[Epidermodysplasia verruciformis: clinicaland epidemiological features of 45 cases in the Department of Dermatology at the University Hospital Center of Yalgado Ouedraogo, Ouagadougou]. / Epidermodysplasie verruciforme: aspects epidémiologiques et cliniques de 45 cas dans le service de Dermatologie du Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou.

INTRODUCTION: The epidermodysplasia verruciformis is a rare, autosomic, recessive, genodermatose characterized by a chronic, disseminated, cutaneous infection with human papillomavirus. The majority of these patients have a genetic or acquired immunodeficiency. PATIENTS AND METHODS: This retrospective study was conducted on the records of all patients who presented in our dermatology department with an epidermodysplasia verruciformis in a 13 years and 6 months period, from January 1st, 1992 to June 30th, 2005. RESULTS: We have collected 45 cases of epidermodysplasia verruciformis. They were aged from 3 to 57 years, with a mean of 24.6 years. The most concerned age bracket was that from zero to 9 years. They were 29 women (64.4%) and 16 men (35.6%). The eruption presented as papules of 2 to 3 mm size, associated with hypochromic, finely squamous macules with the same size. We noted three cases of itching. We found 37.7% of family cases. We observed 14 cases of HIV positive patients and one case of cancer. CONCLUSION: This study confirmed that the epidermodysplasia verruciformis was rare. Genetic factors or immunodeficiency would support the appearance of the disease.

[Cutaneous leishmania in HIV patient in Ouagadougou: clinical and therapeutic aspects]. / Leishmaniose cutanée chez les malades infectés par le VIH. Aspects cliniques et thérapeutiques.

BACKGROUND: Immune suppression cause by HIV infection is a risk factor in the progression of leishmania diseases. In Burkina Faso atypical clinical presentations of leishmaniases have been observed among people living with HIV. The goal of this study was to describe clinical and evolutionary aspects of cutaneous leishmania and HIV co-infection among patients followed at Ouagadougou University Hospital. PATIENTS AND METHODS: This 16-month prospective study was carried out from January 2003 to April 2004 among HIV-seropositive patients with a diagnosed cutaneous leishmania infection. At baseline, infection and lesions were classified. Clinical diagnosis of cutaneous leishmania depended on finding parasites by microscopy in smears or tissue biopsies. Histological examinations were done if clinical and parasitological diagnosis were not concordant. Treatment consisted of three 21-day rounds of pentavalent antimonial, (Glucantime(R)). Clinical evolution was monitored at the end of each treatment round. RESULTS: Thirty-two HIV-1 positive patients (16 women and 16 men) were included. Mean age was 35.5 (10-67 years old). Leishmania lesions had been evolving, on average, for 12 weeks. Eleven patients were taking HAART and 21 patients were taking cotrimoxazole prophylaxis against opportunistic infections. Cutaneous lesions were found: in the face (15 cases), torso (18 cases), upperlimbs (26 cases) and lower-limbs (28 cases). Observed clinical forms were: papulo-nodular (9 cases), ulcerative (14 cases), infiltrative (12 cases), lepromatous and diffuse (15 cases), psoriasis-like (5 cases), cheloid, histioid or kaposi-like (1 case each). Some patients presented more than one clinical form. Prognosis was satisfactory in 24 patients after the first treatment. Twelve patients relapsed after the first treatment, among those 10 were only taking cotrimoxazole. At the end of the third treatment, 24 patients were cured, 3 died and 5 were lost to follow-up. CONCLUSION: Clinical polymorphism of cutaneous leishmania has been observed in HIV-patients, thereby increasing the risk of differential diagnosis.

[Complications of thyroid surgery, apropos of 104 thyroidectomies at the Ougadougou University Hospital Center]. / Les complications de la chirurgie thyroïdienne (à propos de 104 thyroïdectomies au CHU de Ouagadougou.

