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Background: Dermatological manifestations are frequent and often constitute a circumstance of HIV discovery in 70% of cases [1]. They are observed in 83% of patients with AIDS and at an early stage in 75% [2,3,4,5]. The objective of this study was to describe the epidemiological, clinical, therapeutic, and evolutionary aspects of skin manifestations during HIV infection in children. Materials and Methods: We conducted a cross-sectional, multicentric, descriptive study over a period of ten years in two dermatology departments and one pediatric department in Dakar, Senegal. We included all HIV-seropositive children aged 0–15 years with mucosal cutaneous manifestations. A dermatologist and a specialist in the medical care of HIV performed the diagnosis of cutaneous manifestations. Data entry and analysis were performed with the SPSS software, version 9.05. Results: We collected 206 cases of cutaneous manifestations in 454 children followed for HIV infection. The hospital frequency was 45.3%. The children were male in 115 cases (55.83%) and female in 91 cases (44.17%), giving a sex ratio of 1.26. The mean age of the patients was sixty months, with extremes of one month to fourteen years. A mycotic dermatosis origin was noted in 47.37%, ringworm in 22.37%, dermatophytosis in 8.58%, oral candidiasis in 6.58%, seborrheic dermatitis in 6.58%, and perleche in 3.29%. Bacterial skin diseases were represented by furunculosis in 1.97%, and impetigo in 7.24%. Viral dermatoses included molluscum contagiosum in 10.53%, shingles in 9.21%, warts in 9.87%, and chickenpox in 3.95%. As for parasitic dermatoses, scabies was noted in 8.55, followed by larva migrans in 0.66% and cutaneous leishmaniosis in 0.66%. Immuno-allergic dermatoses accounted for 25% and included prurigo in 94.3%, atopic dermatitis in 1.90%, and fixed pigmented erythema in 1.90%. Conclusion: Cutaneous manifestations are a common discovery during HIV infection in children. They are marked by a predominance of infectious dermatoses in sub-Saharan Africa. Key words: skin diseases; HIV; children; Dakar

Leukocytoclastic vasculitis is a rare cutaneous manifestation in multiple myeloma and only twenty cases have been described to date. We report an unusual case with kappa IgA multiple myeloma in a 63 years old woman presented with leukocytoclastic vasculitis type of digital necrosis and leg ulcer. The vasculitis seems to be paraneoplastic as skin lesions regressed following multiple myeloma treatment.

Background: Previous studies in Africa have shown severity of toxidermia with a risk of mortality and mucosal synechia. Our objective was to study the epidemiological, clinical, etiological and evolutionary aspects of toxidermia in Dakar. Methods: A cross-sectional retrospective study was conducted at the Department of Dermatology of the Hospital Le Dantec from January 2001 to December 2015. She identified all of the toxidermia cases of hospitalization in this department. The diagnosis was based on the French criteria for drug accountability. Results: Two hundred cases of toxidermia were recorded. The hospital frequency was 9.2%. The sex ratio was 0.61. The average age was 33 years. Clinical forms of bullous toxidermia were Stevens Johnson/Lyell in 54% (n = 108), erythema multiforme in 3% (n = 6), and fixed pigmented erythema in 2% (n = 4). Mucosal involvement was noted in 56.5% (n = 113). Visceral involvement was noted in 15% (n = 30) with respiratory involvement in 24 cases of SSJ/NET and 6 cases of DRESS. The drugs identified were antibiotics in 38,7% (n = 53), analgesics in 15,3% (n = 21), anti-comitials in 13,1% (n = 18), antiretrovirals in 11,7% (n= 16), antituberculosis drugs in 9,5%% (n = 13) and medicinal plants in 11,7% (n = 16). The outcome was favorable in 62.5% (n = 125). Death was noted in 12%. Conclusion: Toxidemia in Dakar are characterized by predominance in severe clinical forms in young adults and mortality was related to infectious and hydro electrolyte complications.

