Angiomas at the university hospital of Yalgado Ouedraogo in Ouagadougou, Burkina Faso: Epidemiological and clinical profile.

Angiomas are vascular abnormalities that affect less than 1% of the world's population. Data on these disorders in Africa are limited. The purpose of our work was to study the epidemiological and clinical aspects of angiomas in the Dermatology-Venerology Department of the University Hospital of Yalgado Ouedraogo in Ouagadougou (Burkina Faso) to contribute to improving knowledge of this group of pathologies in our region. This cross-sectional descriptive, retrospective, and prospective study covers cases from 1998 through 2014. We identified 61 patients with angioma, 67.2% of them younger than 30 months. The sex ratio was 0.56. Vascular tumors (hemangiomas) accounted for 43 cases (70.5%) and vascular malformations 18 (29.5%). Lesions appeared between 0 and 15 days of life in 57.4% of cases. Their size ranged from 1 to 3 cm in 49.2% of cases. They were most frequently located on the head (49.2%). The most frequent clinical forms were cutaneous hemangiomas (tuberous) (36 cases), followed by the nevus flammeus (8 cases), and mixed hemangiomas (7 cases). Only one complex forms was observed: one case of Klippel-Trenaunay syndrome. Superficial vascular abnormalities are rare in our dark skin type context including infantile hemangiomas. The clinical peculiarities of the angiomas observed in this African series in Ouagadougou seem quite similar to the characteristics described in European and American series.

[Ekbom syndrome or delusional parasitosis: Three cases in Ouagadougou (Burkina Faso)]. / Syndrome d'Ekbom ou parasitose délirante : trois cas à Ouagadougou, Burkina Faso.

INTRODUCTION: Ekbom syndrome is a rare disease characterized by a delusional conviction on the part of the patient of infestation with cutaneous parasites. It is rarely described in an African setting. Herein we report three cases observed in Ouagadougou. PATIENTS AND METHODS: Case 1: a 40-year-old housewife, living alone since her spouse left her, consulted for a feeling of insects under the skin and exulceration progressing over the previous year. A diagnosis was made of Ekbom syndrome in a depressed patient. Case 2: a 45-year-old bachelor, unemployed and with no children, consulted in dermatology for a sensation of continuous movement of insects under his skin, experienced over the previous six years. This sensation, which was worse in hair-covered areas, led to regular hair removal and untimely cleansing in a bid to dislodge them. Case 3: an 80-year-old patient, widowed for 3 years, consulted for a sensation of insects under her skin over the previous 2 years. This sensation was accompanied by intermittent pruritus and she removed the "insects" from her skin, which she brought to us in a sachet, but which in reality corresponded to debris of dead skin. We concluded on Ekbom syndrome in a depressive patient. CONCLUSION: These three cases of delusional parasitism observed in Ouagadougou, Burkina Faso, confirm the main clinical characteristics of Ekbom syndrome and underline the role of emotional and financial isolation, as well as pre-existing psychological difficulties, as potential triggers for this syndrome.

[Ecthyma gangrenosum of the eyelid after chickenpox]. / Ecthyma gangreneux de la paupière compliquant une varicelle.

BACKGROUND: Ecthyma gangrenosum is an acute ulcer necrotic skin infection frequently caused by Pseudomonas aeruginosa. It is characterised by necrotic ulcerations circumscribed by an inflammatory halo. Lesions are normally found in the anal, genital and axillary regions. Ecthyma gangrenosum is most commonly seen in immunodepressed patients (cytotoxic chemotherapy, HIV infection, neutropenia or functional neutrophil deficiency, agammaglobulinemia). It is a rarely described complication in chicken pox. PATIENTS AND METHODS: Herein we report the case of a girl aged 2 ½ years presenting in our dermatology department with ecthyma gangrenosum on the right upper eyelid secondary to varicella. The disease course was marked by fibrous scarring of the inner canthus with ptosis of the right upper eyelid. The retractile scarring caused disability. DISCUSSION: There have been previous reports of the contribution of non-steroidal anti- inflammatory drugs (NSAIDs) to the appearance of necrotic cutaneous super infections during the course of chickenpox. The occurrence of such complications on an eyelid may be harmful not only for the function of the eye but it can also cause extensive aesthetic impairment. Subsequent aesthetic and functional impairment may be improved by corrective surgery.

