Quality of Life and Psychiatric Comorbidities among Subjects Practicing Artificial Skin Depigmentation in 2020 in the City of Cotonou (Benin).

Introduction: The purpose of this study was to study the quality of life and psychiatric comorbidities of subjects practicing voluntary skin depigmentation in the city of Cotonou. Methods: A cross-sectional, prospective, and analytical study, based on a three-stage probabilistic sampling method, included from June to October 2020, consenting subjects over 15 years of age, practicing artificial skin depigmentation, and residing for at least one year in Cotonou. The Dermatology Life Quality Index, Rosenberg, and Hospital Anxiety and Depression scales allowed us to evaluate the quality of life and self-esteem, and identify anxiety and depression, respectively. A p value <0.05 indicated a significant result. Results: We included 330 subjects. The mean age was 33.6 ± 11.6 years and the sex ratio was 0.4. Impaired quality of life was observed in 93.7% of subjects. Anxiety was diagnosed in 11.2% and depression in 5.8% of them. Self-esteem was low or very low in 24.2%. The degree of quality of life and the alteration of self-esteem, and the frequency of anxiety and depression were proportional to the number of skin lesions, the lightening products used, and the monthly cost of the products. Conclusion: The use of several lightening products exposes patients to numerous skin lesions, which are a source of impaired quality of life and whose persistence leads to psychiatric comorbidities.

Panorama des dermatoses tumorales vues en consultation dermatologique au Centre National Hospitalier Universitaire Hubert Koutoukou Maga de Cotonou au Bénin / Overview of tumoral dermatoses seen in dermatological consultation at the National University Hospital Center Hubert Koutoukou Maga in Cotonou, Benin

Introduction Les dermatoses tumorales sont des néoformations tissulaires dues à une prolifération cellulaire excessive, anormale, anarchique et plus ou moins autonome, aux dépens de la peau et de ses annexes. Ces dermatoses tumorales peuvent être bénignes, malignes ou à malignité limitée. L'objectif de la présente étude est de répertorier l'ensemble des dermatoses tumorales vues en consultation dermatologique au CNHU-HKM de Cotonou. Patients et méthodes Etude transversale rétrospective et descriptive ayant porté sur les dossiers des patients vus pour des tumeurs cutanéo-muqueuses, dans le service de Dermatologie-vénérologie du Centre National Hospitalier Universitaire Hubert Koutoukou Maga (CNHU-HKM) de Cotonou, de 2009 à 2023. Les données épidémiologiques et cliniques ont été recueillies à partir des registres de consultations puis saisies et analysées avec les logiciels Excel, EPI-DATA et SPSS. Résultats Au total, 15627 nouveaux patients ont été enregistrés, dont 1221 atteints de dermatoses tumorales (7,81%). L'âge moyen était de 33 ans ± 18,71 ; la tranche d'âge la plus représentée était celle de 20 à 39 ans (46,30%). La sex-ratio était de 1,08. Les lésions étaient acquises chez 93,94% des patients. Trente-cinq types de dermatoses tumorales ont été colligés. Les tumeurs bénignes représentaient 95,43% des patients. Elles étaient dominées par les chéloïdes (25,34 %) suivies parles condylomes (17,50 %), les verrues (10,12%), le molluscum contagiosum (7,54 %), l'ensemble formé par les nævi et hamartomes (5,18 %) et les kystes sébacés (4,57 %). Les tumeurs malignes étaient rares et représentées par les carcinomes spinocellulaires (1,14%), basocellulaires (0,30%) et les mélanomes (0,30%). Les tumeurs à malignité limitée sont essentiellement représentées par la maladie de Kaposi retrouvée chez 2,05% des patients. Conclusion Les dermatoses tumorales sont relativement fréquentes en milieu hospitalier au Bénin. Elles sont dominées par les tumeurs bénignes avec à leur tête les chéloïdes et les condylomes