Introduction: The general objective was to determine the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of connectivitis in the dermatology department of the CHU Aristide Le Dantec. Patients and methods: This was a retrospective and descriptive study conducted in the Dermatology Department of the University Hospital Center (UHC) Aristide Le Dantec (HALD) of Dakar between January 2009 and December 2019. Their diagnoses were retained according to the international criteria validated in the course of connectivites Results: We identified 290 cases of connectivitis. Systemic scleroderma was the most frequent in 34.42% (n=94), followed by systemic lupus in 25.86% (n=75), mixed connectivities in 22,06% (n=64) and dermatomyositis in 19,32% (n=56). Cancer was associated with dermatomyositis in 11 cases and with systemic scleroderma in 3 cases. The mean age of our patients was 38.23 years. The sex ratio was 4.2 and the mean duration of evolution was 25 months. Dermatological manifestations were constant, found in all patients. In systemic lupus, they were dominated by discoid lupus lesions found in 40% and hypochromic spots (86%) in systemic scleroderma. In dermatomyositis, skin lesions were dominated by periorbital erythroedema (66.07%). Joint manifestations were found in 56.89% of cases (n= 165), muscular manifestations in 41.37% of cases (n= 120) and pleuropulmonary manifestations in 31.3% of cases (n=91). Neuropsychiatric manifestations were noted in 5.17% of cases (n=15). All our patients were treated with corticosteroid therapy and 12.06% of them had received immunosuppressive treatment, the most commonly used molecules being methotrexate (3.44%) and cyclophosphamide (8.27%). Hydroxychloroquine was prescribed in 59.31% of patients, while D-penicillamine was prescribed in 42.06% of patients, 100% of whom were treated for systemic scleroderma. The main complications encountered were infectious complications in 83 cases (28.6%). Visceral complications, a type of visceral insufficiency, were noted in 4.13% of cases. Conclusion: Our study demonstrates the frequency of connectivitis in the dermatology department. Its particularity was the predominance of systemic scleroderma over lupus which was classically the first connectivite in dermatology services. The delay in diagnosis noted is correlated with visceral attacks; hence the importance of a better knowledge of these affections for an early management.

A 9-year-old girl presented a large inflammatory cup-shaped scalp lesion with alopecia surrounded by pustules, dander, and suppuration associated with an occipital inflammatory lymphadenopathy for 1 month. Wood’s light exam was positive as well as KOH mount showing ectothrix type hair involvement. Hair and pus culture on Sabouraud dextrose agar (SDA) added with chloramphenicol and supplemented with cycloheximide isolated a dermatophyte species identified as Microsporum audouinii according to the colonies features. Species identification was confirmed by matrix-assisted laser desorption-ionization–time of flight mass spectrometry (MALDI–TOF MS) and the patient was treated for kerion celsi with terbinafine tablets 125 mg per day associated with a ketoconazole-based shampoo. The evolution was favorable, with hair regrowth after 2 months.

A 9-year-old girl presented a large inflammatory cup-shaped scalp lesion with alopecia surrounded by pustules, dander, and suppuration associated with an occipital inflammatory lymphadenopathy for 1 month. Wood’s light exam was positive as well as KOH mount showing ectothrix type hair involvement. Hair and pus culture on Sabouraud dextrose agar (SDA) added with chloramphenicol and supplemented with cycloheximide isolated a dermatophyte species identified as Microsporum audouinii according to the colonies features. Species identification was confirmed by matrix-assisted laser desorption-ionization–time of flight mass spectrometry (MALDI–TOF MS) and the patient was treated for kerion celsi with terbinafine tablets 125 mg per day associated with a ketoconazole-based shampoo. The evolution was favorable, with hair regrowth after 2 months.

Background The pathogenesis of lichen planus (LP) is mostly autoimmune, while psychological and infectious factors are recognized to trigger or aggravate the disease. An association with diabetes is reported. Our objective was to determine the epidemio-clinical characteristics of LP and its associated factors. Methods This multicentric, prospective study was conducted over a 6-month period. The histopathology was only performed for atypical forms. Patients with a notion of drug intake before the rash were excluded. Anti-hepatitis C Virus (HCV) antibodies screening was systematical in case of mucosal damage. The data were analyzed using the SPSS IBM 20 software. Results The average age was 38 years. Women represented 84.6% (n = 66) of the studied population. The patients were married in 61.5%. Obesity or overweight status was noted in 41%. A marital or relational conflict was found in 25.6%. History of LP was reported in 24.4% (n = 19). Pruritus was found in 96.2%. The locations were as follows: skin (97.4%), mucous membranes (15.4%), and hair and nails (5.1%). Lesions were diffuse in 56.4%. The clinical forms were as follows: typical (52.6%), erythematosquamous (17%), warty (14.5%), pigmented (14.5%), and blaschkolinear (one case). Histopathology confirmed the diagnosis of LP in 91.4%. Blood sugar level was high in one case. Hepatitis B surface antigen (HBsAg) was positive in 3.03%. Anti-HIV and anti-HCV antibodies were negative. Conclusion Lichen planus is a relatively rare disease in sub-Saharan Africa and is seen more in adults. The clinical manifestations are polymorphic, but the mucosal damage is rarely isolated.

