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Background: Chronic exposure to sunlight is known to cause melanomas, cancers, and photoaging of the skin. The major risk factor associated with these conditions is chronic exposure to ultraviolet rays from the sun, and this can be mitigated with sun protective measures including frequent use of sunscreens as these are known to reflect or absorb these rays. The study aimed to assess the knowledge and prevalence of sunscreen use among undergraduate medical students in a university in Lagos, Nigeria. Methods: A descriptive, cross-sectional study was conducted among medical undergraduate students in the College of Medicine, University of Lagos. Data were collected through an online self-administered questionnaire from 273 participants across all the levels. Analysis was done using IBM SPSS version 26 for Windows. The data obtained were evaluated using the descriptive and parametric tests. Results: Most of the participants were knowledgeable about the sunscreen use. The mean percentage knowledge score was 69% ± 16.2%. This knowledge, however, did not translate into use as only 77; 28.2% of the participants currently used a sunscreen; out of which 83.1% (64) were females. The study showed that the most common reasons for not using sunscreens included no reason in particular, high cost, and not thinking it was necessary for black skin in 58%, 38%, and 26% of the respondents, respectively. Other methods of sun protection used more frequently among the respondents were sun avoidance, hats, and sunglasses. Conclusion: The prevalence of sunscreen use among medical students in Nigeria is low compared to other studies done in similar populations in the West and Asia. More enlightenment is needed to improve the awareness and practice of sunscreen use in young adults.

Introduction: Albinism is a genetic disorder of pigmentation with variable phenotypic presentations. Albinism occurs all over the world, with highest prevalence in sub-Saharan Africa. The most common type is oculocutaneous albinism (OCA), an autosomal recessive disorder. Albinism is associated with morbidity and mortality in Africans. This study aims to describe the epidemiology of OCA, clinical expressions, and effect on the quality of life (QoL). Methods: Individuals with albinism were invited through the albino foundations and dermatology clinic of Lagos University Teaching Hospital. Structured questionnaires were used to document demographic and clinical data: occupational history, sun exposure, sun protective behavior, knowledge of adverse effects of sun exposure, and QoL and features of photodamage. Results: A total of 142 Nigerians with albinism were recruited. The male to female ratio was 1:1.25. The median age was 22.5 and interquartile range 10.25 to 34. Knowledge of need for sun protection was found in 129 (90.8%): 81 (57%) had daily sun exposure and 61 (43%) had work exposure to sun. Use of sun protection was noted in 103 (72.5%). Overall, photodamage was found in 136 subjects (95.8%). Mean effect of albinism and photodamage on QoL was 6.34 ± 4.47 (standard deviation) corresponding to moderate effect on QoL and domain of “symptoms and feelings” was most affected. Conclusion: The prevalence of photodamage among people with albinism is high despite knowledge of sun protection. There is need for efforts on photoprotection by individuals with albinism and public health interventions.

Introduction: The scalp hairs on an average African is dry with low tensile strength and a tendency to break easily. This is mostly due to poor penetration of the natural oils on the scalp and the very curly hair texture. Various techniques developed to manage African hair are associated with certain hair and scalp disorders and are sources of distress. Objectives: This was a cross-sectional survey to compare natural African hair and chemically processed (relaxed) hair to determine the effect of hair care and grooming practices on common scalp disorders and the psychological effect in Nigerian women. Subjects and Methods: Questionnaires were administered to women at the market, churches and outreaches with many women in attendance to document the hair grooming practices, common scalp symptoms and psychological effects experienced. They were also examined for the presence of seborrhoeic dermatitis and traction alopecia. Results: The study involved 452 women (62.17%) with relaxed hair and 275 women (37.83%) with natural (untreated) hair. Women with relaxed hair experienced significantly more flaking of the scalp (P = 0.046, x2 = 6.16), hair breakage (P = 0.023, x2 = 11.35) and hair loss (P = 0.020, x2 = 7.87) than those with natural hair. The most common psychological effects of hair scalp disorders in all participants were feeling of uneasiness 142 (19.5%), frustration 49 (6.7%), poor body image 40 (5.5%) and anger 38 (5.2%). Significantly more women with relaxed hair experienced moderate hair loss from traction than women with natural hair (P = 0.014, x2 = 8.52). Conclusion: Nigerian women experienced clinical and psychological distress consequent to their hair grooming practices. Individuals with relaxed hair had more physical symptoms, hair loss and psychological disturbances than those with natural hair.