Introduction Tumoral dermatoses are tissue neoformations resulting from excessive, abnormal, anarchic, and somewhat autonomous cell proliferation, affecting the skin and its annexes. These tumoral dermatoses can be benign, malignant, or of limited malignancy. The aim of this study is to catalog all the tumoral dermatoses seen in dermatological consultation at NUHC- HKM in Cotonou. Patients and Methods This was a retrospective, descriptive cross-sectional study based on the files of patients seen for cutaneous or mucosal tumors in the Dermatology-Venereology department of the National University Hospital Center Hubert Koutoukou Maga (NUHC-HKM) in Cotonou, from 2009 to 2023. Epidemiological and clinical data were collected from consultation registers and analyzed using Excel, EPI-DATA, and SPSS software. A total of 15,627 new patients were registered, of which 1,221 were affected by tumoral dermatoses (7.81%). The average age was 33 years ± 18.71; the most represented age group was 20 to 39 years (46.30%). The sex ratio was 1.08. Thirty-five types of tumoral dermatoses were collected. The lesions were non congenital in 93.94% of patients. Benign tumors accounted for 95.43% of the patients. They were dominated by keloids (25.34%) followed by condylomas (17.50%), warts (10.12%), molluscum contagiosum (7.54%), the group formed by nevi and hamartomas (5.18%), and sebaceous cysts (4.57%). Malignant tumors were rare and represented by squamous cell carcinomas (1.14%), basal cell carcinomas (0.30%), and melanomas (0.30%). Tumors with limited malignancy were primarily represented by Kaposi's disease found in 2.05% of patients. Conclusion Tumoral dermatoses are relatively frequent in the hospital setting in Benin. They are dominated by benign tumors, headed by keloids and condylomas

Severe Cutaneous Adverse Drug Reactions in Children: Epidemiological, Clinical and Etiological Aspects in Dermatology-Venereology Unit at National and Teaching Hospital of Cotonou.

BACKGROUND: The aim of this study was to describe the epidemiological, clinical and etiological aspects of severe cutaneous adverse drug reactions in children in dermatologyvenereology unit at National and Teaching Hospital of Cotonou. METHODS: A retrospective and descriptive study was carried out for 10 years in dermatology-venereology unit at the National and Teaching Hospital of Cotonou to document the epidemiological, clinical and etiological aspects of severe cutaneous adverse drug reactions in children. It included all children aged from 0 to 18 years with clinical diagnosis of severe cutaneous adverse drug reactions. Drug imputability was based on the criteria of the French pharmacovigilance group. RESULTS: Severe cutaneous adverse drug reactions accounted for 47.3% of paediatric cases (35/74 cases). The mean age was 9.3 years ± 5.2. The sex-ratio was 1.1. Self-medication was noted in 76.5% of children, on the initiative of parents in 66.7% of cases. There were 51.4% cases of Steven Johnson syndrome, 22.8% cases of Lyell syndrome, 8.5% cases of generalized and bullous fixed drug eruption, 2.9% cases of acute generalized exanthematous pustulosis and erythrodermic maculo-papular rash. Drug combinations was noted in 20% of cases. Penicillins (26.5%), paracetamol and sulfonamides (16.3%) were the drugs frequently incriminated. CONCLUSION: Steven Johnson syndrome and Lyell syndrome were the main severe cutaneous adverse drug reactions in children, mostly of school age. Penicillins, paracetamol and sulfonamides were the drugs frequently used and administered most often on self-medication.

