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Introduction: Though chloroquine derivatives are used in the treatment of coronavirus disease 2019 (COVID-19) in many countries worldwide, doubts remain about the safety and efficacy of these drugs, especially in African communities where published data are scarce., Methods: We conducted an observational prospective cohort study from April 24 to September 03, 2020, in Burkina Faso to assess (as primary outcome) the clinical, biological, and cardiac (electrocardiographic) safety of chloroquine or hydroxychloroquine plus azithromycin administered to COVID-19 patients. The main secondary outcomes were all-cause mortality and median time of viral clearance., Results: A total of 153 patients were enrolled and followed for 21 days. Among patients who took at least one dose of chloroquine or hydroxychloroquine (90.1% [138/153]), few clinical adverse events were reported and were mainly rash/pruritus, diarrhea, chest pain, and palpitations. No statistically significant increase in hepatic, renal, and hematological parameters or electrolyte disorders were reported. However, there was a significant increase in the QTc value without exceeding 500ms, especially in those who received chloroquine phosphate. Three adverse events of special interest classified as serious (known from chloroquine derivatives) were recorded namely pruritus, paresthesia, and drowsiness. One case of death occurred. The average onset of SARS-CoV-2 PCR negativity was estimated at 7.0 (95% CI: 5.0-10.0) days., Conclusion: Hydroxychloroquine appeared to be well tolerated in treated COVID-19 patients in Burkina Faso. In the absence of a robust methodological approach that could generate a high level of scientific evidence, our results could at least contribute to guide health decisions that should be made based on different sources of scientific evidence including those from our study., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Rouamba et al.)

Loa loa filariasis is usually found in the forest areas of Central and West Africa. We report a case that was diagnosed in Ouagadougou (Burkina Faso), a savanna area. The patient lived in Gabon but was visiting his family in Ouagadougou. He complained of fatigue, fever, itchy legs with scratch marks, and intermittent edema of the legs. A blood smear was first examined for malaria parasites, but Loa loa microfilariae were observed. Laboratory tests showed hypereosinophilia (30%). Transient angioedema (Calabar edema) was observed. Loa loa filariasis was diagnosed based on these findings. There were no other laboratory test abnormalities, and ophthalmological examination was normal. The patient received a single dose of ivermectin at 200 µg/kg. After 1 month, the patient's course was favorable and a control blood smear was negative., (© 2020 The International Society of Dermatology.)

Introduction: in Burkina Faso, the only epidemic focus of cutaneous leishmaniasis confirmed in the literature by lab tests was in Ouagadougou. We report the epidemiological, clinical and biological results of the assessment of a new epidemic focus in Larama in western Burkina Faso., Methods: camps were used to receive patients. Sociodemographic and clinical data were collected using a questionnaire. Confirmation was based on microscopy and polymerase chain reaction (PCR)., Results: a total of 108 suspected cases have been identified in Larama, reflecting an attack rate of 5.8%. Sex ratio was 1.08. The patients were most often farmers (35.2%) and traders (33.3%). The working population (15-49 years old) accounted for 51.9%. The number of lesions varied between 1 and 5 in 91.7% of the cases. The lesions manifested as raised and infiltrated ulcerative lesions on the limbs (87%) with evolution ranging from 1 to 5 months in 96.3% of the cases. Samples were collected from two patients; microscopy showed leishmanias and PCR confirmed Leishmania major., Conclusion: our results confirm the presence of a cutaneous leishmaniasis major outbreak in the western part of the country. Additional surveys are needed to clarify the burden of leishmaniasis in Burkina Faso., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts., (© Issouf Konate et al.)

