[Newborns dermatitis: about 116 cases collected in a university hospital in abidjan]. / Les dermatoses neonatales : a propos de 116 cas colliges dans un hopital universitaire d'abidjan.

AIMS: To determine the epidemiological profile of newborn dermatitis and to describe the different clinical aspects of the observed neonatal dermatitis. PROCEDURE: The study took place at the University Hospital of Cocody (Abidjan). The study was cross-sectional, descriptive and analytical, carried out on the basis of prospective recruitment. The study included newborns who were seen in outpatient or inpatient settings by 4 april 2018 to 23 August 2018 and in whom the pediatrician had observed cutaneous and/or mucosal lesions. The diagnosis was made with the collaboration of a dermatologist. RESULTS: During the study period, 116 newborns were identified. The age of the patients seen in pediatrics with dermatitis varied from 1 to 28 days, with a mean of 16.86 ± 8.4 days. The median age was 19 days. The most representative age range (32.8%) was 24-28 days. The sex ratio (M/F) was 1. In almost 2/3 of the cases, the children were born at term, 29.3% were premature and 5.2% were born after term. In almost 2/3 of the cases (63.8%), the newborns had a birth weight of more than 2500 g. Only 3.4% of newborns seen in pediatric consultations were referred for a dermatitis. The age of the lesions at the time of consultation varied from 1 to 26 days, with a mean of 06.19 days ± 5.13. In more than half (53.5%) of the cases, the lesions had evolved for less than 5 days. Transient dermatitis was more frequent (51.7%), followed by infectious dermatitis (32.8%). Transient dermatitis of the newborn was dominated by sweaty miliaria (40%). Infectious dermatitis were mainly represented by mycotic (68.4%) and bacterial (31.9%) infections. Bacterial dermatitis were composed of neonatal impetigo (83.3%) and folliculitis (16.7%). In almost half of the cases (46.1%) the mycotic dermatitis were represented by candidosis intertrigo and in 38.5% of the cases there was oral candidiasis. The other neonatal dermatitis observed were dominated by diaper rash (64.3%) (Photo 2) and congenital nevi (21.5%). More than half (57.1%) of the cases of toxic erythema neonatorum occurred between days 6 and 10 of life. Nearly half (41.6%) of the cases of sudoral miliaria occurred between birth and day 5 of life. More than half (57.1%) of the cases of sebaceous hyperplasia occurred before the 5th day of life. All cases of neonatal scaling and mongoloid spots were already present between birth and day 5 of life. The mean age of patients with transient dermatitis was 14.31 days compared with 19.41 days for those with the other dermatitis. The difference in age was statistically significant (p < 0.05). The transient dermatitis predominated in male neonates while the other dermatitis predominated in females, however the difference observed at the level of sex was not statistically significant (p > 0.05). CONCLUSION: The diagnosis of neonatal dermatitis is not always obvious, especially on black skin where few publications have been published.