INTRODUCTION: L'objectif de cette étude était de décrire les aspects épidémiologiques, cliniques et étiologiques des toxidermies graves chez les enfants en dermatologie à Cotonou. METHODES: Une étude rétrospective et descriptive a été réalisée sur 10 ans dans le service de dermatologie du Centre National Hospitalier et Universitaire de Cotonou pour documenter les aspects épidémiologiques, cliniques et étiologiques des toxidermies graves chez les enfants. Étaient inclus tous les enfants âgés de 0-18 ans chez qui le diagnostic clinique de toxidermie grave a été retenu. L'imputabilité médicamenteuse était basée sur les critères du groupe français de pharmacovigilance. RESULTATS: Les toxidermies graves représentaient 47,3% des cas pédiatriques (35/74 cas). L'âge moyen était de 9,3 ans ± 5,2. La sex-ratio H/F était de 1,1. Une automédication a été notée chez 76,5% des enfants, sur l'initiative des parents dans 66,7% des cas. Il y avait 51,4% de cas de syndrome de Steven Johnson, 22,8% de cas de syndrome de Lyell, 8,5% de cas d'érythème pigmenté fixe bulleux étendu, 2,9% de pustulose exanthématique aigüe généralisée et d'exanthème maculo-papuleux eìrythrodermique. Une polymédication a été notée dans 20% des cas. Les pénicillines (26,5%), le paracétamol et les sulfamides (16,3%) étaient les médicaments fréquemment incriminés. CONCLUSION: Le syndrome de Steven Johnson et le syndrome de Lyell étaient les principales toxidermies graves chez les enfants, majoritairement en âge scolaire. Les pénicillines, le paracétamol et les sulfamides étaient les médicaments fréquemment incriminés et administrés le plus souvent en automédication. Mots clés: Toxidermies graves, syndrome de Steven Johnson, syndrome de Lyell, automédication, sulfamides, enfants, Benin.

Pityriasis versicolor, aspects épidémio-cliniques, facteurs associés et qualité de vie à Parakou (Bénin) en 2020

Le pityriasis versicolor (PV) est une pathologie cutanée fréquemment rencontrée en consultation dermatologique, surtout dans les pays à climat tropical. Une étude épidémio-clinique, s'intéressant aussi aux comorbidités associées et au retentissement de la maladie a été réalisée. Elle a concerné 118 patients venus consulter dans le service de Dermatologie-Vénérologie au Centre Hospitalier Universitaire Départemental Borgou-Alibori, Bénin. La population la plus touchée était les sujets jeunes avec une fréquence plus élevée chez les 20-30 ans (38,98%). L'âge moyen était de 27,03 ans avec une sex ratio à 1,40. Les antécédents familiaux de pityriasis versicolor ont été retrouvés chez 10 patients soit 8,47%. Comme facteurs favorisants, 57,62% utilisaient les laits corporels dépigmentants. La forme classique (20,37%) était majoritairement représentée. L'acné a été notée chez 19 patients (16,10%). La sérologie VIH était revenue positive chez 4 patients (5,55%) et le diabète a été diagnostiqué chez 3 patients (7,5%). Une altération de la qualité de vie des sujets (35,59%) a été retrouvée.

Pityriasis versicolor (PV) is a cutaneous pathology frequently encountered in dermatological consultations, especially in countries with a tropical climate. An epidemio-clinical study, also questioning the associated comorbidities and the repercussions of the disease, was carried out on 118 patients who came to the Dermatology-Venerology Department at the Borgou-Alibori Departmental University Hospital, Benin. The most affected population was young subjects with a higher frequency in the 20-30 years old (38.98%). The mean age was 27.03 years with a sex ratio of 1.40. Family history was found in 10 patients (8.47%). As contributing factors, 57.62% used depigmenting body milks. The classic form (20.37%) was predominantly represented. Acne was noted in 19 patients (16.10%). HIV serology was positive in 4 patients (5.55%) and diabetes was dignosed in 3 patients (7.5%). A slight alteration in the quality of life of the subjects (35.59%) was found.

Buruli ulcer: Evaluation of its medical and surgical management at the Allada (Benin) Screening and Treatment Center, 2010-2014.