OBJECTIVE To determine the epidemiological and etiological profile of tinea capitis in adults in Dakar (Senegal). PATIENTS AND METHODS A 9-month prospective, multicenter, descriptive and analytic study. Patients included were aged over 18 years. Mycological tests were used to confirm the diagnosis. RESULTS 121 patients were included with a mean age of 36.1 years and a hospitalisation frequency of 0.8%. The age range of 64.4% of patients was between19 and 38 years. 51% of patients were housewives. A low socioeconomic level was found in 72.8% of cases. In 3.3% of patients, the disease began in childhood. 31.4% of patients had already consulted a traditional healer. Similar familial cases were noted in 60.3% of patients. Contact with a sheep was noted in 32.2% of cases, deliberate skin lightening in 64% of women, hair salon attendance in 46.7% of women, and immunosuppression in 17.3% of patients, while itching was present in 95.5%. Dermatologic examination showed scaled plaques and a diffuse form, with 92.6% and 64% (n=75) respectively. Wood's light examination was positive in 40.2% of patients. A positive culture test was found in 71%. The most frequently encountered species were: T. soudanense (65%), M. audouinii (21%), T. rubrum (4.7%), M. gypseum (3.5%), T. violaceum (2.3%), T. verrucosum (2.3%) and M. canis (1 case). The clinical course was favorable under treatment with griseofulvin or terbinafine. CONCLUSION Tinea capitis in adults mainly affects young women. The diffuse form is the most common. The most frequently encountered species was T. soudanense.

Tuberculosis is an endemic disease in Senegal. It rarely affects the skin. In these patients it is characterized by clinical polymorphism. It accounts for 2% of extra-pulmonary tuberculosis. We here report the case of an immunocompetent patient with tuberculosis affecting the buttock characterized by lesions gummy in consistency revealing active pulmonary involvement. This study involved a 47-year-old man admitted for a painful swelling in the right gluteal region that had evolved for four years. Physical examination objectified a polyfistulized hardened plaque characterized by confluent nodules and discharge of yellowish pus in the lower and inner face of the right buttock associated with bilateral inguinal inflammatory adenopathies. The diagnosis of skin tuberculosis was retained based on histological examination which showed tuberculoid granuloma and the detection of Alcohol-Acid Resistant Bacilli (BAAR) in the gastric fluid. Thoracoabdominopelvic CT scan showed multiple bilateral basal lung micronodules with a "bud tree" appearance. Serologic testing for HIV and HBV were negative. The patient achieved recovery after six months of tuberculosis treatment. In endemic areas, skin tuberculosis is characterized by clinical polymorphism. It should be suspected in patients with perineal abscess lesion.

