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Background: Chronic ulcers of the lower limb (CULL) are characterized by non-healing skin loss, often associated with vascular, neurological, infectious, traumatic, or tumoral factors. These ulcers are prevalent, recurrent, severe, and have significant socio-economic implications. While Western data show a higher prevalence among women and the elderly, with varying rates (0.10% to 0.80%), developing countries, especially in sub-Saharan Africa, report a higher prevalence among young men due to infectious causes. Despite their impact, CULL often lacks attention from health authorities, resulting in delays in medical consultation. This study aims to share experiences in understanding the epidemioclinical aspects and management of CULL. Objective: The objective was to offer a comprehensive overview of the epidemiological and clinical characteristics and treatment strategies for chronic lower limb ulcers observed at the University Hospital Center of Dermatology in Bamako. Patients and Methods: Conducted at the Dermatology and Venereology Department of the University Hospital Center of Dermatology in Bamako, this cross-sectional study spanned a period from January to December 2021. It included 520 patients, with 22.1% having chronic ulcers of the lower limbs. Males (52.2%) were predominant, with an average age of 42.4 years. Trauma triggered 73.0% of the cases, and more than half waited over a year before seeking medical help. Bacteriological examinations revealed microbial infections in 67.8% of the cases. Results: There was a 22.1% prevalence of chronic lower limb ulcers among the 520 patients. Males represented 52.2%, with a median age of 42.4 years. Trauma was the primary trigger in 73.0% of the cases. Bacteriological examinations identified various infections, with 67.8% being infectious in origin. There were diverse characteristics in size, shape, and edge conditions of the ulcers. Trauma was the leading factor in 73.0% of the cases. Bacteriological examinations identified Gram-negative bacilli, Staphylococcus aureus, Streptococcus, with 67.8% of the ulcers being infectious in origin. There was outpatient treatment in 64.3% of the cases. Therapies included postural drainage, venotonics, vasculoprotectors, analgesics, compression stockings, and surgical interventions. Antibiotic therapy based on antibiograms for infectious ulcers. There was maintenance treatment with delayed penicillin in recurrent cases; successful skin grafting in 80.9% of cases, with 40.8% achieving complete healing in less than three months. [ABSTRACT FROM AUTHOR]

Introduction: To commemorate March 8, 2023 (International Women's Day), Natur'art engages in a vast caravan of awareness against the harmful effects of the act of depigmentation. Artificial depigmentation (AD) is the lightening of the skin using chemicals. The products employed are highly active corticosteroids, hydroquinone, as well as mercurial products such as soda. Artificial depigmentation is a practice that has emerged over the past three decades and has become one of the main reasons for dermatology consultations. In Mali, one in four women engages in depigmenting, and this phenomenon is not yet to stop as depigmentation products dominate the market. Objective: The main objective of this project was to make African women aware of the dangers of this practice and to make them aware that beauty is plural through the enhancement of the natural integrity of the skin and hair. Timeline of Activities: The awareness caravan on the harmful effects of artificial depigmentation was held at different places of the capital Bamako. The opening ceremony was held at the Bamako International Conference Centre (CICB) on Friday, March 26, 2023. The conference on the main theme followed by booth visits with the exhibition of artistic images of the skin of black African women and finally some high schools chosen on the basis of their high number of girls served as a place of awareness. The setup ended at about 8:10, and the actual ceremony began at 8:30. It was marked by three interventions. The first intervention was that of the Minister of Health and Public Health. The second was the presenter of Natur'art, Awa Bagayoko, who explained the initiative of the caravan, the innovative idea of Natur'art, consisting of preserving and enhancing the natural complexion of the African woman. There were a number of conferences about depigmentation. Conclusion: This awareness-raising caravan, the first of its kind in Mali, served as a motor to intensify the fight against this harmful practice that devalues black African women. [ABSTRACT FROM AUTHOR]

Herein, we report a case of thromboembolic disease occurring during endemic Kaposi's disease treated with bleomycin. Kaposi's disease is a vascular and fibroblastic disorder caused by human herpes virus type 8. The endemic form remains prevalent yet with a less severe prognosis. The first line of systemic treatment in our country is classically a monotherapy with bleomycin. This case of endemic Kaposi's disease was treated with bleomycin monotherapy that reportedly caused thromboembolic disease on two occasions after administration. This was one of the rarely reported effects of bleomycin in monochemotherapy, especially in the case of the treatment of endemic Kaposi's disease, considering the chronology of the appearance of this effect in your patient. [ABSTRACT FROM AUTHOR]

