Cutaneous basidiobolomycosis: Seven cases in southern Benin.

BACKGROUND: Cutaneous basidiobolomycosis is the most common form of entomophthoramycosis. Herein we report seven cases of cutaneous basidiobolomycosis. PATIENTS AND METHODS: A retrospective observational study was conducted at the Buruli ulcer treatment centre in Pobè and at the national teaching hospital in Cotonou from 2010 to 2015. RESULTS: Seven cases of cutaneous basidiobolomycosis were diagnosed. The mean patient age was 9.53 years. There were 4 female and 3 male patients, all from southeast Benin. Clinically, the disease presented in all cases as a hard, well-defined, subcutaneous plaque with little inflammation, and which could easily be lifted from the deep structures but remained attached to the surface structures. The overlying skin was hyperpigmented. Plaques were localized to the buttocks or thighs. All patients had inflammatory anaemia with an accelerated erythrocyte sedimentation rate (30 to 70mm over the first hour), and a low haemoglobin count (8.7 to 11.4g/dL). Blood hypereosinophilia (650 to 3784elements/mm3) was present in six of the seven subjects. Histopathology (performed for 5 of the 7 subjects) showed granulomatous lesions with foreign-body giant cells, and inflammatory cells, with occasional eosinophils surrounding fungal hyphae (Splendore-Hoeppli phenomenon). Mycological analysis revealed Basidiobolus ranarum in three cases. The patients were treated with ketoconazole (5/7) and itraconazole (2/7), with good outcomes after 10 to 24 weeks of therapy. DISCUSSION: Cutaneous basidiobolomycosis is uncommon in southern Benin, with only seven cases being diagnosed over 6 years. The diagnosis of cutaneous basidiobolomycosis is a challenge in the field in Benin due to the non-specific clinical presentation, the lack of technical resources, and the existence of numerous differential diagnoses. CONCLUSION: Cutaneous basidiobolomycosis is an uncommon fungal infection in southern Benin chiefly affecting children.

Prevalence of xerosis, eczema, and hair and nail abnormalities in PLWHA in Cotonou, Benin.

BACKGROUND: The objective of this investigation was to study the prevalence of xerosis, eczema, and hair and nail abnormalities in PLWHA in Cotonou. PATIENTS AND METHODS: A retrospective study was performed on the records of PLWHA in Cotonou. All PLWHA with xerosis, eczema, or abnormal appendages were included. RESULTS: Forty-seven patients had xerosis or eczema. Their mean age was 38 years; the sex ratio 0.51 and the mean CD4 count 89 cells/mm(3). Twenty-three patients had xerosis, which affected the whole body (n = 20), lower limb (n = 2), limbs and trunk (n = 1), without gender difference. Twenty-four patients had eczema of which eight had both eczema and xerosis. Forty-two patients had abnormalities of the hair or nails. Their sex ratio was 0.80 and the mean CD4 count 110 cells/mm(3) . Nineteen patients had abnormalities of the hair and scalp: straight hair (n = 16), squamous lesions (n = 2), and folliculitis abscess (n = 1) with a male predominance. Twenty-three patients had nail dermatophytosis (n = 15), candidiasis (n = 7), and ingrowing nails (n = 1). These conditions affected more often women (74%) than men (26%). CONCLUSION: The prevalence of eczema and xerosis is low in our patients. Onychomycosis was the most frequent nail abnormality.

[Drug eruptions in children in Cotonou, Benin]. / Toxidermies Chez Les Enfants A Cotonou, Benin.

INTRODUCTION: The aim of this study was to investigate the epidemiological aspects of drug eruptions in children in hospital area in Cotonou. PATIENTS AND METHOD: A retrospective study was carried out in the Department of Dermatology of Cotonou (Benin) from 1998 to 2009. All cases of drug eruption occurred, during the study period, in children under 16 years old were selected for the study. The diagnosis of the drug eruption was based on clinical findings. The Identification of culprit drugs was based on the criteria as defined by the French Group of Pharmaco-vigilance. RESULTS: From 1998 to 2009, 232 cases of drug eruption were diagnosed in the Department of Dermatology. Of this, 35 cases occurred in children under 16 years old. The patient mean age was 6.6 years with a sex ratio of 0.94. 4 patients were HIV positive. The culprit drug was identified in 21 patients (60%): sulfonamides 52.38% (11/21 cases), penicillin 9.52% (2 cases), vaccine 9.52% (2 cases), acetaminophen 9.52% (2 cases), acetyl salicylic acid 4.76% (n = 1), quinine 4.76% (n = 1), phenobarbital 4.76% (n = 1) and ceftriaxone 4.76% (n = 1). The main clinical patterns were: fixed drug eruption 45.71% (16/35), maculopapular rash 17.14% (n = 6), Stevens-Johnson syndrome 17.14% (n=6), and urticaria 8.57% (n = 3), 1 case of toxic epidermal necrolysis was seen and one patient died. CONCLUSION: Skin reactions caused by drug intake are a rare disorder among children and fixed drug eruption is the main clinical presentation of the disease in Cotonou (Benin).