Summary Background The cosmetic use of bleaching products is common among women from sub-Saharan Africa. The most frequently used products are highly potent corticosteroids (clobetasol propionate) and hydroquinone. Herein, we report 8 cases of SCC in women using skin bleaching products for cosmetic purposes. Our aim is to describe the epidemiological, clinical and pathological aspects of the carcinomas observed during the course of skin lightening. Methods We conducted a descriptive multicentre study from August 2005 to January 2016 in three dermatology units in Senegal. We included all patients consulting for cutaneous squamous cell carcinoma associated with skin bleaching. Sociodemographic, clinical, paraclinical and therapeutic data were recorded. Results A total of 8 female patients were included. The mean age was 48.1 years (37–63 years). Topical hydroquinone and highly potent corticosteroids were the main products used over the whole body, for an average duration of 20.3 years. No pre-neoplastic skin disease was found in our patients. The clinical aspects of tumours were as follows: cauliflower-like (n = 4), ulcerated (n = 3) and nodular (n = 1). The average development time before consultation was 6.75 months. All the cutaneous squamous cell carcinomas were localized to lichenoid lesions or exogenous ochronotic lesions on photo-exposed areas: face (n = 1), neck (n = 3) or upper back (n = 4). The most common histopathological type was the infiltrating form and there was one case of in situ carcinoma. The outcome was favourable in six of eight patients after surgical resection. Two deaths occurred: one through tumour recurrence and the other through haemorrhagic shock. Conclusions From 2005 to 2016, eight cases of cutaneous squamous cell carcinomas associated with cosmetic use of bleaching products were reported in Senegal. The mechanism was not fully elucidated and further studies are necessary. These observations provide an additional argument for combating this practice and including skin bleaching among known risk factors for squamous cell carcinoma.

INTRODUCTION The distribution of extranodal NK/T-cell lymphoma (ENKTCL) is highly inhomogeneous throughout the world. In Sub-Saharan Africa, despite the precocity of Epstein-Barr virus (EBV) infection and its endemicity, ENKTCL remains exceptionally reported. The purpose of this study was to report the epidemiological, clinical, paraclinical, and evolutionary characteristics of ENKTCL at the Aristide LeDantec University Hospital in Dakar, Senegal. METHODOLOGY A 5-year retrospective review of all patients with histopathological, immunohistochemical, and in situ hybridization proven cutaneous lymphomas RESULTS: We collected seven cases corresponding to a frequency of 1.4 cases per year. ENKTCL accounted for 10.5% of all cutaneous lymphomas, ranking second after T-cell lymphomas. Men were predominantly affected (M : F ratio of 6), and the mean age was 38.5 years ± 4.06. The mean time before consultation was 7.3 months. The lymphomas affected primarily the nasal cavity in five cases and the skin in two cases. At admission, six patients had nasal mucosa involvement, which was isolated in three cases, associated with cutaneous lesions in three cases and lymph node involvement in three cases. CD56 was positive in only one case, and Eber transcribed RNA of EBV was expressed by in situ hybridization in all patients. DISCUSSION To our knowledge, we have reported the first and largest series of ENKTCL in Sub-Saharan Africa. Our study shows an intermediate prevalence between that reported from Asia, Latin America, and the West. It was also noted a young age of patients, a prolonged diagnostic delay, a frequent negativity of CD56 marker, and a very poor prognosis of the disease in our region.

Introduction La gale est une maladie tropicale negligee (MTN) qui touche entre 150 a 200 millions de personnes au monde. Nos objectifs etaient d’evaluer l’impact de la gale sur la qualite de vie (QDV) et d’evaluer le retentissement psychologique, social, professionnel et scolaire de la gale chez des patients consultant dans des services de dermatologie a Dakar. Materiel et methodes Il s’agit d’une etude longitudinale multicentrique prospective qui a ete menee du 18 aout au 19 decembre 2020, aux services de Dermatologie-Venereologie de l’Institut d’Hygiene Sociale, du Centre Hospitalier National Aristide Le Dantec, et du Centre Hospitalier National d’Enfant Albert Royer. Le diagnostic de gale etait retnu sur les criteres de l’IACS (International Alliance for the Control of Scabies) 2020. Les questionnaires Dermatology Life Quality Index (DLQI) et Child Dermatology Life Quality Index (CDLQI) etaient utilises. La saisie et l’analyse des donnees etaient effectuees grâce aux logiciels “IBM SPSS Statistics” version 26. Les tests du Khi 2 ou de Fischer etaient utilises dans leurs conditions d’applicabilite(p Resultats Nous avons inclus 104 patients atteints de gale âges de 2 mois a 80 ans (60 adultes et 26 enfants). Le sex-ratio etait de 0,8. Les troubles du sommeil etaient presents chez 81,3 % des patients. Le score moyen du CDLQI etait de 7,8 ± 3,49 (7–15). Le score moyen du DLQI etait de 8,1 ± 4,75 (6 et 16). Plus de la moitie des adultes avaient un effet modere a important sur la QDV. Le retentissement psychologique concernait aussi bien les enfants que les adultes (sentiments de tristesse chez 84,6 % des enfants et de gene et d’embarras chez 70 % des adultes). Chez les enfants, le retentissement concernait aussi la qualite du sommeil (80,8 %), et les activites de loisirs (53,8 %). Les femmes avaient un retentissement plus important que les hommes sur les relations sociales (60,5 % vs 18,2 %), les habitudes vestimentaires (57,9 % vs 18,2 %) et les activites quotidiennes (57,9 % vs 36,4 %) et de loisirs (52,6 % vs 45,5 %). Le retentissement sur les activites scolaires et professionnelles concernait plus les hommes que les femmes (54,5 % vs 29 %). Des liens statistiquement significatifs ont ete trouves entre la severite du score DLQI et le revenu mensuel moyen (p = 0,03), les troubles du sommeil (p = 0,002) et la depigmentation cosmetique volontaire (p = 0,04). La presence de consultations prealables etait significativement associee a la severite des scores CDLQI et DLQI (p = 0,04). Discussion Les troubles du sommeil etaient presents chez la grande majorite des patients. Le score moyen du CDLQI montrait que la moitie des patients avaient un effet modere a important sur la QDV. Plus des 2/3 des adultes avaient un score moyen du DLQI qui correspondait a un effet modere a important sur la QDV.

