

This article is aimed at giving some light on detecting some of the skin problems which might be related to HIV infection

AIDS related conditions (ARCs) in dermatology - Q.E.C.H. experience

This article is aimed at giving some light on detecting some of the skin problems which might be related to HIV infection

Skin lightening products - specification

It provides the expected requirements of such products and for establishing acceptable levels for reactive ingredients; toxic metals; instruction for and limitations of use; warning; labelling and packaging