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K Tchangai-Walla

Publications and source records attributed to K Tchangai-Walla.

12 recordsLinked to original sources

[Factors associated with palmoplantar or plantar pompholyx: a case-control study].

BACKGROUND: Disydrosis or pompholyx is a chronic and recurrent form of dermatosis that poses a number of therapeutic issues. The etiopathology of the condition is unclear. The aim of this study was to identify factors associated with the palmoplantar and plantar dysidrosis. PATIENTS AND METHODS: This was a prospective case-control study conducted between June 2001 and February 2004 at the University Hospital of Lome (Togo). Each case (palmoplantar or plantar pompholyx) was matched for age (+/- 5 years) and sex with two controls. Examination for tinea pedis was performed in all participants (patients and controls) but mycologic culture alone was done in patients with interdigital-plantar intertrigo. RESULTS: One hundred patients with pompholyx were matched with 200 controls. Mean age was 32.8 +/- 14.8 years in the patient group and 31.4 +/- 14.8 years in the control group. For univariate analysis, the main factors associated with pompholyx were: personal atopy (OR = 12.6; CI95%: 6.4 - 25.1) and familial atopy (OR = 5.8; CI95%: 3.2 - 10.5); history of eczema (OR = 5.4; CI95%: 2.6 - 11.4); hyperhidrosis (OR=4.5; CI 95%: 5.5 - 40.7), sport (OR = 8.8; CI 95%: 3.9 - 20.8); tinea pedis (OR = 15.6; CI 95%: 7.5 - 32.9). In multivariate analysis, atopy (OR = 10.5; CI95%: 8.4 - 20.8) and tinea pedis (OR = 18; CI95%: 10.5 - 25.2) were the only factors associated with pompholyx. Trichophyton rubrum was the most common etiology of tinea pedis in both patients and controls. DISCUSSION: The results of this study show atopy and tinea pedis as factors statistically associated with palmoplantar or plantar pompholyx. However, only cohort studies can determine the precise causal relationship between tinea pedis and pompholyx.

Adult↗

[Stevens-Johnson syndrome and toxic epidermal necrolysis after intake of rifampicin-isoniazid: report of 8 cases in HIV-infected patients in Togo].

Dermatological reactions are frequent drug-related complications in patients with HIV infection. The most serious disorders are Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), a.k.a. Lyell's syndrome, that are potentially fatal. The purpose of this report is to describe 8 cases of SJS/TEN observed in Lomé teaching hospital (Togo) after intake of a combination of rifampicin-isoniazid by HIV-infected patients. There were 5 men and 3 women with a mean age of 28 years. All patients presented AIDS. The disorder was SJS in 3 cases and TEN in 5. In 6 cases, manifestations occurred during initiation of treatment (mean delay for onset, 16 days). In the remaining two cases, manifestations occurred 6 days and 8 days respectively after beginning treatment for recurrent tuberculosis. Mean skin detachment was 8% in patients with SJS and 55.7% in patients with TEN. Five patients including 4 with TEN and 1 with SJS died. This study documents incrimination of combined rifampin-isoniazid treatment in the occurrence of SJS/TEN in patients with HIV infection and confirms the severity and poor prognosis of these disorders. The presence of opportunistic infections such as pulmonary tuberculosis may be an unfavourable prognostic factor in immunocompromised patients with these severe dermatological disorders.

Adult↗

[Anogenital warts in young children in hospital consultation in Lome (Togo). Role of transmission by sexual abuse].

The purpose of this 20-month prospective study conducted in the dermatology department of Lomé Teaching Hospital was to determine the prevalence of sexual abuse in pre-adolescent children with anogenital warts. From May 1997 to December 1998, a total of 16 cases of anogenital warts were diagnosed in children under the age of 12 years. Sexual abuse was discovered in 8 cases. All 8 cases involved girls (mean age, 6.1 +/- 1.9 years). The mode of acquisition involved self-infection from non anogenital warts in three cases and contamination by the mother in three cases. In two cases the mode of acquisition could not be identified. The alleged abuser was a member of child's family in 3 cases, a household employee working at the child's home in three cases, a teacher in 1, and a neighbor in 1. Syphilitic tests were negative in all children. However HIV infection was detected and the contaminator was identified in one 10-year-old girl. The results of this study document the correlation between anogenital warts and sexual abuse. In Black Africa, the consequences of child sexual abuse, which is not uncommon especially in major cities, are aggravated by the high prevalence of HIV infection.