Angiomas are vascular abnormalities that affect less than 1% of the world's population. Data on these disorders in Africa are limited. The purpose of our work was to study the epidemiological and clinical aspects of angiomas in the Dermatology-Venerology Department of the University Hospital of Yalgado Ouedraogo in Ouagadougou (Burkina Faso) to contribute to improving knowledge of this group of pathologies in our region. This cross-sectional descriptive, retrospective, and prospective study covers cases from 1998 through 2014. We identified 61 patients with angioma, 67.2% of them younger than 30 months. The sex ratio was 0.56. Vascular tumors (hemangiomas) accounted for 43 cases (70.5%) and vascular malformations 18 (29.5%). Lesions appeared between 0 and 15 days of life in 57.4% of cases. Their size ranged from 1 to 3 cm in 49.2% of cases. They were most frequently located on the head (49.2%). The most frequent clinical forms were cutaneous hemangiomas (tuberous) (36 cases), followed by the nevus flammeus (8 cases), and mixed hemangiomas (7 cases). Only one complex forms was observed: one case of Klippel-Trenaunay syndrome. Superficial vascular abnormalities are rare in our dark skin type context including infantile hemangiomas. The clinical peculiarities of the angiomas observed in this African series in Ouagadougou seem quite similar to the characteristics described in European and American series.

Introduction: Ekbom syndrome is a rare disease characterized by a delusional conviction on the part of the patient of infestation with cutaneous parasites. It is rarely described in an African setting. Herein we report three cases observed in Ouagadougou., Patients and Methods: Case 1: a 40-year-old housewife, living alone since her spouse left her, consulted for a feeling of insects under the skin and exulceration progressing over the previous year. A diagnosis was made of Ekbom syndrome in a depressed patient. Case 2: a 45-year-old bachelor, unemployed and with no children, consulted in dermatology for a sensation of continuous movement of insects under his skin, experienced over the previous six years. This sensation, which was worse in hair-covered areas, led to regular hair removal and untimely cleansing in a bid to dislodge them. Case 3: an 80-year-old patient, widowed for 3 years, consulted for a sensation of insects under her skin over the previous 2 years. This sensation was accompanied by intermittent pruritus and she removed the "insects" from her skin, which she brought to us in a sachet, but which in reality corresponded to debris of dead skin. We concluded on Ekbom syndrome in a depressive patient., Conclusion: These three cases of delusional parasitism observed in Ouagadougou, Burkina Faso, confirm the main clinical characteristics of Ekbom syndrome and underline the role of emotional and financial isolation, as well as pre-existing psychological difficulties, as potential triggers for this syndrome., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Background: Ecthyma gangrenosum is an acute ulcer necrotic skin infection frequently caused by Pseudomonas aeruginosa. It is characterised by necrotic ulcerations circumscribed by an inflammatory halo. Lesions are normally found in the anal, genital and axillary regions. Ecthyma gangrenosum is most commonly seen in immunodepressed patients (cytotoxic chemotherapy, HIV infection, neutropenia or functional neutrophil deficiency, agammaglobulinemia). It is a rarely described complication in chicken pox., Patients and Methods: Herein we report the case of a girl aged 2 ½ years presenting in our dermatology department with ecthyma gangrenosum on the right upper eyelid secondary to