Exfoliative dermatitis: patterns of clinical presentation in a tropical rural and suburban dermatology practice in Nigeria.

BACKGROUND: Exfoliative dermatitis (ED) refers to a skin condition in which the skin is diffusely red and inflamed, with varying degrees and types of scaling. It is a serious medical condition and may require hospitalization. OBJECTIVES: This study was conducted to establish the demographics, etiology, and clinical outcomes of patients presenting with ED at the dermatology outpatient clinic at Irrua Specialist Teaching Hospital (ISTH), Irrua, Edo State, Nigeria. METHODS: The study used a retrospective, cross-sectional, descriptive design. The records of all dermatology patients attending the ISTH outpatient clinic were scrutinized for patients in whom ED was diagnosed and managed between March 1, 2004, and November 30, 2010. Relevant records were extracted and details subjected to statistical analysis. Main outcome measures were discharge and death. RESULTS: A total of 1422 dermatology patients were seen at the dermatology outpatient clinic during the study period. Of these, 39 were diagnosed with ED (hospital prevalence rate: 2.7%). The mean age of the ED patients was 60.0 ± 19.5 years (range: 21-90 years). Patients included 22 men and 17 women, giving a male:female ratio of 1.3:1. Of patients aged <40 years, 70% were HIV-positive, and antiretroviral medications accounted for 5% of cases of ED, whereas 50% of elderly patients had a suspected underlying malignancy. CONCLUSIONS: Erythroderma is an uncommon dermatologic presentation. Its recognized association with various internal malignancies makes it a diagnosis of significant clinical importance, particularly in resource-poor rural and suburban centers across Africa. Its recognition and prompt treatment can prevent early mortality or reduce morbidity in elderly patients who present with this condition in the early stages, especially if it is the first harbinger of internal malignancy.

Prevalence of acne keloidalis nuchae in Nigerians.

BACKGROUND: The prevalence of acne keloidalis nuchae (AKN), a chronic inflammatory process of the hair follicles resulting in keloidal papules and plaques at the nape of the neck, is increasing in our environment. METHODS: A prospective hospital-based observational study was conducted at the adult medical dermatologic outpatient department of Irrua specialist teaching hospital, Edo State, Nigeria. All patients referred to the dermatology clinic with symptoms and signs of AKN were recruited. RESULTS: Thirty patients presented to the adult dermatologic unit with AKN over a period of 22 months, giving a gross incidence of 9.4% of dermatologic consultations. The common etiologic factor was secondary to trauma from an electric razor whilst having a haircut, followed by spread of keloid from the beard area. CONCLUSIONS: Minimization of trauma during hair cutting or shaving and personalization of haircare instruments may reduce the recently increased incidence of this condition in our environment.