Factors associated with traction alopecia in women living in Yaoundé (Cameroon).

BACKGROUND: Traction alopecia (TA) is very common in Africa but few studies on African population are available. We sought to determine factors associated with TA and measure the association between these factors and TA. METHODS: We carried out an analytical cross-sectional study in 29 hairdressing saloons in the city of Yaoundé. A questionnaire was administered and scalp exams were performed in order to look for TA and determine Marginal TA severity score if present. Participants were separated in two groups: TA group and a group without TA. RESULTS: We finally included 223 women (77 having TA and 146 without TA). The median age was 26 years for women with TA and 24 years for women without TA. The factors associated with traction alopecia we found included: age ≥ 35 years (adjusted OR = 4; p = 0.016). Hairdressing undertaken by hairdressers only (adjusted OR = 0.2; p = 0.008), the avoidance of the regular use of nets, caps and head ties (OR = 0.2; p = 0.006) and relaxing hairs once a year or less (adjusted OR = 0.2; p = 0.005) could be protective factors. As well, we found a positive correlation between age and TA severity (r = 0.235; p < 0.001). CONCLUSION: Age and some haircare practices are associated to TA occurrence in our context. Women therefore need to be educated on these various factors that could be able to cause, worsen or prevent TA.

Hair care and epidemiological-clinical profile of traction alopecia among women in hair salons in Yaoundé, Cameroon.

Background: Hair is valued by all individuals especially women. The perception of beauty is specific to everyone. In order to fulfil their ideal beauty, women use various methods to modify their hair's appearance. Afro hair is particularly fragile, so using these methods can be particularly deleterious for black women's hair. Objectives: Describe hair care practices of women living in Yaoundé, determine the prevalence of traction alopecia (TA) and describe its clinical profile. Methods: We carried out a cross-sectional study in hairdressing saloon in Yaoundé. A questionnaire was administered and scalp exams were performed to determine Marginal TA severity score. Results: We included 223 women with a mean age of 24.9 ± 7 years. The prevalence of TA was 34.5%. Mild and moderate stages were most represented. As far as haircare is concerned, extensions were regularly used by 95.1% of participants. Wigs were regularly worn by 58.7% of participants. Chemical hair straightening was done by 87.9% of women and was performed twice to thrice a year by 43.9%. Almost 76% of women used hair straightener and hair dryer. Hair washing was done monthly by 43.8% of participants and the main cosmetic used was shampoo (75.3%). Conclusion: Traction alopecia is a very common disease in women living in Yaoundé. Extensions, wigs and shampooing are their main hair care practices.

Keloids on stretch marks: Case of a Cameroonian lady.

Keloids are hypertrophic scars that develop as a result of various pathophysiologic mechanisms. We report a case of a 30-year-old Cameroonian woman who presented with keloid-like masses in the abdomen. The onset was postpartum without trauma. After histopathologic confirmation, we concluded a postinflammatory keloid.

Bifocal contact dermatitis following a temporary tattoo.

Allergic contact dermatitis from henna tattoos is often caused by PPD. This was a 35-year-old female patient with eczema lesions of the left forearm that occurred after henna's tattoo. The inner side of the left thigh, although not tattooed, was the site of eczema lesions, reproducing the design of the tattoo.

Trends in dermatology consultations in the COVID-19 era in Cameroon.

Introduction: With the advent of COVID-19, a highly infectious viral pandemic, first declared in Cameroon in March 2020, access to expert dermatology care was postulated to decrease. We carried out a descriptive study to understand the epidemiology of skin diseases amongst patients consulting at an outpatient dermatology clinic and its variations with the onset of COVID-19. Methods: We conducted a retrospective database study over a period of 2 years at Laquintinie hospital, Cameroon. Two periods were distinguished: 1 March 2019 to 29 February 2020 (pre-COVID-19 era) and 1 March 2020 to 28 February 2021 (COVID-19 era). Results: Overall, 5946 patients with one or more clinical conditions were analysed. The most common age group described was young adults (18-40 years). Females consulted twice as much as males (M/F ratio; 1:1.7). The mean age was 28.9 (±18.0) years with an age range of 1 month to 89 years. Infectious dermatoses predominated. However, the single most prevalent dermatologic condition was acne. There was a 35.6% drop in consultation frequency in the COVID-19 era. Conclusion: Three in four patients consulting at dermatology clinic are below 40 years, with a female predominance. Epidemiological profile of dermatoses in Cameroon is similar to that in the rest of Africa. Consultation frequency decreased in the COVID-19 era but trends in consultations were rather unaltered except for patients above 50 years where eczema and scabies increased. More studies should be conducted to understand these trends better at a national level and envisage training of health personnel on prevalent dermatoses.

