Search

Background The pathogenesis of lichen planus (LP) is mostly autoimmune, while psychological and infectious factors are recognized to trigger or aggravate the disease. An association with diabetes is reported. Our objective was to determine the epidemio-clinical characteristics of LP and its associated factors. Methods This multicentric, prospective study was conducted over a 6-month period. The histopathology was only performed for atypical forms. Patients with a notion of drug intake before the rash were excluded. Anti-hepatitis C Virus (HCV) antibodies screening was systematical in case of mucosal damage. The data were analyzed using the SPSS IBM 20 software. Results The average age was 38 years. Women represented 84.6% (n = 66) of the studied population. The patients were married in 61.5%. Obesity or overweight status was noted in 41%. A marital or relational conflict was found in 25.6%. History of LP was reported in 24.4% (n = 19). Pruritus was found in 96.2%. The locations were as follows: skin (97.4%), mucous membranes (15.4%), and hair and nails (5.1%). Lesions were diffuse in 56.4%. The clinical forms were as follows: typical (52.6%), erythematosquamous (17%), warty (14.5%), pigmented (14.5%), and blaschkolinear (one case). Histopathology confirmed the diagnosis of LP in 91.4%. Blood sugar level was high in one case. Hepatitis B surface antigen (HBsAg) was positive in 3.03%. Anti-HIV and anti-HCV antibodies were negative. Conclusion Lichen planus is a relatively rare disease in sub-Saharan Africa and is seen more in adults. The clinical manifestations are polymorphic, but the mucosal damage is rarely isolated.

Background: Diaper dermatitis in infant is a common reason for dermatological consultation. The aim of this study was to describe the epidemiological, clinical, etiological and evolutionary aspects of diaper dermatitis in infant. Materials and Methods: A cross-sectional descriptive study was conducted in three dermatology departments in Dakar. All infants [1-30 months] who are followed from October 1, 2015 to April 30, 2016 for diaper dermatitis was included. Results: We collected 205 cases, a hospital frequency of 22.18%. The sex ratio was 1.02 and the mean age was 8.49 months. Diaper dermatitis was inflammatory in 67%, irritative in 18%, infectious in 12% and associated with general disease in 3%. Dermatitis was seborrheic in 51.7%, mycotic in 14.6% and associated with: acrodermatitis enteropathic in 4 cases and granuloma gluteale infantum in one case. Baby diapers were used in 93.7% by moms with a change of less than 6 times a day in 84.9%. The clinical outcome was favorable in 56.1%. Conclusion: Diaper dermatitis in infant is a common infant dermatosis in Dakar. The multiple causes necessitate a rigorous diagnostic approach. Severity is related to association with general diseases. RÉSUMÉ Introduction: Les dermites du siège du nourrisson est un motif fréquent de consultation dermatologique. L’objectif de notre étude était de décrire les aspects épidémiologiques, cliniques, étiologiques et évolutifs des dermites du siège du nourrisson. Matériels et Méthodes: Une étude descriptive a été menée dans trois services de dermatologie à Dakar. Tous les nourrissons [1-30 mois] suivis du 1er Octobre 2015 au 30 Avril 2016 pour une dermite du siège étaient inclus. Résultats: Nous avons colligé 205 cas, soit une fréquence hospitalière de 22,18%. Le sex- ratio était de 1,02 et l’âge moyen de 8,49 mois. Les dermites du siège étaient inflammatoire dans 67%, irritative dans 18%, infectieuse dans 12% et associée à une maladie générale dans 3%. La dermite était séborrhéique dans 51,7%, mycosique dans 14,6% et associée à : une acrodermatite entéropathique dans 4cas et un granulome glutéal dans un cas. Les couches étaient utilisées dans 93,7% par les mamans avec un changement de moins de 6 fois par jour dans 84,9%. L’évolution clinique était favorable dans 56,1%. Conclusion: Les dermites du siège du nourrisson sont des dermatoses fréquentes chez le nourrisson à Dakar. Les causes multiples rendent nécessaire une démarche diagnostique rigoureuse. La gravité est liée à l’association avec des maladies générales.

The pyoderma gangrenosum (PG) is a chronic ulcerative neutrophilic dermatosis rare in children. It is often associated with chronic inflammatory bowel disease, some systemic diseases and leukemias. We report six cases in children. We collected six cases, the average age was 10 years (4-15 years), the sex ratio was 0.16 (5 boys and 1 girl). The ulcerated clinical form of PG was noted in all children. The topography was in the lower limbs in five cases and in the cephalic extremity in three cases. The mean duration of evolution was 2 years (15 days-7 years). PG was associated with ulcerative colitis in one case. Oral corticosteroids were administered in all cases at a dose of 0.5 to 1 mg/kg. The complete healing of the cutaneous lesions was obtained. Two children were lost to sight. Our study reports a male predominance of PG in children with ulcerative clinical form of the limb and association with ulcerative colitis. Corticosteroids appear to be efficient, but may be limited by their complications.