OBJECTIFS: Déterminer le profil épidémiologique des dermatoses du nouveau-né et de décrire les différents aspects cliniques des dermatoses néonatales observées. MATÉRIEL ET MÉTHODES: L'étude s'est déroulée au Centre hospitalier universitaire de Cocody (Abidjan). L'étude était transversale, à visée descriptive et analytique, réalisée sur la base d'un recrutement prospectif. Ont été inclus, les nouveau-nés ayant été vus en consultation externe ou en hospitalisationdu 4 avril 2018 au 23 août 2018 chez qui le médecin pédiatre avait observé des lésions cutanées et/ou muqueuses.Ensuite,le diagnostic était posé par le dermatologue référant de l'étude. RÉSULTATS: Pendant la période d'étude, 116 nouveau-nés ont été recensés. La moyenne d'âge était 16,86 ± 8,4 jours avec un âge médian de 19 jours. Lesex ratio (H/F) était de 1. Dans plus de la moitié (53,5%) des cas, les lésions évoluaient depuis moins de 5 jours. Une dermatose transitoire était diagnostiquée dans plus de la moitié des cas (51,7%) et dans près du tiers des cas (32,6%) une dermatose infectieuse. Les dermatoses transitoires du nouveau-né étaient dominées par la miliaire sudorale (40%), l'érythème toxique (23%), la desquamation néonatale (10,7%) et l'hyperplasie néonatale (10,7%).Les taches mongoloïdes représentaient3,3% des cas. Les dermatoses infectieuses étaient essentiellement représentées par des infections mycosiques (68,4%) et bactériennes (31,6%). Les autres dermatoses néonatales observées étaient dominées par dermite du siège (64,3%) et les nœvi congénitaux (21,5%). Plus de la moitié (57,1%) des cas d'érythème toxique néonatal survenaient entre le 6e et le 10e jour de vie. L'âge moyen des patients présentant une dermatose transitoire était de 14,31 jours contre 19,41 jours pour ceux présentant les autres dermatoses. La différence observée au niveau de l'âge était statistiquement significative (p < 0,05). CONCLUSION: Les dermatoses néonatales sont multiples et variées. Certaines sont transitoires, ne nécessitant pas toujours de prise en charge thérapeutique. Leur diagnostic n'est pas toujours évident pour le pédiatre d'où la nécessité d'une étroite collaboration entre pédiatres et dermatologues afin d'améliorer la démarche diagnostique et parfois thérapeutique.

Dermatite néonatale: à propos de 116 cas recueillis dans un CHU d'Abidjan / Newborns dermatitis: about 116 cases collected in a university hospital in Abidjan

Objectifs : Déterminer le profil épidémiologique des dermatoses du nouveau-né et de décrire les différents aspects cliniques des dermatoses néonatales observées. Matériel et méthodes : L'étude s'est déroulée au Centre hospitalier universitaire de Cocody (Abidjan). L'étude était transversale, à visée descriptive et analytique, réalisée sur la base d'un recrutement prospectif. Ont été inclus, les nouveau-nés ayant été vus en consultation externe ou en hospitalisationdu 4 avril 2018 au 23 août 2018 chez qui le médecin pédiatre avait observé des lésions cutanées et/ou muqueuses.Ensuite,le diagnostic était posé par le dermatologue référant de l'étude. Résultats : Pendant la période d'étude, 116 nouveau-nés ont été recensés. La moyenne d'âge était 16,86 ± 8,4 jours avec un âge médian de 19 jours. Lesex ratio (H/F) était de 1. Dans plus de la moitié (53,5%) des cas, les lésions évoluaient depuis moins de 5 jours. Une dermatose transitoire était diagnostiquée dans plus de la moitié des cas (51,7%) et dans près du tiers des cas (32,6%) une dermatose infectieuse. Les dermatoses transitoires du nouveau-né étaient dominées par la miliaire sudorale (40%), l'érythème toxique (23%), la desquamation néonatale (10,7%) et l'hyperplasie néonatale (10,7%). Les taches mongoloïdes représentaient3,3% des cas. Les dermatoses infectieuses étaient essentiellement représentées par des infections mycosiques (68,4%) et bactériennes (31,6%). Les autres dermatoses néonatales observées étaient dominées par dermite du siège (64,3%) et les nævi congénitaux (21,5%). Plus de la moitié (57,1%) des cas d'érythème toxique néonatal survenaient entre le 6e et le 10e jour de vie. L'âge moyen des patients présentant une dermatose transitoire était de 14,31 jours contre 19,41 jours pour ceux présentant les autres dermatoses. La différence observée au niveau de l'âge était statistiquement significative (p < 0,05). Conclusion: Les dermatoses néonatales sont multiples et variées. Certaines sont transitoires, ne nécessitant pas toujours de prise en charge thérapeutique. Leur diagnostic n'est pas toujours évident pour le pédiatre d'où la nécessité d'une étroite collaboration entre pédiatres et dermatologues afin d'améliorer la démarche diagnostique et parfois thérapeutique

