Suzanne Oumou Niang

Aesthetic problems associated with the cosmetic use of bleaching products

Background and aimu2002 The use of skin bleaching products for cosmetic purposes is a frequent practice (25–96%) in women from sub‐Saharan Africa. The dermatologic complications associated with this practice have been comprehensively reported. The aim of this work was to study the epidemiologic, clinical, and cosmetic aspects of these complications in order to produce better therapeutic guidelines for their management.

Epidemiologic, clinical, and therapeutic features of acne in Dakar, Senegal.

Backgroundu2003 Acne, a chronic inflammatory dermatosis of the pilosebaceous follicle, is very widespread worldwide, affecting 75–80% of adolescents, with an impact on their quality of life. The etiologic factors are not always the same, and the treatments proposed are not always well tolerated in black individuals.

Dermatosis papulosa nigra in Dakar, Senegal

Backgroundu2003 Dermatosis papulosa nigra (DPN) is a benign epithelial tumour, common in the black population. It is a special topographic form of ethnic seborrheic keratosis, which is more common in the white population. Its benign character has meant that very few studies have been performed. In Senegal, no investigation has been carried out to date.

Behçet's disease in black skin. A retrospective study of 50 cases in Dakar.

INTRODUCTIONnAlthough Behçets disease is well-documented in Eastern populations, epidemiologic data in Sub-Saharan African population is scarce. The aim of this study was to define the epidemiologic and therapeutic aspects as well as clinical course of Behçets disease in African black population.nnnRESULTSnThe study included 50 patients with Behçets disease. The average age was 32 (18-67) years. A total of 31 patients were men and 19 were women. Two patients had a positive family history of Behçets disease. The oral and genital aphthous lesions were present in 100% of patients. The pathergy test was positive in 16 patients (32%). Following skin conditions were observed: pseudofolliculitis in 15 patients (30%), acneiform papules in 6 patients (12%), erythema nodosum in 4 patients (8%) and leg ulcers in one patient. Ocular involvement was reported in 22 patients (44%) and joint involvement in 20 patients (40%). Neurological abnormalities were noted in 12 patients (24%). Gastrointestinal involvement with wide and deep ulcerations in the ileocecal region was observed in a patient. As treatment, a combination of oral corticosteroids and colchicine was used in 97% of our patients. Thalidomide was introduced in 3 patients and anticoagulation treatment in 19 patients. Clinical improvement was noted in 25 patients (50%), recurrence in 14 patients (28%) and 3 patients were lost to follow (6%).nnnCONCLUSIONnThe Behçets disease is not uncommon in black skin and generally affects young adults. Severe aphthous ulcers of the oral cavity and genital area are the most consistent finding.

Negative cutaneous effects of medicinal plants in Senegal

Use of medicinal plants is common and widespread throughout Africa, including in Senegal. Because efficacy has been demonstrated, public policies have been instituted that have allowed plant‐based therapies to have an important role in general primary care. However, little is known about the cutaneous safety of many plant‐based therapies. In this 6‐month prospective study all cases of dermatitis induced or aggravated by exclusive use of medicinal plants were evaluated via skin allergy testing. The results were classified and compared with the available literature. Forty‐three cases of plant‐therapy‐associated cutaneous reactions were identified, including worsening of existing conditions (56%), recurrence of a previously resolved condition (16%) and new dermatitis arising spontaneously (28%). In the cases where the condition was new, generalized exfoliative dermatitis occurred in 42% of cases with an average time of onset of 9 days. Specific plants were identified in 65% of cases and included 18 varieties. The frequency and severity of plant‐induced cutaneous reactions should be the basis for the creation of a phytovigilance programme and re‐evaluation of how traditional medicine is used in the general population. When irritation occurs, identification of the responsible plant and allergy testing should be the first steps towards relieving symptoms.

Tinea in Senegal: an epidemiologic study

The tineas are frequent in poor countries, especially in the tropics, where they are promoted by the hot climate and by promiscuity. One characteristic of the disease is alopecia, which can be distressing for patients and their relations and adversely affect their quality of life. In the majority of cases it is children who are affected. However, tinea is increasingly reported in adults, promoted by many factors. The aim of our study was to explore the epidemiologic profile of tinea in Senegal.

Alopecia in Senegalese women.