varicella. The disease course was marked by fibrous scarring of the inner canthus with ptosis of the right upper eyelid. The retractile scarring caused disability., Discussion: There have been previous reports of the contribution of non-steroidal anti- inflammatory drugs (NSAIDs) to the appearance of necrotic cutaneous super infections during the course of chickenpox. The occurrence of such complications on an eyelid may be harmful not only for the function of the eye but it can also cause extensive aesthetic impairment. Subsequent aesthetic and functional impairment may be improved by corrective surgery., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Background: Through the story of two families presenting ichthyosis, we report the support and social integration difficulties inherent in these genetic diseases., Patients and Methods: Family No. 1: a 38-year-old shepherd and his wife of 25 years both had lamellar ichthyosis that had been present continually since childhood. They had had 2 stillborn infants as well as a live newborn that were all presenting lamellar ichthyosis. Family No. 2: a 45-year-old housewife was seen at our consultation with her 3 youngest children aged 8 years, 6 years and 18 months. According to the mother, at birth, all 3 children were covered with a membrane resembling plastic that crackled during movement, and they had red eyes. Examination of the 3 children revealed a clinical picture of lamellar ichthyosis with ectropion, malformed ears and brachydactyly. Although they presented delayed growth and weight development, psychomotor development was normal. There was no consanguinity between the parents., Discussion: In both families, the visible nature of the dermatosis resulted in discrimination and ostracism. The precarious living conditions of the parents and the high cost of treatment in an African setting resulted in degradation of quality of life with exacerbation of the difficulties of social integration, resulting in a lack of schooling and a bleak future for these children., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Pedicure-manicure represents the aesthetic care of hands, feet and nails. In Burkina Faso, the use of manicure-pedicure products, the techniques used and the level of risk remain unknown. The aim of our study was to evaluate the practice of manicure-pedicure in the city of Ouagadougou. We conducted a descriptive cross-sectional study of all practitioners with at least six months experience in aesthetic care and customers present at the time of the survey from December 2010 to November 2012. We interviewed a total of 313 practitioners and 313 clients. The average age of practitioners was 19 years and of customers was 32.2 years. Fixed location practitioners were mostly women (96.87%) while mobile practitioners were mostly men (68.37%); 64.53% of customers were women. The percentage of practitioners who did not receive professional training was 93.92%. 29.7% of practitioners soaked the instruments in javel water for at least ten minutes; 75.71% knew that the use of certain tools was dangerous and 26.51% had side effects. 40.25% of customers knew that the used equipment may pose some risks and 30.35% were victims of accidents. The manicure and pedicure is done in hair salons by untrained hairdressers to the professional practice. The origin and composition of the products is not known. Not recommended products are used (foot soak shampoo, razor blade and scissors for feet scraping). The use of manicure and/or pedicure is sometimes necessary but that should not obscure the risks to which it exposes customers. Customers education and practitioners training seem necessary to minimize risks.

