ABSTRACT
INTRODUCTION: Hemangiomas are regenerative benign vascular tumors of the child, which may be of interest to all organs, most often located on the skin. The aim of our study is to determine the prevalence of haemangiomas on black skin. It is a descriptive cross-sectional study that took place from November 2015 to August 2016 at CNAM, in the department of dermatology-leprology- Venereology of Mali. RESULTS: Of 14,810 patients seen in consultation, we received 17 cases of hemangioma, ie 0,11%. The average age was 5 months with extremes of 1 month and 60 months. Tuberous angiomas represent 82,35% of clinical forms, subcutaneous angiomas 11,76% and mixed angiomas 5,89%. In 4/17 of our patients there was an infectious complication, following an ulceration on the first day of the consultation. The average lesion size was 3,25cm with extreme 0.5cm and 8cm. The number of lesions per patient was 1 in 16 patients and 2 in 1 patient. In 10/17 patients the lesions were localized at the cephalic level, 3/17 at the trunk level, and 4/17 at the perineum. CONCLUSION: Infantile hemangioma is a poorly reported condition on black skin. The demands for care are motivated either by the character showing lesions or by ulcerative complications. Sensitization of populations and ongoing training of health workers are needed to detect hemangiomas.
INTRODUCTION: Les hémangiomes sont des tumeurs vasculaires bénignes régressives de l'enfant, qui peuvent intéresser tous les organes, le plus souvent localisés sur la peau. Le but de notre étude est de déterminer la prévalence des hémangiomes sur peau noire. C'est une étude transversale descriptive qui s'est déroulée de novembre 2015 à Août 2016 au CNAM, dans le service de dermatologie-léprologie- Vénéréologie du Mali. RÉSULTATS: Sur 14 810 patients vus en consultation, nous avons reçu 17 cas d'hémangiome soit 0,11%. La moyenne d'âge était de 5 mois avec des extrêmes de 1mois et 60 mois. Les angiomes tubéreux représentent 82,35% des formes cliniques, les angiomes sous-cutanés 11,76% et les angiomes mixtes 5,89%. Chez 4/17 de nos patients existait une complication infectieuse, suite à une ulcération le premier jour de la consultation. La taille moyenne des lésions était de 3,25cm avec des extrêmes 0,5cm et 8cm. Le nombre de lésions par patient était de 1 pour 16 patients et 2 pour 1 patient. Chez 10/17 des patients les lésions étaient localisées au niveau céphalique, 3/17 au niveau du tronc, et 4/17 au niveau du périnée. CONCLUSION: L'hémangiome infantile est une affection peu rapportée sur peau noire. Les demandes de soins sont motivées soit par le caractère affichant des lésions ou par les complications ulcéreuses. Une sensibilisation des populations et une formation continue des agents de santé sont nécessaires pour détecter les hémangiomes.
ABSTRACT
BACKGROUND: Mycobacterium tuberculosis of the cervical spine is a rare but dangerous manifestation of extra-pulmonary tuberculosis. The clinical picture ranges from early, nonspecific, insidious symptoms to severe neurological complications and death, attributed to craniocervical junction instability and cervicomedullary compression. The different lines of management include antituberculous medication with traction and external fixation or adjunctive surgery (debridement and stabilization) in patients with severe or persistent neurological complications and/or vertebral instability. METHODS: We describe two patients with advanced craniocervical junction tuberculosis. The early clinical picture was nonspecific in Case 1 and obscured by psychiatric illness in Case 2. The detailed clinical and radiological findings, and the management, will be described. Involvement of the occipital condyles and foramen magnum, which has not been reported previously, will be demonstrated. RESULTS: Both cases underwent transoral biopsy, aspiration, and debridement of retropharyngeal abscess (granuloma). Histological and tissue culture studies proved the abscesses were tuberculous and anti-tuberculous medications were started. Case 1 showed complete resolution of the clinical and radiological findings. Case 2 developed cardiorespiratory arrest while in a halo jacket. He was resuscitated but remained quadriplegic and semiconscious; he developed nosocomial gram negative pneumonia. He was referred back to his local hospital where he died 1 year later. CONCLUSIONS: Tuberculosis is an infrequent but notable cause of cervicomedullary compression. It should be suspected in patients with infective spondylitis who are immunocompromised or reside in an area highly endemic for tuberculosis. Management strategies include antituberculosis medication, transoral biopsy and drainage of the abscess, traction and external fixation, posterior decompression, and internal fixation, according to the clinical and radiological findings.
