Cutaneous basidiobolomycosis: Seven cases in southern Benin.

BACKGROUND: Cutaneous basidiobolomycosis is the most common form of entomophthoramycosis. Herein we report seven cases of cutaneous basidiobolomycosis. PATIENTS AND METHODS: A retrospective observational study was conducted at the Buruli ulcer treatment centre in Pobè and at the national teaching hospital in Cotonou from 2010 to 2015. RESULTS: Seven cases of cutaneous basidiobolomycosis were diagnosed. The mean patient age was 9.53 years. There were 4 female and 3 male patients, all from southeast Benin. Clinically, the disease presented in all cases as a hard, well-defined, subcutaneous plaque with little inflammation, and which could easily be lifted from the deep structures but remained attached to the surface structures. The overlying skin was hyperpigmented. Plaques were localized to the buttocks or thighs. All patients had inflammatory anaemia with an accelerated erythrocyte sedimentation rate (30 to 70mm over the first hour), and a low haemoglobin count (8.7 to 11.4g/dL). Blood hypereosinophilia (650 to 3784elements/mm3) was present in six of the seven subjects. Histopathology (performed for 5 of the 7 subjects) showed granulomatous lesions with foreign-body giant cells, and inflammatory cells, with occasional eosinophils surrounding fungal hyphae (Splendore-Hoeppli phenomenon). Mycological analysis revealed Basidiobolus ranarum in three cases. The patients were treated with ketoconazole (5/7) and itraconazole (2/7), with good outcomes after 10 to 24 weeks of therapy. DISCUSSION: Cutaneous basidiobolomycosis is uncommon in southern Benin, with only seven cases being diagnosed over 6 years. The diagnosis of cutaneous basidiobolomycosis is a challenge in the field in Benin due to the non-specific clinical presentation, the lack of technical resources, and the existence of numerous differential diagnoses. CONCLUSION: Cutaneous basidiobolomycosis is an uncommon fungal infection in southern Benin chiefly affecting children.

[Profile of immune and allergic dermatoses among children at the outpatient dermatology clinic in Cotonou (Benin)]. / Profil des dermatoses immunoallergiques chez les enfants dans le service de dermatologie du CNHU-C (Bénin).

OBJECTIVE: The aim of this work was to study the profile of immune and allergic dermatoses (IAD) in children consulting at the outpatient dermatology clinic at the National University Hospital in Cotonou (Benin). METHOD: This retrospective descriptive study examined records of children consulting with this diagnosis over a 10-year period. RESULTS: IAD (902 cases, 37%) were the most common pediatric dermatosis, followed by infectious dermatosis (24%). The sex ratio of children was 0.78. The age groups most strongly affected were those aged 1-30 months (25.39%) and 150-180 months (19.73%). The main IAD were: eczema (47.9%) and prurigo simplex (40.7%). Other IADs included lichen planus (5.1%), toxicoderma (3.8%), urticaria (1.5%), and erythrodermic eczema (1%). The incidence of eczema increased from 13.5% in 2000 to 21.5% in 2009, an increase of 62.2% over 10 years. CONCLUSION: IADs are common at the Cotonou hospital clinic and are dominated by eczema, the incidence of which has increased significantly over time.

[Epidemiological and clinical characteristics of anogenital dermatoses in the department of dermatology-venereology in Cotonou, Benin]. / Profil épidémioclinique des dermatoses anogénitales dans un service de dermatologie à Cotonou (Bénin).

OBJECTIVE: The aim of this study was to document the epidemiological and clinical characteristics of anogenital dermatoses (AGDs) in Cotonou, Benin. METHOD: This retrospective, descriptive study, conducted in the Department of Dermatology-Venereology at the National University Hospital of Cotonou, examined medical records of admissions and outpatient consultations for the 5-year period 2005-2009 and included the records of all patients with a clinical diagnosis of AGD. RESULTS: The prevalence of AGD in our series was 2.6% and the prevalence of sexually transmitted AGDs (STIs) was 1.3%. The sex ratio (M:F) was 2.5, and the patients' average age was 31.1 years. AGDs were classified as infectious (77%), inflammatory (12.6%), non-infectious tumors (3.7%), physiological (2.1%), psychodermatoses (2.1%), non-infectious ulcers (1.6%), and dyschromia (1%). STIs accounted for 44% of the AGDs: condyloma (65.5%), genital herpes (19%), urethritis (8.3%), and chancroids (4.8%). The primary sites in men were the foreskin, the groin, the scrotum, and the glans, and in women, the labia majora, the groin, the labia minora, and the anal cleft. CONCLUSION: AGDs were relatively rare in hospital consultations in Cotonou. They were mainly infectious (viral or fungal), and nearly half were STIs.

Prevalence of xerosis, eczema, and hair and nail abnormalities in PLWHA in Cotonou, Benin.

