Prurigo strophulus: Epidemiological, clinical aspects and environmental factors among children in Yaoundé, Cameroon (Sub-Saharan Africa).

Background: Prurigo Strophulus (PS) is a chronic and recurrent inflammatory disease caused by a hypersensitivity reaction to arthropod bites. The objective of this study was to determine the prevalence of PS and its clinical characteristic in our context. Methods: We performed a cross-sectional study during February to May 2017 in Dermatology's units of six hospitals in Yaoundé. Children with clinical signs of PS were included. A questionnaire was administered for data collection. Results: A total of 112 children (62 boys and 50 girls) were included in the study, with a median age of 2 years; with range varied from 5 months to 16 years. The prevalence of PS was 5.4%. The most represented age group was 0-5 years (78.6%). PS lesions were most often located in exposed areas of body such as lower limbs (101/112; 90.2%), upper limbs (85/112; 75.9%) and face (19.6%). Papule-vesicle (87.5%) was the predominant type of lesions. Conclusion: PS is a common disease in Yaoundé (Cameroon). Papule-vesicle lesions are the most frequent signs. It is usually found in exposure areas of body.

[Contribution of histopathology in the diagnosis of mycetoma in a Cameroonian trader and possibility of an urban contamination]. / Mycétome : apport de l'histopathologie au diagnostic chez un commerçant camerounais, et possibilité d'une contamination urbaine.

BACKGROUND: Mycetoma are rare cutaneous affections caused by pathogens such as fungi or bacteria. They settle preferentially on limb extremities. We are going to talk about an original case of mycetoma in a young Cameroonian trader. OBSERVATION: A cutaneous mass with multiple draining sinuses was received at the anatomy and cytopathology laboratory. That mass was from a 30-year-old male trader, with no particular medical history and living in Yaounde, who was received for a lesion at the sole of the foot, which appeared some months before. This lesion started like a tough and painless nodule, which later showed draining sinuses to the skin. The surgical resection of the tissue mass was performed. The histopathological analysis with special staining procedures, which was later on performed, revealed mycetoma caused by fungi. DISCUSSION: This observation describes an original case of fungal mycetoma, which occured in a Cameroonian trader living in an urban milieu away from any mycetoma endemic zone. This case confirms the undeniable or undisputable contribution of histopathology in diagnosis of certainty. To our knowledge and according to available data, it is a premiere to find a case of mycetoma described in an urban milieu in Cameroon.

[Mycological profile of onychomycosis in Yaoundé, Cameroon]. / Profil mycologique des onychomycoses vues en consultation de dermatologie à Yaoundé, Cameroun.

BACKGROUND: The lack of data concerning the mycological spectrum of onychomycosis in Cameroon prompted us to conduct the present study, which aimed to determine the mycological profile of onychomycosis diagnosed during dermatologic consultations in Yaoundé, Cameroon. METHODS: This was a cross-sectional study held from October 2014 to March 2015 in six hospitals of Yaoundé. Patients suspected of onychomycosis were consecutively recruited during dermatologic consultations; anamnestic and clinical data were recorded and one or several nail fragments sampled for mycological examination (direct examination or culture). RESULTS: A total of 3457 patients were examined during the study period, 117 of whom were suspected of onychomycosis; 133 samplings were performed. The distolateral subungual form was the dominating one: 72/110; 65.5%. The diagnosis was confirmed with 110 of the 133 samples (82.7%), these collected among 96 patients, hence a prevalence of 2.8% (96/3457). We isolated 99 germs, among which two-co-infestations. Dermatophytes (52/99; 52.5%), especially Trichophyton rubrum (23/52; 44.2%) and Trichophyton verrucosum (11/52; 21.2%) were the main pathogens causing onychomycois of the toes whereas yeasts (43/99; 43.4%), Candida albicans (31/43; 72.1%) in majority, were the prevailing germs incriminated in onychomycosis of the fingers. There were few cases of molds infestation (4/99; 4%). CONCLUSION: Onychomycosis are common in dermatology consultations in Yaoundé. Candida albicans, Trichophyton rubrum and Trichophyton verrucosum are the main pathogens in cause.

[Acne in Cameroon: Quality of life and psychiatric comorbidities]. / Acné au Cameroun : qualité de vie et comorbidités psychiatriques.

