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Mendrika Fifaliana Rakotoarisaona,1 Tsiory Irintsoa Razafimaharo,1 Naina Harinjara Razanakoto,1 Fandresena Arilala Sendrasoa,1 Anne Ducournau,2 Christine Devalland,3 Anne-Sophie Dupond,2 Irina Mamisoa Ranaivo,4 Lala Soavina Ramarozatovo,1 Fahafahantsoa Rapelanoro Rabenja1 1Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar; 2Department of Dermatology, Nord Franche-Comté Hospital, Trevenans, France; 3Department of Pathology, Nord Franche-Comté Hospital, Trevenans, France; 4Department of Dermatology, University Hospital Morafeno, Toamasina, MadagascarCorrespondence: Mendrika Fifaliana Rakotoarisaona, Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Rue Dr Davioud Jacques, Antananarivo, 101, Madagascar, Tel/Fax +261 34 61947 34, Email lulubslj@gmail.comIntroduction: Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease. Neoplastic and infectious etiologies must be ruled out. IGM is a diagnostic challenge for countries with high tuberculosis endemicity like Madagascar since it may clinically and radiologically mimic breast tuberculosis. We report a case of IGM associated with erythema nodosum in a Malagasy.Case Report: A 29-year-old primiparous woman came to a dermatological consultation for typical erythema nodosum lesions that appeared one month after a breast swelling. She had no particular medical history. Examination revealed typical erythema nodosum lesions on the legs, voluminous tender mass in the right breast. Bacteriological samples and tuberculosis test were negative. Imaging showed mastitis on the right breast with no evidence of malignancy. Histology revealed a non-caseating granulomas on the lobule of the right breast. As part of an etiological work-up, COVID-19 serology was performed with a positive IgG antibody. The diagnosis of IGM associated with erythema nodosum was evocated. The evolution was favorable under systemic corticosteroid therapy.Discussion

Fandresena Arilala Sendrasoa, Tsiory Iarintsoa Razafimaharo, Samson Leophonte Ramily, Lala Soavina Ramarozatovo, Fahafahantsoa Rapelanoro Rabenja Department of Dermatology, Faculty of Medicine, University of Antananarivo, Antananarivo, 101, MadagascarCorrespondence: Fandresena Arilala SendrasoaDepartment of Dermatology, Faculty of Medicine, University of Antananarivo, Antananarivo, 101, Madagascar, Email nasendrefa@yahoo.frAbstract: The treatment of parotid hemangiomas has posed a challenge. A male infant presented with large hemangioma of the right parotid gland diagnosed at the age of 3 months. Starting at the age of 4 months, he was treated with oral propranolol for 10 months, which led to a marked reduction in tumor size and strawberry hemangioma. Our case shows that propranolol is effective and safe in treating large parotid infantile hemangioma.Keywords: large parotid hemangioma, propranolol, infantile

Fandresena Arilala Sendrasoa, Irina Mamisoa Ranaivo, Arifetraniaina Julia Raherivelo, Fahafahantsoa Rapelanoro Rabenja, Lala Soavina Ramarozatovo Department of Dermatology, Faculty of Medicine, University of Antananarivo, Antananarivo, MadagascarCorrespondence: Fandresena Arilala SendrasoaDepartment of Dermatology, Faculty of Medicine, University of Antananarivo, Antananarivo, MadagascarEmail nasendrefa@yahoo.frBackground: Long-term oral corticosteroids have an important role in dermatological care in Madagascar. However, significant adverse effects have been associated with continuous exposure to oral corticosteroids.Objective: We aim to assess the adverse effects of long-term corticosteroid therapy in patients seen in the Department of Dermatology at the University Hospital Joseph Raseta Befelatanana Antananarivo (UH/JRB), Madagascar, and to identify the risk factors associated with these adverse effects.Methods: A cross-sectional study was conducted during 4 months to assess the adverse effects of long-term corticosteroid therapy in patients seen in the Department of Dermatology. Patients treated with oral corticosteroids for more than 3 months were included in our study.Results: The prevalence of long-term use of oral corticosteroids in the Department of Dermatology of UH/JRB was 34.28%. A total of 51 patients were included and adverse effects occurred in 64.70% of this population. Repetitive infections and cutaneous adverse reactions were the most frequent adverse effects, in 23.52% and 11.76% of cases, respectively. There were no correlations between age, gender, type of disease treated, the molecule used or daily dose and the risk of adverse effects. Patients who received a corticosteroid dose of more than 40 mg daily (longer than 3 months) or a high cumulative dose of corticosteroids had a high risk of adverse effects.Conclusion: Repetitive infections and cutaneous adverse reactions are the most frequent adverse effects of long-term oral corticosteroid use.