BACKGROUND: The objective of this investigation was to study the prevalence of xerosis, eczema, and hair and nail abnormalities in PLWHA in Cotonou. PATIENTS AND METHODS: A retrospective study was performed on the records of PLWHA in Cotonou. All PLWHA with xerosis, eczema, or abnormal appendages were included. RESULTS: Forty-seven patients had xerosis or eczema. Their mean age was 38 years; the sex ratio 0.51 and the mean CD4 count 89 cells/mm(3). Twenty-three patients had xerosis, which affected the whole body (n = 20), lower limb (n = 2), limbs and trunk (n = 1), without gender difference. Twenty-four patients had eczema of which eight had both eczema and xerosis. Forty-two patients had abnormalities of the hair or nails. Their sex ratio was 0.80 and the mean CD4 count 110 cells/mm(3) . Nineteen patients had abnormalities of the hair and scalp: straight hair (n = 16), squamous lesions (n = 2), and folliculitis abscess (n = 1) with a male predominance. Twenty-three patients had nail dermatophytosis (n = 15), candidiasis (n = 7), and ingrowing nails (n = 1). These conditions affected more often women (74%) than men (26%). CONCLUSION: The prevalence of eczema and xerosis is low in our patients. Onychomycosis was the most frequent nail abnormality.

[Keloids on dark skin: a consecutive series of 456 cases]. / Chéloïdes sur peau noire: à propos de 456 cas.

INTRODUCTION: Keloids are abnormal growths of fibrous tissue often seen on dark skin. We studied their clinical, epidemiological and therapeutic aspects in 456 consecutive cases. PATIENTS AND METHODS: This retrospective study covering a 20-year period describes and analyzes all patients seen for keloids during that period. RESULTS: The age range of 15-24 year-olds was affected most often (35.72%), and the male/female sex ratio was 0.66. Pruritus was the most frequent symptom (72.23%). The zones at high risk for keloids were: the trunk (chest and abdominal area) (39.57%) and the face (10.65%).The most frequent causes were various sorts of trauma (75%), in descending order of frequency: cutaneous infections, surgical trauma, ulcerating lesions, and burns. The existence of spontaneous keloids remains controversial. Steroid infiltration used alone or with other medication remains the first-line treatment in our study. DISCUSSION: Our study confirms the high frequency of keloids in dark skin, especially females. The trunk and face are zones at high risk for keloid formation. CONCLUSION: An underlying trauma must always be sought for keloids on dark skin.

[Drug eruptions in children in Cotonou, Benin]. / Toxidermies Chez Les Enfants A Cotonou, Benin.

INTRODUCTION: The aim of this study was to investigate the epidemiological aspects of drug eruptions in children in hospital area in Cotonou. PATIENTS AND METHOD: A retrospective study was carried out in the Department of Dermatology of Cotonou (Benin) from 1998 to 2009. All cases of drug eruption occurred, during the study period, in children under 16 years old were selected for the study. The diagnosis of the drug eruption was based on clinical findings. The Identification of culprit drugs was based on the criteria as defined by the French Group of Pharmaco-vigilance. RESULTS: From 1998 to 2009, 232 cases of drug eruption were diagnosed in the Department of Dermatology. Of this, 35 cases occurred in children under 16 years old. The patient mean age was 6.6 years with a sex ratio of 0.94. 4 patients were HIV positive. The culprit drug was identified in 21 patients (60%): sulfonamides 52.38% (11/21 cases), penicillin 9.52% (2 cases), vaccine 9.52% (2 cases), acetaminophen 9.52% (2 cases), acetyl salicylic acid 4.76% (n = 1), quinine 4.76% (n = 1), phenobarbital 4.76% (n = 1) and ceftriaxone 4.76% (n = 1). The main clinical patterns were: fixed drug eruption 45.71% (16/35), maculopapular rash 17.14% (n = 6), Stevens-Johnson syndrome 17.14% (n=6), and urticaria 8.57% (n = 3), 1 case of toxic epidermal necrolysis was seen and one patient died. CONCLUSION: Skin reactions caused by drug intake are a rare disorder among children and fixed drug eruption is the main clinical presentation of the disease in Cotonou (Benin).

[Reasons for consultation in a dermatology/venereology department in 2009 in Cotonou, Benin]. / Motifs de consultation en Dermatologie-Vénéréologie en 2009 a Cotonou, Bénin.

The purpose of this retrospective study was to determine the reasons for consultation in a Dermatology Venereology Department in Cotonou, Benin. A total of 1,070 new patients were included. The main reason for consultation was immunoallergic dermatosis.

[Mucocutaneous manifestations of human immunodeficiency virus infection in Cotonou, Benin]. / Manifestations cutanéo-muqueuses des personnes vivant avec le virus de l'immunodéficience humaine à Cotonou, Bénin.