The objective of our study was to evaluate the medico-surgical management of Buruli ulcer (BU) in the BU Screening and Treatment Center (CDTUB) of Allada in Benin. This retrospective and descriptive study retrospectively reviewed records of patients seen from 2010 to 2014 at the CDTUB of Allada. It included patients diagnosed with BU according to WHO epidemiological and clinical criteria as well as laboratory results and who were treated according to WHO medical and surgical recommendations. In all, 274 patients were diagnosed and treated, 57.7% of them children younger than 15 years. Ulcerative lesions (189, 69%) and WHO category II lesions (144, 52.5%) predominated. All patients received dual antibiotic therapy and 43.4% (119) underwent surgery as well. Category III lesions and multifocal lesions required more surgery, whereas most category I lesions healed under medical treatment. The overall rate of healing was 92%: 53.3% for patients who received only antibiotic therapy and 38.7% for those who also had surgery. The median healing time was 13 weeks and ranged from 4 to 56 weeks. In the CDTUB of Allada, between 2010 and 2014, most patients were treated with antibiotic therapy alone, but a significant number still received surgery.

Position Statement on Atopic Dermatitis in Sub-Saharan Africa: current status and roadmap.

BACKGROUND: The first International Society of Atopic Dermatitis (ISAD) global meeting dedicated to atopic dermatitis (AD) in Sub-Saharan Africa (SSA) was held in Geneva, Switzerland in April 2019. A total of 30 participants were present at the meeting, including those from 17 SSA countries, representatives of the World Health Organization (WHO), the International Foundation for Dermatology (IFD) (a committee of the International League of Dermatological Societies, ILDS www.ilds.org), the Fondation pour la Dermatite Atopique, as well as specialists in telemedicine, artificial intelligence and therapeutic patient education (TPE). RESULTS: AD is one of the most prevalent chronic inflammatory skin diseases in SSA. Besides neglected tropical diseases (NTDs) with a dermatological presentation, AD requires closer attention from the WHO and national Departments of Health. CONCLUSIONS: A roadmap has been defined with top priorities such as access to essential medicines and devices for AD care, in particular emollients, better education of primary healthcare workers for adequate triage (e.g. better educational materials for skin diseases in pigmented skin generally and AD in particular, especially targeted to Africa), involvement of traditional healers and to a certain extent also patient education, bearing in mind the barriers to effective healthcare faced in SSA countries such as travel distances to health facilities, limited resources and the lack of dermatological expertise. In addition, several initiatives concerning AD research in SSA were discussed and should be implemented in close collaboration with the WHO and assessed at follow-up meetings, in particular, at the next ISAD meeting in Seoul, South Korea and African Society of Dermatology and Venereology (ASDV) meeting in Nairobi, Kenya, both in 2020.

[Hookworm-related folliculitis in a woman performing skin bleaching in Benin]. / Folliculite ankylostomienne compliquant une dépigmentation cutanée volontaire au Bénin.

Hookworm-related cutaneous larva migrans is caused by the subcutaneous migration of hookworm larvae. The characteristic sign is a serpiginous cutaneous track. Folliculitis is an uncommon clinical manifestation. We report a case of hookworm-related folliculitis in a woman performing skin bleaching. A 33-year-old woman presented with a widespread cutaneous eruption made of erythematous and itchy follicular papulo-nodules, with erythematous serpiginous tracks, about 5-10cm long and numerous streaks of scratching, located on the limbs, buttocks and trunk. The cutaneous lesions occurred two days after contact with the floor of a warehouse contamined by faeces of cats. The lesions have been evolving for a week and have been treated with antibiotics without success. Clinical examination found cutaneous atrophy, purple stretch marks and hyperpigmentation of dorsal parts of fingers joints. The patient reported having been using bleaching cosmetics containing topical steroids and hydroquinone for twelve years. She was cured within 4 weeks with oral albendazole 400mg per day during 7 consecutive days.

