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Potenciais fatores associados a maior chance de recidiva de erisipela. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao02822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Chamli A, Jaber K, Ben Lagha I, Malek BS, Rabhi F, Doss N, Dhaoui MR. Factors associated with acute and recurrent erysipelas in a young population: a retrospective of 147 cases. LA TUNISIE MEDICALE 2021; 99:886-889. [PMID: 35261016 PMCID: PMC9003589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND erysipelas is a common infection of the superficial layer of the skin, predominantly caused by groups A β-hemolytic streptococci. It is an acute infection of the skin and frequently affects the legs. It is common in the elderly and favoured by the associated comorbidities. Its occurrence in young healthy people is rare. AIM The present study aimed to elucidate factors associated with acute and recurrent erysipelas in a young population. METHODS We retrospectively analyzed 147 cases of erysipelas admitted to the dermatology department of the Military Hospital of Tunis, Tunisia, over 18 years, identifying factors associated with recurrence. All patients were aged less than 35 years. RESULTS During the study period, 147 patients were registered with the diagnosis of erysipelas. There were 125 military soldiers and 22 non-military patients. The prevalence of erysipelas was 2.23%. The median age was 25 years. Almost 86.2% of patients were male. The main favorable factors were: obesity (9%), alcoholism (8%), chronic venous insufficiency (6.5%), chronic lymphedema (3%), leg fracture (2%), and diabetes mellitus (1%). The lesions were mostly located in the lower limbs in 94.9%. According to our multivariate analysis, there was an association between recurrence and diabetes mellitus (p=0.02), female sex (p=0.004), onychomycosis (p=0.004), and plantar dyshidrotic eczema (p<0.005). CONCLUSION Identifying factors associated with recurrent erysipelas in a young population remains essential for proposing primary and secondary prevention measures.
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Affiliation(s)
- Amal Chamli
- 1- Hôpital Militaire de Tunis, Université de Tunis El Manar/ Faculté de médecine de Tunis
| | - Kahena Jaber
- 1- Hôpital Militaire de Tunis, Université de Tunis El Manar/ Faculté de médecine de Tunis
| | - Imen Ben Lagha
- 1- Hôpital Militaire de Tunis, Université de Tunis El Manar/ Faculté de médecine de Tunis
| | - Ben Slimane Malek
- 1- Hôpital Militaire de Tunis, Université de Tunis El Manar/ Faculté de médecine de Tunis
| | - Faten Rabhi
- 1- Hôpital Militaire de Tunis, Université de Tunis El Manar/ Faculté de médecine de Tunis
| | - Nejib Doss
- 1- Hôpital Militaire de Tunis, Université de Tunis El Manar/ Faculté de médecine de Tunis
| | - Mohamed Raouf Dhaoui
- 1- Hôpital Militaire de Tunis, Université de Tunis El Manar/ Faculté de médecine de Tunis
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Pitché P, Diata AB, Faye O, Tounkara TM, Niamba P, Mouhari-Toure A, Ly F, Soumah MM, Some-Korsaga N, Akakpo AS, Diané BF, Cissé M, Niang S, Traore A, Saka B. Risk factors associated with necrotizing fasciitis of the lower limbs: A multicenter case-control study. Ann Dermatol Venereol 2021; 148:161-164. [PMID: 33558036 DOI: 10.1016/j.annder.2020.08.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/29/2020] [Accepted: 08/31/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of this case-control study was to identify risk factors associated with necrotizing fasciitis (NF) of the lower limbs. PATIENTS AND METHODS We conducted a prospective case-control study in hospital dermatology departments in 5 sub-Saharan African countries over a 2-year period (April 2017 to July 2019). The cases were patients with NF of the lower limbs and the controls were patients with leg erysipelas. Each case was matched with two controls for age (±5 years) and sex. We analyzed local and general factors. RESULTS During the study period, 159 cases (73 females, 86 males) were matched with 318 controls. The mean age was 48.5±15.8 years for cases and 46.5±16.2 years for controls (P=0.24). The main local signs of NF were cutaneous necrosis (83.7%), pain (75.5%) and induration (42.1%). Multivariate analysis showed the following to be independent risk factors associated with NF of the lower limbs: obesity (odds ratio [OR]=2.10; 95% confidence interval [CI]: 1.21-3.42), diabetes (OR=3.97; 95% CI: 1.95-6.13), nicotine addiction (OR=5.07; 95% CI: 2.20-11.70), use of non-steroidal anti-inflammatory drugs (NSAIDs) (OR=7.85; 95% CI 4.60-14.21) and voluntary cosmetic depigmentation (OR=2.29; 95% CI: 1.19-3.73). CONCLUSION Our study documents the role of NSAID use at the onset of symptoms as a risk factor for NF of the lower limbs. However, the originality of our study consists in the identification of voluntary cosmetic depigmentation as a risk factor for NF of the lower limbs in sub-Saharan Africa patients. Our results also identified typical overarching factors such as diabetes, obesity and nicotine addiction. Knowing these factors and taking them into account will enable optimization of management strategies for these conditions.
