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Syphilis reemerged in Martinique in 2004 and initially affected 3 HIV-infected patients. By March 2008, syphilis was diagnosed for 37 men and 18 women. As of October 31, 2009, this outbreak had not yet been brought under control. It initially affected mainly men who had sex with men before it spread to heterosexual persons, minority group members, and crack cocaine users.

Background Leprosy and vitiligo are common affections in the West Indies. Vitiligo frequently occurs in lepromatous patients, an observation rarely reported in the literature. Methods We studied the prevalence of vitiligo in patients affected by leprosy by performing a retrospective study between 1978 and 1999 in the French West Indies (Martinique). Results Eleven patients presented with vitiligo among 101 with lepromatous (multibacillary) leprosy. None presented with vitiligo among the 364 with the tuberculoid (paucibacillary) form. The mean age of the vitiligo patients was 55.4 years at vitiligo onset. The sex ratio was 0.8. Vitiligo occurred 19 years after the diagnosis of leprosy, with a range from 3 to 42 years. The prevalence of vitiligo in lepromatous patients was 10.9%, compared to 0% in tuberculoid patients. Such an increase in prevalence compared with that in the general population (0.34%) was shown to be highly significant (P

The epidemiology of melanoma in populations of African-European descent has rarely been reported. The authors studied melanoma in the French West Indies (Martinique), where black Caribbeans and whites represented 96% and 4% of the population, respectively. Among the 85 cases of melanoma collected from 1976 to 1995, blacks represented 75% and whites, 25%. The average incidence rates were 1.48 and 0.9 per 100,000 per year in females and males, respectively. The sole of the foot represented 72% of the primary sites in blacks. Breslow's tumor thickness was > 1.5 mm in 68% of the cases. The 5-year survival was 44%.

Introduction Devant une recente recrudescence des cas de syphilis en Martinique, nous en decrivons les caracteristiques epidemiologiques. Patients et methodes Tous les patients ayant eu une syphilis precoce nouvellement diagnostiquee entre le 1 er juillet 2007 et le 31 janvier 2008 au CHU et au dispensaire antivenerien de Fort de France ont ete inclus. Les donnees recueillies etaient : sexe, âge, mode de contamination, stade de la syphilis, statut serologique pour le VIH, usage de drogues (crack) et contexte social. Resultats 26 patients etaient inclus dont 13 hommes (50 %), d’âge moyen 40,1 ans (31-53) et 13 femmes (50 %), d’âge moyen 37,5 ans (28-46). L’orientation sexuelle etait : homo-bisexualite ( n = 3, un cas de prostitution) et heterosexualite ( n = 23, un cas de prostitution feminine). 4 patients presentaient une syphilis primaire, 15 une syphilis secondaire et 7 une syphilis latente precoce. 8 patients etaient co-infectes par le VIH (31 %). 11 patients etaient usagers de drogues. 8 patients etaient en situation de precarite. L’incidence brute etait estimee a 11,1/100 000 hab/an. Discussion L’incidence brute de la syphilis precoce estimee ici sur une courte duree est particulierement elevee en comparaison aux donnees nationales declaratives (InVS), et aux annees precedentes en Martinique. A l’epidemie qui existait depuis 2004 chez les hommes homosexuels infectes par le VIH se surajoute une epidemie en phase d’attaque, d’incidence elevee, de core groupe caracterise par toxicomanie - precarite - nombre eleve de femmes - prostitution, proche de l’epidemie guadeloupeenne de 2001 (BEH N° 48, 2002) et contrastant avec l’epidemiologie metropolitaine. Conclusion Ces donnees imposent une adaptation regionale des strategies de depistage et de prevention de la syphilis.