[Conidiobolomycosis (rhinofacial entomophthoromycosis) in Gabon. About of one case]. / Conidiobolomycose (entomophthoromycose rhinofaciale) au Gabon, à propos d'une observation.

Background: Entomophthoromycosis constitutes a nosological group of subcutaneous mycoses including conidiobolomycosis (rhinofacial form) and basidiobomomycosis (subcutaneous form involving the trunk and the limbs). Conidiobolomycosis is characterized by a progressive nasal and facial deformity giving, in the evolved forms, a "hippopotamus snout". The literature review finds a hundred cases, with a tropism for the humid tropical regions. Methods. We report the observation of a 25-year-old patient, living in the equatorial zone, in the south of Gabon in a humid forest area, presenting a swollen aspect of the face mainly involving the eyelids, the nose and the upper lips. Results: The diagnosis of entomophthoromycosis was compatible with the histopathological and clinical aspects. The evolution was favorable in terms of facial aesthetics under itraconazole 300 mg/day for 2 months and corticosteroid therapy (bolus of methylprednisone 240 mg/day for 3 days relayed per os at a dose of 0.5 mg/kg/day, i.e. 30 mg/day) of prednisone), maintained for 3 months. The average nasal improvement could not be completed by surgery and the patient was lost to follow-up. Conclusion: This second observation of conidiobolomycosis in Gabon in the same province makes Ngounié a privileged ecosystem for this affection.

[Still disease in subSaharan Africa: report of four cases in Gabon]. / Maladie de Still en Afrique subsaharienne : à propos de quatre observations gabonaises.

Still disease is an inflammatory rheumatism occurring predominantly in children and adolescents, but which is sometimes diagnosed in adults. A combination of fever, arthralgia, transient dermatological lesions, hyperleucocytosis predominantly neutrophilic, and ferritinaemia greater than 1,000 µg/L is suggestive of this disease, but infectious, haematological, immunological, and tumor diseases must first be ruled out. Accordingly, patients' financial limitations keep this disease from being diagnosed often in sub-Saharan Africa. We report four cases of Still disease with favourable outcome after corticosteroid therapy.

Regression of cutaneous xerosis with emollient treatment in sub-Saharan African patients.

Emollients have proven effective in improving cutaneous xerosis in various populations; however, no clinical data are available for African patients. The observational study "Xerafrica" was conducted by dermatologists in seven sub-Saharan countries to assess the evolution of xerosis after an 8-week treatment with an emollient. Patients were children above 3 years or adults. Secondary objectives were to assess pruritus, improvement in symptoms, quality of life, satisfaction, and tolerance. An analysis of 185 patients was made. After 8 weeks of emollient treatment, the relative reduction of the "Scaling Roughness Redness Cracks" (SRRC) score was -83.9% and -80.4% in children and adults, respectively. The effect was significantly stronger when topical steroids were co-prescribed with the emollient and in patients with co-dermatosis. To a lesser extent, the effect of emollient was also observed at week 4. Similarly, pruritus and quality of life strongly improved during follow-up. Skin lesions improved in almost all patients, with a high level of satisfaction noted by both dermatologists and patients. The "Xerafrica" study addressed, for the first time, the treatment of xerosis by emollients in an African population. In this specific context, the emollient markedly reduced xerosis as soon as 4 weeks and resolved it almost totally by 8 weeks. The study confirms, under real-life conditions, the efficacy and tolerability of an emollient in improving xerosis.