Aims: To determine the epidemiological profile of newborn dermatitis and to describe the different clinical aspects of the observed neonatal dermatitis. Procedure: The study took place at the University Hospital of Cocody (Abidjan). The study was cross-sectional, descriptive and analytical, carried out on the basis of prospective recruitment. The study included newborns who were seen in outpatient or inpatient settings by 4 april 2018 to 23 August 2018 and in whom the pediatrician had observed cutaneous and/or mucosal lesions. The diagnosis was made with the collaboration of a dermatologist. Results: During the study period, 116 newborns were identified. The age of the patients seen in pediatrics with dermatitis varied from 1 to 28 days, with a mean of 16.86 ± 8.4 days. The median age was 19 days. The most representative age range (32.8%) was 24-28 days. The sex ratio (M/F) was 1. In almost 2/3 of the cases, the children were born at term, 29.3% were premature and 5.2% were born after term. In almost 2/3 of the cases (63.8%), the newborns had a birth weight of more than 2500 g. Only 3.4% of newborns seen in pediatric consultations were referred for a dermatitis. The age of the lesions at the time of consultation varied from 1 to 26 days, with a mean of 06.19 days ± 5.13. In more than half (53.5%) of the cases, the lesions had evolved for less than 5 days. Transient dermatitis was more frequent (51.7%), followed by infectious dermatitis (32.8%). Transient dermatitis of the newborn was dominated by sweaty miliaria (40%). Infectious dermatitis were mainly represented by mycotic (68.4%) and bacterial (31.9%) infections. Bacterial dermatitis were composed of neonatal impetigo (83.3%) and folliculitis (16.7%). In almost half of the cases (46.1%) the mycotic dermatitis were represented by candidosis intertrigo and in 38.5% of the cases there was oral candidiasis. The other neonatal dermatitis observed were dominated by diaper rash (64.3%) (Photo 2) and congenital nevi (21.5%). More than half (57.1%) of the cases of toxic erythema neonatorum occurred between days 6 and 10 of life. Nearly half (41.6%) of the cases of sudoral miliaria occurred between birth and day 5 of life. More than half (57.1%) of the cases of sebaceous hyperplasia occurred before the 5th day of life. All cases of neonatal scaling and mongoloid spots were already present between birth and day 5 of life. The mean age of patients with transient dermatitis was 14.31 days compared with 19.41 days for those with the other dermatitis. The difference in age was statistically significant (p < 0.05). The transient dermatitis predominated in male neonates while the other dermatitis predominated in females, however the difference observed at the level of sex was not statistically significant (p > 0.05). Conclusion: The diagnosis of neonatal dermatitis is not always obvious, especially on black skin where few publications have been published

[Epidemioclinical and Therapeutic Study of Condylomas (Genital Warts) in Dermato-Venereology Department (CHU Treichville, Abidjan, Côte d'Ivoire, 2013-2016)]. / Étude épidémioclinique et thérapeutique des condylomes vénériens dans un service de dermatovénéréologie (CHU Treichville, Abidjan, Côte d'Ivoire, 2013-2016).

We have conducted a retrospective study in the dermatology department of the CHU Treichville in Abidjan during 4 years. Three hundred and fifty cases of venereal warts were recorded with a hospital frequency of 1.5%, an average age of 29.37, a female predominance (51.3%), and a sex ratio (M/F) of 0.94. We have observed a giant condyloma in 0.9%, a main localization to the vulva (47.7%) and male genitalia (34.6%); HIV testing carried out in 60.8% of patients was positive in 80.7% of cases, all HIV1. Electrocoagulation was the mean treatment (93.1%), followed by cryotherapy (15 cases), chemotherapy (6 cases), and surgery (3 cases). Recurrences were reported in 9 cases (2.6%) of which more than half has occurred within a month.

