Mpox and Chickenpox Coinfection: Case Series From Southern Nigeria.

BACKGROUND: We describe clinicoepidemiologic characteristics of mpox-chickenpox coinfection in Nigeria. METHODS: A retrospective cohort analysis was performed of confirmed mpox cases in Nigeria from January 2022 to March 2023. Mpox and chickenpox were confirmed by real-time polymerase chain reaction (RT-PCR). RESULTS: Of 94 (60.0%) suspected cases, 56 had confirmed mpox, of whom 16 (28.6%) had chickenpox coinfection. The median age of confirmed mpox cases was 29 years (interquartile range, 20-37 years), 24 were men (60.7%), 6 (10.7%) were bisexual, and 5 (8.9%) died. Mpox-chickenpox-coinfected patients had more complications than mpox-monoinfected cases (56.3% vs 22.5%, P = .015). CONCLUSIONS: The high frequency of mpox-chickenpox coinfection argues for accelerated access to mpox and chickenpox vaccines in Africa.

Higher vitamin D levels in Nigerian albinos compared with pigmented controls.

BACKGROUND: Several studies have suggested that the lower vitamin D levels in blacks is attributable to the effect of increased pigmentation in blocking cutaneous ultraviolet (UV)-mediated production of vitamin D. Albinos are devoid of melanin and should invariably have higher vitamin D levels when compared with their pigmented counterparts. However, strict photoprotection required in their medical management has been shown to reduce UV-dependent vitamin D production. Associations between low vitamin D and several diseases suggest that the pattern of vitamin D in the black African albino be investigated. OBJECTIVE: To compare the vitamin D levels between albinos and normal pigmented controls in Anambra State, Nigeria, and thus highlight the impact of skin pigmentation and sun protection practices on vitamin D levels. METHODOLOGY: This was a cross-sectional study of a consecutive series of albinos from the Albino Foundation, Anambra State. The vitamin D levels of 61 albinos and 58 matched pigmented controls were analyzed. The sun exposures of the participants were calculated using validated sun exposure questionnaires. RESULTS: The albinos had significantly higher vitamin D levels (median 95.9 [50.1-177.4] ng/ml) than the controls (78.2 [12.1-250] ng/ml). None of the albinos had low vitamin D levels. None of the sun protection practices had significant effects on vitamin D levels. CONCLUSION: This study contests the claim that black Africans including albinos have low vitamin D levels. Albinos living in South East Nigeria have significantly higher vitamin D levels than their pigmented counterparts.

Unsuspected Skin Metastasis of Adenocarcinoma of the Prostate in a Patient on Goserelin (Zoladex).

Prostate cancer remains the most common noncutaneous cancer in men, especially in this era of prostate-specific antigen assay. Prostate cancer metastases have been known to commonly affect the lymphatics, bones, and lungs. Prostate cancer metastasis to the skin is very rare (<1%) and often signifies a terminal disease. Involvement of the skin has been thought to be through lymphatic spread by embolization or permeation, hematogenous spread, and implantation during surgery (port site in radical prostatectomy). We report a 74-year-old man on management for advanced prostate cancer with subcutaneous goserelin (Zoladex) but developed skin metastasis in the course of treatment. The skin metastasis in our patient, however, was initially localized to the site of the regions of subcutaneous goserelin injection that we imagined if there is a link between the two. We reviewed the literature and currently found no connection. Is there truly a link?