K. Tchangaï-Walla

Cosmetic use of skin-bleaching products and associated complications

This was a cross-sectional study performed on a sample of women over 15 years of age and resident in the city of Lomé. The sample was based on a rational selection from different neighborhoods and departments of the city of Lomé, covering all socio-professional categories of the female population. A pre-set and pre-tested questionnaire was used. In the first part of the study, direct contact was made with the women to collect sociodemographic data (age, socio-professional activity, marital status and educational level) and the names of the cosmetic products used. In the second part, after identifying the users of skin-bleaching cosmetic products, we performed a dermatologic examination on these women to investigate any potential cutaneous complications arising from this practice. The findings were analyzed using the E PI -I NFO program, version 5.01b (1992; Epicentre, Paris). The χ 2 test and Fisher’s exact test were used for the statistical analysis with a 5% significance threshold.

Kaposi's sarcoma in a hospital setting in Lomé (Togo): a study of 93 cases

Aim  To define the epidemiologic and clinical profile and course of the disease in African Kaposis sarcoma (KS) and acquired immunodeficiency syndrome (AIDS)‐associated KS in Togo.

Acne and skin bleaching in Lomé, Togo

Objective  This study aims at describing the clinical characteristics of patients with acne using skin bleaching (SB) products.

Epidemiology of melanoma in Togo.

There can be no doubt that the incidence of melanoma has been continuously increasing for several years. Melanoma constitutes a real public health problem in Europe, the USA and Australia. 1 Its incidence is inversely proportional to the degree of skin pigmentation. 1,2 In fact, melanoma is reputed to be rare in black people and subjects with pigmented skin, but in sub-Saharan Africa melanoma has been very poorly documented. 2,3 The aim of this study was to determine the epidemiologic profile of melanoma in Togo.

Basidiobolomycose probable chez un jeune rural togolais traitée avec succès par du kétoconazole

Basidiobolomycosis is a deep mycosis which preferentially affects rural young people in tropical countries. We report a case of basidiobolomycosis successfully treated with ketoconazole. It was a 9-year-old boy of rural origin in whom the diagnosis of basidiobolomycosis was suspected due to a deep skin infiltration involving the chest and neck. Histology revealed hypodermic granulomatous inflammation with predominantly macrophage and eosinophils. The child was treated successfully with ketoconazole in eight weeks. Treatment of basidiobolomycosis is based on azole derivatives which are particularly effective. Histopathology is very important in the diagnosis of this affection, especially in tropical countries where it may simulate Mycobacterium ulcerans infection.

Is There an Association between Keloids and Blood Groups

Objective. The aim of the study is to investigate the possible associations between the blood groups ABO and Rhesus systems and the presence of keloids in patients with black skin. Method. This case-control study was conducted between September 2007 and August 2011 comparing dermatologic outpatients with keloids to matched controls recruited in preanesthetic consultation at Tokoin Teaching Hospital of Lomé (Togo). Results. The distribution of different ABO blood groups and Rhesus blood groups in both groups (cases versus controls) was not significantly different. This distribution of different blood groups was superimposed on the general population of blood donors at the National Blood Transfusion Center of Lomé. Univariate analysis between each blood group and the presence of keloid does not yield any statistically significant association between blood groups and presence of keloids in the subjects. Conclusion. The study shows no significant association between blood groups and the presence of keloids in our patients. Further investigation needs to be conducted to elucidate this hypothesis further by conducting multicenter studies of several ethnic groups.

Facteurs de risque associés à l’érysipèle de jambe en Afrique subsaharienne : étude multicentrique cas-témoins

BACKGROUND Acute bacterial cellulitis of the leg (erysipelas) is a common problem involving considerable morbidity in dermatology practice in Africa. Previous studies conducted in Europe and North Africa have highlighted lymphoedema and toe-web intertrigo as independent factors associated with leg erysipelas. The aim of this case-control study was to identify risk factors associated with leg erysipelas in sub-Saharan Africa, within a different socio-economic and culture context. PATIENTS AND METHODS We conducted a prospective case-control study in hospital dermatology departments in 8 sub-Saharan African countries over a 12-month period (October 2013 to September 2014). Each case of acute leg cellulitis was matched with 2 controls for age (±5 years) and sex. We analysed the general and local factors. RESULTS During the study period, 364 cases (223 female, 141 male) were matched with 728 controls. The mean age was 42.15±15.15 years for patients and 42.11±36 years for controls. Multivariate analysis showed the following to be independent risk factors associated with leg erysipelas in our study: obesity (odds ratio [OR]=2.82 ; 95% confidence interval: 2.11-3.76), lymphoedema (OR=3.87, 95%CI: 2.17-6.89), voluntary cosmetic depigmentation (OR=4.29, 95%CI: 2.35-7.83), neglected traumatic wound (OR=37.2, 95%CI: 24.9-57.72) and toe-web intertrigo (OR=37.86, 95%CI: 22.27-64.5). CONCLUSION The results of this study confirms the major role of local risk factors (toe-web intertrigo, lymphoedema) previously identified in other geographical settings. However, the originality of our study consists of the identification of voluntary cosmetic depigmentation as a risk factor for leg erysipelas in sub-Saharan Africa.