Mycetoma is a bacteriological or fungal infectious disease affecting the skin and/or soft tissues, which can be complicated by bone involvement. The most common feature is a tumor of the foot, but extrapodal localizations have been described. We report one case of a 47-year-old man who presented with tumefaction of a leg with multiple skin fistulae. Histopathological examination permitted to confirm the diagnosis of actinomycetoma and TDM showed the degree of bone and soft tissues involvement. Our case was characterized by the very inflammatory aspect of the tumor, its localization to the leg without foot involvement, the modest functional signs compared to the importance of radiological bone involvements, the deep destruction of the fibula while the tibia was apparently intact and the good response to treatment. In spite of its characteristic features, diagnosis of mycetoma is still late in our country, often with bone and/or articular spread. Priority may be given to measures for reduction of mycetoma diagnosis lateness., (Copyright © 2015. Published by Elsevier Masson SAS.)

Objective: The fight against fungal infections in prisons is within the overall framework of the fight against these diseases in the general population. To contribute to the fight against these diseases, we conducted this study among inmates of the big prison of Ouagadougou. It aimed to analyze the epidemiological and etiological aspects of superficial fungal infections among prison inmates in Ouagadougou., Materials and Methods: It was a matter of an analytical descriptive study (December 2011-April 2012) that examined 212 selected using a stratified sampling detainees. It consisted firstly of a survey on risk factors. Secondly, samples were taken from prisoners with suspicious lesions of superficial mycoses. For each lesion, some fragments were examined directly between slide and coverslip in KOH (10% or 30%). The remaining fragments were cultured on Sabouraud-Chloramphenicol and Sabouraud-Chloramphenicol-Actidione. The media were then incubated at 27°C for 1 month before declaring any negativity., Results: The overall prevalence of superficial fungal infections among prison inmates Ouagadougou was 25.5%. The recent prison inmates (≤24 months) were the most affected (89.8%). Dermatophytes (15.56%) were more isolated than non-dermatophytes (12.26%) Anthropophilic species predominated among dermatophytes: T. mentagrophytes (7.0%), T. rubrum (3.3%), M. langeronii (23%), E. floccosum (1.41%) and T. violaceum (0.94%). M. gypseum (0.47%) was the only land-based species encountered. Non-dermatophytes were Malassezia sp. (11.79%) and Candida sp. (0.47%). Polyparasitism was less represented (7.4% of infected prisoners). Several body sites were mostly infected by one fungal agent. Pityriasis versicolor was the most common fungal infection (37.31%)., Conclusion: Considering the results, specific control measures are to be taken against the superficial fungal infections in prisons and in the general population., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Histoplasmosis is a fungal infection due to Histoplasma capsulatum. The African form of this mycosis, caused by Histoplasma capsulatum var. duboisii, remains rare. We report a case of disseminated African histoplasmosis with skin, lymph nodes, bones and viscera localizations. The 22-year-old patient was HIV-seronegative and was considered immunocompetent. The presence of Histoplasma capsulatum var duboisii in ulcerations and a nodule pus aspiration was confirmed by direct microscopic examination and by culture. The medical treatment was based on fluconazole. Even though a regression of the symptoms was observed, the patient died. In disseminated African histoplasmosis, an early laboratory diagnosis must be carried out for accurate treatment., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

It is a retrospective study in the Service of Dermatology at the University Hospital Center Yalgado Ouédraogo of Ouagadougou (C.H.U.-YO). This study aimed to list the leishmaniasis clinical cases reported in the registers of this department from January 1999 to December 2007. In total, 251 leishmaniasis clinical cases have been reported. The hospital prevalence was 1,1%. Women represented 53% versus 47% men. The average age of patients was 22,78 ans +/- 121. The most frequent clinical forms were those often crusted (40.2%), papulo ulcerative (16.7%) and papulonodular (13.9%). Lesions most often sat on the lower limbs (33%) and thoracic limbs (45%). On the therapeutic level, the first line treatment meglumine antimonite (Glucantime) accounted for only 25.9% of prescriptions.

Objective: The purpose of this study was to document the clinical profile, etiologies, and outcomes of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in hospitals in four sub-Saharan African countries., Patients and Methods: A retrospective study on cases of SJS/TEN treated in dermatology departments and/or intensive care units in four sub-Saharan African countries (Benin, Burkina Faso, Central African Republic, and Togo) from 2000 to 2010. The study focuses on variables such as age, sex, type of SJS/TEN, epidermal detachment of the skin surface, HIV status, drug(s) involved, and outcomes (death and sequelae)., Results: This study identified 177 cases of SJS/TEN from 2000 to 2010: 129 with SJS; 37 TEN; and 11 overlapping SJS/TEN. The average age of patients was 32.3 ± 15.4 years, and the sex ratio (M/F) was 0.6. HIV serology was positive in 69 (54.8%) of the 126 patients tested. Antibacterial sulfonamides (38.4%) were the most commonly used drugs followed by nevirapine (19.8%) and tuberculosis drugs (5.6%). We recorded 22 deaths (i.e. six cases of SJS, 15 of TEN, and one of overlapping SJS/TEN). Of the 22 patients who died, 16 were infected with HIV; among them, seven had an opportunistic infection (four cases of cerebral toxoplasmosis and three of pulmonary tuberculosis). Twenty-seven cases of sequelae were noted with a large part of eye complications., Conclusion: This study has highlighted: (i) the high proportion of patients infected with HIV among patients who had SJS/TEN in sub-Saharan Africa; (ii) the high frequency of antiretroviral drugs as new SJS/TEN causes in sub-Saharan Africa; and (iii) the impact of HIV infection on morbidity and mortality of these affections., (© 2013 The International Society of Dermatology.)

