Diagnosis, Management, and Outcome of Bart's Syndrome Observed in a Sub-Saharan African Country (Senegal, Dakar): 2 Case Reports.

Introduction: Bart's syndrome is an uncommon inherited congenital disorder associating congenital cutaneous aplasia of the extremities and inherited epidermolysis bullosa. Bilateral and symmetrical involvement of the limbs is exceptionally described on black skin. In most cases, the diagnosis is clinical; however, the management remains very difficult and the extended forms are a real therapeutic challenge. We report 2 cases of Bart's syndrome observed in a sub-Saharan African country (Senegal, Dakar). Case Presentation: It was about 2 premature female and male newborns. On physical examination, the girl presented with a total absence of skin on the limbs, associated with cutaneous detachment of the trunk representing a detached and detachable skin surface of 46%; the boy underwent a total absence of skin of more than 50% of the skin surface. The diagnosis of Bart's syndrome was set based on the typical clinical aspect. The blood count and CRP were normal for the girl whereas it revealed some disorders for the boy. The 2 newborns were urgently admitted to an incubator, and the intensive care was started with hyperhydration, anti-staphylococcal prophylaxis, and daily dermatological care with antiseptic baths and fatty dressings. Conclusion: Bart's syndrome is an uncommon genodermatosis characterized by a clinical triad associating congenital cutaneous aplasia of the extremities, inherited epidermolysis bullosa suspected in the presence of bubbles, and areas of cutaneous fragility and nail deformity. All types of which can be associated with this syndrome. The easy clinical diagnosis but the difficult management encumber the vital prognosis of our cases.

[Unadjusted and customized fetal growth curves: a comparative study in a sub-Saharan population]. / Courbes de croissance fœtale non ajustées et personnalisées: une étude comparative dans une population du Sud du Sahara.

The purpose of this study was to compare the unadjusted EPOPé M0 curve with the customized Gardosi curve in the diagnosis of small-for-gestational-age (SGA) fetuses in a sub-Saharan population. We compared the Gardosi et al. and EPOPé M0 classifications. Classification differences were analyzed according to patient characteristics and obstetric conditions. Data collected from FileMaker software were analyzed using SPSS 20.0 and R Studio software. The statistical tests were carried out according to applicability conditions. Alpha risk was set at 0.05. The Gardosi curve showed that the rate of SGA newborns was higher (31.4% versus 28.9%) and did not differ between overweight and normal-weight women. The rate of severe SGA in preterm infants was also higher (23.6 versus 19.7%). Diseases were more frequent in newborns classified as severe SGA by the customized growth curve. The customized curve is recommended for the sub-Saharan Africa population.