The purpose of this study was to describe mucocutaneous manifestations observed in persons living with human immunodeficiency virus (PLHIV) in Cotonou, Benin. A transverse retrospective study was carried out on the records of PLHIV who underwent follow-up at the Military Teaching Hospital in Cotonou from February 2002 to September 2005. The files of all eligible adult patients examined by dermatologists prior to initiation of antiretroviral treatment were reviewed. Dermatologic manifestations were defined as any cutaneous or cicatricial lesion of the skin. Data was analyzed using the EPI INFO software package. (version 6.0). A total of 152 patient files were included. The sex ratio was 1.10 with a female predominance. Mean age was 37.8 years. HIV1 was predominant (98%). Two-thirds of patients were as stage 3 according to the WHO classification. A total of 276 dermatologic manifestations were identified. The most common manifestations were buccopharyngeal candidiasis (24.6%), prurigo (20.6%), shingles (11.6%), and dermatophytosis (10.5%). The mean CD4 lymphocyte level was 106 cells/mm3. The CD4 level was below 100 cells/mm3 in 52% of cases involving candidiasis and 60% of cases involving prurigo. Dermatologic findings in this study were identical to those described in most studies from Africa and Asia. However the low prevalence of Koposi's sarcoma and seborrheic dermitits was surprising given the advanced stage of immunodepression in our patients. The most frequent mucocutaneous manifestations of HIV infection in Benin are infectious disease and prurigo.

Manifestations cutaneo-muqueuses des personnes vivant avec le virus de l'immunodeficience humaine a Cotonou (Benin)

L'objectif de cette etude est de decrire les manifestations cutaneo-muqueuses des personnes vivant avec le virus de l'immunodeficience humaine (PVVIH) naives de tout traitement antiretroviral a Cotonou au Benin. Une etude retrospective transversale a ete menee sur des dossiers de PVVIH suivies a l'Hopital d'Instruction des Armees a Cotonou; de fevrier 2002 a septembre 2005. Tous les dossiers de patients adultes eligibles et examines par un dermatologue avant la mise sous traitement antiretroviral ont ete revus. Toute lesion evolutive ou cicatricielle de la peau ou des muqueuses a ete retenue comme affection dermatologique. Les donnees ont ete analysees avec le logiciel Epi Info version 6.0 152 dossiers de patients ont ete retenus. Le sex-ratio etait de 1;10 en faveur des femmes. La moyenne d'age etait de 37;8 ans. Le VIH1 etait predominant (98). 2/3 des patients etaient au stade clinique 3 de l'OMS

[Contact eczema and allergens: an analysis of the preliminary results of patch tests in the Dermatology Service of the National Hospital and University Center in Cotonou]. / Eczema de contact et allergenes: analyse des resultats preliminaires des tests epicutanes du Service de Dermatologie du Centre National Hospitalier et Universitaire (CNHU) de Cotonou.

About a preliminary study of patch-test in 39 cases of contact dermatitis with allergens of international Contact Dermatitis Research (ICDRG), the authors noted 27 (69.2%) positive patch-tests. Men are frequently exposed to formaldehyde and dichromate potassium. Women are more exposed to fragrance-mix and formaldehyde. Hand workers have the uppermost percentage of positive patch-test (90.9%). The authors observed also 16 cases of contact polysensitivity for at least two allergens.

[Buschke-Loewenstein tumor. Apropos of 2 cases in Cotonou, Benin]. / Tumeur de Buschke-Loewenstein. A propos de deux cas vus à Cotonou, Bénin.

About two cases of Buschke-Loewenstein tumor--one of the penis in man infected with HIV and another of perianal area-, the authors insist on the relative frequency of Buschke-Loewenstein tumor in non-circumcised and homosexual groups. They emphasize the continuous precancerous spectrum of Buschke-Loewenstein tumor.

[Mibelli porokeratosis in 2 brothers]. / Porokératose de Mibelli chez deux frères.

INTRODUCTION: Mibelli's porokeratosis is uncommon in black persons. We report two brothers who had two different clinical presentations. CASE REPORT: The brothers were seen at the ages of 16 and 19 years. Both had Mibelli's porokeratosis, one with a papulo-verruciform presentation located on the scrotum, the anus, the gluteal area and the back of the hand, and the other with a superficial disseminated eruption involving the face and the forearm. DISCUSSION: The incidence of Mibelli's porokeratosis in the black population at Cotonou is approximately 0.3 per 10.000. The presence of the disease in two uterine brothers confirms the monogenic and familial nature of Mibelli's porokeratosis. Dominant transmission cannot be easily demonstrated when the parents of the patients are phenotypically healthy.

[Ectodermal dysplasia. Apropos of 6 familial cases in negroid children]. / Dysplasie ectodermique. A propos de 6 cas familiaux chez des enfants de race noire.

Six cases of ectodermic dysplasia were observed in children of a black family. The different forms include dental abnormalities and a particular pilar dysplasia in black subjects. Ectodermic dysplasia is transmitted recessively on the X chromosome.