Nous avons réalisé une étude rétrospective au sein du service de dermatologie du CHU de Treichville d'Abidjan pendant quatre ans. Trois cent cinquante cas de condylomes vénériens ont été recensés (1,5 % des hospitalisations en dermatologie) ; une moyenne d'âge de 29,37 ans ; une prédominance féminine (51,3 %) et un sexe-ratio (H/F) de 0,94. Nous avons observé un condylome géant dans 0,9 %, une localisation à la vulve (47,7 %) et aux organes génitaux externes masculins (34,6 %). Le dépistage du VIH-1, réalisé dans 60,8 % des cas, s'est avéré positif dans 80,7 % des cas, toujours avec VIH-1. L'électrocoagulation a été le traitement de choix (93,1 %), suivie de la cryothérapie (15 cas), la chimiothérapie (6 cas) et la chirurgie (3 cas). Des récidives ont été relevées dans neuf cas (2,6 %), dont plus de la moitié avant un mois.

[Umbilical endometriosis mimicking a keloid in a young black woman: A case report]. / Endométriose ombilicale simulant une chéloïde chez une patiente à peau foncée.

BACKGROUND: Most umbilical tumors are diagnosed as benign tumors, umbilical metastases of abdominal and pelvic tumors, or Sister Marie Joseph nodule. Herein, we report a case of cutaneous umbilical endometriosis mistaken for a keloid. PATIENTS AND METHODS: A young black woman aged 26 consulted for a painful umbilical tumefaction. She had noted the appearance of a nodule of the umbilicus 10 months ago with bleeding during her menstrual periods. Skin examination revealed a firm and painful umbilical nodule 2.5cm in diameter. She was treated with corticosteroid injections for one month for umbilical keloid. Given that the symptoms recurred regularly at the time of menstruation, we suspected umbilical endometriosis. This diagnosis was finally confirmed by histopathological examination and hormone therapy was instituted on gynecological advice before scheduled surgical excision. CONCLUSION: In a setting of an umbilical tumor simulating a keloid associated with cyclical symptoms in a black woman, the diagnosis of umbilical endometriosis should not be overlooked by the dermatologist.

Efficacité du Dakin Cooper Stabilisé® dans la prise en charge des plaies drépanocytaires

Objectif : Apprécier l'efficacité et la tolérance du Dakin Cooper Stabilisé® dans le traitement des plaies drépanocytaires.Patients et méthodes : Il s'agit d'une étude prospective descriptive sur 35 patients, ayant des plaies drépanocytaires, recrutés au centre de Dermatologie de Treichville (Abidjan, Côte d'Ivoire) de janvier 2010 à déceRésultat : La douleur a disparu chez 91,4% des patients, une semaine après le début du traitement. La guérison est survenue chez 80% des patients après six semaines.Conclusion : Le Dakin Cooper Stabilisé® est efficace en six semaines dans le traitement des plaies drépanocytaires et est bien toléré

[Squamous cell carcinoma secondary to Buruli ulcer in West Africa]. / Carcinomes épidermoïdes sur cicatrices d'ulcère de Buruli en Afrique de l'Ouest.

BACKGROUND: Buruli ulcer is an infection caused by Mycobacterium ulcerans occurring in tropical areas. In West Africa, it is an emerging threat mainly affecting children aged under 15years. This chronic disease is complicated by dystrophic scars in which squamous cell carcinoma can occur in the long term. PATIENTS AND METHODS: This is a retrospective study of squamous cell carcinomas in Buruli ulcer scars seen at the Treichville University Hospital (Abidjan, Ivory Coast) over a five-year period. RESULTS: During the study period, 8cases were observed and concerned young adults presenting Buruli ulcer in their childhood. Tumours were restricted to the limbs, with loco-regional invasion. Treatment was primarily surgical. Four of the patients died. DISCUSSION: The risk of recurrence of cancer in these scars remains poorly evaluated, highlighting the importance of long-term monitoring strategies for human patients in order to ensure rapid identification of any changes in Buruli ulcer scars.

Melanoma of the Right Foot Simulating Kaposi's Disease.