Introduction Au Sénégal, les études portant sur les tumeurs du cuir chevelu sont quasi inexistantes. Notre objectif était de déterminer le profil épidémiologique et anatomo-clinique des tumeurs du cuir chevelu en dermatologie. Méthodes Il s'agit d'une étude prospective, descriptive et analytique, réalisée sur une période de 16 mois (01 mars 2014 au 30 juin 2015), effectuée aux deux services de dermatologie de Dakar. La confirmation diagnostique était histopathologique. Résultats Nous avions colligé 36 patients dont 14 cas de tumeurs malignes et 22 cas de tumeurs bénignes. Le sex ratio était de 1:1, et l'âge moyen de 51 ans pour les premières et 39 ans pour les dernières. La fréquence hospitalière était de 0,18%. Le délai moyen de consultation était de 14 mois pour les tumeurs malignes et 52 mois pour les formes bénignes. Dans 11 cas de tumeurs malignes, le traitement traditionnel était le premier recours. Les tumeurs malignes étaient: carcinome épidermoïde (n=8), carcinome basocellulaire (n=3), lymphome, hidradénocarcinome et dermatofibrosarcome de Darier Ferrand (un cas chacun). Les tumeurs bénignes étaient: botriomycome (n=5), kyste trichilemmal, hamartome sébacé, cylindrome et lipome (2 cas chacun), et chéloide, syringocystadénome papillifère, schwannome, neurofibrome et nævus (un cas chacun). La malignité de la tumeur était associée à l'aspect ulcéro-bourgeonnant (p=0.003), au diamètre >4cm (p=0.05), à la douleur (p=0.009) et au saignement (p=0.006). Conclusion Les tumeurs du cuir chevelu, sur peau noire, sont dominées par les formes bénignes. Le carcinome épidermoïde est la tumeur maligne prédominante.

Background and aim The use of skin bleaching products for cosmetic purposes is a frequent practice (25-96%) in women from sub-Saharan Africa. The dermatologic complications associated with this practice have been comprehensively reported. The aim of this work was to study the epidemiologic, clinical, and cosmetic aspects of these complications in order to produce better therapeutic guidelines for their management. Methods This was a prospective, descriptive study performed over a 6-month period. All women aged between 15 and 50 years, who consulted a dermatologist (Le Dantec Hospital or Institute of Social Hygiene), experienced a complication associated with artificial depigmentation, and agreed to take part in the study, were included. The data were input and analyzed using Epi info version 6.0. Results Eighty-six female patients were included, with a mean age of 29.34 years (range, 16-49 years). The breakdown by level of education was as follows: primary (48.8%), secondary (18.3%), and higher (8.5%) education. Twenty-two per cent of our population had not attended school. The mean monthly cost of skin bleaching products was 6.22 euros. The initial skin tone before using skin bleaching products was black in 41.5% of patients, light in 32.9%, and intermediate in 25.6%. The mean duration of exposure was 6.7 ± 5 years (range, 1-30 years). The breakdown by skin bleaching products showed that topical corticosteroids were the most frequently used (78%), followed by hydroquinone (56%), products based on vegetable extracts (31.7%), caustic products (8.5%), and, finally, products of unknown composition (41.4%).Two components or more were frequently combined (86.5%). The aesthetic complications of artificial depigmentation were the reason for consulting a dermatologist in 10 patients (12%). Nineteen types of aesthetic complication were reported in our sample. Hyperpigmentation of the joints was the most frequently found complication (85.4%), followed by striae atrophicae (72%) and skin atrophy (59.8%). The number of aesthetic complications found in the patients varied from one to nine. Patients frequently presented (71.9%) with other complications associated with artificial depigmentation. Conclusions Aesthetic complications associated with artificial depigmentation are common, but rarely the reason for consulting a dermatologist. In the absence of suitable therapeutic agents, prevention, based on informing women of the damaging effects of artificial depigmentation, is the only way forward.

Background Acne, a chronic inflammatory dermatosis of the pilosebaceous follicle, is very widespread worldwide, affecting 75-80% of adolescents, with an impact on their quality of life. The etiologic factors are not always the same, and the treatments proposed are not always well tolerated in black individuals. Aims To determine how acne affects the black population in Dakar, Senegal, and to assess the results of and tolerance to treatment. Methods This was a prospective study conducted on a sample of patients who attended consultations for acne in our dermatology department between December 2002 and March 2003, and who agreed to take part in the study (informed consent was obtained). An anonymous questionnaire was used as a support. Results Ninety-three patients were included in the study, with a hospital frequency of 5.3% and an average age of onset of acne of 25.58 years. In 75% of cases, the acne sufferers were young women, 76.3% of whom were single. Acne was of the superficial inflammatory type in 76.3%, retentional in 67.7%, and nodulocystic in 12.9% (Some patients who have acne vulgaris may have pustules, papules and nodules or cystic lesions so the percentages add up to 100). Signs of hyperandrogeny were observed in 19.1%, with hirsutism in 93.8%. Artificial depigmentation was noted in 38.7%. Stress was found in 89.2% and a depressive state in 3.4%. Solar exposure aggravated the lesions in 52.7%. In terms of therapy, only 1.1% received oral retinoids. An improvement was noted in 67.2%, and resistance was observed in 7.3%. Discussion In Dakar, Senegal, patients with acne consult later than elsewhere. The majority of cases are women, contrary to certain other studies. The inflammatory forms predominate in adult women. The most frequent location is on the face. An evolution to pigmentary disorders is found in 67.7%. Predisposing factors include the use of depigmenting cosmetic products and sun exposure. Local treatment, such as benzoyl peroxide and topical retinoids, which promote melanoderma in black skin, is widely used. The exorbitant cost of oral retinoids considerably limits their use in Senegal. Conclusion Acne, an adolescent pathology, is increasingly being observed in adults using depigmenting cosmetics. The multiple clinical forms are dominated by inflammatory acne. The many relapses and cost of treatment have a detrimental effect on the quality of life of patients.

