Background: The combination of systemic pulse corticosteroids and methotrexate in the treatment of severe alopecia areata has never been reported. Objective: The objective of this work was to give arguments for the efficacy and safety of this combined treatment. Methods: This was a retrospective case series of patients treated with intravenous 500 mg methylprednisolone per day for 3 consecutive days monthly during 3 months plus methotrexate initiated at the end of the second pulse regimen. We reviewed all case notes of patients who received this regimen between January 1 2007 and December 1 2010. Results: Twenty patients were treated. Data on hair regrowth at month 12 were available for all patients; 14 patients were still receiving the treatment on December 1 2010, 2 patients were lost of follow-up, and 4 patients had stopped the treatment. Of the 14 patients who were still receiving the treatment regimen at month 18, 10 (10/20, 50%) had total hair regrowth and 4 (4/20, 20%) had incomplete but satisfactory hair regrowth. The treatment was well tolerated. Conclusion: The initial treatment by pulse intravenous corticosteroids may influence the overall response. This approach should be evaluated in a larger series of patients.

Background Keloids are a common presenting complaint in Black Africans but remain poorly documented in these populations. The aim of our study was to describe the epidemiological and clinical profiles of patients with keloids seen at dermatology outpatient consultations in Yaoundé (Cameroon) and to determine driving factors of keloid occurrence. Methods This was a 1 : 2 case–control study conducted from February to May 2016 at the dermatology unit of five health facilities in Yaoundé, Cameroon. Cases were patients with black skin and diagnosed with keloids while controls had no keloid scar, paired to cases according to age and sex. The diagnosis of keloid was based on clinical history and findings. Results Of 2,940 patients seen during the study period, 102 (54.9% females) had keloids, hence a prevalence of 3.5% (95% confidence interval [CI]: 2.8–4.2). The most affected age group was ≥25 years (69.6%). Lesions at the origin of keloids were mostly traumatic (66.7%). In 68 patients (66.7%), keloid scars were associated with pruritus. The presternal region was the predominant localization (26.5%). Existence of a family history of keloids was significantly associated with presence of keloids (adjusted odds ratio: 4.2, 95% CI: 2.4–7.2; P < 0.001). Conclusions Keloids commonly affect black skin as recorded during dermatology consultations in Yaoundé, Cameroon. More often, they are secondary to skin trauma and seem to occur among those with a family history of keloids. Therefore, these people should be closely monitored accordingly.

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Balanitis of Zoon (BZ) characterized by an important plasma cell infiltration occurs exclusively in uncircumcised men aged between 40-80 years. We report here a case of BZ in an HIV infected patient who was circumcised since birth. A 43-year old man consulted in 2009 for itchy and not painful glans erosion evolving for one year. He is HIV1 infected and has been under didanosine, lamiduvine and nelfinavir for three years. Under this treatment, his CD4 count increased from 26 cells/mm(3) in 2007 to 206 cells/mm(3) at the time of the consultation. We noted after examination clean burgeoning erosion, red in places, pink in other places, with fuzzy boundary, sitting on the glans and extending into the preputial sulcus. Histopathology showed infiltration by sheets of plasma cells with perivascular topography in the dermis. The bacterial cultures and syphilis serology were negative. We noted a good outcome after four weeks of application of 3% oxytetracycline ointment. This observation suggests that the BZ can occur on a HIV infected patient whether he was circumcised or not. Thus, it appears fair to think of BZ faced with a chronic erosion of the glans in HIV infected patient.

Introduction. Dermatological damage in chronic hemodialysis patients is not uncommon. In Benin, to date, no study on the dermatological manifestations of chronic hemodialysis patients has been carried out. However, the presence of cutaneous signs is evident in these patients, and the need for dermatological care is not negligible. The objective of this study was to identify the epidemiological and clinical profile of the main dermatological manifestations presented by chronic hemodialysis patients at the NTH-HKM of Cotonou (Benin). Methods. This was a descriptive cross-sectional study conducted in chronic hemodialysis patients from May 15th to September 15th, 2018. Included were all patients seen during the study period who had been on hemodialysis for at least three months, had at least one dermatological manifestation, and gave verbal or written consent. Chronic hemodialysis patients who did not wish to participate in the survey were excluded. Results. 87 patients were included in the study for a hospital frequency of 33.8%. The sex ratio (male to female) was 2. The median age was 49 years (IQ [40.75–59]). Median age in hemodialysis was 36 months with two weekly sessions. The main dermatological manifestations were xerosis (48.3%), pruritus (34.5%), alopecia (14%), nail dystrophy (9.2%), equisegmented nails (8%), and melanoderma (8%). Pruritus was associated with a longer duration of hemodialysis sessions p=0.01, while xerosis, alopecia, and melanoderma were associated with seniority in hemodialysis. Conclusion. Cutaneous manifestations in hemodialysis patients were frequent and dominated by xerosis, pruritus, and alopecia. Factors associated with some of these dermatologic manifestations were seniority in hemodialysis, long duration of the hemodialysis session, and female gender.

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Purpose: The aim of this work was to describe the epidemiological, clinical and therapeutic features of pigmented skin acne in Benin. Methods: This was a prospective, cross-sectional and analytical study conducted in the dermatology departments of the Borgou-Alibori Departmental Teaching Hospital and the National Teaching Hospital Hubert Koutoukou Maga from January 2017 to December 2018, which has included black-skinned patients who were diagnosed with acne and gave their free and informed consent. The ECLA score was used for clinical evaluation of the severity of the acne. Results: We collected 129 patients including 35 men and 94 women. The median age of the patient was 24.6 years ± 8.5 years. The median age of onset was 17.9 years ± 7.6 years. The main triggering of worsening factors was inadequate self-medication (53.5%), excoriation (48.1%), certain foods (34.9%) and lightening cosmetic (32.5%). Most patients had inflammatory (51.9%) or comedonal (31.8%) acne associated with post-inflammatory hyperpigmentations (70.5%) and excoriated lesions (31%). In the majority of cases, acne was moderate in women (52.1%) and severe in men (62.8%) with p = 9 × 10 −3 . The lesions were electively seated in the face (95.3%), mainly on the forehead and cheeks. Active cosmetics (76.7%), retinoids (58.9%), oral antibiotics (55.8%), and benzoyl peroxide (48.9%) were the most commonly used therapeutic classes. Conclusion: The majority of young and adult women consulted for predominant inflammatory acne on the forehead and cheeks, moderate in woman and severe in men in Benin. The therapeutic arsenal consisted mainly of active cosmetics, retinoids, antibiotics and benzoyl peroxide.