Introduction: Mansonella perstans is a genus of filaria that is often asymptomatic or responsible for unspecific symptoms. M. perstans microfilariae are uncommon on cervicovaginal smears., Case: We report the case of a woman with pruritis and eosinophilia. Microfilariae of M. perstans were observed on both cervicovaginal and blood smears. The patient was successfully treated with a combined single dose of 400 mg of albendazole and ivermectin (150 μg/kg)., Conclusion: We described here an atypical and rare localization of M. perstans. The routine examination of cervicovaginal smears of women admitted to Bobo-Dioulasso Hospital for screening of cervical neoplasia should allow us to determine the frequency of this parasitosis and propose appropriate treatment.

Aims of the Study: To study the prevalence of neuromeningeal cryptococcosis since the availability of antiretroviral drugs and to determine the epidemiological profiles, clinical and biological treatment of neuromeningeal cryptococcosis cases diagnosed in the service of parasitology and mycology of university hospital center of Bobo-Dioulasso from 2002 to 2010., Patients, Material and Methods: We included all patients diagnosed with neuromeningeal cryptococcosis for which the presence of the fungi was observed on microscopic examination of cerebrospinal fluid after staining with Indian ink. Data were collected from the registers of the clinical service and from the laboratory of the university hospital center of Bobo Dioulasso., Results: The prevalence of neuromeningeal cryptococcosis was 1.8% (61/5129). A decrease in the prevalence was observed from 2002 to 2010 (3.1%, to 0.2%). This decrease occurred even though the number of patients treated with antiretroviral drugs increase. Headaches were the predominant clinical signs (81.9%). The CD4 median count was 56/mm(3). All patients were successfully treated with fluconazole in relay to amphotericin B intravenous. Lethality rate is 27.8%., Conclusion: The overall prevalence of 1.8% of neuromeningeal cryptococcosis observed in this study was lower than that in previous studies in the same laboratory in 2001. The arrival of antiretroviral drugs could have contributed to the decline in the prevalence of neuromeningeal cryptococcosis in this study., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Background: Darier's disease is a rare disease. Multiple clinical forms have been observed, but the psychosocial aspects in Africa are rarely described. We report three cases involving difficulties regarding social integration., Observations: Case no. 1: a 19-year-old woman consulted for hyperchromic, greyish, keratotic papules, grouped in small plaques scattered all over the body. She had trouble finding a husband and was rejected by her peers. Case no. 2: a 20-year-old woman presented generalized keratotic, vegetative lesions. She was rejected by her husband because of the lesions. Like patient no. 1, she was unable to purchase her prescribed treatment. Case no. 3: a 33-year-old blacksmith presented Darier's disease with lesions on the interscapular region and chest. He was epileptic and depressive and was partly rejected by his family., Discussion: Darier's disease, diagnosed on the basis of anatomoclinical factors, had a major impact on the social integration of all three patients. These generalised disfiguring forms of the disease adversely affect the quality of life and their association with neuropsychiatric disorders is another major handicap., Conclusion: Difficulties concerning social integration and therapeutic problems must be considered in the management of Darier's disease in Africa., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Background: Burkina Faso achieved the leprosy elimination as a public health problem but this benefit was being lost. So, the National Program for Fighting against Leprosy has defined a strategy to reverse this situation. The aim of this survey was to evaluate the performance of the national program in the execution of this strategy in the region of "Hauts Bassins" (Burkina Faso) from 2005 to 2009., Method: The survey was led through the five sanitary districts of the region. It consisted in interview with the mean actors of leprosy control program and the analysis of the data notified on the leprosy cases, in order to estimate the progression of the key indicators of detection and follow-up care for patients having leprosy., Results: During the survey period, 248 cases of leprosy were recorded including 236 new cases and 12 relapses. The prevalence of leprosy was 0.28 per 100 000 inhabitants in 2009. The detection rate decreased from 3.77 per 100 000 in 2005 to 2.75 per 100 000 in 2009. Among the 236 new cases of leprosy, 194 (82.2 %) were multibacillary form (MB). MB patients proportion increased from 69,3 % in 2005 to 91.1 % in 2009. The proportion of children was on average 3.8 %, the one of female cases 38.9 %. Newly diagnosed cases with grade 2 disabilities moved up from 21.4 % in 2005 to 42.2 % in 2009. The completion of cure rate was globally 88.26 %. The losts from follow-up among the patients who started multi-drug therapy were 7.14 %., Conclusion: The aim of the leprosy elimination as a public health problem is achieved but some challenges may be taken up, particularly in the organization of leprosy detection by the heath structures.