La folliculite ankylostomienne est une forme folliculaire de larva migrans cutanée ankylostomienne rarement observée. Nous en rapportons un cas chez une patiente de 33 ans, se dépigmentant depuis 12 ans. Elle a consulté pour une éruption évoluant depuis une semaine, diffuse, très prurigineuse, apparue deux jours après le contact avec le sol d'un entrepôt souillé par des déjections de chats. L'examen physique retrouvait de nombreuses lésions de folliculites, érythémateuses coexistant avec des cordons serpigineux de dermatite rampante sur les zones d'extension des membres, le dos, les fesses et l'abdomen, typiques de folliculite ankylostomienne. Un traitement à base d'albendazole 400 mg par jour pendant 7 jours a permis d'obtenir la guérison.

Aspects épidemiologiques et cliniques des mycoses superficielles en milieu hospitalier à Cotonou de 2005 à 2014

Introduction : Les mycoses superficielles sont fréquentes en zones tropicales et représentent le premier motif de consultation en dermatologie dans de nombreux pays africains. Matériel et méthodes : Une étude rétrospective, descriptive et analytique a été réalisée dans le service de Dermatologie du Centre National Hospitalier et Universitaire de Cotonou pour décrire le profil épidémiologique et clinique des mycoses superficielles. Elle a inclus sur 10 ans tous les patients chez qui un diagnostic clinique de mycose superficielle a été retenu. Résultats : La prévalence des mycoses superficielles était de 9,6% (1037/10787 patients). Les deux sexes étaient uniformément représentés et l'âge moyen était de 32,2 ans. Trois groupes cliniques de mycoses superficielles étaient retrouvés : dermatophytoses (44,7%), candidoses cutanéo-muqueuses (32,8%) et pityriasis versicolor (31,3%). Les épidermomycoses (93,4%) étaient réparties en dermatophytoses de la peau glabre et des plis (36,4%), pityriasis versicolor (31,3%) et candidoses des plis (25,7%). Les onychomycoses (9,7%) étaient soit de suspicion candidosique (6,4%) ou soit dermatophytique (3,3%). Les teignes représentaient 5% de l'ensemble des mycoses superficielles et la candidose muqueuse 0,7%. Les principaux facteurs favorisants identifiés étaient l'utilisation abusive des savons antiseptiques (20,4%) et l'usage à visée cosmétique de produits dépigmentants (12,7%). Conclusion : Les mycoses superficielles étaient fréquentes avec une prédominance des épidermomycoses dans le service de dermatologie de Cotonou. Les habitudes cosmétiques représentaient un important facteur favorisant de ces épidermomycoses

Zona en milieu hospitalier à Cotonou de 2005 à 2014: aspects épidemiologiques et cliniques

L'objectif de cette étude était de documenter les aspects épidémiologiques et cliniques du zona en milieu hospitalier à Cotonou. Matériel et méthodes : L'étude était rétrospective et descriptive sur 10 ans et a concerné tous les nouveaux patients reçus en consultation dans le service de Dermatologie du Centre National Hospitalier et Universitaire de Cotonou (CNHU-C), chez qui le diagnostic clinique de zona a été retenu. Résultats : Sur les 10787 nouveaux patients reçus durant la période, 70 présentaient un zona correspondant à une prévalence de 0,6%. Le sex-ratio H/F était de 1,1. La moyenne d'âge était de 42,3 ans avec des extrêmes de 1 an et 73 ans. La tranche d'âge la plus touchée était celle des patients de 50-60 ans. L'infection à VIH était associée au zona dans 46,9% des cas. Les formes érythémato-vésiculeuses à disposition unilatérale étaient prédominantes (79%). Les formes nécrotiques (10%) et nécrotico-hémorragiques (4%) étaient l'apanage des patients infectés par le VIH. Conclusion : Le zona était une dermatose rare dans le service de dermatologie du CNHU- C. L'immunodéficience par le VIH et l'immunosénescence étaient les principaux facteurs de co-morbidité

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.

