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1.
Ann Dermatol Venereol ; 142(11): 633-8, 2015 Nov.
Article in French | MEDLINE | ID: mdl-26364000

ABSTRACT

BACKGROUND: Acute bacterial cellulitis of the leg (erysipelas) is a common problem involving considerable morbidity in dermatology practice in Africa. Previous studies conducted in Europe and North Africa have highlighted lymphoedema and toe-web intertrigo as independent factors associated with leg erysipelas. The aim of this case-control study was to identify risk factors associated with leg erysipelas in sub-Saharan Africa, within a different socio-economic and culture context. PATIENTS AND METHODS: We conducted a prospective case-control study in hospital dermatology departments in 8 sub-Saharan African countries over a 12-month period (October 2013 to September 2014). Each case of acute leg cellulitis was matched with 2 controls for age (±5 years) and sex. We analysed the general and local factors. RESULTS: During the study period, 364 cases (223 female, 141 male) were matched with 728 controls. The mean age was 42.15±15.15 years for patients and 42.11±36 years for controls. Multivariate analysis showed the following to be independent risk factors associated with leg erysipelas in our study: obesity (odds ratio [OR]=2.82 ; 95% confidence interval: 2.11-3.76), lymphoedema (OR=3.87, 95%CI: 2.17-6.89), voluntary cosmetic depigmentation (OR=4.29, 95%CI: 2.35-7.83), neglected traumatic wound (OR=37.2, 95%CI: 24.9-57.72) and toe-web intertrigo (OR=37.86, 95%CI: 22.27-64.5). CONCLUSION: The results of this study confirms the major role of local risk factors (toe-web intertrigo, lymphoedema) previously identified in other geographical settings. However, the originality of our study consists of the identification of voluntary cosmetic depigmentation as a risk factor for leg erysipelas in sub-Saharan Africa.


Subject(s)
Erysipelas/diagnosis , Erysipelas/microbiology , Adult , Africa South of the Sahara/epidemiology , Aged , Body Mass Index , Case-Control Studies , Erysipelas/epidemiology , Erysipelas/etiology , Female , Hospitals , Humans , Intertrigo/complications , Leg/pathology , Leg Ulcer/complications , Lymphedema/complications , Male , Middle Aged , Obesity/complications , Poverty/statistics & numerical data , Pressure Ulcer/complications , Prospective Studies , Risk Factors
2.
Med Sante Trop ; 24(1): 94-8, 2014.
Article in French | MEDLINE | ID: mdl-24736218

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 Adult
3.
Ann Dermatol Venereol ; 140(2): 125-8, 2013 Feb.
Article in French | MEDLINE | ID: mdl-23395495

ABSTRACT

BACKGROUND: Buruli ulcer (BU) denotes a cutaneous infection by Mycobacterium ulcerans endemic in certain tropical and subtropical regions. Treatment may be either medical and surgical or else purely medical for early lesions. The literature contains reports of several cases of transient aggravation of BU following initiation of medical treatment. We report a case observed in the Ivory Coast, one of the areas with the highest prevalence of BU worldwide. The distinguishing features of our case are the early onset of this paradoxical reaction and the multiple cephalic site of lesions. PATIENTS AND METHODS: A 4-year-old child with no prior medical history was referred for two painless ulcerative cutaneous nodules. Incubation of samples from the edges of these lesions revealed the presence of acid-alcohol resistant bacilli (AARB), which were shown by PCR to be M. ulcerans, the causative agent in BU. Treatment consisted of levofloxacin (100mg/d) and rifampicin (150mg/d) for 8weeks. After 7days of medical treatment, seven painless nodules appeared on the patient's scalp. Further PCR for these lesions confirmed the presence of M. ulcerans. The same medical therapy was maintained and after 54days of treatment, all lesions had been healed. DISCUSSION: The originality of this case rests on two features: the bifocal aspect of the lesions, which is uncommon, and the early development of cephalic predominance that occurred after the start of drug treatment. While cases of lesions secondary to initiation of medical therapy have already been described, such lesions generally occurred after at least 2months of treatment and did not involve the head.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Buruli Ulcer/drug therapy , Levofloxacin , Ofloxacin/therapeutic use , Rifampin/therapeutic use , Scalp Dermatoses/drug therapy , Anti-Bacterial Agents/administration & dosage , Buruli Ulcer/microbiology , Child, Preschool , Chin , Cicatrix/etiology , Cote d'Ivoire , Drug Therapy, Combination , Endemic Diseases , Facial Dermatoses/drug therapy , Facial Dermatoses/microbiology , Female , Humans , Leg , Mycobacterium ulcerans/isolation & purification , Ofloxacin/administration & dosage , Rifampin/administration & dosage , Scalp Dermatoses/microbiology , Time Factors
4.
Case Rep Med ; 2013: 348628, 2013.
Article in English | MEDLINE | ID: mdl-24454398

ABSTRACT

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.