Giant anogenital tumor of Buschke-Löwenstein in a patient living with human immunodeficiency virus/acquired immunodeficiency syndrome: a case report.

BACKGROUND: Buschke-Löwenstein tumor is a giant condyloma acuminata infection that is characterized by degeneration, invasion, and recurrence. It is associated with human papilloma virus infection. It develops around the genital and perineal area, sometimes causing a large budding ulcerated lesion. Although human immunodeficiency virus infection is frequent in Africa, there are few descriptions of Buschke-Löwenstein tumor diagnosis and its management. Screening for other sexually transmitted infections must be systematic among these patients. CASE PRESENTATION: We report herein the case of a 21-year-old African origin male patient who developed a perineal swelling. Physical examination showed evidence of a huge exophytic tumor made up of budding pinkish vegetations, with serrated crests, a ''butterfly wing'' structure, and a cauliflower-like appearance crowned with centrifugal circinate lesions. Multiple condylomatous lesions of the anal margin were also present. The patient tested positive for human immunodeficiency virus (cluster of differentiation 4 count of 119 cells/mm3) and hepatitis B infections. Real-time polymerase chain reaction revealed human papilloma virus-16 and other high-risk human papilloma virus deoxyribonucleic acid. The diagnosis of Buschke-Löwenstein tumor was made on mass biopsy, and the patient underwent multidisciplinary intervention (surgery, podophyllin application, and antiretroviral therapy). Medium-term evolution was, however, fatal due to opportunistic infection. CONCLUSION: Buschke-Löwenstein tumor is a rare tumor associated with human immunodeficiency virus infection. It is more frequent in male human immunodeficiency virus-positive patients. There is a need to screen for other sexually transmitted infections. In most cases, the treatment is surgical, in association with local therapies. However, recurrences are common.

Bart's syndrome associated with a disorder of sexual differentiation: An atypical presentation in a Cameroonian newborn.

Bart's syndrome consists of congenital aplasia of the skin affecting only the lower limbs, associated with bullae over the skin and/or mucous membranes, as well as a nail anomaly. It is an extremely rare genetic disorder, which can be associated with other birth defects. We report the case of a newborn baby admitted at day 0 of life in the neonatal department, for multifocal skin detachment predominantly at the lower limbs. In addition, examination of the external genitalia revealed a clitoridomegaly genital bud measuring 14 mm, scrotalized and unfused genital bulges with the presence of 2 orifices. No gonad was palpated. The clinical diagnosis of Bart's syndrome associated with a disorder of sexual differentiation was retained. We hereby report the first case of Bart's syndrome described in Cameroon in association with a disorder of sexual differentiation.

Knowledge, attitudes, and practices associated with personal health care on urticaria in peripheral health facilities of Yaoundé, Cameroon (Sub-Saharan Africa).