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Affiliation(s)
- P Pitché
- Department of Dermatology, Sylvanus Olympio University Hospital, Université de Lomé, Lomé, Togo.
| | - A-B Diata
- Department of Dermatology, Le Dantec University Hospital, Université Cheik Anta Diop, Dakar, Senegal
| | - O Faye
- Department of Dermatology-STD, Donka University Hospital, Université de Conakry, Conakry, Guinea
| | - T-M Tounkara
- Department of Dermatology, CNAM, Université de Bamako, Bamako, Mali
| | - P Niamba
- Department of Dermatology, Yaldago Ouédraogo University Hospital, Université de Ouagadougou, Ouagadougou, Burkina Faso
| | - A Mouhari-Toure
- Department of Dermatology, Kara University Hospital, Université de Kara, Kara, Togo
| | - F Ly
- Department of Dermatology, Le Dantec University Hospital, Université Cheik Anta Diop, Dakar, Senegal
| | - M-M Soumah
- Department of Dermatology-STD, Donka University Hospital, Université de Conakry, Conakry, Guinea
| | - N Some-Korsaga
- Department of Dermatology, Yaldago Ouédraogo University Hospital, Université de Ouagadougou, Ouagadougou, Burkina Faso
| | - A-S Akakpo
- Department of Dermatology, Sylvanus Olympio University Hospital, Université de Lomé, Lomé, Togo
| | - B-F Diané
- Department of Dermatology-STD, Donka University Hospital, Université de Conakry, Conakry, Guinea
| | - M Cissé
- Department of Dermatology-STD, Donka University Hospital, Université de Conakry, Conakry, Guinea
| | - S Niang
- Department of Dermatology, Le Dantec University Hospital, Université Cheik Anta Diop, Dakar, Senegal
| | - A Traore
- Department of Dermatology, Yaldago Ouédraogo University Hospital, Université de Ouagadougou, Ouagadougou, Burkina Faso
| | - B Saka
- Department of Dermatology, Sylvanus Olympio University Hospital, Université de Lomé, Lomé, Togo
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Ebob-Anya BA, Bassah N, Palle JN. Management of cellulitis and the role of the nurse: a 5-year retrospective multicentre study in Fako, Cameroon. BMC Res Notes 2019; 12:452. [PMID: 31337435 PMCID: PMC6651919 DOI: 10.1186/s13104-019-4497-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/17/2019] [Indexed: 11/23/2022] Open
Abstract
Objective This was a 5 year retrospective study of patients’ hospital records to find out how patients with cellulitis are managed and the care provided by nurses to these patients in some hospitals in Fako, Cameroon. Results Of the 236 cases of cellulitis identified from a study of hospital records, 202 were included in the study. Most of the participants (55%) were female and the mean (SD) age was 43 (1.1) years. Cellulitis accounted for 2.3% of admissions in this study. The predisposing factors identified were; the presence of trauma (60.5%), HIV infection (18.6%), alcohol consumption (8.4%) and tobacco use (4.8%). Commonly recorded complications were necrosis (32.2%), sepsis (23%), abscess formation (19.5%), and ulcer development (19.5%). Medical management was with antibiotic therapy, including mostly penicillin (26.5%), aminoglycoside (22.1%), nitroimidazole (20.2%) and cephalosporin (19.6%). Debridement (46.7%), and incision and drainage (44.4%) were the most implemented surgical interventions. Nursing care, as found in patients’ hospital records were predominantly on medication administration (98.0%), vital signs assessment (90.5%) and patient assessment (53%). Cellulitis therefore was found among a substantial number of patients and management was predominantly with combination antibiotics therapy and inadequate nursing care. Electronic supplementary material The online version of this article (10.1186/s13104-019-4497-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bachi-Ayukokang Ebob-Anya
- Department of Nursing, Faculty of Health Sciences, University of Buea, P.O Box 63, Buea, South-West Region, Cameroon
| | - Nahyeni Bassah
- Department of Nursing, Faculty of Health Sciences, University of Buea, P.O Box 63, Buea, South-West Region, Cameroon.
| | - John Ngunde Palle
- Department of Nursing, Faculty of Health Sciences, University of Buea, P.O Box 63, Buea, South-West Region, Cameroon.,Saint Luke's Medical Center Buea, Buea, Cameroon
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Abstract
OBJECTIVE To summarise available data on the risk factors, complications and the factors associated with complications of lower limb cellulitis in Africa. METHODS We did electronic searches on PubMed, EMBASE, Scopus and African Journals Online from 1 January 1986 to 30 October 2017, extracted and summarised data on the risk factors, complications and the factors associated with the complications of lower limb cellulitis from eligible literature. RESULTS A total of seven studies were retained for final review after the search and screening processes. Local risk factors of cellulitis reported were: disruption of the skin barrier, neglected wounds, toe-web intertrigo, leg ulcers, use of depigmentation drugs and leg oedema. Obesity was the only reported general risk factor of cellulitis. Five studies reported on the complications of cellulitis which included: abscess formation, necrotising fasciitis, bullae, haemorrhagic lesions, necrosis, phlebitis and amputations. Nicotine addiction, chronic use of non-steroidal anti-inflammatory drugs, delay in the initiation of antibiotic treatment and elevated erythrocyte sedimentation rate were risk factors of complications of lower limb cellulitis identified from three studies. CONCLUSION This review highlights the important role of local risk factors in the pathogenesis of lower limb cellulitis in Africa. The association between voluntary skin depigmentation and lower limb cellulitis should alert public health authorities and the general population to the health risks associated with this practice. The identification and improved management of the risk factors of lower limb cellulitis and its complications could go a long way in decreasing the morbidity and health costs incurred by lower limb cellulitis in Africa.