5.
Bull Soc Pathol Exot ; 101(5): 402-3, 2008 Dec.
Article in French | MEDLINE | ID: mdl-19192610

ABSTRACT

The authors report 13 cases of Gayet-Wernicke's encephalopathy observed in 13 patients of a refugee population. 11 presented the classical triad: oculomotor signs, cerebral ataxia and state of confusion and in 2 patients, only 2 symptoms were noted. The etiological factors: chronic alcoholism, malnutrition, uncontrollable vomiting, HIV and tuberculosis were identified. The outcome was evaluated on the basis of the disappearance of symptoms after treatment with 500 mg of thiamine in 7 patients, 1 death and 5 patients progressed toward Korsakoff amnesic syndrome.


Subject(s)
Wernicke Encephalopathy/pathology , Alcoholism/complications , Confusion/etiology , Guinea , HIV Infections/complications , Humans , Refugees , Survival Rate , Survivors , Thiamine/therapeutic use , Tuberculosis/complications , Wernicke Encephalopathy/drug therapy , Wernicke Encephalopathy/mortality , Wernicke Encephalopathy/psychology
6.
Med Trop (Mars) ; 66(3): 247-51, 2006 Jun.
Article in French | MEDLINE | ID: mdl-16924815

ABSTRACT

The purpose of this report is to describe 29 cases of phakomatosis including 18 cases of tuberous sclerosis (Bourneville) and 11 cases of neurofibromatosis (von Recklinghausen) observed over a 10-year period at the Neurology Department of the University Hospital Centre in Conakry, Guinea. Findings during this period were consistent with those classically reported in the literature: high frequency of advanced skin lesions coalescing into massive tumours, occurrence of seizures of all types and development of a wide variety of complications as a result of late diagnosis. Our experience underscores the need for follow-up and surveillance of these patients by somatic studies based on neurological, ophthalmologic and tomographic data depending on clinical findings.


Subject(s)
Neurocutaneous Syndromes/diagnosis , Electroencephalography , Guinea , Humans , Neurofibromatosis 1/diagnosis , Seizures , Skin Diseases , Tomography, X-Ray Computed , Tuberous Sclerosis/diagnosis
7.
Médecine Tropicale ; 66(3): 247-251, 2006.
Article in French | AIM (Africa) | ID: biblio-1266724

ABSTRACT

Les auteurs rapportent 29 observations de phacomatoses dont 18 cas de sclerose tubereuse de Bourneville et 11 cas de neurofibromatose de Recklinghausen; observees dans le service de neuro l ogie du centre hospitalo-universitaire de Conakry; sur une periode de 10 ans. Dans cette peri o d e;les donnees classiques de la litterature sont retrouvees : frequence elevee des lesions dermatologiques evoluees atteignant de volumineuses tumeurs royales; des crises epileptiques sous toutes ses formes et les complica-tions diverses en raison du retard du diagnostic. Nos resultats soulignent la necessite de suivi et de surveillance de ces patients par un examen somatique (neurologique; ophtal- mologique) et un examen scannographique dicte par les donnees cliniques


Subject(s)
Tuberous Sclerosis
8.
Bull Soc Pathol Exot ; 93(2): 108-10, 2000 Apr.
Article in French | MEDLINE | ID: mdl-10863613

ABSTRACT

Thirty two cases of subacute sclerosing panencephalitis were reported. Diagnosis was based on epidemiological, clinical and electroencephalographic data; myoclonies and alterations of intellectual functions were the most frequent symptoms.


Subject(s)
Subacute Sclerosing Panencephalitis/diagnosis , Cerebrospinal Fluid Proteins/analysis , Child, Preschool , Electroencephalography , Female , Guinea , Humans , Infant , Male , Prognosis , Subacute Sclerosing Panencephalitis/cerebrospinal fluid , Subacute Sclerosing Panencephalitis/physiopathology
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