[Ichthyosis and social stigma in Burkina Faso]. / Ichtyose et stigmatisation sociale au Burkina Faso.

BACKGROUND: Through the story of two families presenting ichthyosis, we report the support and social integration difficulties inherent in these genetic diseases. PATIENTS AND METHODS: Family No. 1: a 38-year-old shepherd and his wife of 25 years both had lamellar ichthyosis that had been present continually since childhood. They had had 2 stillborn infants as well as a live newborn that were all presenting lamellar ichthyosis. Family No. 2: a 45-year-old housewife was seen at our consultation with her 3 youngest children aged 8 years, 6 years and 18 months. According to the mother, at birth, all 3 children were covered with a membrane resembling plastic that crackled during movement, and they had red eyes. Examination of the 3 children revealed a clinical picture of lamellar ichthyosis with ectropion, malformed ears and brachydactyly. Although they presented delayed growth and weight development, psychomotor development was normal. There was no consanguinity between the parents. DISCUSSION: In both families, the visible nature of the dermatosis resulted in discrimination and ostracism. The precarious living conditions of the parents and the high cost of treatment in an African setting resulted in degradation of quality of life with exacerbation of the difficulties of social integration, resulting in a lack of schooling and a bleak future for these children.

Disseminated histoplasmosis caused by Histoplasma capsulatum var. duboisii in a non-HIV patient in Burkina Faso: Case report.

Histoplasmosis is a fungal infection due to Histoplasma capsulatum. The African form of this mycosis, caused by Histoplasma capsulatum var. duboisii, remains rare. We report a case of disseminated African histoplasmosis with skin, lymph nodes, bones and viscera localizations. The 22-year-old patient was HIV-seronegative and was considered immunocompetent. The presence of Histoplasma capsulatum var duboisii in ulcerations and a nodule pus aspiration was confirmed by direct microscopic examination and by culture. The medical treatment was based on fluconazole. Even though a regression of the symptoms was observed, the patient died. In disseminated African histoplasmosis, an early laboratory diagnosis must be carried out for accurate treatment.

[Connective tissue diseases in hospital practice in Ouagadougou (Burkina Faso)]. / Les connectivites en pratique hospitalière à Ouagadougou (Burkina Faso).

To describe the semiological and immunological features of connective tissue diseases seen at the Yalgado Ouédraogo University Hospital in Ouagadougou. A retrospective study reviewed the records of patients seen in the hospital dermatology and internal medicine departments from January 1, 2004, through December 31, 2009 and diagnosed with systemic lupus erythematosus (SLE), systemic sclerosis (ScS), dermatopolymyositis (DPM), primary Gougerot-Sjögren disease (GS), polymyositis (PM) or indeterminate connective tissue disease (ICTD) meeting the criteria of the American College of Rheumatology. The study included 42 patients, 36 women and 6 men. Their mean age was 41.2 years ±11.97 (range: 15-75). SLE was the diagnosis for 10 patients, ScS for 14, DPM for 7, primary GS for 1, PM for 1, and ICTD for 9. Hematologic (93%), cutaneous (88%), and rheumatologic (81%) abnormalities were the most frequent manifestations. The specific auto-antibodies associated with SLE patients were: anti-native DNA (3/6), anti-Sm (3/6), anti-RNP (3/6), and anti-SSA (4/6); anti-Scl 70 antibodies were present in 5 patients with ScS. Connective tissue diseases seem to be rare in Africa, south of the Sahara. However, the very fragmentary studies and the weak healthcare coverage do not allow any definitive conclusions.

