Subject(s)
Ceremonial Behavior , Ethnicity , Tattooing , Aged , Aged, 80 and over , Humans , Laos , Male , Middle AgedABSTRACT
The objective of this study was to examine the characteristics of cutaneous lupus erythematosus, excluding systemic lupus erythematosus (SLE), in patients of African descent. Indeed, since the description of subacute cutaneous lupus erythematosus (SCLE), which had been included in chronic cutaneous lupus erythematosus (CCLE), there has been no description of the disease in black patients. In 2000, we performed a retrospective epidemiological study by querying multiple sources to identify all patients with lupus in French Guiana--a part of France in South America having western living conditions, free healthcare and 157,000 inhabitants, most of whom are of African origin. We found 45 patients with pure cutaneous lupus, which included CCLE (mostly discoid), SCLE and bullous lupus. The disease characteristics of these patients exhibited few differences compared with those of the Caucasian patients cited in the literature. However, the age of onset for our patients of African descent was younger than that of Caucasian patients. In contrast to the race-related differences reported for SLE, we found no major differences in terms of demographic, clinical and biological presentation between this cohort of pure cutaneous lupus erythematosus patients of African origin and Caucasian patients with similar forms of lupus.
Subject(s)
Black People , Lupus Erythematosus, Cutaneous/ethnology , Adolescent , Adult , Age of Onset , Antibodies, Antinuclear/blood , Biomarkers/blood , Child , Female , French Guiana/epidemiology , Humans , Lupus Erythematosus, Cutaneous/blood , Lupus Erythematosus, Cutaneous/diagnosis , Lupus Erythematosus, Cutaneous/immunology , Male , Middle Aged , Retrospective Studies , Skin/pathology , White People , Young AdultABSTRACT
In French Guiana cutaneous leishmaniasis occurs mainly in the localized form with L. guyanensis accounting for more than 90% of cases. Mucocutaneous leishmaniasis is uncommon (less than 2% of cases) with L. braziliensis accounting for all previously reported cases. The purpose of this report is to describe a case of mucocutaneous leishmaniasis due to L. guyanensis that led to diagnosis of HIV infection in a patient living in French Guiana.
Subject(s)
HIV Infections/complications , Leishmania guyanensis , Leishmaniasis, Mucocutaneous/etiology , Adult , Animals , Humans , MaleABSTRACT
Furuncular myiasis is an infestation of the skin caused by Dermatobia hominis larvae known as "ver macaque" in French Guyana, "berne" in Brazil, "torsalo" in Colombia, or "human botfly" in English-language literature. It has identical features in man and domestic mammals. The primary lesion consists of a boil-like inflammatory papule with a central punctum exuding a serosanguinous discharge. The respiratory sinus of the D. hominis larvae may be visible through the punctum. Myiasis secondary to D. hominis accounts for 10% of imported tropical dermatosis observed in Paris. Diagnosis of furuncular myiasis should be considered in any patient with a history of travel or residence in an endemic area. Treatment depends mainly on mechanical removal that may be facilitated by injection of lidocaine into the lesion or prior application of a 1% solution of ivermectin.
Subject(s)
Diptera , Furunculosis/parasitology , Myiasis/parasitology , Animals , Furunculosis/diagnosis , Furunculosis/epidemiology , Furunculosis/surgery , Humans , Larva , Myiasis/diagnosis , Myiasis/epidemiology , Myiasis/surgery , South America , TravelABSTRACT
French Guyana borders Brazil with the second highest number of cases of leprosy in the world. The purpose of this retrospective study of leprosy cases diagnosed in Guyana between January 1997 and December 2006 was to calculate the incidence of the disease and to identify any special clinical and epidemiological features. A total of 90 new cases were recorded during the study period for a mean incidence of 0.53 cases/10,000 inhabitants/year. Since this incidence is below the 1/10,000 threshold defined by the World Health Organization, leprosy is no longer considered as a major public health issue in French Guyana. However it must be noted that while the number of "native leprosy" cases has declined, the number of Brazilian cases has increased (p<0.01). Brazilian leprosy has different epidemiological features, i.e., dominance of multibacillary forms and high incidence in gold panning and western regions of the country where the incidence is over 1/10,000 inhabitants/year.
