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Biomedical subjects

A Mahé

Publications and source records attributed to A Mahé.

At least 55 records · Page 3Linked to original sources
PubMed1996

Pemphigus in Mali: a study of 30 cases.

Pemphigus has been largely studied in developed countries (North America and Europe) and in Brazil. In these geographical settings, pemphigus presents two very different epidemiological and clinical patterns. Little is known about pemphigus in other regions of the world, particularly in Africa. We report here a study of 30 cases of pemphigus observed in Bamako, Mali. Our data suggest that pemphigus in this area presents a distinctive pattern. Our cases of pemphigus were diagnosed on the basis of clinical, histological and direct immunofluorescence studies. We estimated the annual incidence in the Bamako region to be 0.29 cases per 100,000 inhabitants. There was no endemic focus in Mali. The disease was observed mainly in women (24 of 30; 80%), especially those older than 40 years (mean age, 46.7 years), and in the Fulani ethnic group (10 of 30; 33%). Our study group was composed of 25 cases of pemphigus foliaceus (PF) (83%), four cases of pemphigus vulgaris and one case of pemphigus vegetans. Pustules with hypopyon were observed in 11 patients (37%). A diffuse verrucous change in the skin was noted in four cases of erythrodermic PF. In 16 patients with PF, localized verrucous lesions mimicking seborrhoeic keratoses were observed when oral corticosteroid treatment was decreased. Histopathological examination demonstrated eosinophilic spongiosis in 50% of patients. These data suggest that pemphigus in Mali differs from the two main known patterns of the disease: the North American/European one, and the Brazilian pattern, with which it shares the predominance of superficial forms but otherwise differs in many features.

Adult↗
PubMed1996

[Subcutaneous phycomycosis successfully treated with itraconazole].

INTRODUCTION: We report a case of basidiobolomycosis (subcutaneous phycomycosis), an uncommon deep mycosis in the entomophtoromycosis group. CASE REPORT: A 12-year-old girl presented a deep skin infiltration involving the back and buttocks. Histology reported filamentous formations without septa surrounded by Splendore-Hoepple phenomenon, the characteristic aspect of entomophtoromycosis. Outcome was favorable after treatment with itraconazole. DISCUSSION: Basidiobolomycosis is a deep mycosis rarely observed in children. Most reported cases have occurred in the tropics. The clinical presentation can simulate deep scleroderma or a tumoral disease. Treatment is currently based on imidazole derivatives which are particularly effective.

Adolescent↗
PubMed1996

[Leprosy differential diagnosis in 1996].

Due to a decrease in the prevalence of leprosy, discussion of its differential diagnosis assumes increasing importance. Research on the early diagnosis of leprosy, before the onset of nervous lesions, the appearance (or improved definition) of certain diseases and the expansion of intercontinental migration are some of the factors which have induced changes in the conditions of leprosy diagnosis. The most frequent and most sensitive differential diagnosis of leprosy have been reviewed: hypochromic diseases, tropical infections diseases, systemic diseases, deforming diseases, cutaneous lymphoma and AIDS. The difficulties posed by forms of leprosy revealed by reactional manifestations are stressed. Today, as in previous times, positive and differential diagnosis of leprosy is based on the following simple practices: study of lesion, sensitivity, bacilloscopy and the examination of the peripheral nervous system. Cutaneous histology is the complementary reference examination.

Diagnosis, Differential↗
PubMed1996

[Anatomopathologic study of five cases of leprosy in HIV seropositive patients].

In an effort to establish whether the human immunodeficiency virus (HIV) modifies the histological image of lepromatous skin lesion, a comparative study was conducted in 1994 at the Marchoux Institute in Bamako, Mali, on persons newly suffering from leprosy who had been tested seropositive and seronegative for the HIV virus. These new leprosy patients had never been treated and could be grouped as follows: 5 HIV-positive (1 TT, 1 BT, 1 BL, 2 LL) and 10 controls testing HIV-negative, selected according to the following criteria: each seropositive leprosy subject was matched with two seronegative controls having the same clinical features, same stage under the Ridley classification system, same age and sex. No discordance between the clinical classifications and the histological features in the subjects testing HIV-positive has been observed. They display features similar to those testing negative, with the presence of histiocytes, in particular epithelioid cells and giant cells in normal proportion depending on the form of leprosy. The only remarkable difference was a greater incidence of oedema in the subjects testing seropositive, compared with patients testing seronegative. In conclusion, HIV infection does not appear to cause major modifications in cellular response to Mycobacterium leprae, and no changes should be made in leprosy control programmes.

AIDS-Related Opportunistic Infections↗
PubMed1996

[Bullous IgA linear dermatosis of children in Mali].