BACKGROUND: Urticaria is an acute or chronic inflammatory dermatosis that is characterized by erythematous, edematous, itchy, and transient urticarial plaques that cover the skin and mucous membranes. The aim of this study was to evaluate the knowledge of consulting staff on urticaria in Yaoundé, Cameroon, as well as the attitudes and practices resulting from it. METHODS: We conducted a descriptive cross-sectional study. The participants were enrolled from January to April 2017 in 25 health facilities in Yaoundé, Cameroon. The sample consisted of health personnel including doctors, nurses, and nursing aids. Data were collected using a self-administered questionnaire; the evaluation scores for each heading were established. Data processing was done using the SPSS software Version 21. RESULTS: We recruited 101 participants, with a sex ratio of 0.4 (73/101 were female); 44.6% of the participants were doctors, and 50% of our participants had less than 5 years of professional experience. The level of knowledge on urticaria was insufficient for 40.6% of the staff enrolled. Attitudes towards urticaria were incorrect for 36.6% of staff, and 95% of our sample had harmful practices. CONCLUSION: Our study reveals that skills of the health care provider regarding urticaria are generally poor and do not enable them to ensure an adequate management of the disease.

Epidemiological and Clinical Patterns of Kaposi Sarcoma: A 16-Year Retrospective Cross-Sectional Study from Yaoundé, Cameroon.

BACKGROUND: The burden of Kaposi sarcoma (KS) is increasing fast among HIV-infected populations, but the disease remains desperately underexplored in Cameroon, where the burden of HIV is high. METHODS: This is a retrospective cross-sectional study carried out over a period of 16 years (January 2001 to December 2016) at the HIV day care unit of the Central Hospital of Yaoundé, Cameroon. The diagnosis was based on clinical aspects and histological confirmation, and we used a preconstructed questionnaire for data collection through patients' electronic and physical files. RESULTS: Among 14,220 files reviewed, 316 cases of KS were identified, yielding a cumulative incidence of 2.2%. In the end, 266 patients (55% male) were included in this study. The patients' age ranged from 17 to 72 years, with a mean of 37.8 ± 9.5 years. KS was the presenting manifestation of HIV in 89.8% of the cases. Cutaneous lesions occurred more often (81.6%), mainly located on the lower limbs (47.7%); mucous lesions were found in 15.8% of the patients, while 8 patients (3.0%) had associated visceral lesions. The lesions predominantly were lymphedemas (28.6%) and papulonodules (21.1%). At the diagnosis of KS, the median CD4 count was 175 cells/mm3 (interquartile range 80.5-288.5), and 150 patients (56.6%) had CD4 counts < 200 cells/mm3. CONCLUSIONS: KS is frequent among our HIV-infected patients; it seems to occur most often at a younger adult age and represents one of the presenting manifestations of HIV/AIDS in our context. It seems to equally affect men and women, occurring more often when CD4 counts are < 200 cells/mm3.

Burden of human scabies in sub-Saharan African prisons: Evidence from the west region of Cameroon.

BACKGROUND/OBJECTIVES: There is little data on the profile and magnitude of scabies in sub-Saharan African prisons. The present study aimed to assess the prevalence and determinants of scabies in prisons of the west region of Cameroon. METHODS: We conducted a cross-sectional study from March to August 2014, and consecutively recruited volunteer detainees of three randomly selected prisons in the West Region of Cameroon. The diagnosis was based on clinical findings after assessment by two experienced and well-trained dermatologists. RESULTS: We enrolled 755 prisoners, 17 (2%) of whom were women. Their mean age was 32 ± 12 years. There were 242 cases (32%) of scabies, with significantly more cases in the most crowded prison (P < 0.0001). Men were significantly more affected than women (P = 0.004) and the prevalence of scabies significantly decreased when the level of education increased (P < 0.0001). In addition to a low level of education (adjusted odds ratio (aOR) 1.90; P < 0.0001), sharing clothes/bedding (aOR 2.72; P < 0.0001) and the number of detainees per cell > 10 (aOR 1.89; P = 0.002), but not age, duration of incarceration, number of baths/week and washing/week, were independent drivers of scabies occurrence. CONCLUSION: Almost one-third of prisoners suffered from scabies in our prisons. A low educational level, the sharing of clothes/bedding and number of detainees/cell > 10 were independent determinants of the disease. Urgent measures must be undertaken to reduce the burden of scabies in our prisons.

Determinants of Kaposi Sarcoma during HIV infection: A nested case-control study from Yaoundé, Cameroon.

