Aspects épidémiologiques et cliniques des brûlures cutanées graves en milieu hospitalier en Côte d'Ivoire / Epidemiological and Clinical Aspects of severe Cutaneous Burns in Hospital in Cote d'Ivoire

Contexte et Objectif. Les brûlures cutanées graves constituent un véritable problème de santé publique à l'échelle mondiale. L'objectif de cette étude était de décrire le profi l épidémiologique et clinique des brûlures cutanées graves dans le but de mettre en place de mesures préventives effi cientes. Méthodes. Ils'agissait d'une étude transversale rétrospective à visée descriptive et analytique déroulée sur une période de 3 ans au sein du service de Dermatologie du CHU de Bouaké. Tous les malades quelque soit l'âge et le sexe reçus au service dermatologie pour brûlure cutanée grave ont été inclus. Les tests statistiques utilisés étaient les tests de Kruskal Wallis (KW) et de Mann whitney-Wilcoxon(MWW) Résultats. Sur la période d'étude, nous avons inclus 46 patients sur 6074 admissions soit une prévalence hospitalière de 0,75%. L'âge moyen était de 20,79 ans. Le sex-ratio était de3,18. 10,9% de nos patients avaient une condition socio-économique défavorable. Les antécédents les plus retrouvés étaient l'épilepsie (6,5%) et les troubles psychiatriques (4,3%). Les brûlures thermiques étaient majoritaires(95,7%), etles brûlures par fl amme (56,8%) et l'ébouillantement (43,2%)en constituaient les principales causes.Les membres étaient plus atteints (93,5%).Les brûlures étaient du premier degré (10,9%) et du deuxième degré (89,1%). L'étendue moyenne de la brûlure était de 23,91%. Les sujets d'âge plus jeunes étaient surtout brûlés par les liquides chauds. Il n'y'avait pas de lien entre l'âge et l'étendue des lésions ni entre l'agent causal et l'étendue des lésions. Conclusion. Les brûlures cutanées graves représentent un fl éau en Côte d'ivoire.Il est indispensable d'instaurer des mesures de prévention en vue de limiter les conséquences de celles-ci.

A case of squamous cell carcinoma occurring on a scar of Buruli ulcer in Bouake, Ivory Coast.

Buruli ulcer is infectious necrotizing panniculitis due to Mycobacterium ulcerans. Buruli ulcer is healed by leaving dystrophic, fibrous and retractile scars. On these scars can occur long-term squamous cell carcinoma. We report the first case of squamous cell carcinoma occurring on healing of Buruli ulcer. A 32-year-old woman with Buruli ulcer who has been cured for about 10 years is seen for ulcero-bulging knee swelling. The examination had revealed a large swelling of about ten centimeters in diameter, ulcero-budding, with an easily bleeding cauliflower appearance. The diagnosis of squamous cell carcinoma being retained without metastasis, resection of the tumor with scarring after one month without chemotherapy. There was no recurrence after six months of decline. The epidemiology of Buruli ulcer, responsible for scarring, explains the young age of our patient and the localization of carcinoma on the limb. The carcinomatous degeneration of scars, especially the scars of old burns, is constantly reported. The characteristics of Buruli ulcer scars, which bring them closer to burn scars, may explain why they are particularly affected by carcinomatous degeneration. One could also mention the chronicity of the wound in this infection, or wonder if the mycobacteria itself could play a role in carcinogenesis. This observation is, in our opinion, an alarm signal. We must fear an outbreak of cases in the years to come. To this end, preventive measures should already be taken by sensitizing the patients for an early consultation before any modification of their scars. After recovery, Buruli ulcer seems to present a risk of long-term evolution to a cancer. The scars of this condition, which could be considered precancerous lesions.

Squamous Cell Carcinoma Associated with Cosmetic Use of Bleaching Agents: About a Case in Ivory Coast.

