View The Abstract Book - Sudanese Association of Dermatologists

Sudanese Association of Dermatologists
13th
Scientific
conference
2011
.
Abstract
Book
Pre­Conference
Workshops
27
–
28
March
2011
Coordinator: Dr. Nadia Hassanein
Date
Time
Workshop
Title
Presenter
Saturday,
26
March
9:30
–
11:30
Mesotherapy
Dr.
Marium
Okair
Saturday,
26
March
18:00
–
20:30
Chemical
Peeling
Dr.
Marium
Okair
Sunday,
27
March
12:30
–
14:30
Botox
Dr.Abdelazim
Almalik
Monday,
28
March
12:30
–
14:30
Fillers
Dr.Abdelazim
Almalik
13th
Dermatology
Conference
=
The
Programme
Tuesday,
29th
March,
2011
8:00
–
9:00
Registration
9:00
–
10:00
Opening
Ceremony
10:00
–
10:40
Break
Day
One:
March
29
First
Session
Chair
Persons:
Prof
Osman
Taha,
Dr
Maher
Abdullah,
Dr
Dafa
Allah,
10:40
–
11:00
In
memory
of
Dr
Mohammed
Ali
Ahmed
Dr
Mahdi
Osman
11:00
–
11:40
Guest
Lecture:
Langerhans
cell
Histiocytosis
Prof
Ahmed
M
Elhassen
11:40
‐
12:00
Discussion
12:00
–
12:10
Adult
Letterer
Siwe
Langerhans
cell
histiocytosis
associated
with
H.
pylori
infection:
Single
case
report
Adil
HH
Bashir
12:10
–
12:25
Updates
in
Psoriasis,
what
is
in
the
basket?
Abdelazim
Almalik
12:25
–
12:35
A
close
look
at
lymphedema
Osman
Suleiman
Elkhalifa
12:35
–
12:45
Discussion
12:45
–
12:55
Human
papilloma
virus
infection:
different
morphology,
characteristic,
histopathology,
and
different
prognosis
Abbas
Omer
12:55
–
13:05
Rare
but
can
be
encountered
(Case
Report)
Hussein
Salman
13:05
–
13:15
Disseminated
Coetaneous
leishmaniasis
(Case
Report)
Mahasen
Mohamed
Elhassen
13:15
–
13:30
Discussion
13:30
–
14:00
SPIMACO
(DAL
Medical):
Metaz
14:00
Lunch
Dr
Hasab
ElRasoul
Elfadil
Day
Two:
Second
Session
March
30
Chair
Persons:
Dr
Mahdi
Abdulla,
Dr
Abbasher,
Dr.
Ali
Babiker
9:00
–
9:40
Guest
Lecture:
Basic
Dermatology
9:40–
10:00
Discussion
Prof
AbdElRaheem
Abdullah
Updates:
Fillers
in
Facial
Rejuvenation
and
Remodeling
10:00
–
10:30
Recent
advances
in
the
aging
face
&
Botox
application
10:30
–
10:45
Discussion
10:45
–
11:30
Break
Abdelazim
Almalik
Third
Session
Chair
Persons:
Prof
Yousif
Kordofani,
Dr
Abdullah
Mohamed
Tom,
Dr
Abdulla
Laser
treatment
for
Dermatosis
Papulosa
Nigra
in
dark
skin
Muhamad
Tom
Abdelmajeed
11:40
–
11:50
Laser
hair
Removal
and
Rejuvination
in
dark
skin:
Experience
of
Elkhalifa
Suleiman
Hospital
Mahdi
Shamad
11:50
–
12:00
Clinical
&
laboratory
study
of
a
photodynamic
therapy
&
Pulsed
Dye
laser
treatment
for
psoriasis
in
comparison
with
conventional
topical
PUVA
Abdelmoniem
Elwidaa
12:00
–
12:10
Utilization
of
Nd:YAG
laser
(1064
nm)
in
the
treatment
of
Dermatosis
Papulosa
Nigra
in
Sudanese
patients
Shaza
Mohammed
Yousif
12:10
–
12:20
Low
Level
Laser
Therapy
in
Treatment
of
Keloid
(Comparative
study)
Mahasin
Belo
12:20
–
12:30
The
efficacy
of
Nd:YAG
laser
in
the
treatment
of
Pseudofolliculitis
Barbae
and
Acne
Keloidals
Nuchae
in
Sudanese
patients
Halima Ahmed S. Abu Samra
12:30
–
13:00
Discussion
11:30
–
11:40
Hirsutism
acne:
hyperandrology
syd,
pathophysiology
&
management
13:00
–
14:00
Skin
thickness
and
estrogens