Melanoma is a malignant tumor rarely being described in sub-Saharan Africa. We reported an unusual and atypical clinical presentation. It was a 59-year-old patient who was hospitalized for a monomelic black tumor evolving for 10 years. Histopathological examination confirmed the melanocytic origin of this tumor. Paraclinical assessment did not find any visceral metastasis. A partial resection of the tumor was performed. The patient left the hospital against medical consent due to lack of technical facilities. The delay in the consultation and the lack of knowledge of melanoma by doctors and patients might contribute to the severity and the difficulties of its management.

[Fixed drug eruption after taking ethambutol]. / Érythème pigmenté fixe secondaire à la prise d'éthambutol.

INTRODUCTION: Fixed drug eruption (FDE) is a specific skin reaction and the only exclusively medicinal dermatosis. Among the drugs usually responsible are the antituberculous antibiotics including rifampicin and, less often, isoniazid and pyrazinamide. FDE after taking ethambutol is rarely described. CASE REPORT: A 32-year old HIV negative patient presented a FDE localized to the internal surface of the lips and the interdigital folds during the 4th month of antituberculous treatment comprising rifampicin, isoniazid and ethambutol. The diagnosis was supported by the characteristic appearances of the lesions of FDE and their early reappearance in the same areas after accidental reintroduction of antituberculous triple therapy including ethambutol. Double-agent therapy with rifamicin and isoniazid was tolerated well. CONCLUSION: Discovery of FDE requires a rigorous search for the responsible medicine. During antituberculous treatment, the practitioner has to bear in mind the potential role of ethambutol, which is possibly potentiated by rifampicin.

[Clinical-epidemiological profile of severe cutaneous drug reactions in children in Abidjan (Côte d'Ivoire)]. / Profil épidémio-clinique des toxidermies bulleuses chez l'enfant à Abidjan (Côte d'Ivoire).

Severe cutaneous drug reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life threatening in adults. They seem to be less common in children. The purpose of this study was to describe the epidemiological, clinical and etiological profile of these drug reactions in African child. It was about a retrospective study carried on for 10 years at the Dermatology center of University Hospital of Treichville, Abidjan (Cote d'Ivoire).Were included all children aged 0-15 years hospitalized for severe cutaneous drug reaction. They represented 14.1% (27 cases) with an estimated hospital rate of 0.01%. The sex ratio (M/F) was 1.2. The mean age was 10.3 years. 19 children were suffering from SJS (63%) and 9 children (33.3%) from TEN. Sulfonamides were the most commonly used drugs with sulfadoxin-pyrimethamin (25.9%), used for malariae, and cotrimoxazole (22.2%). Self-medication was practiced by 70.4% of parents. The average time to onset of lesions from drug intake was 8.2 days. Only one child was HIV infected. Three children affected by TEN (11.1%) died.

[Stevens-Johnson syndrome and toxic epidermal necrolysis: retrospective study of 185 cases in Abidjan (Côte d'Ivoire)]. / Syndromes de Stevens-Johnson et de Lyell : étude de 185 cas au CHU de Treichville (Abidjan, Côte d'Ivoire).

BACKGROUND: Cutaneous bullous adverse drug eruptions are a dreaded complication of drug use. OBJECTIVE: The purpose of this study was to document the epidemiological features, outcomes, and causes of these reactions, in particular, Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell disease), in a teaching hospital in Abidjan (Côte d'Ivoire). PATIENTS AND METHODS: A retrospective study reviewed the records of severe cutaneous drug reactions in patients managed in the dermatology department of the University Hospital of Treichville (Abidjan) over a period of ten years (from September 2000 through August 2010). RESULTS: These diseases were diagnosed in 185 patients during the study period. Their mean age was 31.8 years (range: 2-70 years) and the M/F sex ratio was 0.6 The most frequent reactions, as expected, were Stevens-Johnson syndrome (73%) and toxic epidermal necrolysis (27%). The drugs most commonly involved were the antibacterial sulfonamides (22.1%), followed by the antiviral nevirapine (11.1%), and the antimalarial agent, sulfadoxine/pyrimethamine. The fatality rate was 22.5%, including 46% of the patients with toxic epidermal necrolysis and 14.6% of those with Stevens-Johnson syndrome. Respiratory distress (39.5%) and dehydration (23.4%) were the primary direct causes of death. CONCLUSION: Antibacterial sulfonamides are the leading drugs implicated in the occurrence of bullous drug eruptions in Abidjan.