Introduction L’importance des manifestations dermatologiques dans le diagnostic des deficits immunitaires primitifs a ete deja rapportee par certaines etudes mais exceptionnellement en Afrique subsaharienne. Le but de cette etude est de decrire les manifestations dermatologiques au cours des deficits immunitaires primitifs sur peau noire. Materiel et methodes Il s’agit d’une etude de cohorte ouverte portant sur des enfants presentant des manifestations dermatologiques suspectes de deficit immunitaire primitif a l’hopital d’Enfant Albert Royer de Dakar. Le diagnostic de deficit immunitaire primitif est basee sur la classification phenotypique de l’union internationale des societes d’immunologistes. Resultats Vingt huit patients ont ete suivi dont 18 filles et 10 garcons. L’âge moyen etait de 7 ans (extreme = 4 mois et 18 ans). L’âge de debut des symptomes etait inferieur a 3 ans dans 17 cas, entre 3 et 10 ans dans 6 cas, superieur a 10 ans dans 5 cas. La medecine traditionnelle etait le premier recours therapeutique dans 26 cas. Les manifestations dermatologiques etaient : condylomes ano-genitaux (n = 9) ; maladie de Kaposi (n = 2), epidermodysplasie verruciforme (n = 2), varicelle maligne (n = 1), molluscum contagiosum tumoral dissemine (n = 1) ; Candidose bucco-oesophagienne (n = 1) ; mycetome fongique cervico-facial (n = 1) ; becegite disseminee (n = 1) ; tuberculose scrofuloderme (n = 1) ; lupus aigu (n = 3) ; vitiligo extensif (n = 1) ; syndrome PAA ou Pyoderma-Acne-Arthrite (n = 1) ; erythrodermie (n = 1) ; acrodermatite enteropathique (n = 2) ; lymphome cutane (n = 1). Les manifestations extradermatologiques etaient : sepsis (n = 4) ; arthrite (n = 4) ; diarrhee (n = 3) ; pneumopathie infectieuse (n = 2) ; pericardite (n = 1) ; calcifications cardiaques (n = 1) ; crises convulsives (n = 1), thyroidite auto-immune (n = 1) ; alteration de l’etat general (n = 7). Cinq cas ont beneficie d’exploration pour le typage immunologique du deficit. Cette exploration a revele : 1 deficit d’expression de la classe CMHII, 1 syndrome d’hyper Ig E, 1 deficit primitif en complement C2 et 2 deficits congenitaux en zinc. Apres 3 ans de suivi regulier de la cohorte, nous avons eu 4 perdus de vue, 3 deces dont 2 par sepsis et 1 par metastase de neoplasie, 1 cas d’aggravation de molluscum contagiosum tumoral et 7 cas de recidive de condylome. Discussion Ces resultats montrent le deficit d’exploration des deficits immunitaires primitifs dans notre contexte d’exercice et la diversite des manifestations dermatologiques revelatrices. Cependant, tous les cas qui beneficie d’un typage immunologique ont ete confirme, suggerant une tres grande sensibilite des manifestations dermatologiques pour le diagnostic des deficits immunitaires primitifs. Ce constat devra etre confirme par d’autres etudes.

