[Gonorrhea in sexually abused young girls in Lome (Togo)]. / Gonococcie de la petite fille à Lomé (Togo) et abus sexuel.

INTRODUCTION: Sexually transmitted diseases due to a sexual abuse cause are rarely documented in black Africa. The purpose of this study was to demonstrate the existence of sexual abuse in young girls with gonorrhea observed in Lome (Togo). PATIENTS AND METHODS: A cross-sectional study was conducted to document cases of sexually transmitted diseases diagnosed in young children (0 to 11 years of age) seen at the dermato-venereology unit of the Lome teaching hospital over a 20 month period. Syphilis serology (TPHA-VDRL) and HIV serology were carried out for all children with sexually transmitted disease and repeated after two weeks for TPHA-VDRL, and three months for HIV serology in children who had been sexually abused. RESULTS: During this period, 13 of 33 cases of sexually transmitted diseases diagnosed in young children were gonorrhea (mean age 7.2 +/- 2.7 years). It was due to sexual abuse in 12 cases (all in young girls). The abuser was a domestic employee in the child's home (n =3), a member of the child's family (n =7), an educator (n =1), a neighbor (n =1). Mean age of the alleged authors of sexual abuse was 25.7 +/- 5.5 years. Syphilis serology was negative, but one case of HIV infection in a 10-year-old girl was observed with identification of the contaminator. CONCLUSION: The results of this study confirm that sexual abuse in children is not an uncommon occurrence in black Africa and that it often leads to gonorrhea. The classic consequences of such abuse are aggravated by the high prevalence of HIV infection observed in the majority of the countries in black Africa.

[Cutaneous periarteritis nodosa resistant to combined corticosteroids and immunosuppressive agents. Efficacy of treatment with intravenous immunoglobulins]. / Periarterite noueuse cutanee resistante aux corticoides et immunosuppresseurs. Efficacite du traitement par immunoglobulines intraveineuses.

INTRODUCTION: Cutaneous polyarteritis nodosa is a subset of polyarteritis nodosa (PAN) characterized by a good prognosis because of the absence of severe visceral involvement. Dapsone, colchicin, non steroidal anti-inflammatory drugs are the first line treatments of cutaneous PAN. Corticosteroids are an alternative therapy. CASE-REPORT: A case of cutaneous PAN followed for 6 years is reported. Dapsone, colchicin, corticosteroid and cyclophosphamide have failed to control cutaneous lesions. Intravenous immunoglobulins 400 mg/kg/d five day monthly for 5 months was successful, but a cutaneous relapse occurred 3 months later which was another time controlled with intravenous immunoglobulins. DISCUSSION: Some cases of necrotizing vasculitis have been treated with intravenous immunoglobulins. This is the first reported case of cutaneous PAN treated with intravenous immunoglobulins. Because of the lack of controlled studies, the indications of intravenous immunoglobulins in vasculitis are restricted to those resistant to corticosteroids and immunosuppressive therapy.

[Physiological cutaneous signs in normal pregnancy: a study of 60 pregnant women]. / Signes cutanés physiologiques au cours de la grossesse normale: étude de 60 femmes enceintes.

We made a prospective study of 60 pregnant women from February 1992 to July 1992. Women with pathologic pregnancies were excluded. Fifty-one women had pigmentary changes; the most frequent was linea nigra in 45. Melasma was observed in 3 women only, and the other local melanosis were rare. Vascular changes appeared in 50 women and vascular spiders in 32. Only one vascular spider was seen on a leg; all the others were on the upper part of the body. Eighteen women had a palmar erythema. New striae distensae appeared in 37 women, the more often on the abdomen. Among the other non classified skin changes, acne appeared in 14 women, oedemas of the legs in 22, oedemas of the eyelids in 3 and molluscum fibrosum gravidarum in 4. We emphasize that skin changes are a frequent and polymorphous feature in pregnancy.