Food and Aeroallergen Sensitization, Eosinophils Levels and Risk of Atopic Dermatitis in Abuja.

BACKGROUND: The barrier dysfunction of atopic dermatitis (AD) promotes epicutaneous sensitization to aeroallergens. This study aimed to evaluate the prevalence of food and aeroallergen sensitization in AD and to explore the relationship between allergen sensitization and the personal or family history of allergic rhinitis, conjunctivitis, asthma, eosinophil count, and AD severity of Nigerian patients. METHODS: Children and adults with AD who visited the dermatology clinic were included in this study. AD diagnosis was made using the modified Hanifin and Rajka criteria, and severity was rated and graded using the Scoring Atopic Dermatitis (SCORAD) index. Skin-prick test for 14 allergens (5 food and 9 aeroallergens) was used to assess IgE sensitization. To look for significant relationships, chi-square and odds ratio were used. RESULTS: Sensitization to at least one allergen was observed in 65.8% of the patients, sensitization to aeroallergen was 85% and to foods was 15%. More patients had concomitant allergic conjunctivitis (n=29) and only three had asthma. The mean age of onset of AD was 10.6±12.9 years, ranging from 2 months to 51 years, and a family history of atopy was observed in 49.4%. Majority had moderate AD and normal eosinophil count. Allergen sensitization in AD patients was significantly associated with the age of patients but not with personal or family history of allergic rhinitis, conjunctivitis, asthma, eosinophil count or AD severity. CONCLUSION: Analysis of our result showed a high prevalence of food and aeroallergen sensitization in AD. Sensitization was not influenced by the presence of other allergic diseases, eosinophils and the severity of AD.

CONTEXTE: La dysfonction de la barrière cutanée de la dermatite atopique (DA) favorise la sensibilisation épicutanée aux aéroallergènes. Cette étude visait à évaluer la prévalence de la sensibilisation alimentaire et aéroallergénique dans la DA et à explorer la relation entre la sensibilisation aux allergènes et les antécédents personnels ou familiaux de rhinite allergique, conjonctivite, asthme, le taux d'éosinophiles et la sévérité de la DA chez les patients nigérians. MÉTHODES: Les enfants et les adultes atteints de DA qui ont visité la clinique dermatologique ont été inclus dans cette étude. Le diagnostic de la DA a été établi en utilisant les critères modifiés de Hanifin et Rajka, et la gravité a été évaluée et classée à l'aide de l'indice de ScoringAtopic Dermatitis (SCORAD). Le test cutané aux 14 allergènes (5 alimentaires et 9 aéroallergènes) a été utilisé pour évaluer la sensibilisation IgE. Pour rechercher des relations significatives, le chi carré et le rapport de cotes ont été utilisés. RÉSULTATS: Une sensibilisation à au moins un allergène a été observée chez 65,8% des patients, la sensibilisation aux aéroallergènes était de 85% et aux aliments de 15%. Plus de patients présentaient une conjonctivite allergique concomitante (n=29) et seulement trois avaient de l'asthme. L'âge moyen de début de la DA était de 10,6 ± 12,9 ans, allant de 2 mois à 51 ans, et des antécédents familiaux d'atopie ont été observés chez 49,4%. La majorité avait une DAmodérée et un taux d'éosinophiles normal. La sensibilisation aux allergènes chez les patients atteints de DA était significativement associée à l'âge des patients, mais pas aux antécédents personnels ou familiaux de rhinite allergique, conjonctivite, asthme, au taux d'éosinophiles ou à la gravité de la DA. CONCLUSION: L'analyse de nos résultats a montré une prévalence élevée de la sensibilisation alimentaire et aéroallergénique dans la DA. La sensibilisation n'était pas influencée par la présence d'autres maladies allergiques, d'éosinophiles et de la sévérité de la DA. Mots-clés: Dermatite atopique, sensibilisation alimentaire et aéroallergénique, maladies atopiques, éosinophiles, sévérité de la dermatite atopique. Severity of atopic dermatitis Short title:Allergen sensitization in atopic dermatitis.

Dermoscopic Features seen in Tinea Capitis, Tinea Corporis and Tinea Cruris.