BACKGROUND: Although the burden of Kaposi sarcoma (KS) is fast increasing among HIV-infected populations, there is still critical lack of knowledge on its related driving factors in Cameroon. This study purposed to determine risk factors for KS in HIV-infected patients living in Yaoundé, Cameroon. METHODS: This was a 1:3 case-control study nested on a retrospective cohort study, carried-out over a period of 16 years at the Yaoundé Central Hospital, Cameroon. Cases were HIV-infected patients, diagnosed with KS after histological confirmation. Controls were HIV-infected patients, naive of KS and paired to cases through age and sex. Logistic regression analyses served to identify risk factors for KS. RESULTS: Of 14,220 files reviewed, 316 cases of KS (2.2%) were identified. We included 266 cases (55% males), to whom 798 controls were paired. The mean age of patients was 37.7 ± 9.6 years. Results of multivariable logistic regression analysis identified diabetes [adjusted odds ratio (aOR) 2.9, 95%CI: 1.3-7.7; p = 0.028] and HIV-related prurigo [aOR 0.3, 95%CI: 0.1-0.7; p = 0.010] as factors impacting significantly KS occurrence in this study. CONCLUSION: KS is frequent among our HIV-infected patients. Those having diabetes seem at increased odds of developing KS.

Prevalence and Clinical Profile of Drug Eruptions among Antiretroviral Therapy-Exposed HIV Infected People in Yaoundé, Cameroon.

BACKGROUND: Prevalence and incidence of drug eruptions vary around the world and are influenced by some key factors including HIV infection. OBJECTIVE: This study aimed to find the peculiarities of drug eruptions in people living with HIV (PLHIV) and on antiretroviral therapy (ART). METHODS: This was a retrospective cross-sectional study including ART-taking PLHIV, aged 15+ years, followed up between January 2010 and December 2014 at the day-care unit of the Yaoundé Central Hospital, and who presented with drug eruptions after ART initiation. RESULTS: Of 6,829 ART-experiencing PLHIV, 41 presented with drug eruptions, giving a prevalence of 0.6%. The M/F sex ratio equaled 0.17. The mean age was 41.07 ± 11.36 years. Benign drug eruptions accounted for 83.3%. Milder forms were essentially maculopapular exanthema (36.6%), fixed pigmented erythema (7.3%), and urticaria (4.9%). Severe forms were represented by multiform erythema (4.9%), toxic epidermal necrolysis (2.4%), and drug hypersensitivity syndrome (2.4%). The Zidovudine + Lamivudine + Efavirenz ART-protocol was received by 48.8% of patients and 69% of patients were receiving Cotrimoxazole prophylaxis. Nevirapine, Efavirenz, Zidovudine, and Cotrimoxazole were suspected as the potential causes in 43.7%, 4.8%, 2.4%, and 26.8% of cases, respectively. CONCLUSION: Drug eruptions seem infrequent among ART-exposed HIV infected adult Cameroonians.

Failure to return to receive HIV-test results: the Cameroon experience.

BACKGROUND: To be acquainted of one's HIV serological status is an important strategy for the fight against HIV/AIDS, but many patients still miss the appointment to receive their HIV-test result. The aim of this study was to determine the epidemiological and serological profiles of patients not coming back to collect their HIV-test result in a tertiary health care facility in Yaoundé, Cameroon. METHODS: We undertook a retrospective analysis of data of patients who visited the HIV-day care unit of the Yaoundé Central Hospital (Yaoundé, Cameroon) from January to December 2009 in order to be screened for HIV, and who did not come back to retrieve their result. RESULTS: Of the 3990 patients who visited the unit during the study period, 396 (9.92%) did not come back to collect their HIV-test result, of whom 21% were aged 26-30 years representing the most encountered age group. Females (57.8%) were significantly more present than males (p = 0.023). More than half of these patients (54.9%) visited the unit for a voluntary HIV testing. Two hundred and three patients (51.3%) had a positive HIV-test result, of whom 63.5% were females. The most HIV-infected group was the one coming for a voluntary screening (36.5%). Women not returning to receive their results were more likely to be tested HIV-positive (odds ratio = 1.62, 95% confidence interval: 1.08-2.42; p < 0.05). CONCLUSIONS: Almost 10% of patients screened for HIV infection did not come back to collect their result. More strategies should be implemented to reduce this rate, especially targeting young adults (20-35 years) and women. The delay in delivering patients' results should be shortened. Concurrently, there is need to increase voluntary HIV-testing in our settings.