Voluntary skin depigmentation is defined as a set of procedures for obtaining skin clarification for cosmetic purposes. Skin cancers are possible complications, but rarely reported. We describe a case observed in Ivory Coast. A 52-year-old Ivorian woman consulted the Dermatology Department of the University Hospital of Treichville, Abidjan for an ulceration of the middle third of the right clavicle evolving for 10 months. A diagnosis of squamous cell carcinoma (SCC) was confirmed by histological examination of the tumour biopsy. Retroviral serology (HIV) was negative. An excision of the tumour was performed. The postoperative consequences were simple. We report a case of SCC following long-term use of depigmenting cosmetic products in a female phototype VI. SCC is the most common skin cancer among black Africans. It is secondary to precancerous lesions or takes place on a damaged skin. Concerning our patient, the onset of this carcinoma could be associated with the carcinogenic effect of hydroquinone and topical corticoids used for a long time. In addition, no precancerous lesion or preexisting condition were found. The chronic evolution without healing was in favour of a neoplastic origin achieved through the analysis of the biopsy sample.

Squamous Cell Carcinoma in African Children with Xeroderma Pigmentosum: Three Case Reports.

INTRODUCTION: Xeroderma pigmentosum is a rare autosomal recessive genetic disease. This disease predisposes patients to early-onset skin cancers, particularly squamous cell carcinoma. Here, we report 3 pediatric cases, including 2 deaths. OBSERVATION: The subjects included 2 boys and 1 girl with skin type VI. All subjects were from consanguineous marriages, and the average age was 7.6 years. The patients all had ulcerative budding tumor lesions in the cephalic region, and the mean disease duration was 18 months. In all 3 cases, the diagnosis of xeroderma pigmentosum was made before the poikilodermal appearance of sun-exposed areas and photophobia. Neurological-type mental retardation was noted in 1 case. Histology confirmed squamous cell carcinoma in all 3 cases. The evolutions were marked by the death of 2 children (cases 1 and 3). In one case, the outcome was favorable following cancer excision and subsequent chemotherapy with adjuvant radiotherapy. CONCLUSION: Squamous cell carcinoma is a serious complication related to xeroderma pigmentosum in Sub-Saharan Africa. Prevention is based on the early diagnosis of xeroderma pigmentosum, black skin photoprotection, screening and early treatment of lesions, and genetic counseling.

Allergy to Red Meat: A Diagnosis Made by the Patient and Confirmed by an Assay for IgE Antibodies Specific for Alpha-1,3-Galactose.

We report the first case of allergy to red meat observed in Ivory Coast. A 49-year-old male presented with pruritus. The diagnosis of allergy to red meat was confirmed by an assay for IgE antibodies specific for alpha-1,3 galactose. Interestingly, the disease was considered a spell to the patient who was suspected of being a sorcerer by the community.

Epidemiological, Clinical, and Paraclinic Aspect of Cutaneous Sarcoidosis in Black Africans.

The specific objectives were to identify the epidemiology of cutaneous sarcoidosis and describe the clinical and laboratory aspects of the disease. Materials and Methods. We performed a descriptive cross-sectional study involving 24 referred cases of cutaneous sarcoidosis in 25 years (1990-2014) collected at Venereology Dermatology Department of the University Hospital of Treichville (Abidjan) both in consultation and in hospitalization. Results. The hospital frequency was one case per year. The average age was 42 years, ranging from 9 to 64. The sex ratio was 1. The shortest time interval between the appearance of the skin lesion and consultation of Dermatology Department at CHU Treichville was 3 months. The elementary lesions were represented primarily by a papule (18 cases), placard (3 cases), and nodule (2 cases) and mainly sat on the face and neck in 8 cases (38%). Extra cutaneous lesions were dominated by ganglion and respiratory involvement with 5 cases each followed by musculoskeletal damage in 3 cases. Chest radiography showed abnormality in 13 cases (54%). The pulmonary function test performed in 13 patients found 7 cases (54%) having restrictive ventilatory syndrome and 6 cases (46%) being normal. A tuberculin anergy was found in 11 cases (61%).