Fifty female patients aged between 14 and 45 years were included in the study. This represents 7.6% of the 654 women aged 14 years and above who consulted a dermatologist during the period of the study. The course of the alopecia was progressive in 92% of cases. The pattern of alopecia was diffuse in 86% of cases and localized in 14%. Alopecia was partial in 78% of cases. Associated signs comprised scaling in 14 cases, pruritus in two cases, folliculitis in three cases (Fig. 1), anemia in one case and pregnancy in one case. There were 11 cases of tinea capitis and four cases of alopecia areata. The hair was tightly braided on a regular basis in 100% of cases, synthetic hair extensions were used in 90% of cases (Fig. 2), and in 70% of cases hair was pulled back into a chignon. Hair straightening using a “cold” method was practised by 78% of patients: on a regular monthly basis in 38% of cases, every 2 months in 45% of cases, and every 3 months in 17% of cases. Thirty-seven per cent of patients used brushing techniques, hot curling irons, dryers and steam hoods. All patients used various types of cosmetic products regularly and simultaneously (gels or hair sprays, oil baths, lotions and creams). Figure 1 Folliculitis decalvans secondary to chemical straightening Blackwell Publishing, Ltd. Oxford, UK IJD nternational Jour al of Dermatology 0011-9059Science, 2005 44 Original article

The Vitiligo in Senegal

The aim of our study was to determine the epidemiological and clinical aspects of vitiligo in the largest dermatology department of Senegal. A cross-sectional and descriptive study in a period of 5 months was performed covering all the vitiligo cases. Fifty patients were identified (26 women and 24 men). The mean age was 26.5 years. A family history of vitiligo was found in 11 cases and a psychoaffective disturbance in 6 cases. The clinical forms distinguished were generalized vitiligo (n = 33), localized vitiligo (n = 16), vitiligo universalis (n = 4), and segmental vitiligo (n = 1). The Koebner phenomenon was found in 7 cases. Associated diseases were atopic dermatitis (n = 2), contact dermatitis (n = 1), diabetes (n = 1), and Graves disease (n = 1). The disgraceful character of Vitiligo was the predominance of generalized forms and the elective localization in sun-exposed areas. The family character, the psychoaffective disturbances, the Koebner phenomenon increased by the lifestyle and the itching dermatosis were the aggravating factors.

Leishmaniose cutanée à Leishmania infantum associée à une infection par le VIH

BACKGROUNDnIn Senegal, reported cases of cutaneous leishmaniasis are often due to Leishmania major. Immunosuppression related to HIV infection contributes to the emergence of leishmaniasis in humans and to cutaneous localization of viscerotropic species. We report the first observed case in Senegal of opportunistic cutaneous leishmaniasis due to Leishmania infantum associated with HIV.nnnPATIENTS AND METHODSnA 5-year-old boy presented crusted ulcerative lesions of the scalp and left forearm, together with axillary and cervical lymphadenopathy present for two months. Direct parasitological examination of the scalp and arm lesions, coupled with liquid aspiration of lymph nodes and bone marrow, enabled identification of amastigote forms of Leishmania. Polymerase chain reaction performed on skin, lymph node and bone marrow biopsy samples allowed identification of L.xa0infantum. The child was positive for HIV1. Treatment of HIV infection and leishmaniasis resulted in clinical improvement.nnnDISCUSSIONnCo-infection with cutaneous leishmaniasis due to L.xa0infantum and HIV is a complex combination in terms of the related therapeutic issues. The clinical and laboratory outcomes depend on restoration of immunity and on the efficacy, safety and availability of anti-leishmaniasis drugs.

Epidemiologic and clinicopathologic aspects of Leprosy in Dakar; evaluation of 73 new cases

Hundreds of new leprosy cases are still diagnosed in Dakar despite all the efforts in the struggle by the national program for elimination of leprosy by the Institute of Applied Leprosy in Dakar. The aim of our study was to evaluate the epidemiological, clinicopathological and outcome of new cases of leprosy. A prospective study was conducted over a period of one year listing all new cases of leprosy based on clinical diagnosis, bacteriology and histology. 73 new cases were recorded. The sex ratio was 1.5 and the mean age of 39.5 years. Children aged from 0 to 15 years old represented 12%. The clinical forms were rated in order of decreasing frequency Borderline 47.94%, 30.13% lepromatous lepromatous, indeterminate 8.21, borderline lepromatous 6.84, TT: 5.47%, 1.36 and neurological bb%. Neurological signs were enlarged nerve in 50 cases, a neurological deficit in 16 cases and a sensitive deficit in 16 cases. The complications were burns and ulcerations in 10 cases, a claw in 7 cases, a reversal reaction in 7 cases, erythema nodosum in 4 cases and neuritis in 8 cases. The number of new cases mutilated was 24.65%. The smear was positive in 42% and histology contribution in 91.37% of cases. Our study highlights the significant number of patients with multibacillary contagious, affected children, the high proportion of disability grade 2/OMS reflecting the delay in diagnosis. This delay is due to ignorance, to traditional treatments and low socio-economic status and lack of trained diagnostic teams in different areas apart from referral centres.