ABSTRACT
BACKGROUND: Exfoliative erythroderma (EE), (Synonyms: Exfoliative dermatitis, Red man syndrome) is a clinical syndrome characterised by generalised erythema and scale. It is an important cause of functional skin failure and associated high morbidity and variable mortality rates. OBJECTIVES: To study demographics, aetiology, complications and clinical outcomes of exfoliative erythroderma (EE) on patients attending Kenyatta National Hospital (KNH). DESIGN: Cross- sectional descriptive study. SETTING: Kenyatta National Hospital, Dermatology Unit. SUBJECTS: All available medical records on inpatients seen by qualified dermatologists at KNH with generalised erythema and scale from 1996 to 2006. MAIN OUTCOME MEASURES: Discharge or death. RESULTS: Incidence exfoliative erythroderma was documented in 146 out of all 123 admissions (13%) into the dermatology unit from 1996-2006. Demographic mean age was 47 years, M: F ratio was 3:2, 67% had no income and 53% and 30% were residents of Nairobi and adjacent districts respectively. Sixty three percent were due to skin diseases, 23% due to systemic diseases of which 20% were due to HIV/AIDS and 14% due to adverse cutaneous drug reactions. Ninety percent of patients were treated and discharged and 10% died; 50% of whom had dermatoses and 29% due to HIV associated antituberculous drugs. CONCLUSIONS: Exfoliative erythroderma is an important cause of morbidity, admission and mortality in patients attending KNH. Dermatoses and HIV / AIDS were the most frequent causes. The mortality rate was relatively low and attributable to controllable diseases.
Subject(s)
Dermatitis, Exfoliative/physiopathology , Treatment Outcome , Anti-Bacterial Agents/therapeutic use , Cross-Sectional Studies , Dermatitis, Exfoliative/diagnosis , Dermatitis, Exfoliative/mortality , Female , HIV Infections/complications , Humans , Incidence , Kenya , Male , Middle Aged , National Health Programs , Risk Factors , Skin Diseases/complicationsABSTRACT
OBJECTIVE: To compare the pattern of use of skin care products between children with eczematous skin lesions and those without. DESIGN: Case control study. SETTING: Two well baby clinics at the Kenyatta National Hospital and the Mbagathi District Hospital in Nairobi. SUBJECTS: Eighty nine infants with eczematous skin lesions and 89 age and sex matched controls without skin lesions. MAIN OUTCOME MEASURES: Presence and severity of skin lesions related to the type of skin care products used by the child. RESULTS: Exposure to various products was not significantly different between infants with skin lesions and those without. However, more mothers whose children had a skin rash had made a change in the type of soap and or skin cream used for their child (p<0.0001). The principal reason for changing products was skin rash in the baby and most mothers made changes away from scented baby soap products. CONCLUSION: The study found no significant difference between the cases and controls regarding the type of skin care products used.
Subject(s)
Skin Care/adverse effects , Skin Care/statistics & numerical data , Skin Diseases, Eczematous/chemically induced , Skin Diseases, Eczematous/epidemiology , Age of Onset , Case-Control Studies , Face/physiopathology , Female , Humans , Infant , Kenya/epidemiology , Male , Soaps/adverse effects , TimeABSTRACT
BACKGROUND: Primary basal cell carcinoma(BCC) of the skin is the commonest tumour in Caucasians. Its incidence and mode of presentation in Kenyan Africans are unknown. OBJECTIVE: To study the incidence and mode of presentation of BCC in Kenya. DESIGN: A thirty year retrospective study (1968-1997) of all BCCs documented in the Kenya Cancer Registry (KCR), and a case report of one patient seen at Kenyatta National Hospital (KNH), Nairobi. RESULTS: Seventy four BCCs were recorded in thirty five Caucasians and thirty nine Africans. The race-specific mean annual incidence rates per million population were 58.5 and 0.065 for Caucasians and Africans, respectively. Clinical presentation in both racial groups was similar. CONCLUSION: BCC is a rare malignant tumour in Kenyan Africans but its mode of clinical presentation is similar to that in Caucasians.
Subject(s)
Carcinoma, Basal Cell/epidemiology , Skin Neoplasms/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Black People , Carcinoma, Basal Cell/ethnology , Female , Humans , Incidence , Kenya/epidemiology , Middle Aged , Skin Neoplasms/ethnology , White PeopleABSTRACT
The purpose of this study was to determine if Mycobacterium leprae is an opportunistic pathogen in immunosuppressed subjects with HIV infection. Ninety six leprosy patients at Infectious Diseases Hospital (IDH), Nairobi were screened for, HIV-1 antibody between January 1991 and June 1992. The patients included 15 who were diagnosed during the study period and 81 who were previously diagnosed and were on anti-leprosy treatment. Blood was screened for HIV antibody by first ELISA and double positive samples were confirmed by a second ELISA. The HIV seronegative patients were re-tested serologically every 3 months. Smears from skin slits were used to determine bacterial index and the patients were classified according to criteria described by Ridley and Jopling. The patients were re-assessed clinically monthly. The mean age of the patients was 40 years and ranged from 13 to 78 years. Forty seven percent had paucibacillary and 53% had multibacillary leprosy. The HIV seroprevalence was 8% in previously diagnosed patients and zero in the newly diagnosed patients. There were no changes in clinical spectrum in HIV seropositive patients during follow up period; neither reversal reactions nor erythema nodosum leprosum were observed. The study suggests that M. leprae may not be an opportunistic pathogen in immunosuppressed subjects with HIV infection.