Skin whitening among Cameroonian female university students: knowledge, attitudes, practices and motivations.

BACKGROUND: Lack of data on skin whitening (SW) among Cameroonian female university students prompted us to undertake the present study which aimed at assessing the knowledge, attitudes, practices and motivations of female university students vis-a-vis SW. METHODS: This was a cross-sectional study conducted from January to April 2013 in 4 university campuses of Yaoundé, Cameroon. Any female student regularly registered in one of the study sites, who was present at the campus when the investigator visited and volunteered to participate in the study was enrolled. RESULTS: Overall, we recruited 620 female students, their ages ranging from 16 to 46 years with a mean of 21.3 ± 2.9 years. Only 87 participants (14%) found that SW was a good practice. One hundred and sixty nine respondents (27.3%) were currently practicing SW with no age difference when compared to their counterparts (p = 0.09). The desire to have a uniform body skin color was the prevailing reason motivating the practice of SW (39.1%), followed by the need to have a soft skin (29%). Assessment of levels of knowledge regarding advantages of the black skin and deleterious effects of SW showed excellent scores (≥75% of good answers) only in 6.1 and 0.5% of cases respectively, with no difference between those practicing SW or not (all p values > 0.05). CONCLUSION: The practice of SW is common among Cameroonian female university students who should therefore be educated on the advantages of the black skin and the harmful effects of SW.

Knowledge, attitudes and practices of the medical personnel regarding atopic dermatitis in Yaoundé, Cameroon.

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing and pruritic inflammatory skin disease whose management remains unclear to most non-dermatologists. This study aimed to assess the knowledge, attitudes and practices (KAP) of the medical staff regarding AD in Yaoundé, Cameroon. METHODS: This was a cross-sectional study conducted from January to April 2014 in 20 health facilities located in Yaoundé, the capital city of Cameroon. All medical staff who provided their consent were included in the study. A score was established for each of the KAP categories, and subsequently grouped into 4 classes considering a score <50, 50-<65, 65-<85 or ≥85%, respectively. RESULTS: We enrolled 100 medical personnel, 62% of whom were females. Overall, the level of knowledge on AD was moderate (65%). Allergy was the main cause of AD, stated by 64% of participants. Only 43% personnel cited the genetic cause. Asthma was mentioned by 78% as an associated pathology. Regarding attitudes, the majority (84%) thought that AD is equally common among Black and Caucasian populations; 42% of participants believed that evolution is favorable when appropriate medical treatment is prescribed. These attitudes were considered wrong (64%). Similarly, the general level of practice was inadequate: 50%. CONCLUSION: Levels of knowledge, attitudes and practices of the medical staff regarding AD were poor, implying that management of this condition is non optimal in our setting.

Prevalence and drivers of human scabies among children and adolescents living and studying in Cameroonian boarding schools.

