Comorbidities and Environmental Factors Associated with Atopic Dermatitis in Children and Adults in Dermatology-Venereology in Cotonou, Benin.

INTRODUCTION: The objective of this work was to document the comorbidities and environmental factors associated with atopic dermatitis (AD) in dermatology Venereology in Cotonou. METHODS: A cross-sectional, prospective, and analytical study included, from January 2016 to December 2018, in the Dermatology-Venereology Department of the National Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM) of Cotonou, children and adults after free and informed consent, in whom the diagnosis of AD was retained according to the criteria of the United Kingdom Working Party. Severity was assessed using SCORAD (severity scoring of atopic dermatitis). RESULTS: The overall prevalence of AD was 7.7%. AD was more frequent in children (56.8% and 40.6%) and adults (59.8% and 37.4%) from urban and periurban areas (0.003 < p < 0.034). It was more frequent in children who regularly dewormed and those with complete vaccination (0.001 < p < 0.01). In 54.8% of children and 58.9% of adults, flare-ups occurred during the warm season. The main associated comorbidities were rhinitis and conjunctivitis in both children (49.7% and 36.1%, respectively) and adults (32.7% and 26.2%, respectively). The main triggering factors in children were heat (43.2%), pneumallergens (28.4%), and skin irritants (22.6%). In adults, we noted skin irritants (58.9%), heat (47.7%), and psychological factors (34.6%). In adults, the use of detergent soaps was associated with lichenified and severe AD (0.003 < p < 0.006) and that of lightening soaps with acute AD (p=0.042). CONCLUSION: AD in the Dermatology-Venereology Department of the CNHU-HKM of Cotonou was associated with comorbidities. It was influenced by environmental factors related to the tropical climate and by skin irritants or allergens.

Epidemic, Endemic, or Stewart-Bluefarb? When Several Forms of Kaposi Seem to Dispute Paternity.

The role of human herpes virus 8 (HHV8) is demonstrated in the occurrence of Kaposi's disease, but the role of cofactors is still hardly known. We report a case of Kaposi's disease which occurred 10 years after a local trauma in an HIV-positive patient from Central Africa. A 38-year-old female, from and living in Central Africa, consulted for angiomatous papulo-nodules associated with purple-colored macules and painful lymphoedema of the right leg and foot that had been developing for 6 months. She reported a history of posttraumatic lymphoedema of the affected limb as a result of a road accident that occurred ten years earlier. The mucous were healthy. There was no sign of systemic lesions. The diagnosis of Kaposi's disease was evoked with, in differential, a Stewart-Bluefarb syndrome-type of pseudo-Kaposi and an epidemic Kaposi disease. Retroviral serology was positive to HIV1 with a CD4 count of 600 cells/mm3. Histopathology of the lesions and duplex ultrasonography could not be performed. The rest of the biological assessment was without particularity. The diagnosis of epidemic Kaposi's disease associated with cofactors involved in endemic Kaposi's disease and Stewart-Bluefarb syndrome was retained. An antiretroviral treatment (emtricitabine, tenofovir, and efavirenz) allowed to obtain after 6 months a noticeable improvement of the lesions and a disappearance of the pain with however the persistence of a residual lymphoedema. This is a special case of Kaposi's disease that seems to involve several factors. The role of cofactors in Kaposi's disease remains to be elucidated.

[Scalp disorders in black Africans treated in a dermatology department in Cotonou (Benin): age-sex-specific epidemiological and clinical features]. / Pathologies du cuir chevelu chez le Noir africain en dermatologie à Cotonou (Bénin): aspects épidémiologiques et cliniques en fonction du sexe et de l´âge.

INTRODUCTION: scalp disorders are related to several factors including ethnicity, gender or age. In black people, they can be caused by intrinsic and extrinsic factors. Very few studies have been conducted in this ethnic group residing in black Africa, hence the purpose of our survey was to highlight the epidemiological and clinical features of age-sex-specific scalp disorders in patients treated in a dermatology department in Cotonou (Benin). METHODS: we conducted a retrospective and descriptive study of all the medical records of new patients coming to consultation in the dermatology department at the National Hospital and University Center (CNHU) of Cotonou over a period of seven years. The main reason for consultation was scalp disorder. Data on epidemiological and clinical features were collected and analyzed with the EPI-Info 7 software. RESULTS: prevalence of scalp disorders was 2.4% (181/7554). Children (0-18 years) accounted for 38.7% (70 patients) and adults 61.3% (111 patients). Children aged 0-10 (54; 29.8%) and adults aged 25-40 (51; 28,2%) were the most affected. Sex ratio was 1.8. Non-alopecizing dermatosis was diagnosed in 10; 5.5% of cases while alopecizing dermatosis in 171 patients (94.5%), of whom 82.9% (151/171) had non-scarring dermatosis and 11.7% (20/171) had scarring dermatosis. The most common conditions were ringworm (41; 22.6%), mainly occurring in 0-10-year-old boys, chronic non-scarring folliculitis (39; 21.5%) mainly occurring in 0-5-year-old boys and 19-40-year-old men, pelade (38; 21%) occurring in both male and female sexes, especially between the ages of 6-10 and 25-40, traction alopecia (17; 9.4%) occurring exclusively in women and mainly in the 25-40-year-old age group, fibrous folliculitis at the nape of the neck (12; 6.6%) occurring exclusively in men from 19 to 50 years, trichotillomania (9; 5%) occurring in both male and female sexes, mainly in children aged 6-10 years and in adults aged 25-40 years, Quinquaud folliculitis decalvans (6; 3.3%) occurring uniformly in both male and female sexes and mainly between 25-40 years of age. CONCLUSION: scalp disorders mainly affect male patients before puberty and young adults. They were arranged in descending order in non-scarring alopecizing dermatoses, scarring alopecia and non-alopecizing dermatoses.

Prurigo in Children of Tropical Zone: Epidemiological, Clinical, and Etiological Characteristics in a Dermatology Department in Cotonou (Benin).

INTRODUCTION: The objective of this work is to document the epidemiological, clinical, and etiological features of prurigo in children. METHODS: This is a descriptive and retrospective study done from January 2013 to September 2018 in the Dermatology Department of National and Teaching Hospital HKM of Cotonou. All children from 0-18 years diagnosed clinically with prurigo were the study sample. Visual analog scale was used to assess the severity of pruritus. The data were entered and analyzed with EpiData and Epi Info 7 software. RESULTS: The prevalence of prurigo was 14.9% (234/1565) in the pediatric population. The mean age of the children at the onset of the disease was 5.4 years ± 4.9 years. Their sex ratio was 0.8. Pruritus was reported in 97.8% of cases; it was moderate in 50% and severe in 50%. Several phenotypes were described, including erosivo-crusted prurigo (36.3%) and papulo-vesicular prurigo (32%). Frequently observed clinical forms were chronic (44.4%), acute (38.9%), impetiginized (8.1%), and lichenified (4.3%). Prurigo predominated on the lower limbs (74.8%), upper limbs (47.9%), and buttocks and trunk (24.8% each). The main etiologies were prurigo strophulus (PS) (55.5%), scabiosis (20.5%), prurigo of Besnier (10.7%), and hookworm cutaneous larva migrans (HCLM) (8.5%). The PS was seasonal (p=0.036), while prurigo of Besnier, scabies, and HCLM were perennial. CONCLUSION: The main etiologies of prurigo in the study participants were PS, prurigo of Besnier, scabiosis, and HCLM. It affected with predilection the limbs of children of less than 5 years. Prurigo was almost always itchy and often evolved in an acute or chronic mode.