BACKGROUND: Superficial fungal infections (SFIs) are infections affecting the keratinized layer of the skin, nail and hair that are mainly caused by dermatophytes. Although diagnosis is routinely done clinically and confirmed by direct potassium hydroxide (KOH) microscopy, fungal culture remains the gold standard for diagnosis and speciation of aetiological agents. Dermoscopy is a recent non-invasive diagnostic tool used to identify features of tinea infections. This study is aimed primarily at identifying specific dermoscopic features seen in tinea capitis, tinea corporis and tinea cruris, and secondarily, to compare dermoscopic features between the three diseases. METHODOLOGY: This is a cross sectional study of 160 patients with suspected superficial fungal infection using a handheld dermoscope. Skin scrapping with 20% KOH microscopy was done, fungal culture was grown on Sabouraud dextrose agar (SDA) and species identified further. RESULTS: There were 20 different dermoscopic features observed in tinea capitis, thirteen in tinea corporis, and twelve in tinea cruris. The commonest dermoscopic feature in tinea capitis was corkscrew hairs, observed in 49 of the 110 patients. This was followed by black dots and comma hairs. There were similar dermoscopic features in tinea corporis and tinea cruris with interrupted hairs and white hairs being the most common features seen respectively. The presence of scales was the dominant feature observed across these three tinea infections. CONCLUSION: Dermoscopy is being used constantly in dermatology practice to improve clinical diagnosis of skin disorders. It has been shown to improve the clinical diagnosis of tinea capitis. We have described the dermoscopic features of tinea corporis and cruris and compared them with that of tinea capitis.

CONTEXTE: Les infections fongiques superficielles (IFS) sont des infections affectant la couche kératinisée de la peau, des ongles et des cheveux, principalement causées par des dermatophytes. Bien que le diagnostic soit systématiquement effectué cliniquement et confirmé par microscopie directe au KOH, la culture fongique reste l'étalon-or pour le diagnostic et la spéciation des agents étiologiques. La dermoscopie est un outil de diagnostic non invasif récent utilisé pour identifier les caractéristiques des infections à tinea. Cette étude vise à identifier les caractéristiques dermoscopiques spécifiques observées dans la tinea capitis, la tinea corporis et la tinea cruris. Ensuite, elle compare les caractéristiques dermoscopiques de ces trois maladies. MÉTHODOLOGIE: Il s'agit d'une étude transversale portant sur 160 patients soupçonnés d'être atteints d'une infection fongique superficielle, réalisée à l'aide d'un dermoscope portatif. Un grattage de la peau avec un microscope à 20 % de KOH a été effectué, une culture fongique a été réalisée sur une gélose dextrose de Sabouraud (SDA) et les espèces ont été identifiées. RÉSULTATS: Vingt caractéristiques dermoscopiques différentes ont été observées dans la tinea capitis, treize dans la tinea corporis et douze dans la tinea cruris. La caractéristique dermoscopique la plus courante dans la tinea capitis était les poils en tire-bouchon, qui ont été observés chez 49 des 110 patients. Viennent ensuite les points noirs et les poils en virgule. La tinea corporis et la tinea cruris présentaient des caractéristiques dermoscopiques similaires, les poils interrompus et les poils blancs étant respectivement les caractéristiques les plus courantes. La présence de squames était la caractéristique dominante observée dans ces trois infections à tinea. CONCLUSION: La dermoscopie est constamment utilisée dans la pratique dermatologique pour améliorer le diagnostic clinique des troubles cutanés. Il a été démontré qu'elle améliorait le diagnostic clinique de la tinea capitis. Nous avons décrit les caractéristiques dermoscopiques des tinea corporis et cruris et les avons comparées à celles de la tinea capitis. Mots clés: Dermoscopiques, Superficielle, Infection fongique, Tinea capitis, Tinea corporis, Tinea cruris.

Impact of Weather Conditions on Atopic Dermatitis Prevalence in Abuja, Nigeria.

BACKGROUND: Climatic conditions may trigger subclinical disease in predisposed individuals and also exacerbate eczematous symptoms resulting in persistence or increased frequency of atopic dermatitis (AD) flares. The aim of this study is to assess the impact of tropical weather conditions on the frequency at which atopic dermatitis patients present at the dermatology clinic of a tertiary hospital in Abuja, Nigeria; and, to find out which component of these conditions exerts the most significant effects. METHODS: Medical records of all new patients seen at the clinic within July 2015 and June 2017 was obtained. Data for monthly temperature, humidity, precipitation, cloud cover and UV index of Abuja during this period was obtained from worldweatheronline. Univariate analyses and multiple regressions were used to assess the associations between monthly prevalence of AD and the above-mentioned meteorological variables. RESULTS: Patients had a 1.6 times odds (95% CI: 1.03-2.56, p = 0.038) of presenting with AD in the dry season as compared to wet season. Dry season was associated with higher temperatures and UV index and lower precipitation, humidity and cloud cover, p<0.001. Multivariate logistic regression modelling adjusting for precipitation, humidity, cloud cover and age group demonstrated that precipitation (OR = 1.01, 95% CI: 1.00-1.02, p = 0.002), humidity (OR = 1.03, 95% CI:1.01-1.05, p = 0.015) and cloud cover (OR = 0.92, 95% CI: 0.88-1.02, p = 0.002) exert the most significant effects. Also infants had 4.4 times odds of AD than adults (95% CI: 2.04-9.69, p<0.001). CONCLUSION: Exposure to tropical season meteorological variables can influence the presentation of AD.