The pyoderma gangrenosum (PG) is a chronic ulcerative neutrophilic dermatosis rare in children. It is often associated with chronic inflammatory bowel disease, some systemic diseases and leukemias. We report six cases in children. We collected six cases, the average age was 10 years (4-15 years), the sex ratio was 0.16 (5 boys and 1 girl). The ulcerated clinical form of PG was noted in all children. The topography was in the lower limbs in five cases and in the cephalic extremity in three cases. The mean duration of evolution was 2 years (15 days-7 years). PG was associated with ulcerative colitis in one case. Oral corticosteroids were administered in all cases at a dose of 0.5 to 1 mg/kg. The complete healing of the cutaneous lesions was obtained. Two children were lost to sight. Our study reports a male predominance of PG in children with ulcerative clinical form of the limb and association with ulcerative colitis. Corticosteroids appear to be efficient, but may be limited by their complications.

Introduction: The increase of both the frequency and severity of the bacterial dermohypodermitis (BDH) in Senegal suggests the existence of other risk factors outside of those classically known to be involved. Our study aimed to clarify the epidemiological, clinical and risk factors of BDH in Senegal.

Introduction: Bacterial dermohypodermitis (BDH) risk factors identified in the literature on series of national hospitals are: obesity, diabetes, lymphedema, venous insufficiency. We report a series in a regional hospital. Material and Methods: This was a retrospective study, conducted over a period of 9 years from 1 January 2007 to 31 December 2015. All data of patients received for BDH including. Socio-demographic, clinical, para-clinical and evolution variables was collected and analyzed using the Statistical Package for Social Sciences (SPSS) Version 20 software. Results: Of the 35,692 patients received in consultation, 425 had BDH (1.19%) and 33.7% were hospitalized. The mean age was 40.6 ± 17.02 years. The age groups 16-59 years were 81% of the cases. There was a female predominance (74%) with a sex ratio H/F = 0.35. The average time to consultation was 8.1 ± 9.5 days for BDH. The lesion were located in the lower limbs in 90.4% cases. The average hospital stay was 8.6 ± 4.7 days. Artificial skin bleaching (p = 0.003), non-steroidal anti-inflammatory drugs (p = 0.001), high blood pressure (p = 0.013), obesity (p = 0.028) were the risk factors identified in our series. Conclusions: Our series shows that the emergence of BDH also affects regional hospitals in West Africa. It also confirms that artificial skin bleaching, Non-steroidal anti-inflammatory drug, high blood pressure, obesity are aggravating factors.

Resume Introduction Les etiologies des intertrigos chez l’adulte sont multiples et variees. L’objectif de notre travail etait d’etudier les aspects epidemiologiques, cliniques, evolutifs et facteurs de risque des intertrigos chez les adultes. Methodologie Nous avons mene une etude prospective d’une duree de 7 mois dans deux services de dermatologie de Dakar. Ont ete inclus apres consentement tous les adultes presentant un intertrigo consultant durant cette periode. Resultats Nous avons recense 103 patients atteints d’intertrigo, soit une prevalence hospitaliere de 2,54 %. Le sex-ratio etait de 0, 63 et l’âge moyen de 41,9 ans. Les habitudes et modes de vie etaient une depigmentation artificielle dans 26 cas, une activite sportive pratiquee dans 22 cas, le port de vetements synthetiques et le tabagisme respectivement dans 20 cas et dans 22 cas. Des complications infectieuses etaient notees dans 9 cas (8,7 %). Elles etaient de type bacterienne (3,88 %) et virale (1,94 %). Une erythrodermie seche etait notee dans 3 cas (2,9 %). Les etiologies etaient dominees par les mycoses dans 48,5 %, les manifestations immuno-allergiques dans 34,9 %, la maladie de Verneuil et le psoriasis inverse dans chacun 2,9 %. Les femmes representaient 58 % des patients ayant une dermatophytie et 63 % des cas de candidoses. La depigmentation artificielle etait notee dans 35 % des cas de dermatophytie et 45 % des cas de candidoses. Conclusion Les intertrigos chez les adultes sont dominees par les etiologies infectieuses en particulier les mycoses et suivies des affections immuno-allergiques. Il existe des professions a risque et des terrains.

