Acne on Pigmented Skin: Epidemiological, Clinical and Therapeutic Features in Dermatology in Benin

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.

Squamous Cell Carcinoma over Cutaneous Verrucous Lichen: One Case in Parakou (Benin)

Introduction: We report an unusual case of squamous cell carcinoma on a verrucous lichen of chronic evolution taken in charge in Borgou/Alibori UHC in Parakou (Bénin). Observation: A 75-year old Beninese woman with a history of portal hypertension post-viral cirrhosis C treated with negative viral load, had consulted for a large chronic ulceration of the right foot back. The beginning of the symptomatology would go back to about 30 years, marked by lichenified, pruriginous popular lesions;these lesions would initially be treated as eczema and then mycosis by health personnel not specialised in dermatology and multitreated with unspecified topicals. General state was altered. In addition to ulceration, the dermatological examination found plates of hyperpigmented lichen lesion, homogeneous and well limited bilateral and symmetrical topography on the pelvic limbs making difficult to walk. Anatomopathological examination of the biopsy sample straddling the ulceration and its edges suggested a hypertrophic cutaneous lichen associated with keratinizing, infiltrating epidermal carcinoma. The chest-abdominal-pelvic scan showed no metastasis. A complete amputation of the right leg and knee was performed after a psychological interview. The follow-up was marked by an over-infection of the amputation stump by Escherichia coli, which was successfully treated. Healed, she is waiting for orthopedic equipment and possible chemotherapy. Conclusion: This clinical case indicates the need for adequate management of certain potentially precancerous dermatoses, in order to limit the progression to carcinogenic transformation.