BACKGROUND AND AIMS: The impact of acne upon quality of life (QOL) among affected patients had not previously been investigated in Cameroon. The present study therefore sought to assess the QOL of patients with acne and related psychiatric comorbidities in this country. PATIENTS AND METHODS: This was a cross-sectional study conducted in three hospitals in Yaoundé, Cameroon. We included patients diagnosed with acne after a consultation with a dermatologist, and who consented to participate in the study. The ECLA scale was used for the clinical evaluation of acne and the CADI score was used to assess QOL. PHQ-9 and GAD-7 questionnaires were used for the respective screening of depression and anxiety. RESULTS: We enrolled 181 patients aged between 13 and 56years. According to the ECLA table, the acne global severity score ranged from 3 to 26 points. Impairment was observed in all patients' QOL, which ranged from 1 to 15 points. We noted 11 cases of depression (6.1%) and 14 cases of anxiety (7.7%). There was a positive and significant correlation between the severity of acne and impairment of patients' QOL (r=0.46; P<0.001). Likewise, the severity of acne and of depression and anxiety scores were positively and significantly correlated with one other: r=0.347 (P<0.001) and r=0.291 (P<0.001), respectively. CONCLUSION: Acne negatively impacts the QOL of patients presenting acne in Cameroon and is associated with depression and anxiety, which must therefore be taken into account when treating these patients.

[A case of vitiligo occurring after initiation of antiretroviral treatment and disappearing during this treatment: autoimmune IRIS syndrome?]. / Vitiligo régressif au début d'un traitement antirétroviral : syndrome de reconstitution immunitaire ?

BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) includes all signs occurring during the reconstitution of an extensive and insufficiently regulated immune response to an infective or a non-infective antigen and observed during the immune suppression phase in an individual. We report a case of vitiligo appearing after the initiation of antiretroviral treatment and with repigmentation during the course of the treatment. PATIENTS AND METHODS: A 30-year-old man, seropositive for HIV1-M, consulted for a diffuse eruption of hypopigmented and achromic macules. The lesions appeared 7 weeks after the start of antiretroviral therapy with zidovudine, lamivudine and efavirenz, starting on the forearm and spreading to the remainder of the skin. At control visits during the ensuing two months, gradual repigmentation of the achromic macules was noted. Plasma viral load, determined only during the treatment period, was less than 40 copies/ml (1.60(log)). DISCUSSION: This report concerns an original case of vitiligo occurring at the start of antiretroviral treatment in an HIV-positive patient, with spontaneous repigmentation during treatment. The chronology points to a hypothesis of immune reconstitution inflammatory syndrome (IRIS), despite the absence of any indication of the patient's viral load prior to therapy.

[Stevens-Johnson's syndrome following ingestion of gunpowder]. / Syndrome de Stevens-Johnson après ingestion de poudre à canon.

BACKGROUND: A cutaneous adverse drug reaction is a skin eruption secondary to the intake of a drug, be it prescribed by a medical practitioner or taken as auto-medication for a given ailment. In this document we present an original case of Stevens-Johnson's syndrome secondary to the ingestion of gunpowder. PATIENTS AND METHODS: A 22-year-old female student was hospitalised for diffuse and painful skin eruptions for the previous three days. She had complained six days earlier of an allergic reaction to pineapples, an allergy she had presented for quite a long time. In an attempt to remedy the situation, her mother made her drink a solution made of gunpowder bought at a market mixed with some water. On the third day of this "treatment", the patient noticed eruptions on her skin. These were initially maculopapular, later becoming erosive, and she had a mild fever. Later, a variety of eruptions appeared on the skin, from hyper-pigmented macular papules to blisters and erosive lesions with no Nicolsky sign. These lesions spared the palms of the hands and the soles of the feet. The mucosa of the conjunctivae, nose, buccal cavity, vulva, vagina and anus were severely affected. This clinical presentation was typical of Steven Johnson syndrome. The patient had stopped taking the "treatment" when she noticed the first lesions. On therapy, the outcome was favourable, except for severe complications such as synechiae with diffuse dyschromia. CONCLUSION: To the best of our knowledge this is the first time gunpowder has been incriminated in Stevens-Johnson's syndrome.