Mycetoma is a neglected tropical disease caused by various actinomycetes or fungi. The disease is characterized by the formation of tumor like-swellings and grains. Senegal is an endemic country where mycetoma cases are under-or misdiagnosed due to the lack of capacities and knowledge among health workers and the community; and where the management of eumycetoma, burdened by a high amputation rate, is currently inadequate. This study aimed to update data on the epidemiology of mycetoma cases diagnosed in three hospital centres in Senegal over a 10 years-period. A total of 193 patients, diagnosed from 2008 to 2018, were included in the study. The most frequent presentation was eumycetoma (47.2%); followed by actinomycetoma (36.8%); it remained undetermined in 16.1% of the patients. The mean age was 38.3 years (68.4% of the patients were between 15 and 45 years-old); the male: female ratio was a 2.94; and most were farmers. One hundred fifty-six (80.8%) patients had used phytotherapy before attending the hospital. Mycetoma was mainly located to the lower limbs (91.2%). Grains were observed in 85% of the patients; including white (25.6%) and yellow (4.3%) grains. The etiological diagnosis was complex, resulting in negative direct microscopy, culture and/or histopathology findings, which explains that 16.1% remained uncharacterized. In most of cases, actinomycetoma were treated with a combination of cotrimoxazole, amoxicillin/clavulanic acid, and streptomycin; whereas eumycetoma cases were treated with terbinafine. The surgery was done in 100 (51.8%) of the patients including 9 in actinomycetoma, 78 in eumycetoma and 13 in undetermined form. The high number of uncharacterized mycetoma in this study, the delay in attending a qualified health-care facility, and the lack of available adequate antifungal drug, point out the need to strengthen mycetoma management capacities in Senegal.
Hundreds of new leprosy cases are still diagnosed in Dakar despite all the efforts in the struggle by the national program for elimination of leprosy by the Institute of Applied Leprosy in Dakar. The aim of our study was to evaluate the epidemiological, clinicopathological and outcome of new cases of leprosy. A prospective study was conducted over a period of one year listing all new cases of leprosy based on clinical diagnosis, bacteriology and histology. 73 new cases were recorded. The sex ratio was 1.5 and the mean age of 39.5 years. Children aged from 0 to 15 years old represented 12%. The clinical forms were rated in order of decreasing frequency Borderline 47.94%, 30.13% lepromatous lepromatous, indeterminate 8.21, borderline lepromatous 6.84, TT: 5.47%, 1.36 and neurological bb%. Neurological signs were enlarged nerve in 50 cases, a neurological deficit in 16 cases and a sensitive deficit in 16 cases. The complications were burns and ulcerations in 10 cases, a claw in 7 cases, a reversal reaction in 7 cases, erythema nodosum in 4 cases and neuritis in 8 cases. The number of new cases mutilated was 24.65%. The smear was positive in 42% and histology contribution in 91.37% of cases. Our study highlights the significant number of patients with multibacillary contagious, affected children, the high proportion of disability grade 2/OMS reflecting the delay in diagnosis. This delay is due to ignorance, to traditional treatments and low socio-economic status and lack of trained diagnostic teams in different areas apart from referral centres.
The aim of our study was to determine the epidemiological and clinical aspects of vitiligo in the largest dermatology department of Senegal. A cross-sectional and descriptive study in a period of 5 months was performed covering all the vitiligo cases. Fifty patients were identified (26 women and 24 men). The mean age was 26.5 years. A family history of vitiligo was found in 11 cases and a psychoaffective disturbance in 6 cases. The clinical forms distinguished were generalized vitiligo (n = 33), localized vitiligo (n = 16), vitiligo universalis (n = 4), and segmental vitiligo (n = 1). The Koebner phenomenon was found in 7 cases. Associated diseases were atopic dermatitis (n = 2), contact dermatitis (n = 1), diabetes (n = 1), and Graves' disease (n = 1). The disgraceful character of Vitiligo was the predominance of generalized forms and the elective localization in sun-exposed areas. The family character, the psychoaffective disturbances, the Koebner phenomenon increased by the lifestyle and the itching dermatosis were the aggravating factors.
Background: Severe forms of psoriasis can be life-threatening for patients. Our objective was to determine the epidemiological, clinical, therapeutic aspects and outcome of severe forms of psoriasis. Methodology: A 18 years retrospective study conducted in the department of Dermatology at Le Dantec hospital listed all the severe forms of psoriasis. Results: We have collected 102 cases of severe forms. The sex ratio was 1.55 and the average age of 47 years.
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