[Profile of immune and allergic dermatoses among children at the outpatient dermatology clinic in Cotonou (Benin)]. / Profil des dermatoses immunoallergiques chez les enfants dans le service de dermatologie du CNHU-C (Bénin).

OBJECTIVE: The aim of this work was to study the profile of immune and allergic dermatoses (IAD) in children consulting at the outpatient dermatology clinic at the National University Hospital in Cotonou (Benin). METHOD: This retrospective descriptive study examined records of children consulting with this diagnosis over a 10-year period. RESULTS: IAD (902 cases, 37%) were the most common pediatric dermatosis, followed by infectious dermatosis (24%). The sex ratio of children was 0.78. The age groups most strongly affected were those aged 1-30 months (25.39%) and 150-180 months (19.73%). The main IAD were: eczema (47.9%) and prurigo simplex (40.7%). Other IADs included lichen planus (5.1%), toxicoderma (3.8%), urticaria (1.5%), and erythrodermic eczema (1%). The incidence of eczema increased from 13.5% in 2000 to 21.5% in 2009, an increase of 62.2% over 10 years. CONCLUSION: IADs are common at the Cotonou hospital clinic and are dominated by eczema, the incidence of which has increased significantly over time.

[Epidemiological and clinical characteristics of anogenital dermatoses in the department of dermatology-venereology in Cotonou, Benin]. / Profil épidémioclinique des dermatoses anogénitales dans un service de dermatologie à Cotonou (Bénin).

OBJECTIVE: The aim of this study was to document the epidemiological and clinical characteristics of anogenital dermatoses (AGDs) in Cotonou, Benin. METHOD: This retrospective, descriptive study, conducted in the Department of Dermatology-Venereology at the National University Hospital of Cotonou, examined medical records of admissions and outpatient consultations for the 5-year period 2005-2009 and included the records of all patients with a clinical diagnosis of AGD. RESULTS: The prevalence of AGD in our series was 2.6% and the prevalence of sexually transmitted AGDs (STIs) was 1.3%. The sex ratio (M:F) was 2.5, and the patients' average age was 31.1 years. AGDs were classified as infectious (77%), inflammatory (12.6%), non-infectious tumors (3.7%), physiological (2.1%), psychodermatoses (2.1%), non-infectious ulcers (1.6%), and dyschromia (1%). STIs accounted for 44% of the AGDs: condyloma (65.5%), genital herpes (19%), urethritis (8.3%), and chancroids (4.8%). The primary sites in men were the foreskin, the groin, the scrotum, and the glans, and in women, the labia majora, the groin, the labia minora, and the anal cleft. CONCLUSION: AGDs were relatively rare in hospital consultations in Cotonou. They were mainly infectious (viral or fungal), and nearly half were STIs.

[Zoon's balanitis in circumcised and HIV infected man, at Cotonou (Benin)]. / Balanite de Zoon chez un homme circoncis et infecté par le VIH, à Cotonou (Bénin).

Balanitis of Zoon (BZ) characterized by an important plasma cell infiltration occurs exclusively in uncircumcised men aged between 40-80 years. We report here a case of BZ in an HIV infected patient who was circumcised since birth. A 43-year old man consulted in 2009 for itchy and not painful glans erosion evolving for one year. He is HIV1 infected and has been under didanosine, lamiduvine and nelfinavir for three years. Under this treatment, his CD4 count increased from 26 cells/mm(3) in 2007 to 206 cells/mm(3) at the time of the consultation. We noted after examination clean burgeoning erosion, red in places, pink in other places, with fuzzy boundary, sitting on the glans and extending into the preputial sulcus. Histopathology showed infiltration by sheets of plasma cells with perivascular topography in the dermis. The bacterial cultures and syphilis serology were negative. We noted a good outcome after four weeks of application of 3% oxytetracycline ointment. This observation suggests that the BZ can occur on a HIV infected patient whether he was circumcised or not. Thus, it appears fair to think of BZ faced with a chronic erosion of the glans in HIV infected patient.