Background: Leishmaniasis covers three well-individualized clinical variants, each due to individual species found in different geographic areas. Herein we report the first case of cutaneous leishmaniasis due to Leishmania major involving bone marrow in an AIDS patient in Burkina Faso., Case Report: A 38-year-old HIV-positive man presented with generalized, copper-coloured, painless, infiltrated, itching, papulonodular lesions present over the previous 10 months. Skin biopsy confirmed the diagnosis of diffuse cutaneous leishmaniasis. The bone-marrow smear showed numerous leishmania. The culture was positive and L. major was identified. The patient was being treated with antiretroviral medication and a pentavalent antimonial compound. The disease progression consisted of attacks and remissions separated by an average of three weeks., Discussion: L. major is the Leishmania species identified in Burkina Faso. It is responsible for typical cutaneous leishmaniasis but particular clinical forms have been described in immunodeficient patients, especially with diffuse cutaneous involvement. The spread of L. major infection to bone marrow could represent a public health problem in our country, where the HIV epidemic is still not under control, and particular vigilance is thus called for.

Cysticercosis is an infection resulting from the larval form of the pig tapeworm, Taenia solium. The subcutaneous localizations are frequent and can have serious consequences such as neurological attacks. We report six cases among whom five men and a woman, in order to point out the severity of the disease and its possible dissemination. The patients' age was ranging from 25 to 57 years old. Three of them had neurological complications as convulsions and headaches. The nodules were painful in one case. We recommend sanitary education to eradicate the affection and to sensitize patients in order to consult physicians at early stage.

Conidiobolomycosis is a deep, rare mycosis, due to Conidiobolus coronatus which is a saprophyte of vegetation in decomposition. We report one case in Burkina Faso. A 17 years old man, shepherd, consulted for tumefactions on the face. It could date back insidiously to a traumatism, one year before. A month later some painless tumefactions appeared on the cheekbone, the right eyelid, the nose with epistaxis. The upper lip then the lower one had swollen. Dermatological exam revealed multiple, painless, hard, sub-cutaneous swellings, affecting the cheekbone, the eyelids, the root and the ala of the nose. This tumefaction sometimes adhered to underlying tissues and to the overlying skin, sometimes mobile; painless and hard swelling of the two lips was also noted. ENT exam showed an inflammation of the nasal mucous without ulceration and the permeability of the nasal tracts was subnormal. The cephalic tomodensitometry showed a thickness of the soft tissues of the lips and the nose with an infectious feature associated to a pansinusitis without bone lesion. Histology was in favour of conidiobolomycosis. The patient was treated with fluconazole and the swelling progressively disappeared. Conidiobolomycosis is a disease generally reported in some humid tropical countries. It begins in the nasal cavities leading then to a nasal obstruction. This case was singular by the fact it happened in a dry Sudano-Sahelian climate and by its clinical features.

The main aetiology of human arsenic toxicity provide from natural geological source. The characteristic skin lesions of arsenic toxicity may be used as an indicator of high exposure. We have registered 45 cases. The age bracket was one to 70 years. We have registered 27 women (60%) and 18 men (40%). The cutaneous manifestations have been dominated by the palmo plantar hyperkeratosis and hyperpigmentations (77,8% each one). The urinary concentrations of arsenic were 13 microg/l to 212 microg/l; they were 69 to 101 microg/l in the drinking water localized in the golden area, however they were normal outside this area. The clinical features were similar with the description of the literature. Intoxication of drinking water is problem of public health and we recommend checking all the other golden areas to find some appropriate solutions.