Quality of life in black African patients with keloid scars.

A keloid scar is a benign skin tumor and we aimed to assess the Quality of Life (QoL) of black Africans with keloid scars based on the Dermatology Life Quality Index (DLQI). We conducted a cross-sectional descriptive study in the department of dermatology of the teaching hospital of Treichville in Ivory Coast. We recruited 132 patients with keloid and 3612 dermatoses without keloid: The prevalence was 3.50% (132/3753). We included 120 patients aged from 16 to 63 years old, the sex ratio was 0.46 (38/82) and the mean age was 34.20 years. Keloid scars were mostly secondary to skin trauma in 30.00 % and infection in 21.67%. The commonest site was the ear in 29.17 %. We reported Keloid with pain in 53.33% and pruritus in 95.00%. We observed psychological impact in 65.83%. The DLQI scores were moderate and high in 61.66 %. QoL was impacted significantly when keloid was associated with pain (p=0.046), pruritus (p=0.81) and functional disorders (p=0.29). The DLQI score could be a valuable tool to assess QoL in black African patients with keloid, for better treatment option.

Automédication et toxidermies bulleuse à Abidjan : aspects épidémiologiques, cliniques et évolutifs

Objectif : Cette étude a été réalisée pour décrire les caractéristiques épidémiologiques, cliniques et évolutives des toxidermies bulleuses chez les patients suite à une automédication.Matériel et méthodes : Il s'agissait d'une étude transversale rétrospective à visée descriptive. Elle s'est déroulée du 01 septembre 2004 au 31 Août 2014 au centre de dermatologie du CHU de Treichville (Côte d'ivoire). Ont été inclus tous les patients ayant eu une toxidermie bulleuse suite à une automédication et hospitalisés pendant la période d'étude. Résultats : Pendant 10 ans nous avons recensé 191 cas de toxidermies bulleuses hospitalisés en dermatologie du CHU de Treichville. Quatre-vingt-quatre patients ont eu recours à une automédication soit 44,0%. La moyenne d'âge de ces patients était de 29,22 ans avec des extrêmes de 2 et 69 ans. Il y avait une prédominance féminine avec 56 patientes (66,7%). Le syndrome de Stevens Johnson avec 58 cas représentait 69,0 % des toxidermies suivi du syndrome de Lyell avec 23 cas (27,4%). La sulfadoxine pyrimethamine a été le médicament le plus incriminé avec 16 cas (19,1%) suivi du cotrimoxazole avec 15 cas (17,9%). Le taux de décès était de 22,6% (19 patients) dont 13 cas (68,42%) de syndrome de Lyell et 6 cas (31,58%) de syndrome Stevens Johnson. Conclusion : L'automédication est une pratique qui augmente l'incidence des toxidermies à Abidjan

[Cutaneous depigmentation in black female population for cosmetic purposes: results of a KAP survey conducted in Abidjan (Ivory Coast)]. / Dépigmentation cutanée cosmétique des femmes noires: résultats d'une enquête CAP à Abidjan (Côte d'Ivoire).

INTRODUCTION: Cutaneous depigmentation for cosmeticis purposes is a widespread practice among black African women. It has many complications that have been well documented for decades. However, the reasons of practitioners are not well known. The aim of our study was to understand the motivating reasons of these women in order to conduct a communication campaign for behavior change. METHODS: We performed a cross-sectional KAP survey (Knowledge/Attitudes/Practices) at the Dermatology Department of the University Hospital of Treichville (Abidjan) Data were analyzed using Epi Info 3.5.1. and 6.04 software. RESULTS: Practitioners were mostly young urban single, literate and professionally active women (20-40 years). Cutaneous depigmentation and its consequences were known to women, however, they thought that women with the lightest complexion were more attractive. They were influenced by media and friends. The most frequently observed complications were exogenous ochronosis and stretch marks. The local means of communication remained what essentially sustained the information needs of these women, because they help them to change their behavior. CONCLUSION: The development of local communication strategies for behavior change seems necessary to stop the phenomenon of cutaneous depigmentation for cosmetic purposes in black female population in Abidjan.

Psoriasis in elderly patients in the Côte d'Ivoire: socio-demographic, clinical, and therapeutic aspects, and follow-up.