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Background: The increase in prescriptions of antiretrovirals (ARVs) implies the increasing occurrence of side effects, including skin manifestations. The objective of this work was to identify the epidemiological and therapeutic aspects of drug eruptions during ARV treatment in the support and counseling units (SCU) of commune IV of the district of Bamako. Material and methods: In a documentary study, the data of patients living with HIV (PLHIV) followed in the SCUs between January 2008 and December 2010, i.e. 3 years, in strict respect of their confidentiality were collected. Parameters of interest included epidemiological, clinical and therapeutic characteristics. Results: The frequency of drug eruptions was 2.85% of cases, ie 50 patients out of 1748 PLWHA. Women accounted for 76% of cases with a sex ratio of 0.32. The mean age was 30.8 ± 11.46 years with extremes ranging from 5 to 60 years. PLHIV were in WHO clinical stage III, or 48% of cases. The mean time to onset of drug eruption was 23.5 ± 17.7 days. Common clinical manifestations were pruritus (24%), rash (22%) and Lyell’s syndrome (12%). 96% of patients (48 cases) were on ARVs, of which 78% were on nevirapine and 14% on efavirenz. The treatment was symptomatic. Conclusion: Antiretrovirals are sources of drug eruption despite their benefits in the treatment of HIV/AIDS. Rigorous monitoring is essential to prevent these harmful effects. [ABSTRACT FROM AUTHOR]

Aim: To assess the COVID-19 patients' treatment duration according to the place of treatment at the Dermatology Hospital of Bamako (DHB)., Methods: This was a cross-sectional study comparing the management of COVID-19 PCR-positive patients in the hospital to that of those managed at home from March 2020 to April 2021 until two consecutive negative PCR 48 hours apart., Results: Among the 1109 patients, 369 were hospitalized, 497 followed at home. As of April 31, 2021, 81.2% (900/1109) of the patients recovered, 1.3% (14/1109) were transferred to another health structure, and 2.5% (28/1109) died. No statistically significant difference was observed between the mean duration of the treatment for patients treated at home (10 days) in (95% CI, 9.69-10.3) and those managed at hospital (10 days95% CI, 9.76-10.23) (Mantel-Cox test, p= 0.060)., Conclusion: These results suggest that the place of treatment do not influence the time to recovery. This is particularly important given the current burden of COVID-19 management on the health workforce., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Neonatal lupus is rare. It is due to the transmission of maternal autoantibodies across the placenta during pregnancy. We here report the case of a 2-month old female infant treated for erythematous macular cutaneous lesions on the face and the trunk. Her mother was followed up for dermatomyositis diagnosed on the basis of clinical lesions, muscle weakness and elevation in muscle enzyme levels. However she had not underwent antinuclear antibody test (ANA). Clinical examination showed atrophic erythematous lesions distributed like butterfly wings on both sides of the nasal pyramid, satellite lesions on the front, with red hair. The remainder of the physical examination was unremarkable. Laboratory tests were not performed because infant's parents also refused the biopsy. These lesions suggested seborrheic dermatitis, rosacea or atopic dermatitis. However, rosacea is very rare in infants and usually affects fair-skinned people. In seborrheic dermatitis, lesions are not atrophic. The age of onset of atopic dermatitis is usually 3 months. Lesions regressed in 15 days under dermocorticoid therapy.

In sub-Saharan Africa, in particular in rural areas, patients have limited access to doctors with specialist skills in skin diseases. To address this issue, a teledermatology pilot programme focused on primary health centres was set up in Mali. This study was aimed at investigating the feasibility of this programme and its impact on the management of skin diseases. The programme was based on the store-and-forward model. Health care providers from 10 primary centres were trained to manage common skin diseases, to capture images of skin lesions, and to use an e-platform to post all cases beyond their expertise for dermatologists in order to obtain diagnosis and treatment recommendations. After training, the cases of 180 patients were posted by trained health workers on the platform. Ninety-six per cent of these patients were properly managed via the responses given by dermatologists. The mean time to receive the expert's response was 32 h (range: 13 min to 20 days). Analysis of all diseases diagnosed via the platform revealed a wide range of skin disorders. Our initiative hugely improved the management of all skin diseases in the targeted health centres. In developing countries, Internet accessibility and connection quality represent the main challenges when conducting teledermatology programmes.