BackgroundType 2 diabetes mellitus (T2DM) is a disease of public health importance globally with an increasing burden of undiagnosed pre-diabetes and diabetes in low- and middle-income countries, Nigeria in particular. Pre-diabetes and diabetes are established risk factors for cardiovascular complications. However, data are scanty on the current prevalence of these conditions in Nigeria, based on haemoglobin A1c (HbA1c) diagnosis as recommended by the WHO in 2009. We aimed to determine the prevalence of pre-diabetes, diabetes, and undiagnosed diabetes among the adult population of Nigeria using HbA1c.MethodologyA cross-sectional, multi-site population study was carried out in selected states in Nigeria (namely, Ekiti, Lagos, Osun, Oyo, and Kwara states) involving 2,708 adults (≥18 years) in rural and urban community dwellers, without prior diagnosis of pre-diabetes or diabetes. Participants with ongoing acute or debilitating illnesses were excluded. Data were collected using an interviewer-administered pretested, semi-structured questionnaire. Socio-demographic, clinical (weight, height, blood pressure, etc.), and laboratory characteristics of participants including HbA1c were obtained. Data were analysed using STATA version 16.ResultsThe mean age of participants was 48.1 ± 15.8 years, and 65.5% were female. The overall prevalence of pre-diabetes and undiagnosed diabetes was 40.5% and 10.7%, respectively, while the prevalence of high blood pressure was 36.7%. The prevalence of pre-diabetes was the highest in Lagos (48.1%) and the lowest in Ekiti (36.7%), while the prevalence of diabetes was the highest in Kwara (14.2%) and the lowest in Ekiti (10%). There was a significant association between age of the participants (p< 0.001), gender (p = 0.009), educational status (p = 0.008), occupation (p< 0.001), tribe (p = 0.004), marital status (p< 0.001), blood pressure (p< 0.001), and their diabetic or pre-diabetic status. Independent predictors of diabetes and pre-diabetes include excess weight gain, sedentary living, and ageing. Participants within the age group 45–54 years had the highest total prevalence (26.6%) of pre-diabetes and diabetes.ConclusionOver half of the respondents had pre-diabetes and diabetes, with a high prevalence of undiagnosed diabetes. A nationwide screening campaign will promote early detection of pre-diabetes and undiagnosed diabetes among adult Nigerians. Health education campaigns could be an effective tool in community settings to improve knowledge of the risk factors for diabetes to reduce the prevalence of dysglycaemia.

Introduction: Public health awareness on sun-protection practices especially sunscreen use is established in developed countries compared with some other tropical African countries. Open-market traders in Nigeria, who typically have black skin, spend up to 8 hours in daylight with unprotected sun exposure. Aim: To determine prevalence of the knowledge of sunscreen use and to discover if adequate and appropriate sunscreen use is practiced by market traders. Methods: Cross-sectional study on 307 consenting traders at Sandgrouse Market in Lagos, Nigeria. Demographic data and responses to questions on sun exposure and its effects, knowledge and use of sunscreen, source of knowledge, and frequency of application were documented with a predesigned study questionnaire. Data were analyzed with SPSS 22. Results: More females (207; 67.4%) were observed and the mean age was 42.7 ± 12.8 years, though most were within the 35- to 39-year age range. One-third (102; 33.2%) were unaware that sun exposure could damage the skin and only 30 (9.8%) were aware of or knew what sunscreen meant. Commercials or advertisements were the most common source of knowledge and females were significantly more aware of sunscreens (P = 0.018). Conclusion: There is poor knowledge and awareness of the use of sunscreen among urban market traders in Nigeria who have prolonged unprotected exposure during their daily activities. Females were significantly more aware of sunscreens than males but there was no significant difference in the use pattern.

Background: The etiology and pathophysiology of chronic urticaria is poorly understood with several implicated factors. The role of autoimmunity has been explored by several studies with such studies on chronic urticaria lacking in the black population despite the significant morbidity caused by chronic urticaria. Aim: We assessed the possible contribution of autoimmunity in the etiology of chronic urticaria using autologous serum skin testing (ASST). Materials and Methods: Sixty consecutive patients with chronic spontaneous urticaria (CSU) with age- and sex-matched controls in a ratio of 2:1 had ASST done for comparison. Student's t-test and Chi-square were used to compare means and percentages, respectively. Results: The male:female ratio of CSU was 1:2.5 with females presenting more often. The ASST was noted to be significantly positive in patients compared to controls with a positivity rate of 68.3% in the former compared to 16.7% in the latter (P = 0.0001). A higher incidence of angioedema was also documented in patients with a positive ASST in association with urticaria (23/28, P = 0.04). Conclusion: Overall, we conclude from our study that autoimmunity may be a possible cause of chronic urticaria in Nigerians which may also be extrapolated to other black population. Patients with positive ASST may have more severe disease which may be important when educating and counselling the patients about the course of the disease. This study is the first to assess the possible role of autoimmunity in a predominantly black population and will serve as a baseline for future studies.