Subject(s)
Leprosy/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Female , Guyana/epidemiology , Humans , Incidence , Leprostatic Agents/therapeutic use , Leprosy/diagnosis , Leprosy/drug therapy , Male , Middle Aged , Retrospective Studies , Sex DistributionABSTRACT
We present a descriptive analysis of dermatoses observed in Lao RDP. A total of 421 patients consulted in 3 provinces. A predominance of infectious dermatoses, rarity of acne and absence of skin cancer were notified. These observations are consistent with what has been observed in developing countries in the tropics. But, the causes of consultation are different from other more developed Asian countries.
Subject(s)
Skin Diseases/epidemiology , Adult , Child , Comorbidity , Female , HIV Infections/epidemiology , Humans , Laos/epidemiology , Male , Medically Underserved Area , Skin Diseases, Infectious/epidemiologyABSTRACT
Endemic treponematoses are present in inter-tropical countries in Africa, America, Indonesia and Papua New Guinea. Epidemiology and transmission of the disease are well known. After eradication in some countries after mass treatment in 1950-60, a resurgence of endemic treponematoses has been reported since 1980-90. We present 2 cases of endemic syphilis from the dermatology unit of the Maputo hospital, the first to be described in Mozambique. The endemic syphilis was probably facilitated by the social conditions induced by the Mozambican civil war between 1975 and 1993.
Subject(s)
Syphilis, Cutaneous/pathology , Child , Endemic Diseases , Female , Humans , Infant , Male , Mozambique , Syphilis, Cutaneous/epidemiologySubject(s)
Exanthema Subitum/diagnosis , Axilla , Child , Exanthema Subitum/virology , Humans , Male , Thorax , Urticaria/virologySubject(s)
Mite Infestations/diagnosis , Skin Diseases, Papulosquamous/parasitology , Face , Female , HumansABSTRACT
We report the occurrence of myiasis owing to Dermatobia hominis (Dh) in a HIV-infected subject. HIV infection did not modify the pathogenicity of myiasis. However, the clinical presentation seemed unusual with voluminous inflammatory nodules. Use of topical ivermectin killed the larvae and facilitated their extraction.
Subject(s)
Antiparasitic Agents/therapeutic use , HIV Infections/complications , Ivermectin/therapeutic use , Myiasis/complications , Myiasis/drug therapy , Administration, Topical , Humans , Tropical MedicineSubject(s)
Paragonimiasis/therapy , Praziquantel/therapeutic use , Skin Diseases, Parasitic/therapy , Abscess/pathology , Abscess/therapy , Adolescent , Animals , Anthelmintics/therapeutic use , Drainage/methods , Female , Humans , Paragonimiasis/parasitology , Paragonimiasis/pathology , Paragonimus/drug effects , Paragonimus/growth & development , Recurrence , Skin Diseases, Parasitic/parasitology , Skin Diseases, Parasitic/pathology , Treatment OutcomeABSTRACT
In a retrospective study set in French Guiana, the efficacy and tolerance of the intramuscular treatment of cutaneous leishmaniasis (CL) with a single injection of pentamidine isethionate, at 7 mg/kg, were compared with those observed, earlier, using two such injections (given 48 h apart). Although 83.6% of the 281 patients given two injections each were cured, the single-injection protocol was generally as effective, curing 78.8% of 137 patients. The single-injection protocol was also associated with fewer adverse effects than the two-injection. In the treatment of "difficult" cases (those with satellite papules or relatively high numbers of amastigotes in their lesions), however, the two-injection protocol appeared significantly more effective than the single-injection. In French Guiana, therefore, patients with CL should be given one injection with pentamidine isethionate and only be given a second, 48 h later, if they have satellite papules and/or relatively high numbers of amastigotes in their lesions.