Occupational dermatitis, mainly allergic contact dermatitis and skin irritations are increasing because of new allergens and diversity of the industrial procedures. In Senegal occupational contact dermatitis are currently observed and they are not declared at our social security institution. The aim of our trial was to determinate the frequency of occupational allergic contact dermatitis, the allergens responsible and the exposed occupations. We included in a one year lasting prospective trial, all patients with occupational contact dermatitis confirmed by positive cutaneous allergological tests. Among 201 cases of contact dermatitis, 27 (12,91%) were included and predominant occupational sectors were building, mechanics, health, cleaning and trade. Main responsible allergens were dichromate of potassium (7), N-isopropyl N-phenylparaphenylenediamine (3), fragrance mix (3), thiuram mix (3), colophane (3), formaldehyde (2), nickel sulphate (2), Chalk (2). Building sector was the most frequent source because of high use of dichromate of potassium in cement and formaldehyde in painting-glue. In mechanics, N-isopropyl N-phenylparaphenylenediamine is present in rubbers and fragrance mix in oils. Occupational dermatitis in health workers are due to presence of thiuram mix in the gloves, and dichromate of potassium found in antiseptics. To decrease the incidence of occupational contact dermatitis in our country, we have to promote prevention among workers by using individual protective outfits and increasing workers medical survey and information about risks and means of prevention.

The koranic schools are in poor socio-economical conditions in Dakar and skin diseases are common in these conditions. The goal of our descriptive study was to determine the prevalence of skin diseases occurring in these situations. One hundred five boys from four koranic schools of Dakar were examined. Eighty percent of the examined boys were with unless one skin disease. Tinea capitis (42.66%), scabiosis (13.33%), pyoderma (15.33%), plantar keratodermia (100%) were the skin diseases. In 34.52% these skin disease were associated and antecedents of skin infections diseases were reported in 89.5% of boys. Atopic dermatitis was in 2.38% cases, keloid in 1.19%. The other frequent diseases were abdominal parasitosis (71.42%), umbilical hernia (6.66%). All skin diseases were improved only in 50% of cases after two months of treatment. Tinea capitis was cured in 4 months after treatment. The high prevalence and the chronicity of the skin disease were due to poor socio-economical conditions.

Background Dermatosis papulosa nigra (DPN) is a benign epithelial tumour, common in the black population. It is a special topographic form of ethnic seborrheic keratosis, which is more common in the white population. Its benign character has meant that very few studies have been performed. In Senegal, no investigation has been carried out to date. Aim To determine the epidemiologic and semiological characteristics of DPN, and the aesthetic results of DPN exeresis. Methods A prospective study was carried out over a period of 6 months (November 2005 to April 2006) at the Dermatology Department, Le Dantec CHU, Dakar, Senegal.The diagnosis of DPN was clinical. If desired, exeresis of the lesions by fine-needle or fine-scissor electrosurgery was carried out, and the results were evaluated over a period of 6 weeks. Results Thirty patients were evaluated: 21 women and nine men. The average age was 39.8 years (range, 25-70 years). A family predisposition was found in 93.3% of cases. The average age of onset of the lesions was 22 years, with a progressive increase in size and number. The lesions appeared initially on the face and then spread to all photoexposed areas. The lesions were profuse, numbering between 50 and 100 in 66.6% of cases, and coalesced to form plaques in 26.6%. In other cases, the lesions were papular, pediculate, or wide-based brown to deep black in colour, and with a keratotic appearance. Eight of the 21 women practiced artificial depigmentation and presented with profuse lesions. Aesthetic problems were found in 60% of patients. When performed, exeresis was satisfactory without scarring in 60% of cases at day 45. Hypochromic scars persisted in four patients who practiced artificial depigmentation and in one who had been treated with carbon dioxide snow. Conclusion This study on 30 cases of DPN is the first in Senegal. The classic female predominance, family predisposition, and photodistribution of the lesions were found. The lesions were profuse, with a background of artificial depigmentation. This suggests that the sun may be an etiopathogenic factor. Aesthetic problems are an indication for ablation of the lesions using a method that minimises the risk of scarring. Artificial depigmentation may cause delayed healing and dyschromic scars, as may the application of carbon dioxide snow.