Maladie de kaposi developpee sur greffon de peau chez un patient infecte par le VIH a Abidjan

Introduction : La maladie de Kaposi est une proliferation maligne multifocale de cellules endotheliales. 95 des cas observes a Abidjan; sont associes au SIDA. Observation : Nous rapportons chez un malade atteint de SIDA un cas d' erysipele de jambe complique de fasciite necrosante; sur laquelle se sont developpees des lesions de maladie de Kaposi a la phase de cicatrisation. Conclusion Devant une lesion angiomateuse chez un malade seropositif presentant une grosse jambe; il faudrait evoquer une maladie de Kaposi

[Necrotizing fasciitis of the breast and HIV infection. A case report]. / Fasciite nécrosante du sein: une observation chez une personne vivant avec le VIH en Côte d'Ivoire.

Necrotizing fasciitis is a severe soft tissue infection caused by flesh-eating bacteria. It usually occurs on the lower limbs. The purpose of this report is to describe a case involving Streptococcus pyogenes on the breast of a 22-year-old African woman with HIV.

[Cutaneous histoplasmosis due to Histoplasma capsulatum variety duboisii in an immune competent child. About one case in Abidjan, Côte d'Ivoire]. / Histoplasmose due à Histoplasma capsulatum var. duboisii à localisation cutanée chez un enfant immunocomp tent. A propos d'un cas à Abidjan, Côte d'Ivoire.

Histoplasmosis is a subcutaneous mycosis caused by dimorphic fungus which is to be found in two types: the capsulatum and duboisii types. The capsulatum type has had an increasing incidence with the HIV-AIDS epidemics but it is not demonstrated that the duboisii one has had the same upward incidence. Signs in children and immunocompetent patient are rarely described during this disease. The diagnosis is often late in the child as it looks like Molluscum contagiosum lesions. We report a case of skin histoplasmosis of duboisii type non associated with HIV infection in a child. Diagnosis has been confirmed by a histopathological test of a nodule biopsy. Medical treatment was successfully based on itraconazol.

[An uncommon localization of pyoderma gangrenosum on the penis of an HIV infected patient in the Ivory Coast]. / L'atteinte du pénis, une localisation rare du pyoderma gangrenosum: à propos d'un cas chez un patient immunodéprimé par le VIH en Côte d'Ivoire.

Pyoderma gangrenosum is an uncommon chronic ulcerative dermatosis with unknown aetiology and with a pathology which is still obscure. In 15-45% of cases, it is related to intestinal chronic inflammatory disease (MICI), to a systemic disease that it can sometimes reveals or to an immunodeficiency This disease starts whether with a pustule, a bubble or a nodule which leads during its evolvement to a superficial ulceration with clear edges. Its diagnosis is easy and is mainly clinical. It is a disease which is localized preferably in lower limbs. Treatment is mainly based on oral route corticotherapy. We report a case of gangrenosum pyoderma localized on the penis in a 43-year-old HIV infected patient. It is an uncommon localization, misleading and delicate. We have treated successfully this patient by oral corticotherapy combined with local antiseptic treatments for 6 months.

[Disseminated cutaneous histoplasmosis due to Histoplasma capsulatum var. duboisii associated with AIDS. A case report in Abidjan, Côte d'Ivoire]. / Histoplasmose due a Histoplasma capsulatum var. duboisii a localisation cutanée et associée au sida. A propos d'un cas a Abidjan, Côte d'Ivoire.

Histoplasmosis is a deep mycosis whose capsulatum variety is recognized as being an AIDS-defining infection. However AIDS associated with Histoplasma capsulatum var. duboisii is rarely reported. We report a case of cutaneous duboisii histoplasmosis associated with AIDS which has been mistaken for molluscum contagiosum for many months. The diagnosis has been confirmed by means of a biopsy of a nodule followed by an anatomo-pathological examination. The medical treatment was successfully based on combination Triomune (stavudine + lamividine + nevirapine) and itraconazole.

