ABSTRACT
BACKGROUND: Most umbilical tumors are diagnosed as benign tumors, umbilical metastases of abdominal and pelvic tumors, or Sister Marie Joseph nodule. Herein, we report a case of cutaneous umbilical endometriosis mistaken for a keloid. PATIENTS AND METHODS: A young black woman aged 26 consulted for a painful umbilical tumefaction. She had noted the appearance of a nodule of the umbilicus 10 months ago with bleeding during her menstrual periods. Skin examination revealed a firm and painful umbilical nodule 2.5cm in diameter. She was treated with corticosteroid injections for one month for umbilical keloid. Given that the symptoms recurred regularly at the time of menstruation, we suspected umbilical endometriosis. This diagnosis was finally confirmed by histopathological examination and hormone therapy was instituted on gynecological advice before scheduled surgical excision. CONCLUSION: In a setting of an umbilical tumor simulating a keloid associated with cyclical symptoms in a black woman, the diagnosis of umbilical endometriosis should not be overlooked by the dermatologist.
Subject(s)
Abdominal Neoplasms/pathology , Endometriosis/pathology , Keloid/pathology , Umbilicus , Adult , Black People , Diagnosis, Differential , Female , HumansABSTRACT
Melanoma is a malignant tumor rarely being described in sub-Saharan Africa. We reported an unusual and atypical clinical presentation. It was a 59-year-old patient who was hospitalized for a monomelic black tumor evolving for 10 years. Histopathological examination confirmed the melanocytic origin of this tumor. Paraclinical assessment did not find any visceral metastasis. A partial resection of the tumor was performed. The patient left the hospital against medical consent due to lack of technical facilities. The delay in the consultation and the lack of knowledge of melanoma by doctors and patients might contribute to the severity and the difficulties of its management.
ABSTRACT
BACKGROUND: Cutaneous bullous adverse drug eruptions are a dreaded complication of drug use. OBJECTIVE: The purpose of this study was to document the epidemiological features, outcomes, and causes of these reactions, in particular, Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell disease), in a teaching hospital in Abidjan (Côte d'Ivoire). PATIENTS AND METHODS: A retrospective study reviewed the records of severe cutaneous drug reactions in patients managed in the dermatology department of the University Hospital of Treichville (Abidjan) over a period of ten years (from September 2000 through August 2010). RESULTS: These diseases were diagnosed in 185 patients during the study period. Their mean age was 31.8 years (range: 2-70 years) and the M/F sex ratio was 0.6 The most frequent reactions, as expected, were Stevens-Johnson syndrome (73%) and toxic epidermal necrolysis (27%). The drugs most commonly involved were the antibacterial sulfonamides (22.1%), followed by the antiviral nevirapine (11.1%), and the antimalarial agent, sulfadoxine/pyrimethamine. The fatality rate was 22.5%, including 46% of the patients with toxic epidermal necrolysis and 14.6% of those with Stevens-Johnson syndrome. Respiratory distress (39.5%) and dehydration (23.4%) were the primary direct causes of death. CONCLUSION: Antibacterial sulfonamides are the leading drugs implicated in the occurrence of bullous drug eruptions in Abidjan.
Subject(s)
Stevens-Johnson Syndrome , Adolescent , Adult , Aged , Child , Child, Preschool , Cote d'Ivoire , Female , Humans , Infant , Male , Middle Aged , Retrospective Studies , Stevens-Johnson Syndrome/diagnosis , Stevens-Johnson Syndrome/epidemiology , Stevens-Johnson Syndrome/etiology , Young AdultABSTRACT
BACKGROUND: Although propranolol has become the first-line therapy for infantile haemangiomas (IHs), no study has yet investigated factors associated with the risk of relapse in children with IH treated with propranolol after cessation of treatment. OBJECTIVES: To compare factors associated with the risk of relapse in children with IH treated with oral propranolol. METHODS: We conducted a single-centre retrospective observational study. All files and photographs of patients with IH aged 5 months or less at the time of treatment initiation, and who were seen between 1 June 2008 and 31 December 2011 at the National Reference Center for rare skin diseases of Bordeaux, were retrospectively reviewed. RESULTS: In total 158 children were included, of whom 118 had not relapsed and 40 had relapsed. Fifty-two patients were boys and 106 were girls (male : female ratio 1 : 2), and 19 had a segmental IH (12%). When conducting multivariate analysis, only IHs with a deep component and those with segmental distribution were independently associated with relapse. CONCLUSIONS: Our study shows that segmental IHs, as well as haemangiomas with a deeper component, are more at risk of relapse and should thus indicate closer follow-up after treatment interruption, and/or longer treatment.
Subject(s)
Antineoplastic Agents/administration & dosage , Head and Neck Neoplasms/drug therapy , Hemangioma/drug therapy , Neoplasm Recurrence, Local/etiology , Propranolol/administration & dosage , Skin Neoplasms/drug therapy , Administration, Oral , Child , Child, Preschool , Female , Humans , Infant , Male , Retrospective Studies , Treatment OutcomeABSTRACT
Histoplasmosis is a deep mycosis whose capsulatum variety is recognized as being an AIDS-defining infection. However AIDS associated with Histoplasma capsulatum var. duboisii is rarely reported. We report a case of cutaneous duboisii histoplasmosis associated with AIDS which has been mistaken for molluscum contagiosum for many months. The diagnosis has been confirmed by means of a biopsy of a nodule followed by an anatomo-pathological examination. The medical treatment was successfully based on combination Triomune (stavudine + lamividine + nevirapine) and itraconazole.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Dermatomycoses/diagnosis , Facial Dermatoses/microbiology , Histoplasmosis/diagnosis , AIDS-Related Opportunistic Infections/complications , Adult , Anti-HIV Agents/therapeutic use , Antifungal Agents/therapeutic use , Biopsy , Cote d'Ivoire , Dermatomycoses/complications , Diagnosis, Differential , Histoplasma/classification , Histoplasmosis/complications , Humans , Male , Molluscum Contagiosum/diagnosisABSTRACT
Infection due to Mycobacterium ulcerans or Buruli ulcer usually occurs on the limbs (70%) or trunk (20%). Involvement of the head and neck region is less frequent but can lead to serious sequels. The purpose of this report is to describe 8 patients including 7 children who were treated for Buruli ulcers on the head in the dermatology department of the University Hospital Center in Abidjan, Cote d'Ivoire. Eye lesions and visual impairment were the most frequent sequels.
Subject(s)
Buruli Ulcer/therapy , Eye Infections, Bacterial/microbiology , Soft Tissue Infections/microbiology , Adolescent , Anti-Bacterial Agents/therapeutic use , Anticoagulants/therapeutic use , Buruli Ulcer/pathology , Child , Child, Preschool , Cote d'Ivoire , Enoxaparin/therapeutic use , Eye Infections, Bacterial/therapy , Face , Female , Humans , Male , Ofloxacin/therapeutic use , Rifampin/therapeutic use , Severity of Illness Index , Soft Tissue Infections/therapy , Young AdultABSTRACT
Caused by Mycobacterium ulcerans, Buruli ulcer is an infectious disease which leads to large cutaneous ulceration and is responsible for huge socio-economic consequences. Since 1997 the World Health Organization has started a global Buruli ulcer initiative in which African endemic countries are committed. After an epidemiological background of the disease in Côte-d'Ivoire and a description of the different clinical aspects, we report the main disease management actions carried out in the country by the National Program for Buruli ulcer control from 1998 to 2003. It seems that surgical team missions carried out in health center to treat cases, early detection and treatment of cases together with the implementation of a specific poly-chemotherapy lead to an effective control of the disease.