We report a series of 104 thyroidectomies collected in Surgery and ENT departments of the University Hospital Center (UHC) of Ouagadougou. This study was composed of 85 women (81.73%) and 19 men (18.27%) 8 to 73 years old. 49 unilateral resection and 85 bilateral one were realized. Histopathologic examination has been done for 54 specimen only: 49 benign lesions (95.20%) and 5 malignant lesions (4.80%) were noted. We have observed: 7 cases of hemorrhagic complications (6.73%) with 1 death, 10 cases of unilateral laryngeal recurrent nerve palsy, permanent in 4 cases (3.85%), 2 cases of upper laryngeal nerve palsy (1.92%), 2 cases of permanent hypoparathyroidism (1.92%), 5 cases of post operative infection (4.80%). There were 2 deaths (1.92%). These results are similar with other authors results but the frequency of thyroidectomy complications is still important. Improvements in clinical practice, more specialists and great experience would improve post operative results of thyroidectomy.

[Sexuality and AIDS. KAPB study accomplished in 1989 in a school environment in Ouagadougou (Burkina Faso)]. / Sexualité et SIDA. Etude CAPC réalisée en 1989 en milieu scolaire à Ouagadougou (Burkina Faso).

AIDS is nowadays one of the major problems of public health in Burkina Faso. In order to get informations on pupils' sexual behaviour and knowledge about AIDS, we conducted a study on a representative sample from secondary schools' students in Ouagadougou (n = 466). The mean age was 18.2 years old; 48.7% among these pupils declared to have had least one sexual intercourse. The mean age of the first intercourse was 16.3 years old. For them, media was the main information source on AIDS (72.1%), whereas schools were not named. 58.4% mentioned condom as a mean of prevention and 64.1% among males who have had a sexual experience used condom. Although they were afraid of AIDS the school students asked did not think they were likely to contract the illness; but they pointed out the prostitutes as a risk behaviour group. These results are discussed according to the gravity of AIDS. So, the risky sexual behaviour, due to ignorance and/or thoughtlessness, endanger this youth and challenge all actors.

[Problems after thyroid gland surgery in Burkina Faso, 83 cases]. / Problemes posés par la chirurgie du corps thyroïde au Burkina Faso, à propos de 83 cas.

Management of thyroid tumor can be problematic in developing countries due to poor diagnostic and therapeutic facilities. This is true in Burkina Faso where there are no facilities for radioisotope scans and intraoperative biopsy is usually unfeasible due to a shortage of histologists. The purpose of this retrospective analysis of the files of 83 patients who underwent surgery of the thyroid between January 1988 and December 1993 at the National Hospital Center of Ouagadougou was to obtain information necessary to define suitable pre-, per-, and post-operative strategies for these conditions. The mean delay to consultation for the 83 patients studied was 8 years. The fact that dysphonia and/or dysphagia was present at the first examination in 68 cases and that paralysis of the recurrent laryngeal nerve was observed in 17 cases testifies to the advanced stage at which patients were seen. Cancer was confirmed in only 3 of the 41 surgical specimens that were examined (7.3%). In cases involving only one nodule with no signs of malignancy, resection of the nodule is justifiable (18.1% of cases). In other cases radical resection is indicated either by lobo-isthmectomy or subtotal thyroidectomy for diffuse or multinodular goiter (74.7% of cases) or by total thyroidectomy (7.2% of cases). The immediate postoperative period was marked by the occurrence of hemorrhage (n = 7), transient paralysis of the recurrent laryngeal nerve (n = 4), and infection of the surgical wound (n = 5). There were 2 deaths.

[Thyroglossal duct cysts. Apropos of 17 cases in the National Hospital Center in Ouagadougou, Burkina Faso]. / Les kystes du tractus thyréoglosse. A propos de 17 observations au CHN de Ouagadougou, Burkina Faso.

The thyroglossal duct cysts originate from thyroglossal duct involution default. The case record of 17 patients admitted for that disease in the ORL department of the national hospital of Ouagadougou during those past 7 years, is reviewed. They represent 1.5% of patients operated in this department during the same period, all diseases concerned. In the present report, the thyroglossal duct cysts are essentially observed in children under 10 years old (13/17 patients). In most of the cases (12/17), our patients have needed medical advice for an anterior cervical tumefaction 7 years after the first symptoms. Between clinical and paraclinical findings we give preference to the first ones that can avoid, in most of the cases, a lot of complementary tests which are of limited interest and too expensive in our countries. In the therapeutic field, the Sistrunk technic has been recognized since 1920 as the best method. Our patients who have been operated according to that technic have no tendency to relapse.