Subject(s)
Antiprotozoal Agents/administration & dosage , Leishmaniasis, Cutaneous/drug therapy , Pentamidine/administration & dosage , Adult , Antiprotozoal Agents/adverse effects , Drug Administration Schedule , Female , French Guiana/epidemiology , Humans , Injections, Intramuscular , Leishmaniasis, Cutaneous/epidemiology , Male , Pentamidine/adverse effects , Retrospective Studies , Treatment OutcomeABSTRACT
Immune reconstitution syndrome (IRIS) is an unusual inflammatory reaction to an opportunistic infection in an HIV-positive patient. This syndrome occurs when immunity is restored in the first months of an effective highly active antiretroviral treatment (HAART). First, we described all patients with a cutaneous form of IRIS. Then, between 1992 and 2004 we conducted a retrospective cohort study comparing Herpes Zoster and Herpes Simplex infections among untreated patients, patients treated by HAART for < or = six months, and patients treated for > six months. We observed three cases of atypical leprosy and three original observations: two of these were fistulisation of lymph node histoplasmosis and tuberculosis, the third one reports the recurrence of a treated cutaneous leishmaniasis. Multivariate analysis showed that, after controlling for age, sex and CD4 counts, patients receiving HAART for < or = six months were more likely to develop Herpes Zoster or herpes simplex infections (p < 0.005). Herpes Simplex and Herpes Zoster infections are the two most frequent dermatological manifestations in our tropical setting. Although mycobacterial infections are more rarely observed than in visceral IRIS, the increased incidence of leprosy may be quite significant when the availability of HAART spreads to developing countries.
Subject(s)
Antiretroviral Therapy, Highly Active , Dermatitis/etiology , HIV Infections/drug therapy , Leprosy/complications , Skin Diseases, Infectious/etiology , Abscess/etiology , Adult , Cohort Studies , Cutaneous Fistula/etiology , Dermatitis/immunology , Disease Susceptibility , Female , Fistula/etiology , French Guiana/epidemiology , HIV Infections/complications , Herpes Simplex/etiology , Herpes Simplex/immunology , Herpes Zoster/etiology , Herpes Zoster/immunology , Histoplasmosis/complications , Histoplasmosis/immunology , Humans , Immunocompromised Host , Immunologic Memory , Leishmaniasis, Cutaneous/complications , Leishmaniasis, Cutaneous/immunology , Leprosy/immunology , Lymphatic Diseases/etiology , Male , Middle Aged , Recurrence , Retrospective Studies , Skin Diseases, Infectious/immunology , Tuberculosis, Lymph Node/complications , Tuberculosis, Lymph Node/immunologyABSTRACT
INTRODUCTION: Demodex is a saprophyte parasite in mammals. In Man, it is associated with differing clinical profiles (rosacea-like dermatitis, folliculitis and blepharitis). We report a case of demodecidosis in an HIV-infected patient that was successfully treated with ivermectin. CASE REPORT: A man from Laos, infected by HIV and treated for glandular tuberculosis, presented with a prurigenous eruption on the face and the pre-sternal and interscapular areas. Direct examination of scraped product and histopathological examinations confirmed the diagnosis of demodecidosis. Clinical cure was obtained after 2 single cures of ivermectin a one month's distance. DISCUSSION: The features of demodecidosis are often similar to those of rosacea. In immunodeficient patients, the semiology remains the same but the eruption is more abundant. During HIV-infection, demodecidosis occurs at the AIDS stage or with a CD4 count lower than 200/mm3. Many anti-dust mite molecules are used to treat the disease but frequently lead to irritation. Administration of a single cure of ivermectin, repeated if necessary, appears to be an interesting alternative to contact anti-dust mite agents.