Introduction Au Sénégal, les études portant sur les tumeurs du cuir chevelu sont quasi inexistantes. Notre objectif était de déterminer le profil épidémiologique et anatomo-clinique des tumeurs du cuir chevelu en dermatologie. Méthodes Il s'agit d'une étude prospective, descriptive et analytique, réalisée sur une période de 16 mois (01 mars 2014 au 30 juin 2015), effectuée aux deux services de dermatologie de Dakar. La confirmation diagnostique était histopathologique. Résultats Nous avions colligé 36 patients dont 14 cas de tumeurs malignes et 22 cas de tumeurs bénignes. Le sex ratio était de 1:1, et l'âge moyen de 51 ans pour les premières et 39 ans pour les dernières. La fréquence hospitalière était de 0,18%. Le délai moyen de consultation était de 14 mois pour les tumeurs malignes et 52 mois pour les formes bénignes. Dans 11 cas de tumeurs malignes, le traitement traditionnel était le premier recours. Les tumeurs malignes étaient: carcinome épidermoïde (n=8), carcinome basocellulaire (n=3), lymphome, hidradénocarcinome et dermatofibrosarcome de Darier Ferrand (un cas chacun). Les tumeurs bénignes étaient: botriomycome (n=5), kyste trichilemmal, hamartome sébacé, cylindrome et lipome (2 cas chacun), et chéloide, syringocystadénome papillifère, schwannome, neurofibrome et nævus (un cas chacun). La malignité de la tumeur était associée à l'aspect ulcéro-bourgeonnant (p=0.003), au diamètre >4cm (p=0.05), à la douleur (p=0.009) et au saignement (p=0.006). Conclusion Les tumeurs du cuir chevelu, sur peau noire, sont dominées par les formes bénignes. Le carcinome épidermoïde est la tumeur maligne prédominante.

Les auteurs rapportent l'observation d'une maladie périodique diagnostiquée à l'aide de placards érysipélatoïdes récidivants et persistants sous antibiothérapie. L'interrogatoire, les tests génétiques et l'évolution favorable sous colchicine ont permis d'asseoir le diagnostic.

Introduction La pseudo-folliculite de la barbe (PFB) est une dermatose inflammatoire chronique, favorisee par le rasage, particulierement frequente chez les hommes de phototype VI, avec un important prejudice esthetique et professionnel. Malgre sa frequence, il existe tres peu d’etudes qui lui soit consacrees, a travers le monde et particulierement en Afrique sub-Saharienne. Notre objectif etait de determiner les aspects epidemiologiques et cliniques, ainsi que les facteurs de risque associes a la survenue de la PFB. Materiel et methodes Il s’agissait d’une etude prospective, longitudinale et descriptive a visee analytique, portant sur 655 eleves policiers, de phototype VI, consentants, de l’ecole nationale de police de Dakar. Le diagnostic de PFB etait clinique. L’exploitation des donnees a ete realisee a l’aide du logiciel Epi-info version 6.0 avec un test de Chi2 au seuil de significativite de 5 % et un odd-ratio > 2. Resultats Sur les 655 eleves policiers, 254 presentaient une PFB, soit une prevalence de 38,8 %. Il s’agissait de 242 hommes et 12 femmes (sex-ratio de 20,2), d’âge moyen de 26,80 ans (± 2,59) avec des extremes allant de 22 a 36 ans. L’âge de debut de la PFB se situait en majorite entre 18 et 20 ans (39,8 %) avec un âge moyen de debut de 22,2 ans (± 3,6). Les manifestations cliniques etaient le plus souvent a type de papulo-pustules (60,2 %). Des signes de penetration trans-epidermique etaient observes chez 27,9 % des patients. Le prurit etait present chez 66,1 % des cas. Les lesions se localisaient le plus souvent au niveau de la region sous-mandibulaire (69,8 %), la region mandibulaire (49,6 %) et la face anterieure du cou (44 %). Des complications etaient notees chez 90,1 % des cas a type d’hyperpigmentation post-inflammatoire (87 %) et de lesions cheloidiennes (3,1 %) et un retentissement psychologique chez 91 % des cas. L’existence de cas familiaux de PFB (p Discussion Il s’agit de la premiere etude realisee en Afrique sur la PFB. Elle revele une frequence elevee de la PFB chez les noirs africains. Une anomalie genetique revelee par le rasage doit etre evoquee dans la survenue de la PFB. D’autres etudes sur le plan genetique et immuno-histochimique seraient souhaitables.

