Daylight photodynamic therapy as a treatment for for actinic field change in patients diagnosed with Oculocutaneous albinism in Sub-Saharan Africa.

BACKGROUND: Oculocutaneous albinism (OCA) is a genetically inherited condition, whereby melanin is reduced or absent in the skin. A lack of melanin predisposes patients to actinic damage and skin malignancies. In Tanzania, a resource-limited country, the treatment of choice for pre-cancerous skin lesions is cryotherapy. OBJECTIVES: To investigate whether daylight PDT is a safe and well-tolerated treatment for actinic field change in the OCA population in Tanzania. METHODS: 12 participants with actinic damage were recruited from a Standing Voice skin surveillance clinic and treated with dPDT. Study participants completed tolerability and acceptability questionnaires at day 5 and 3-months post-treatment. A dermatologist assessed clinical response to dPDT at 3 months. RESULTS: Daylight PDT was well-tolerated and acceptable to the majority of patients. Actinic damage was reduced by 25-90%. No skin cancers developed during the treatment. CONCLUSIONS: This pilot study suggests that dPDT is a safe and tolerable treatment for actinic damage in the OCA population in Tanzania. Further work is required to compare the efficacy of dPDT against other topical therapies for actinic field change.

Contributing Factors and Outcome after Cryotherapy of Molluscum Contagiosum among Patients Attending Tertiary Hospital, Northern Tanzania: A Descriptive Prospective Cohort Study.

BACKGROUND: Molluscum contagiosum (MC) is a benign infection caused by a member of the Poxviridae family, molluscum contagiosum virus (MCV). The contributing factors for MCV infection are different in different populations and study areas. Few studies have been conducted to determine the effectiveness of cryotherapy in the treatment of MC. The study's objectives were to determine contributing factors and outcome after cryotherapy of MC among patients attending a tertiary hospital in Northern Tanzania. METHODS: A hospital-based cohort study was conducted at the Regional Dermatology Training Centre (RDTC) from September 2018 to August 2019, involving all patients clinically diagnosed with MC. We used a consecutive sampling method to recruit study participants. We treated all participants with cryotherapy and assessed them after two weeks. Data were collected using a structured questionnaire and analyzed using Statistical Package for the Social Sciences (SPSS) software version 21. RESULTS: There were 49 patients with MC who agreed to participate in this study with a median age of 8 (IQR 3-22). We found 18.4% of patients with active atopic dermatitis (AD) had MC while those with a history of atopic diseases (Ad) were 32%, and 22.4% had a history of using immunosuppressive drugs. The clearance rate of cryotherapy on MC lesions was found to be 94%. Hypopigmentation was the commonest adverse effect. CONCLUSION: The findings of this study show that AD and immunosuppression may be contributing to MC development. Based on the clearance rate results, cryotherapy has shown to be effective and may be used in the treatment of MC.

Mycetoma in Moshi, Tanzania.

The geographic spread of the neglected tropical disease mycetoma is still poorly understood, largely because there is no mechanism for official reporting and the general lack of identification facilities in many regions. Nonetheless many countries in the tropics have such cases. This brief report is submitted to provide an example of recent experience of mycetoma in six patients presenting to a single centre in Tanzania.