[Reasons for consultation in a dermatology/venereology department in 2009 in Cotonou, Benin]. / Motifs de consultation en Dermatologie-Vénéréologie en 2009 a Cotonou, Bénin.

The purpose of this retrospective study was to determine the reasons for consultation in a Dermatology Venereology Department in Cotonou, Benin. A total of 1,070 new patients were included. The main reason for consultation was immunoallergic dermatosis.

[Contact eczema and allergens: an analysis of the preliminary results of patch tests in the Dermatology Service of the National Hospital and University Center in Cotonou]. / Eczema de contact et allergenes: analyse des resultats preliminaires des tests epicutanes du Service de Dermatologie du Centre National Hospitalier et Universitaire (CNHU) de Cotonou.

About a preliminary study of patch-test in 39 cases of contact dermatitis with allergens of international Contact Dermatitis Research (ICDRG), the authors noted 27 (69.2%) positive patch-tests. Men are frequently exposed to formaldehyde and dichromate potassium. Women are more exposed to fragrance-mix and formaldehyde. Hand workers have the uppermost percentage of positive patch-test (90.9%). The authors observed also 16 cases of contact polysensitivity for at least two allergens.

[Buschke-Loewenstein tumor. Apropos of 2 cases in Cotonou, Benin]. / Tumeur de Buschke-Loewenstein. A propos de deux cas vus à Cotonou, Bénin.

About two cases of Buschke-Loewenstein tumor--one of the penis in man infected with HIV and another of perianal area-, the authors insist on the relative frequency of Buschke-Loewenstein tumor in non-circumcised and homosexual groups. They emphasize the continuous precancerous spectrum of Buschke-Loewenstein tumor.

Serologie treponemique: Interpretation a propos de 326 cas

A partir d'une triple confrontation des donnees epidemiologiques; cliniques et biologiques; les auteurs ont apprecie les limites d'une interpretation de la serologie treponemique chez 326 sujets testes par le VDRL (test non specifique) et le TPHA (test specifique). 21/326 patients (6;4 pour cent) ont une serologie treponemique positive dont 5 cas de fausses reactions positives. Les 16 cas de treponematoses sont reparties en 15 cas de syphilis venerienne et 1 cas de pian recent. Les auteurs ont egalement tente de classer les cas de syphilis veneriennes en stade evolutif. Par ailleurs; une serologie VIH effectuee chez ces sujets a permis d'apprecier l'influence de l'infection par le VIH sur le profil serologique classique des treponematoses

[Mibelli porokeratosis in 2 brothers]. / Porokératose de Mibelli chez deux frères.

INTRODUCTION: Mibelli's porokeratosis is uncommon in black persons. We report two brothers who had two different clinical presentations. CASE REPORT: The brothers were seen at the ages of 16 and 19 years. Both had Mibelli's porokeratosis, one with a papulo-verruciform presentation located on the scrotum, the anus, the gluteal area and the back of the hand, and the other with a superficial disseminated eruption involving the face and the forearm. DISCUSSION: The incidence of Mibelli's porokeratosis in the black population at Cotonou is approximately 0.3 per 10.000. The presence of the disease in two uterine brothers confirms the monogenic and familial nature of Mibelli's porokeratosis. Dominant transmission cannot be easily demonstrated when the parents of the patients are phenotypically healthy.

[Ectodermal dysplasia. Apropos of 6 familial cases in negroid children]. / Dysplasie ectodermique. A propos de 6 cas familiaux chez des enfants de race noire.

Six cases of ectodermic dysplasia were observed in children of a black family. The different forms include dental abnormalities and a particular pilar dysplasia in black subjects. Ectodermic dysplasia is transmitted recessively on the X chromosome.

[Cutaneous-pulmonary sarcoidosis. Diagnostic difficulties in the Black African milieu]. / Sarcoïdose cutanéo-pulmonaire. Difficultés diagnostiques en milieu Noir Africain.

About a case of pulmonary and dermatologic manifestations of sarcoidosis, in a Black African patient, the authors emphasize the clinical polymorphism of sarcoidosis. They insist on the diagnostic criteria of sarcoidosis which are not at all specific of the disease but necessitate a compatible interpretation; particularly in Black Africa where leprosy, tuberculosis and many others granulomatous diseases are endemic.

[Herpes Zoster, predictive element of human immunodeficiency virus infection (HIV). Epidemio-clinical study in Cotonou (Benin)]. / Le zona, élément prédictif de l'infection à virus de l'immuno-déficience humaine (VIH). Etude épidémio-clinique à Cotonou (Bénin).

An epidemio-clinical study of Herpes Zoster in 39 healthy patients of Benin has permitted to the authors to evaluate the positive predictive value of Herpes Zoster for HIV infection on West Africa; and to compare it with results of central Africa. The mean age of patients is 34.74 years. The positive predictive value of Herpes Zoster for HIV infection is 41.02%. It is increased by the cranial site of Herpes Zoster.