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Affiliation(s)
- Frank-Leonel Tianyi
- Department of General Medicine, Mayo Darley Sub-divisional Hospital, Banyo, Cameroon
| | | | - Celestin Danwang
- Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Valirie Ndip Agbor
- Department of General Medicine, Ibal Sub-divisional Hospital, Oku, Cameroon
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Ly F, Diousse P, Ndiaye C, Déme A, Diatta B, Ndiaye M, Diallo M, Diop A, Kebe A, Fall F, Kane A. Cutaneous squamous cell carcinomas (SCC) associated with cosmetic skin whitening: 8 cases reported in Senegal. Ann Dermatol Venereol 2018; 145:83-88. [DOI: 10.1016/j.annder.2017.10.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 04/07/2017] [Accepted: 10/02/2017] [Indexed: 11/26/2022]
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Njim T, Aminde LN, Agbor VN, Toukam LD, Kashaf SS, Ohuma EO. Risk factors of lower limb cellulitis in a level-two healthcare facility in Cameroon: a case-control study. BMC Infect Dis 2017; 17:418. [PMID: 28606058 PMCID: PMC5469018 DOI: 10.1186/s12879-017-2519-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 06/01/2017] [Indexed: 11/10/2022] Open
Abstract
Background Cellulitis is a common infection of the skin and subcutaneous tissues. It is associated with significant morbidity from necrosectomies and amputations especially in sub-Saharan Africa. We aimed at identifying the risk factors and burden of lower limb cellulitis to inform preventive strategies in Cameroon. Methods This was a hospital–based case-control study carried out in the Bamenda Regional Hospital (BRH) between September 2015 and August 2016. Cases were defined as consenting adults admitted to the surgical unit who presented with a localised area of lower limb erythema, warmth, oedema and pain, associated with fever (temperature ≥ 38 °C) and/or chills of sudden onset. Controls were adults hospitalised for diseases other than cellulitis, necrotising fasciitis, myositis, abscess or other variants of dermo-hypodermitis. Cases and controls were matched (1:2) for age and sex. Results Of the 183 participants (61 cases of cellulitis and 122 controls) included in the study, the median age was 52 years [Interquartile range (IQR): 32.5–74.5]. After controlling for potential confounders, obesity [adjusted odds ratio (AOR) = 4.7, 95% CI (1.5–14.7); p = 0.009], history of skin disruption [AOR = 12.4 (3.9–39.1); p < 0.001], and presence of toe-web intertrigo [AOR = 51.4 (11.7–225.6); p < 0.001] were significantly associated with cellulitis. Median hospital stay was longer (14 days [IQR: 6–28]) in cases compared to the controls (3 days [IQR: 2–7]). Among the cases, Streptococci species were the most frequent (n = 50, 82%) isolated germ followed by staphylococci species (n = 9, 15%). Patients with cellulitis were more likely to undergo necrosectomy (OR: 21.2; 95% CI: 7.6–59.2). Toe-web intertrigo had the highest (48.9%) population attributable risk for cellulitis, followed by history of disruption of skin barrier (37.8%) and obesity (20.6%). Conclusion This study showed a high disease burden among patients with cellulitis. While risk factors identified are similar to prior literature, this study provides a contextual evidence-base for clinicians in this region to be more aggressive in management of these risk factors to prevent disease progression and development of cellulitis.
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Affiliation(s)
- Tsi Njim
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Old Road Campus, University of Oxford, Oxford, OX3 7BN, UK. .,Health and Human Development Research Group, Douala, Cameroon.
| | - Leopold Ndemnge Aminde
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia.,Clinical Research Education, Networking and Consultancy (CRENC), Douala, Littoral, Cameroon
| | | | - Louise Daniele Toukam
- Faculty of Health Sciences, University of Bamenda, Bamenda, Northwest Region, Cameroon
| | - Sara Saheb Kashaf
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Old Road Campus, University of Oxford, Oxford, OX3 7BN, UK
| | - Eric O Ohuma
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Old Road Campus, University of Oxford, Oxford, OX3 7BN, UK.,Centre for Statistics in Medicine, Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Windmill Road, Oxford, OX3 7LD, UK
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Abstract
Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same ‘study base’ as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases – selection bias and recall bias.
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Affiliation(s)
- Maninder Singh Setia
- Epidemiologist, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India
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