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.

Background This was a descriptive and prospective study that focused on 73 cases of delirium of skin infestation (DSI) from January 1st to December 31st, 2018, in the dermatology department of the Bamako Dermatology Hospital (HDB). Aim The aim of this work was to describe the epidemiological and clinical profile of delusions of infestation (Ekbom syndrome), to deepen our knowledge of the disease in order to improve its overall management. Methods We carried out a descriptive cross-sectional study of cases of identity document (ID) seen in dermatological consultation in the HDB dermatology department between January 1st and December 31st, 2018. Now, this department is the largest dermatological reference center in the country. In our study, we have included any patient with delirium of parasitic infestation (defined as an unshakeable conviction that small vermin, insects, lice, maggots, proliferate in the skin and sometimes in the body without biological proof). Results Delirium of skin infestation constituted 0.3% of consultations in the service. The average age was 52-years with extremes ranging from 12 to 85-years. They were 45 female (62%) and 28 male (45%). The age group (25-64) was the most represented. Out-ofschool patients represented 65% of the sample. Among them, 6 cases (8%) were known in psychiatry. The agents incriminated by the patients were mainly ants, earthworms and cicadas. The specimen sign was found in 89% of cases. Insomnia was the most frequent associated sign, at 75%. The types of lesion complications observed in our patients were mainly lichenification, ulceration and excoriation. Seventy-two percent (72%) of patients have refused referral to the mental health service. The profile of Ekbom syndrome was the one of the adult women, described in the previous work. Conclusion Delirium of skin infestation is generally considered as rare disease, increasingly observed during our dermatology consultations. Its frequency is probably underestimated.

This 33-year-old lady was hospitalised for systemic lupus and received corticosteroid therapy; upper limb edoema developed as a result. The interview revealed a theory of trauma related to a fall in the bathroom. During the examination, it was discovered that the patient’s overall health was quite poor and that her left upper limb was edematous, unpleasant to the touch, and covered in an erythematous plaque with blisters and a necrosis area. After 72-hours, ciprofloxacin, gentamycin, and amoxicillin antibiotic treatment had no noticeable effects. A bacteriological examination of the ulcer indicated the presence of Providencia stuartii, which is susceptible to cefotaxime but resistant to ciprofloxacin and amoxicillin. The biological evaluation revealed hyperleukocytosis (12,800 white blood cells/L), thrombocytopenia (103,000/L), and anaemia (9.1 g/dL). Following the administration of cefotaxime together with surgical debridement, apyrexia set in within 24-hours, and full recovery occurred three-weeks later. The search for atypical germs and the performance of an antibiogram must be mandated in front of an acute necrotizing dermohypodermatitis (AND) due to the odd location, the circumstances of the occurrence, and the clinical component.

Squamous cell carcinomas are favored by repeated sun exposure, especially in fair-skinned people who easily get sunburned. There are also genetic diseases including albinism which can promote their appearance early in life and multiple forms. We report the first observation of frontal squamous cell carcinoma with resection and reconstruction using the H-shaped flap in an albino (in Mali). Oculo -cutaneous albinism consulted for a frontal ulceration evolving for 3 years. The initial lesion was an erythematous macula which progressively evolved into a dragging ulceration. She had been treated with three sessions of cryotherapy (liquid nitrogen) without success. Physical examination found a slightly crusty ulceration, circumscribed (2 x 1.6 cm), painful and non-itchy. Otherwise the rest of the clinical examination was normal. A biopsy for pathological examination was performed. The diagnosis of invasive squamous cell carcinoma was confirmed. Surgical treatment was performed (resection and reconstruction with the H-shaped flap) with simple postoperative course and satisfactory results from an aesthetic point of view.

The objective of this study was to identify medicinal plants used for the skin protection of people with albinism, in the district of Bamako (Mali). Material and methods: Information was collected from members of associations of people with albinism using a questionnaire. The most cited plants were subjected to a bibliographic review. The chemical and anti-free radical components of Bixa orellana seeds were determined by color reactions and by thin layer chromatography. Results: In total, nineteen ( 19) medicinal skin protection. The most frequently mentioned plants were Khaya senegalensis (12 citations), Guiera senegalensis (10), Bixa orellana (8) and Vitellaria paradoxa (5). Carotenoids, mucilages, sterols, triterpenes and antifree radicals components have been characterized in extracts from the seeds of Bixa orellana. Conclusion: These extracts can be used to formulate products that will contribute to photoprotection, hydration and skin protection for people with albinism.