Background: Folliculitis keloidalis (FK) also known as acne keloidalis nuchae is a follicular scalp disease found predominantly in males of African origin. Studies suggested that FK is associated with hair care practices and shaving. This study aimed to determine the prevalence of FK in a community in Lagos. Methods: This was a community-based, cross-sectional study at the Sandgrouse market in Lagos Island, Nigeria. Self-administered questionnaires were used to obtain demographic and clinical information. Diagnosis of FK was clinical and included follicular and keloidal papules, pustules, nodules, and tumors at the nape, sometimes spreading to other parts of the scalp, with intense itching. Results: A total of 100 males and 207 women were enlisted in the study and clinically evaluated for features of FK. None of the female participants presented with history and clinical features of FK. Seventy-five percent were between the age of 30 and 60 years. Fifteen male participants had a prior history of FK on the scalp and eight had previous treatment. Examination revealed the presence of FK in four respondents (4%): 3 had only on the scalp and one had on both the scalp and the beard area; and none had keloidal lesions. Conclusion: All respondents with FK presented at the early stage with keratotic/follicular papules. We posit that self-treatment with antibiotics and triple action creams (consisting of potent steroids, antifungal, and antibiotic) sold in the market and over the counter is responsible for the early and mild presentation.

INTRODUCTION: Pregnancy is associated with many systemic changes mostly linked with hormones. The skin shows many of these changes as dermatoses - directly related to the pregnancy or an exacerbation/amelioration of a prenatal condition. A few of the pregnancy dermatoses can be fatal if unrecognised early. The aim of this study was to document the spectrum of pregnancy dermatoses and effect on quality of life of pregnant women presenting at the antenatal clinics of two tertiary hospitals in South west Nigeria. METHODS: a prospective observational cohort study carried out concurrently at the antenatal clinics of two tertiary hospitals: Lagos University Teaching Hospital (LUTH) and Olabisi Onabanjo University Teaching Hospital (OOUTH) over seven months. Consecutive patients filled questionnaires and had full dermatology examination by specialists with results documented and analysed with SPSS 21st edition. RESULTS: of 296 patients studied, 175; 59.1% first presented for antenatal clinic in the 3rd trimester. Most common symptom was itching (125; 42.2%) and 85.5% had signs of dermatoses. Atopic eruption of pregnancy (AEP) and pruritic urticarial papules and plaques of pregnancy were seen in (11; 3.7%) of patients. A background history of atopic dermatitis was significantly associated with AEP. The most common non-specific pregnancy dermatoses were acne vulgaris (129; 43.6%), superficial fungal infections (119; 40.2%) and melasma (55; 18.6%). CONCLUSION: skin conditions are common in pregnancy; fatal pregnancy dermatoses were not seen in this study.

Hansen´s disease (leprosy) is caused by a slow-growing type of bacteria called Mycobacterium leprae (M. leprae). It is an age-old disease that has been around since biblical times yet cases still occur especially in Asia and Africa, despite concerted global efforts to eradicate the disease. Chemotherapeutic agents are available and effective once administered appropriately and adequately. We report an elusive case of Hansen´s disease wherein the only symptom was a nodule on the nasal bridge in an otherwise healthy woman for over one year. Repeated examinations and investigations in different centers were suggestive of sarcoidosis and she was left untreated for leprosy for the period. A skin biopsy was carried out for histopathology diagnosis. Histology confirmed borderline lepromatous leprosy. This case demonstrates the need for a definitive diagnosis of leprosy to reduce the spread of this contagious disease especially in tune with the concerted global efforts.

Background: Epidermodysplasia verruciformis (EV) is a rare genodermatosis with autosomal recessive inheritance linked to human papilloma virus 5 and 8. It presents with flesh-colored or hypopigmented macules and plaques on the face, neck, hands, and body. They are asymptomatic but cause great cosmetic concern to affected individuals. An immune deficient state renders patients more susceptible to it; although some have no demonstrable ill health. Diagnosis is mostly clinical; nevertheless, skin biopsy for histopathology may be performed in doubtful cases. Treatment is aimed at cosmetic removal with retinoids, Imiquimod, and keratolytics among others. The aim of this report is to document the clinical profile of patients with EV, and highlight the challenges faced in managing patients. Materials and Methods: The clinical records from January 2006 to December 2013 were reviewed. Demographic data, HIV status, and biopsy results were extracted and entered onto Microsoft Excel spreadsheet. The results were analyzed with SPSS version 18. Results: A total of 33, 326 patients were seen during the review period; 96 (0.3%) had a clinical diagnosis of EV with 45 (46.9%) males and 51 (53.1%) females. The mean age was 20.8 ± 13.4, with a range of 2–52 years. A quarter of the patients were tested for HIV and 12 (13%) were positive. Conclusions: This study documents the frequency of EV in our environment and provides a baseline for more studies. The results concur with its rare occurrence worldwide and fail to show the exact relationship between HIV infection and EV. The challenges to managing these patients are mostly due to financial constraints; hence, basic investigations and optimal treatment could not be done in many of the patients.