Introduction: Xeroderma pigmentosum is a rare autosomal recessive genetic disease. This disease predisposes patients to early-onset skin cancers, particularly squamous cell carcinoma. Here, we report 3 pediatric cases, including 2 deaths. Observation: The subjects included 2 boys and 1 girl with skin type VI. All subjects were from consanguineous marriages, and the average age was 7.6 years. The patients all had ulcerative budding tumor lesions in the cephalic region, and the mean disease duration was 18 months. In all 3 cases, the diagnosis of xeroderma pigmentosum was made before the poikilodermal appearance of sun-exposed areas and photophobia. Neurological-type mental retardation was noted in 1 case. Histology confirmed squamous cell carcinoma in all 3 cases. The evolutions were marked by the death of 2 children (cases 1 and 3). In one case, the outcome was favorable following cancer excision and subsequent chemotherapy with adjuvant radiotherapy. Conclusion: Squamous cell carcinoma is a serious complication related to xeroderma pigmentosum in Sub-Saharan Africa. Prevention is based on the early diagnosis of xeroderma pigmentosum, black skin photoprotection, screening and early treatment of lesions, and genetic counseling.

Resume Introduction Au Senegal, les leishmanioses cutanees sont souvent dues a l’espece Leishmania major . L’immunodepression liee a l’infection par le virus de l’immunodeficience humaine (VIH) contribuerait a l’emergence de la leishmaniose chez l’homme et faciliterait l’infection de la peau par des especes a tropisme visceral. Nous rapportons la premiere observation senegalaise de leishmaniose cutanee opportuniste a Leishmania infantum sur un terrain d’infection par le VIH. Observation Un garcon de 5 ans avait depuis deux mois des ulcerations crouteuses du cuir chevelu et de l’avant-bras gauche, ainsi que des adenopathies cervicales et axillaires. L’examen parasitologique des lesions du cuir chevelu, du bras et des liquides de cytoponction ganglionnaire et medullaire mettait en evidence a l’examen direct des formes amastigotes de leishmanies. La technique d’amplification genomique pratiquee sur les substrats cutane, ganglionnaire et medullaire identifiait L. infantum comme l’espece responsable. La serologie retrovirale de l’enfant etait positive pour le VIH1. Le traitement antiretroviral combine a celui de la leishmaniose permettait d’obtenir une amelioration clinique. Discussion La co-infection leishmaniose cutanee a L. infantum et VIH constitue une association complexe de par ses enjeux therapeutiques. Les modalites evolutives, cliniques et biologiques de la co-infection dependent de la restauration de l’immunite ainsi que de l’efficacite, de la tolerance et de la disponibilite des medicaments anti-leishmaniens.

The authors report a case of multifocal African histoplasmosis with polymorphic skin involvement occuring in a patient without proven immunosuppression. He was a young 22-year-old patient from eastern Senegal - but born in Ouganda - who presented with polymorphic skin lesions: ombilicated papulo-nodules, gums and ulcerative and budding lesions. He showed lymphadenopathies without clinical inflammation and with a cheesy appearance of the biopsy but without tuberculosis and also hepatosplenic and bone involvement. Mycological samples of the skin and lymph nodes biopsies revealed yeasts of Histoplasma capsulatum var. duboisii with a positive culture on Sabouraud medium. HIV serology, HTLV1et 2, the serum proteins electrophoresis were unremarkable. Treatment with amphotericin B was irregular because of its inaccessibility in the national territory and its cost. The patient died of sepsis together with the aggravation of his disease.