Prevalence and Factors Associated with Self-Medication in Dermatology in Togo.

OBJECTIVE: This study aimed to determine the prevalence of and factors associated with self-medication in dermatology in Lomé, Togo. METHODS: We conducted an analytical cross-sectional study from February to April 2016 in 2 dermatology departments in Lomé. Univariate and multivariate logistic regression models were carried out to identify possible factors associated with self-medication. RESULTS: A total of 711 patients were included in the study. The mean age (±SD) of the patients was 26.6 ± 6.9 years and the sex ratio (male/female) was 0.6. The main dermatologic diseases recorded were immunoallergic dermatoses (39.7%) and infectious skin diseases (22.6%). Two-thirds (481/711; 66.7%) of the patients had practiced self-medication before consultation in dermatology units. In multivariate analysis, factors associated with self-medication were female sex (aOR = 1.44; 95% CI = [1.01, 2.05]), duration of dermatologic disease more than one year (aOR = 1.79; IC = [1.19, 2.68]), adnexal dermatoses (aOR = 2.31; 95% IC = [1.03-5.21]), keratinization disorders (aOR = 4.23; 95% CI = [1.36-13.13]), and fungal skin infections (aOR = 5.43; 95% CI = [2.20, 13.38]). CONCLUSION: Our study confirms that self-medication practice is very common among patients with dermatologic diseases in Lomé and has identified associated factors.

Basidiobolomycosis Simulating a Mycobacterium ulcerans Infection in a Togolese Rural Child.

BACKGROUND: Basidiobolomycosis is a deep mycosis which preferentially affects rural young people in tropical countries. We report an atypical case, with multiple ulcers, simulating a Buruli ulcer. CASE REPORT: A 5-year-old boy, living in a rural area, was seen for ulcers on the buttocks and at the back and right flank that had been in progress for 4 months. On examination, we found an infiltrated plaque with sharp edges, little painful, located on the buttocks, back, and the right flank. On this plaque, there were multiple ulcers with polycyclic contours and fibrinous bottom. There were inguinal inflammatory lymph nodes. The patient had an altered general condition. Examination of other organs was normal. The diagnosis of Buruli ulcer was evoked first; the search for Mycobacterium ulcerans by polymerase chain reaction was negative. Histology test performed revealed hypodermic granulomatous inflammation with predominant macrophage and eosinophils. The mycological culture was not done. The child was treated successfully with ketoconazole (10 mg/kg/day) during eight weeks. DISCUSSION: Our observation shows great clinical and epidemiological similarities between basidiobolomycosis and Buruli ulcer. It confirms the efficacy of ketoconazole in severe basidiobolomycosis infection with alteration of general condition. Histopathology is very important for differential diagnosis between these two diseases.