Fandresena Arilala Sendrasoa, Volatantely Tobiniaina Ratovonjanahary, Naina Harinjara Razanakoto, Mendrika Fifaliana Rakotoarisaona, Onivola Raharolahy, Malalaniaina Andrianarison, Irina Mamisoa Ranaivo, Viviane Estelle Mbotinirina, Moril Sata, Lala Soavina Ramarozatovo, Fahafahantsoa Rapelanoro Rabenja Department of Dermatology, Faculty of Medicine, University of Antananarivo, Antananarivo, MadagascarCorrespondence: Fandresena Arilala SendrasoaDepartment of Dermatology, Faculty of Medicine Antananarivo, Antananarivo 101, MadagascarTel +261 341420496Email nasendrefa@yahoo.frBackground: Several studies have been done to evaluate the relationship between month of birth and atopic diseases but the results are contradictory.Objective: We aim to evaluate the correlation between the month of birth and the prevalence of AD in Malagasy children less than 3 years.Methods: A case-control study was conducted based on patients’ data of the department of Dermatology in the University Hospital Joseph Raseta Befelatanana (UH/JRB) Antananarivo. It included 438 children less than 3 years seen in this department between January 2010 and December 2019. For each atopic dermatitis (AD) patient, two age-and sex-matched controls without a history of AD were selected from the same period.Results: This study included 146 AD cases and 292 non-AD controls. Our case-control study found that there is a statistically significant correlation between birth month and risk of AD in Malagasy children < 3 years. Compared with people born in December, people born in April had the highest risk of AD (OR: 2.11, 95% CI 0.93– 4.78), followed by people born in March (OR: 1.52, 95% CI 0.79– 2,88). Asthma, allergic rhinitis and allergic conjunctivitis were significantly correlated with AD in our patients.Conclusion: Our case-control study found that being born in April and March (dry season) may be associated with an increased risk of AD.Keywords: birth month, atopic derma

Introduction: The Dermatology Department of the University Hospital Center of Befelatanana in Antananarivo deals with both outpatient and inpatient dermatoses. Two outpatient studies were conducted in 2001 and in 2006. But, this will be the first for Madagascar regarding hospitalization. So our aim is to determine the epidemiological-clinical profile of dermatoses seen in hospitalization.Patients and methods: This descriptive retrospective study was conducted from 1 February 2006 to 28 February 2012 in Dermatology department at the University Hospital Befelatanana. The register of hospital consultants and files were used to fill out data collection form.Results : We collected 286 patients seen in the Dermatology department. The mean age was 37.70 years (5- 98 years) with a sex ratio 0.49. Our study showed the importance of autoimmune diseases (33.3%) that are dominated by systemic lupus erythematosus (n = 51). It is a serious chronic pathology evolving by push. The management of severe toxidermia (25,1%) is done in hospital as in any other country. The mean duration of hospitalization was 34 days. The mortality rate was 3.49%.Conclusion: The serious forms of dermatological pathologies require management in hospital.

Introduction: Therapeutic compliance is the adequacy of the patient's behavior regarding medical recommendations. In Madagascar, No survey has not yet been published in that regard. Thus, our purposes are to determine the compliancy rate of patients with chronic diseases in dermatology and to identify the factors affecting their therapeutic compliance.Methods: Monocentric descriptive and retrospective study performed in the dermatology department of Joseph Raseta Befelatanana University Hospital center, On a 6 months duration, among patients with chronic dermatoses.Results: We counted 133 patients with a compliancy rate of 35.34%. Several parameters particularly age, gender, educational level, salary, understanding of pathology and treatment, duration of follow-up, were considered and correlated with the rate of compliance to assess factors of good and bad compliance.Conclusion: In order to improve the therapeutic observance in care unit, It is necessary to intervene on the standard of living of the patients suffering from chronic dermatoses and to promote the therapeutic education accompanied by psychological support to make them understand their pathology as well as the appropriate treatment.

Introduction: Lupus erythematosus is a serious autoimmune inflammatory disease. Mucocutaneous manifestations are themain clinical manifestations, so our aim is to determine the different cutaneous manifestations of lupus erythematosus in Antananarivo.Methods: A retrospective study was conducted over a period of 5 years from January 2007 to December 2011 in the medical derpartment of Joseph Raseta Befelatanana University Hospital.. All patients who presented lupus erythematosus were included.Results: Among 57,509 patients seen in Joseph Raseta Befelatanana University Hospital, sixty seven cases of lupus erythematosus were included. The mean age was 35.08 years [minimum: 9; maximum: 69 years]. The sex ratio was 0.06. Among these 67 patients, forty six presented cutaneous manifestations (68, 65%). As specific lesions in lupus, chronic cutaneous lupus was observed in 47.82%, acute cutaneous lupus in 30.43% and subacute cutaneous lupus in 06.52% of patients. The other dermatological manifestations found were alopecia in 52.17%, photosensitivity in 43.47%, Raynaud's phenomenon in 17.39% and bullous lesions in 06.52% of patients.Conclusion: A little difference was found in epidemiological, clinical and paraclinical aspects in lupus Malagasy patients and Africans. Lupus erythematosus is still a under-diagnosed disease in Madagascar. A deeper understanding of the cutaneous manifestations of SLE is essential for diagnosis and prognosis