[Scleroderma in a hospital setting in Togo]. / Les sclérodermies en pratique hospitalière au Togo.

The purpose of this retrospective study was to determine the epidemiological and semiological profile of scleroderma in Black Africa. Medical records of patients who consulted in the Dermatology Clinic and the Rheumatology Clinic of the Teaching Hospital in Lomé, Togo between 1980 and 1996 and between 1989 and 1996 respectively were reviewed. Scleroderma was diagnosed in 18 of the 34,169 patients seen during the study periods (0,05%). The disease was systemic in 13 cases (8 females, 5 males; mean age: 31 years) and localized in 5 cases (mean age: 20 years). There were no predisposing occupational or therapeutic factors. The clinical manifestations were Raynaud's phenomenon in six of the 13 patients with systemic scleroderma. Extensive cutaneous sclerosis in 10 cases, poikiloderma in seven cases, dysphagia in three cases, pulmonary fibrosis in four cases, and polyarthralgia in two cases. Myalgia and renal involvement were not observed. The findings of this study documents the low incidence of scleroderma in Togo. The high frequency of extensive cutaneous sclerosis, poikiloderma and low frequency of Raynaud's phenomenon which were often mild are the most remarkable features of the disease in Lomé. These features have been pointed out previously but epidemiologic data is still insufficient to confirm the existence of an African form of scleroderma.

[Degenerative spinal disease in an outpatient clinic in Lomé (Togo)]. / Pathologie dégénérative du rachis en consultation hospitalière à Lomé (Togo).

A survey was conducted to determine the frequency and semiological characteristics of degenerative spinal disease in patients attending a hospital rheumatology outpatient clinic in Lomé, Togo. Seven hundred and one of the 1,821 patients seen over a two-year period had degenerative spinal disease. Spinal disease included lower back pain (n = 385), lumbar and radicular pain suggestive of disk protrusion (n = 137), lumbar and radicular pain with claudication suggestive of stenosis of the spinal canal (n = 42), dorsal pain (n = 24), cervical pain (n = 68) and cervical and brachial pain (n = 45). Clinical patterns were similar to those seen in Western countries. However, lumbar and radicular pain with claudication suggestive of stenosis of the spinal canal occurred at a younger age and mainly affected females. These data are in contrast with previous studies suggesting that lumbar and radicular pain due to disk protrusion and stenosis of the spinal canal are uncommon in Black Africa.

[Rheumatic diseases in hospital outpatients in Lome (Togo)]. / Maladies rhumatismales observées en consultation hospitalière à Lomé (Togo).

The aim of this study was to point out the different kinds of diseases in patients attending the rheumatology unit of Lomé Hospital from October 1989 to October 1990. Eight hundred and forty three patients (456 females, 387 males) were examined. The main results of this study are as follows: degenerative spinal involvement: 39.6%; tendinitis: 13.8%; knee osteoarthritis: 12.7%; hip osteoarthritis: 0.7%; hip involvement associated with hemoglobinopathies: 1.3%; gout: 5%; spondylarthropathies/0.8%; asymmetrical oligoarthritis: 0.6%; rheumatoid arthritis/0.2%; chronic polyarthritis without joint destruction: 1.2%; osteoporosis: 0.1%; connective tissue diseases: 0.7%. The scarcity of hip osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus and osteoporosis is in accordance with previous studies. The same is true of the high frequency of degenerative spinal involvement and knee osteoarthritis. However, the high frequency of gout and the non exceptional character of spondylarthropathies are in contrast with previous studies effected in Black Africa.

[Spinal diseases in a rheumatology hospital unit in Lomé (Togo)]. / Pathologie rachidienne en consultation rhumatologique à Lomé (Togo).

A retrospective study was conducted to determine the different kinds of spinal diseases in patients attending the rheumatology unit of Lomé hospital, Togo. Among the 4927 patients seen over a 5-year period, 1966 (40%) had spinal involvement. The disease observed were as follows: degenerative spinal disorders: 1872 cases (95%); infectious discitis: 41 cas (2.1%); spondyloarthropathies: 33 cases (1.8%); tumors: 20 cases (1.1%). Degenerative spinal involvement affected mainly lumbar and cervical spine. The only unusual clinical feature was that Schober's index was often normal. Lumbar spinal stenosis was common (233 cases, 12.4%), especially in females, and occurred at an earlier age than in the Western world. Ankylosing spondylitis features included mildness of extra-articular manifestations and an often negative family history. Pott's disease was de leading cause of infectious discitis. The present study suggests that spinal disorders are as frequent in Africa as in Western countries.