[Impact of Buruli ulcer secondary prevention program in an endemic area in Côte d'Ivoire]. / Effets d'un programme de prévention secondaire de l'ulcère de Buruli dans une zone d'endémie d'ulcère de Buruli en Côte d'Ivoire.

Mycobacterium ulcerans infection or Buruli ulcer begins by a papule, nodule, blotch or oedema and develops into ulceration with complications which can lead to disabilities. Its prevalence is high in West Africa and in Côte d'Ivoire particularly. Until recently, only ulcerated forms were mostly observed, whereas nodular ones were unnoticed or did not draw patients' attention. From 1999 to 2002 we conducted a before-after survey in the endemic area of Zoukougbeu located in Daloa region, the central west part of Côte d'Ivoire in order to assess the potential impact of a screening and treatment strategy for nodular forms of Buruli ulcer on ulceration rate decrease. The survey used clinical criteria necessary to identify Buruli ulcer nodule which were defined according to a former study carried out in the same area in 1998. As result of our survey 781 Buruli ulcer cases were reported of which 34.7% were ulcerative forms, 61.1% were nodules and 4.2% were other forms (blotch and oedema). By comparing the data of 1999, when the prevention program started, to those of 2002, we observed a drop of 47.6% in the ulcerative lesions and an increase of 57.4% in nodule ones. These changes were statistically significant (p < 10-5). Annual trend, from 1999 to 2002, showed a decrease in the detection rate of the respective forms under study. It ranged from 25.8/10000 to 7.3/10000 for ulcerative lesions and from 23/10000 to 19.7/10000 for nodules. In spite of possible defects in the methodology of a before/after survey the incidence decrease of both ulcerative and nodular forms that coincided with the prevention program probably reflects the efficacy of the secondary prevention program that promotes early diagnosis and treatment of nodular forms of Mycobacterium ulcerans infection.

[Fighting against Buruli ulcer: the Côte-d'Ivoire experience]. / La lutte contre l'ulcère de Buruli. experience de la Côte-d'Ivoire.

Caused by Mycobacterium ulcerans, Buruli ulcer is an infectious disease which leads to large cutaneous ulceration and is responsible for huge socio-economic consequences. Since 1997 the World Health Organization has started a global Buruli ulcer initiative in which African endemic countries are committed. After an epidemiological background of the disease in Côte-d'Ivoire and a description of the different clinical aspects, we report the main disease management actions carried out in the country by the National Program for Buruli ulcer control from 1998 to 2003. It seems that surgical team missions carried out in health center to treat cases, early detection and treatment of cases together with the implementation of a specific poly-chemotherapy lead to an effective control of the disease.

Epidemiologic and etiologic features of pigmentation disorders observed during consultation at the Dermatology Center of Abidjan, Ivory Coast.

Skin color is important to people in many societies. In this descriptive cross-sectional study, the causes of skin disorders in patients presenting for consultation over a period of 5 years were assessed and identified. A total of 4,510 dyschromia cases were recorded, representing 9% of the total number of patients attending for consultations at the Dermatology Center of Abidjan over this period. Pigmentation disorders were more often found in female patients (53.56%; sex ratio female:male=1.44) and were predominant in patients 20--30 years old (50%). All socio-professional categories were represented. However, students and service professionals (hairdressers, dressmakers, traders and switchboard operators) represented 50% of the patients with pigmentation disorders. Hyperchromia was common (48.49%) and was found in exposed areas of the skin. Most of the pigmentation disorders (60.94%) were of post-inflammation origin. Vitiligo was the most frequent etiology of systemic or endocrine dyschromia (92.63%). Among the hereditary pigmentation disorders, pigmented naevus was the most commonly found (41.5%). Dyschromic chemical eruptions appeared most frequently in the form of fixed pigmented erythema (84.55%). This study demonstrates that pigmentation disorders are still a frequent reason for consultation due to their distressing consequences.