ABSTRACT
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
Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV) positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune reconstitution inflammatory syndrome (IRIS) occurrence and Mycobacterium dissemination. The deep immune depression, the underline biological, and clinical disorders of the patient might contribute to IRIS occurrence and Buruli ulcer dissemination. Future investigations have to be conducted on the mechanism of IRIS on set and on Mycobacterium ulcerans dissemination after ARV drugs initiation and the patient related underline clinical or biological disorders.