BACKGROUND: Psoriasis is a chronic, inflammatory, and recurrent dermatological disease. In the Côte d'Ivoire, it is about 0.75% of dermatology cases. Psoriasis care is challenging in elderly patients. We aimed to show its specificities related to the sociodemographic, clinical, and therapeutic aspects, and follow-up in geriatric patients. METHODS: Cross-sectional and descriptive study over a period of 10 years (January 2004-December 2013). RESULTS: The prevalence of patients 60 years of age and older was about 0.1% (47 of 46,623 cases). The average age was 67 ± 1 years ranging from 60 to 85 years. The sex ratio was 1 : 9 in favor of men. The average time course of psoriasis was 25 ± 2 months. Comorbidity was found in 27 cases (57.5%). The most observed type of psoriasis in our study was chronic plaque psoriasis in 51.1% of cases. We found severe cases of psoriasis in 25.5% of cases. More than 10% of the body surface area was affected in 27.6% of cases. We used topical treatments in the majority of cases (83%). The course of psoriasis under treatment was good in 63.8% of cases, and only 6.4% of cases were worsening. CONCLUSION: Topical agents could be the first-line treatment in geriatric patients in poor countries. If necessary, systemic agents should be used by taking into account the severity of psoriasis, presence of comorbidity factors, immune system level, and lifestyle.

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%).

The "collerette" technique for skin excision and biopsy: an efficient method for managing lentigo maligna of the head and neck.

BACKGROUND: Melanoma is responsible for 75% of all skin cancer-related deaths. Lentigo maligna (LM), the most prevalent melanoma in situ (MIS), accounts for 79-83% of all MIS. Its location in the head and neck area requires that tissue be spared in the course of clearing the tumor. METHODS: We conducted a therapeutic study based on our practice experience with the so-called "collarette" skin biopsy technique used in the management of LM. RESULTS: Thirty-one patients were diagnosed with LM in the head and neck area. These included 16 women and 15 men with a mean ± standard deviation (SD) age of 64.4 ± 13.6 years (range: 33-88 years). The majority (36%) of lesions were located on the cheek. To clear the tumor, surgery was performed using margins of >10 mm in 71% of cases. The average surface area of the surgical defect was 5.8 cm(2) (range: 1.1-15.5 cm(2) ). Reconstructive skin grafts were performed in the majority (68%) of cases. After the removal of the central tumor, 16 cases of MIS and 15 cases of invasive melanoma were identified. Only one patient experienced recurrence over a mean ± SD follow-up of 31 ± 16 months. CONCLUSIONS: The so-called "collarette" or "spaghetti" skin excision and biopsy technique is an advantageous and efficient way to achieve tumor clearance and represents an equally effective alternative to Mohs micrographic surgery in the treatment of LM in the head and neck area.

Severe skin forms of psoriasis in black africans: epidemiological, clinical, and histological aspects related to 56 cases.

Bacground. Psoriasis is an erythematosquamous dermatosis of chronic development. In sub-Saharan Africa, few studies have been focused on complicated forms of psoriasis. Objective. The aim is to describe epidemiological, clinical, and histological features of severe skin forms of psoriasis in Cote d'Ivoire. Material and Methods. The study was both cross-sectional and descriptive, that focused on patient admitted to the dermatology unit for complicated psoriasis, from January 1st, 1986, to December 31th, 2007. Results. Fifty-six patients admitted to hospital for severe skin forms of psoriasis were recorded and included in our study over 7.503 patients hospitalized during the study period. They represented 0.75% of cases. The average age was 39.6 ± 3.3 years. There were 49 male (87.5%) and 7 female patients (12.5%) with a sex ratio of 7. At socioprofessional level, 48 patients (87.5%) were from category 1. Patients' history was dominated by the psoriasis vulgaris. Physical and general signs were dominated by itching (58.9%). The three severe skin forms were observed with predominant erythrodermic psoriasis (60.7%). Fifteen patients (34.9%) were HIV positive. Conclusion. Severe skin forms of psoriasis are rare in our setting. But in the quarter of HIV-positive patients, they are dominated by the erythrodermic psoriasis.