The spectrum of Malassezia species isolated from students with pityriasis vesicolor in Nigeria.

Pityriasis versicolor (PV) is a common superficial fungal infection of the skin caused by Malassezia. Initially M. furfur was suggested as its main aetiological agent; however, more recent studies suggest M. globosa as the dominant species. The possibility of a variance in predominant species based on geographical basis has not been fully evaluated. The objective of this study was to identify the Malassezia species on affected and non-affected skin of students with PV who reside in a tropical environment (Abuja, Nigeria) and correlate them to clinical characteristics. In this study, the literature on prevalence of Malassezia genus in PV was also reviewed. Samples were taken from 304 PV lesions and 110 normal appearing skin. Microscopy, culture and identification of Malassezia species utilising polymerase chain reaction-restriction fragment length polymorphism analysis were performed. Three Malassezia species were detected in PV with the major species being M. furfur. On normal appearing skin, M. furfur (77.6%) and M. restricta (10.4%) were both detected. No case of M. globosa was identified in this study. There was no significant difference between species identified and clinical features of PV. M. furfur is probably still the most predominant species causing PV in the tropical environment.

Skin Prick Test Analysis in Allergic Rhinitis Patients: A Preliminary Study in Abuja, Nigeria.

Allergic rhinitis (AR) is prevalent in Nigeria, though little information exists on the allergen. We assessed the clinical features of AR patients in our environment based on the allergic rhinitis impact on asthma (ARIA) classification. Only patients with positive skin prick test (SPT) were recruited. Seventy-four patients participated in the study. AR and asthma comorbidity were observed in 13.5%. The proportion of "sneezers-runners" was higher than "blockers" with significantly more "sneezers-runners" having persistent AR (P = 0.007). No relationship was established between these predominant symptoms and the aeroallergens used in this study. Intermittent mild and moderate/severe AR were evident in 13.5% and 31.1%, while persistent mild and moderate/severe were seen in 20.3% and 35.1%, respectively. House dust mites allergen yielded the highest number of positive responses (22.6%) followed by tree pollen (16.8%). No relationship was observed between the allergens tested and AR severity. Majority of patients were oligosensitive (33.8%) and polysensitive (35.1%) and were not significantly associated with AR severity (P = 0.07). Most AR patients presenting for treatment in Abuja, Nigeria, had moderate-severe persistent AR and showed similar SPT sensitization pattern with countries having similar climatic conditions. Sensitization patterns were not related to ARIA classification or predominant AR symptoms.

Spectrum of otorhinolaryngology emergencies in the elderly in Ibadan, Nigeria.

BACKGROUND: The elderly (65 years and above) are a special group of patients whose illnesses and management are modified by the process of aging. It is thus the aim of this study to evaluate the spectrum of ear, nose, throat, head and neck emergencies among the elderly in Ibadan, Nigeria. METHOD: This is an eight-year (April 1996-March 2004) retrospective study of 87 geriatric patients who presented with otorhinolaryngological emergencies at our centre. RESULTS: Eighty-seven emergency cases studied constituted about 20% of the total geriatric cases seen within this period. There were 55 (63.2 per cent) males and 32 (36.8 per cent) females. The pharyngolaryngeal emergencies with upper airway obstruction constituted 55 per cent of the cases, a majority being a result of malignant lesions of the larynx and pharynx. Others were nasal 20.7 per cent, otological 11.5 per cent, oesophageal 9.7 per cent and head and neck 3.1 per cent. Most of the patients had emergency tracheostomy (54 per cent), as a prelude to their definitive management while 24 per cent were managed medically. CONCLUSION: Prevalence of emergency otorhinolaryngology cases among the elderly appears high. Most of the throat diseases with upper airway obstruction were due to malignancy. There is thus the need for increased awareness of the people through social campaigns and health education on the merits of early detection and seeking appropriate treatment for these tumours.

Kaposi's sarcoma in HIV-infected women and men in Nigeria.

Abstract Kaposi's sarcoma (KS) in women with HIV infection is observed to have increased from recent studies. To understand the gender-related differences of AIDS-KS in Nigeria, we conducted a prospective study of the clinical, virologic, and immunologic features of newly diagnosed AIDS-KS patients. Prevalence was similar in both genders. There were differences in the distribution of the lesions and the CD4 count in women was significantly lower.