Child↗

[Prevalence of HIV infection in patients with pellagra and pellagra-like erythemas].

Pellagra is a systemic disorder caused by severe niacin deficiency. While uncommon in Europe and North America, pellagra and pellagra-like erythema are frequently encountered in undernourished adults in poor African countries. The purpose of this three-year prospective study was to determine the prevalence of HIV infection in patients with pellagra. Between 1996 and 1998, all documented cases of pellagra and pellagra-like erythema diagnosed in the Dermatology Department and Internal Medicine Department of the Teaching Hospital in Lome, Togo were included. Patients underwent screening tests for HIV infection. During the study period, pellagra or pellagra-like erythema was diagnosed in a total of 108 patients (59 women and 49 men) with a mean age of 41 +/- 3.5 years (range, 18 to 68 years). Serology tests for HIV were positive in 6 of these patients (5.5 p. 100; mean age 35 years). In four asymptomatic patients with no opportunistic infection, detection of HIV was an incidental discovery. The other two patients had AIDS symptoms. The principal causes of pellagra were malnutrition (n = 30), alcoholism (n = 15), and combined malnutrition and alcoholism (n = 60). The findings of this study suggest that the incidence of HIV infection in patients with pellagra and pellagra-like erythema is low, i.e., not higher than in the general population. This study also confirms previous etiologic and epidemiological data concerning pellagra in poor countries, i.e., the preponderant role of nutritional deficiency.

Adolescent↗

[Recurrent varicella and HIV infection. Apropos of 10 cases seen in Lomé].

Herpes-zoster is commonly observed in immunodepressed patients with HIV infection in Africa. It is due to reactivation of the varicella-zoster virus. Varicella which is usually considered as the acute invasive phase of infection can recur in the same subject during immunodepression, thus constituting recurrent varicella. Little information is available concerning recurrent varicella in Africa. The purpose of the present report is to describe 10 cases observed in 9 adults and 1 child in Lomé, Togo. In 6 cases recurrence of varicella allowed diagnosis of HIV infection. Clinical symptoms were severe with widespread lesions and fever-related changes in general status. Nine of the 10 patients required hospitalization. In all cases the illness lasted more than 3 weeks. This series demonstrates that varicella in adults can be the first clinical manifestation of HIV infection in tropical areas and that this possibility should be investigated especially if varicella is recurrent.

AIDS-Related Opportunistic Infections↗

[Venereal vegetations of the urogenital tract and their urological complications. Apropos of 257 cases].

A retrospective study was conducted during 8 years to determine the epidemiological features of condyloma and its complications in patients attending urology consultations in Lomé teaching hospital. During this period, 257 cases (218 males, 38 females) of condyloma were diagnosed. The condyloma represented the fifth cause of consultation in urology, after genito-urinary infection (n = 1214), prostatic dysuria (n = 1095), vesicovaginal fistula (n = 849), lower tractus urinary lithiasis (n = 500). The average age of the patients was 28 years (range: 14-57). In 51 cases the condyloma were associated with others sexually transmitted diseases: 25 cases of gonococcal infection, 11 cases of chancroid, 9 cases of vaginal candidiasis, and 6 cases of genital trichomoniasis. We noted 41 cases of urological complications: 19 cases of urinary infection, 13 cases of retention of urine, 7 cases of urinary forked jet, and 2 cases of urethrorrhagia. The results of this study shows that, the condyloma is commun sexually transmitted disease seen in urology clinic. Its classically benign course in patients males, were predominant, in this sex, by the urinary infection and urological mechanical accidents.

Adolescent↗

[Kaposi's sarcoma in dermatology consultations at Lome, Togo].