INTRODUCTION: Bullous IgA linear dermatosis is relatively frequent in children in Africa. The aim of this study was to evaluate the frequency of this disease among autoimmune bullous diseases in children in Mali. PATIENTS AND METHODS: Children with chronic bullous disease seen at the Marchoux Institute in Bamako and for whom direct immunofluorescence of the perilesional skin demonstrated immunoglobulin and/or complement deposits were included in the study population. RESULTS: Twelve children were included. Direct immunofluorescence showed linear IgA deposit along the dermo-epidermal junction in 10, once with a pemphigoid aspect and once with a pemphigus aspect. The skin lesions in the children with linear IgA deposits were stereotypic: disseminated bullae, rosettes (9 out of 10), involving the external genital organs (10/10), the limbs, the face and the trunk. Histology showed subepidermal bullae (10/10), with neutrophil papillar abscesses (9/10). Indirect immunofluorescence of the cleaved skin NaCl in 5 patients showed that the cleavage always lied at the roof of the cleavage. All the children responded to dapsone (1 to 2.5 mg/kg/d) which gave complete (7/10), or incomplete remission. Local corticosteroids were used in 2 patients and general corticosteroids in 1. DISCUSSION: This confirms the frequency of bullous IgA linear dermatosis in Africa, in contrast with uncommon dermatitis herpetiformis. Diagnosis is facilitated with immunofluorescence. The low cost of this test makes it a useful diagnostic tool in these countries.

Autoimmune Diseases↗
PubMed1994

[Adult T-cell leukemia associated with HTLV-1 in a HIV-2 seropositive African].

INTRODUCTION: The aim of this report is to describe an HIV-2 seropositive patient from Mali who had adult-T cell Leukaemia/Lymphoma associated with HTLV-I infection. CASE REPORT: The patient presented with erythroderma and foliate lymphocyte leukaemia. Skin biopsy showed an epidermotropic lymphoma. Tumoural cells expressed a mature T-cell phenotype CD4+/CD25+. High anti-HTLV-I titers and the evidence of monoclonal integration of HTLV-I provirus within circulating lymphoid cells led to the confirmation of HTLV-I as the causal agent in tumour cell transformation. HIV-2 serology was positive. DISCUSSION: Sub-Saharan Africa is a vast reservoir of HTLV-I virus with at least 5 million infected persons. Cases of adult-T cell Leukaemia/Lymphoma in Africans are exceptional. Lack of sufficient knowledge of the disease could partially explain this discrepancy. The main differential diagnosis in dermatology is primary T-cell lymphomas of the skin, particularly mycosis fungoides and Sézary syndrome.

Adult↗
PubMed1994

[Dermatologic complications of the cosmetic use of bleaching agents in Bamako (Mali)].

OBJECTIVES: This study was conducted to determine the dermatological complications related to the use of bleaching agents in Bamako, Mali. Patients who were referred to the Marchoux Institute with complications were studied retrospectively. Over a period of 1 year, 74 complications were observed including acne (n = 25), infectious dermatoses modified by the application of local corticosteroids, and in particular dermatophytosis (n = 15), dyschromia (n = 11, including 3 cases of exogenous ochronosis), contact eczema, papular annular lesions and vibices. This pathology is frequent in Bamako and the diagnosis is quite difficult since the patients usually deny use of bleaching agents.

Adult↗
PubMed1993

[An epidemiologic survey on the cosmetic use of bleaching agents by the women of Bamako (Mali)].

In Mali, the cosmetic use of bleaching agents by black people has become a social phenomenon. How wide is this practice is not precisely known. We report the results of a survey conducted in Bamako among women aged from 15 to 45 years in order to evaluate the prevalence of this practice and its socio-economic factors. Two-hundred and ten women were questioned during the cluster survey. Among these, 53 (25 p. 100) used bleaching agents which were topical cortico-steroids (37), hydroquinone-containing products (21), mercury derivatives (11) and products of unknown composition (16). Dermatological side-effects were observed, but they did not hinder the use of these agents. Bleaching was particularly frequent in unmarried women (39 p. 100), literate women (34 p. 100) and female students (45 p. 100).

Administration, Topical↗
PubMed1992

[Deep venous thromboses in erysipelas of the leg. A prospective study of 40 cases].

The treatment of lover limb erysipelas rests on antibiotic therapy directed against streptococci, but the necessity of prescribing a concomitant anticoagulant treatment has not yet been established. The incidence of deep vein thrombosis in patients with erysipelas of the leg in unknown. In a prospective study of 40 patients presenting with this type of skin disease, we looked for deep vein thrombosis, using systematically pulsed Doppler vein exploration combined with ultrasonography and, if necessary, a second Doppler examination and a phlebography. Six cases of deep vein thrombosis were diagnosed. This complication was observed in 5 patients at high risk for deep venous thrombosis; it had never been foreseen at clinical examination.

Adult↗