[Darier's disease: three cases of psychosocial difficulties in an African setting]. / Difficultés d'intégration sociale au cours de la maladie de Darier en Afrique : trois cas.

BACKGROUND: Darier's disease is a rare disease. Multiple clinical forms have been observed, but the psychosocial aspects in Africa are rarely described. We report three cases involving difficulties regarding social integration. OBSERVATIONS: Case no. 1: a 19-year-old woman consulted for hyperchromic, greyish, keratotic papules, grouped in small plaques scattered all over the body. She had trouble finding a husband and was rejected by her peers. Case no. 2: a 20-year-old woman presented generalized keratotic, vegetative lesions. She was rejected by her husband because of the lesions. Like patient no. 1, she was unable to purchase her prescribed treatment. Case no. 3: a 33-year-old blacksmith presented Darier's disease with lesions on the interscapular region and chest. He was epileptic and depressive and was partly rejected by his family. DISCUSSION: Darier's disease, diagnosed on the basis of anatomoclinical factors, had a major impact on the social integration of all three patients. These generalised disfiguring forms of the disease adversely affect the quality of life and their association with neuropsychiatric disorders is another major handicap. CONCLUSION: Difficulties concerning social integration and therapeutic problems must be considered in the management of Darier's disease in Africa.

[Disseminated subcutaneous cysticercosis: a report of six cases in Burkina Faso]. / Cysticercose sous-cutanée généralisee : a propos de six cas au Burkina faso.

Cysticercosis is an infection resulting from the larval form of the pig tapeworm, Taenia solium. The subcutaneous localizations are frequent and can have serious consequences such as neurological attacks. We report six cases among whom five men and a woman, in order to point out the severity of the disease and its possible dissemination. The patients' age was ranging from 25 to 57 years old. Three of them had neurological complications as convulsions and headaches. The nodules were painful in one case. We recommend sanitary education to eradicate the affection and to sensitize patients in order to consult physicians at early stage.

[Pityriasis rosea in secondary schools in Ouagadougou, Burkina Faso]. / Pityriasis rosé de Gibert dans les écoles secondaires à Ouagadougou (Burkina-Faso).

BACKGROUND: Pityriasis rosea is a spontaneously regressive benign erythematous squamous dermatosis. A better understanding of this condition in developing countries would be useful. PATIENTS AND METHODS: We conducted a cross section study based on one-day surveys in Ouagadougou, Burkina Faso, secondary schools. The stratified cluster sampling method described by Henderson was used. Six thousand pupils were examined to collect epidemiology and clinical data and to determine the presence of complications and results of complementary explorations performed. RESULTS: Thirty-six cases of pityriasis rosea were observed (0.6 p. 100). Prevalence was higher in children from an unfavorable social and economic background. A typical eruption was often observed with classical localizations and morphology in 86.1 p. 100 of the cases. Pruritus was often observed with an inaugural lesion (61.1 p. 100) predominantly on the upper limbs (54.6 p. 100) and the trunk (31.8 p. 100) measuring 1 to 3 cm. A typical second eruption was found in most cases, situated on the trunk (75 p. 100), distal portions of the limbs (64.4 p. 100), proximal portions of the limbs (33.3 p. 100) and the neck (30.5 p. 100). The eruption evolved for 1 week to 1 month in most cases (61 p. 100). In 55.5 p. 100 of the cases, therapeutic abstention was the rule. Secondary treatment-related complications occurred in 38.9 p. 100 of the cases. Stool studies generally demonstrate ameba cysts. Syphilis serology was negative. DISCUSSION: Our sampling technique in the secondary school setting provided a representative sample of the urban population of African cities. This work demonstrated the variability of prevalence by social and economic conditions and is in favor of an infections cause, demonstrating several similar features with other series reported in the literature. Generally, a stool study is not necessary and syphilis serology is negative in typical cases. Health care workers should be more aware of pityriasis rosea in order to avoid poorly adapted treatment.