The purpose of this retrospective study conducted in a dermatologic out patient clinic in Lomé was to assess the epidemiologic, clinical, and prognostic profile of Kaposi's sarcoma in Togo during the 15 years period between 1980 and 1994. Only patients who had undergone serologic tests for human immunodeficiency virus (HIV) were included. There were 30 patients (27 men and 3 women) with a mean age of 35.2 years (range: 17 to 59 years). Thirteen patients were seropositive (epidemic Kaposi's sarcoma or EPK) and 17 were seronegative (endemic Kaposi's sarcoma or ENK). The mean age of patients with EPK was lower than that of patients with ENK (30.0 vs 42.3 years). Extensive (92.3%) and edematous (90%) forms and involvement of the upper extremities (66.7%), trunk (01.6%), and mucosa (92.3%) were characteristic clinical features of EPK while localized nodular forms (92.3%) were characteristic of ENK. A death was noted after 5 years of follow-up in the ENK group as compared to 12 deaths after a mean follow-up of 15.95 years in the EPK group. This study illustrates the current profile of Kaposi's sarcoma in Black Africa where HIV infection has greatly changed clinical findings and prognosis.

Adolescent↗

[Stevens-Johnson syndrome and toxic epidermal necrolysis in Lomé (Togo). Evolutional and etiological profiles of 40 cases].

INTRODUCTION: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous drug reactions, the prognosis of which largely depends on the quality of their treatment. The purpose of this study was to determine the evolutional and etiological profiles of SJS/TEN in a teaching hospital in Lome (Togo). METHODS: The medical records of patients hospitalized in the departments of dermatology and intensive care of the university hospital center of Lome for SJS/TEN from 1992 to 2001 were reviewed retrospectively. The records of patients retained corresponded to the international classification criteria of SJS/TEN. RESULTS: We collected 40 cases of SJS/TEN (27 cases of SJS, 12 cases of TEN and one overlap SJS/TEN). Patients' mean age was of 30 +/- 7 years. The sex ratio (male/female) was of 1.5 and the mean follow-up after hospitalization was of 2 months (range: 4 weeks to 8 months). The HIV serology was known in 20 cases (13 cases of SJS and 7 cases of TEN). It was positive in 10 cases (5 during TEN and 5 during SJS). Five of the 12 patients (41.7 p.cent) exhibiting NET died (all were HIV-infected) versus 2 of the 27 patients (7.4 p.cent) exhibiting SJS (2 patients were also HIV-infected). The principle drugs incriminated were: antibacterial sulphonamides (16 cases; 40 p.cent), rifampicin-isoniazid combination (7 cases; 17.9 p.cent), anti-epileptics (5 cases; 12.5 p.cent); amino-penicillin (4 cases; 10 p.cent) and non-steroidal anti-inflammatories (2 cases; 5 p.cent). Chinese drugs of undetermined nature were incriminated in 3 cases of SJS. No drug was formally identified in 3 cases of SJS. DISCUSSION: This study confirms the rareness of SJS/NET. These affections are of poor prognosis, particularly in developing countries. The results of this study suggest that the concomitance of an opportunist infection due to HIV-immunodepression is of poor prognosis in the evolution of SJS/NET. Antibacterial sulphonamides and the rifampicin-isoniazid combination are frequently incriminated in Togo.

Adult↗

[Non-tumor dermatoses diagnosed in the pathologic anatomy laboratory of the Tokoin University hospital center, Lomé (Togo)].

The non-tumorous skin diseases are common in hospital consultation in tropical countries. These infections constitute a great health problem in black Africa. Their diagnosis is often clinically easy, but sometimes histologically examination is necessary to have the positive diagnosis. In Togo, a retrospective study conducted during ten years, allowed to note 516 cases of non-tumoural dermatosis which were histologically diagnosed. The principal infections were: inflammatory dermatosis 339 cases (213 cases were not specific against 108 specific cases predominated by leprosy: 82 cases), epidermal dermatosis (97 cases, predominated by eczema and psoriasis), dermal lesions (44 cases), lesions of dermic and epidermic junction (23 cases), hypodermic (13 cases). The results of this study shows the diversity of non-tumorous dermatosis diagnosed by the histology. The eradication of these diseases in Africa needs to have efficient laboratory diagnosis and research means in every country.

Dermatitis↗