BACKGROUND: The dire lack of information concerning the epidemiology of human scabies in Cameroon, especially in school milieus brought us to undertake the present study which aimed to determine the prevalence and associated factors of scabies in Cameroonian boarding schools. METHODS: A cross-sectional study was conducted from February to March 2015 in four boarding schools in Yaoundé and Buea (Cameroon). Participants were students currently residing in one of the study sites, volunteering to participate in the study and whose parents or guardians had given their consent in this respect. The diagnosis was based on clinical assessment independently performed by two dermatologists. RESULTS: A total of 1,902 students were recruited (50.5 % boys), with a mean age of 14.3 ± 2.5 years. Overall, 338 participants (17.8 %) were diagnosed with scabies. Age ≤ 15 years, male sex, number of students in the school > 500, no access to the school infirmary, sleeping with others, sharing beddings, clothes or toilet stuffs, pruritus in the close entourage and complaining of pruritus were significantly associated with the presence of mites in univariable logistic regression analyses. On the other hand, at least two baths per day, usage of soap for baths and finger nails always cut short appeared as protective factors. After multivariable analysis, male sex (adjusted OR (aOR) 2.06, 95 % CI: 1.40-3.01, P < 0.0001), first cycle level of education (aOR 1.67, 95 % CI: 1.02-2.71, P = 0.040), number of students per dormitory ≤ 10 (aOR 6.99, 95 % CI: 3.34-14.71, P < 0.0001), no access to the school infirmary (aOR 1.62, 95 % CI: 1.12-2.32, P = 0.009) and complaining of pruritus (aOR 93.37, 95 % CI: 60.04-145.19, P < 0.0001) were the independent factors associated with scabies. CONCLUSIONS: The prevalence of scabies was 17.8 %. The male sex, first cycle level of education, a number of students per dormitory ≤ 10, no access to the school infirmary and complaining of pruritus were the independent factors significantly impacting the occurrence of scabies.

[Epidemiological and clinical profile of skin damages in black African patients on chronic hemodialysis]. / Profil épidémio-clinique des atteintes dermatologiques chez le noir Africain en hémodialyse chronique.

INTRODUCTION: Dermatologic manifestations are common among patients on chronic hemodialysis and may represent systemic involvement. Our study aims to determine the epidemiological and clinical profile of skin damages in black patients living in Yaounde, Cameroon. METHODS: We conducted a cross sectional study including all patients receiving chronic haemodialysis treatment for at least 3 months in two hemodialysis centers in Yaounde from February to May 2014. Patients underwent an interview and a dermatological examination. Chi-squared tests and Student's t-test (or equivalents) were used for statistical analysis, with significance level at p <0.05. RESULTS: A total of 112 patients (78 (69.9%) men) with an average age of 48.6 ± 13 years and a mean duration of dialysis of 46,3 ± 37 months were included in the study. Skin lesions were present in 94 (83.9%) patients. Xerosis (63.3%), pruritus (37.5%), melanoderma (34.8%), acne (12.5%) and half and half nails (10.7%) were the most common dermatologic manifestations. Xerosis was associated with anuria (p = 0.0001) and advanced age (p = 0.032); melanoderma was associated with anuria (p = 0.042) and time spent on dialysis (p = 0.027) while half and half nails were associated with young age (p = 0.018) and biweekly dialysis (p = 0.01 ). CONCLUSION: Skin damages are frequent and dominated by xerosis, pruritus and melanoderma in patients on chronic hemodialysis living in Yaounde. Biweekly dialysis, advanced age, anuria and time spent on dialysis were associated factors.

Features of human scabies in resource-limited settings: the Cameroon case.

BACKGROUND: The persistent high prevalence of human scabies, especially in low- and middle-income countries prompted us to research the sociodemographic profile of patients suffering from it, and its spreading factors in Cameroon, a resource-poor setting. METHODS: We conducted a cross-sectional survey from October 2011 to September 2012 in three hospitals located in Yaoundé, Cameroon, and enrolled patients diagnosed with human scabies during dermatologists' consultations who volunteered to take part in the study. RESULTS: We included 255 patients of whom 158 (62 %) were male. Age ranged from 0 to 80 years old with a median of 18 (Inter quartile range: 3-29) years. One to eight persons of our patients' entourage exhibited pruritus (mean = 2.1 ± 1.8). The number of persons per bed/room varied from 1 to 5 (mean = 2.1 ± 0.8). The first dermatologist's consultation occurred 4 to 720 days after the onset of symptoms (mean = 77.1 ± 63.7). The post-scabies pruritus (10.2 % of cases) was unrelated to the complications observed before correct treatment (all p values > 0.05), mainly impetiginization (7.1 %) and eczematization (5.9 %). CONCLUSION: Human scabies remains preponderant in our milieu. Populations should be educated on preventive measures in order to avoid this disease, and clinicians' knowledges must be strengthened for its proper diagnosis and management.