Cas cliniqueLeucodermie en gouttes précoce au cours de la maladie de Darier chez un sujet à peau noireEarly guttate leukoderma in Darier's disease in a patient with black skin

BACKGROUND The clinical manifestations of Dariers disease are polymorphic and diverse. Guttate leukoderma has been described in around twenty patients with genetically pigmented skin. We report a case of widespread guttate leukoderma several years before the classic signs of Dariers disease in a patient with black skin. CASE REPORT A 19-year-old woman consulted for characteristic signs of Dariers disease evolving for the previous four years. Examination revealed perifollicular, non-confluent hypopigmented macules and papules in small drop size (1-5mm in diameter) scattered on the trunk, limbs and the jaw and chin. These hypopigmented lesions had been present since the age of six years. Histology of the keratotic papules confirmed the diagnosis of Dariers disease. Histological inspection of a hypopigmented lesion showed hyperkeratosis, acantholysis and a considerable reduction of epidermal melanin pigment. DISCUSSION Our observation suggests that a guttate leukoderma could be an early sign, readily accessible to dermatologists, in the diagnosis of Dariers disease in black-skinned patients.

Leucodermie en gouttes précoce au cours de la maladie de Darier chez un sujet à peau noire

BACKGROUND The clinical manifestations of Dariers disease are polymorphic and diverse. Guttate leukoderma has been described in around twenty patients with genetically pigmented skin. We report a case of widespread guttate leukoderma several years before the classic signs of Dariers disease in a patient with black skin. CASE REPORT A 19-year-old woman consulted for characteristic signs of Dariers disease evolving for the previous four years. Examination revealed perifollicular, non-confluent hypopigmented macules and papules in small drop size (1-5mm in diameter) scattered on the trunk, limbs and the jaw and chin. These hypopigmented lesions had been present since the age of six years. Histology of the keratotic papules confirmed the diagnosis of Dariers disease. Histological inspection of a hypopigmented lesion showed hyperkeratosis, acantholysis and a considerable reduction of epidermal melanin pigment. DISCUSSION Our observation suggests that a guttate leukoderma could be an early sign, readily accessible to dermatologists, in the diagnosis of Dariers disease in black-skinned patients.

Traitement du lichen cutané étendu par le dipropionate et phosphate disodique de bétaméthasone : étude ouverte de 73 cas

Resume Objectif Le but de cette etude etait d’evaluer l’efficacite du traitement du lichen plan cutane etendu par le dipropionate et phosphate disodique de betamethasone injectable. Malades et methode Une etude prospective a ete menee, entre septembre 2003 et aout 2005, chez les malades souffrant de lichen plan cutane etendu consultant en dermatologie au CHU de Lome (Togo). Chaque malade inclus dans l’etude a eu trois injections de dipropionate et phosphate disodique de betamethasone espacees de 15 jours. L’evaluation a ete effectuee a 6 semaines, a 3 mois et 6 mois. Resultats Soixante-treize cas de lichen plan cutane etendu ont ete inclus dans notre etude. Le sex-ratio (H/F) etait de 0,7. L’âge moyen des malades etait de 29,5 ± 11,9 ans. A 6 semaines, nous avons obtenu 83,6 p. 100 de remission complete 8,2 p. 100 de remission partielle et 8,2 p. 100 d’echec. A 3 mois, la remission complete persistait chez 58,9 p. 100 des malades contre 23,3 p. 100 de rechute. A 6 mois, le taux de recidive etait de 31,5 p. 100. Aucun effet secondaire majeur n’a ete rapporte chez les malades durant toute la periode de l’etude. Discussion Les resultats de cette etude montrent que le dipropionate et phosphate disodique de betamethasone constituent une bonne alternative therapeutique au cours du lichen plan cutane etendu. Mais ces resultats meritent d’etre confirmes par une etude randomisee avec un recul plus long.