Discussion
14:00
Lunch
Michel
Abou
Abdullah
Day
Three:
March
31
Forth
Session
Chair
Persons:
Dr
Sameer
Abbaro,
Dr
Abd
Elraheem
Mahmoud,
Dr
Bushra
Basic
and
clinical
andrology:
from
puberty
till
andropause
FSH
therapy
for
male
subfertility
9:00
–
10:00
Michel
Abou
Abdullah
Discussion
10:00
–
10:10
Variants of Kaposi’s sarcoma case series in Omdurman Military
Hospital, Sudan
10:10
–
10:20
Cutaneous
Malignancy
in
Sudanese
HIV
Patients
10:20
–10:30
Adverse
Cutaneous
Drug
Reactions
in
HIV
positive
Sudanese
patients
on
antiretroviral
therapy
10:30
‐
10:45
Discussion
10:45
‐
11:30
Break
Safiedin
Elnur
Ali
Safiedin
Elnur
Ali
Rehab
Yassin
Fifth
Session
Chair
Persons:
Dr
Osman
Suleiman,
Dr
Hafez,
Dr
Mubarak
11:30
–11:40
Serum
IgE
and
Atopic
Dermatitis
Mahmoud
Abdulla
11:40
–11:50
Scarf
wearing
as
a
risk
factor
for
hair
loss
in
female
medical
students
of
Khartoum
University
Khalifa
Hassan
11:50
–12:00
Immunofluorescence
Techniques
in
Diagnosis
of
Bullous
Diseases
Nossiba
Sayed
A
Elkariem
12:00
–12:10
Diagnostic
Accuracy
of
Leishmania
Oligo
C‐Test
&
NASBA‐
Oligochromatography
for
Diagnosis
of
Leishmaniasis
in
Sudan
Farazdag
Agaid
12:10
–12:20
The
psychological
impact
of
vitiligo
in
adult
Sudanese
patients
Ali
M
Osman
12:20
–12:30
Discussion
12:30
–
12:45
Conclusions
and
Closing
Lunch
A close look at lymphedema
Osman Suleiman Elkhalifa
Worldwide, about 40 millions of lymphoedema cases are estimated to exist,
with filariasis being the most common cause. People in at least 80 countries
of the world are infected with lymphatic filarial parasites. Various types of
lymphedema, though various classifications.
Updates: Fillers in Facial Rejuvenation and Remodeling
Dr.Abdelazim Almalik
Facial lipoatrophy is natural part of the aging process. Facial aging can
stigmatize some patients causing them to suffer low self-esteem and quality
of life. Nowadays, physicians and dermatologists need to understand how to
combine toxins and fillers to achieve facial rejuvenation and restoration.
Updates in fillers can create and restore facial volumes, re-sculpt facial
contour, treat deep wrinkles, erase folds of the skin and restore the face
original curvatures. As people age, the tissue sag, the face becomes lined,
and the skin loses its fairness. Treating facial aging, rejuvenation, and
remodeling require a gentle way to give volume and implant the updates of
hyaluronic acid derivatives by a safe effective methods. Our educational
objectives are to:
• Define the techniques of assessment for aging face.
• Identify the personal plan for diagnosing and prescribing therapy for
the aging face.
• Describe the use of collagen stimulators for non surgical treatment of
facial rejuvenation and restoration.
• Identify treatment options based on location and stage of lipoatrophy.
• Describe safety consideration and injection techniques of facial fillers.
Recent advances in the aging face & Botox appplication
Abdelazim Almalik
Over the past few years, aging and anti aging is becoming a major concern
for dermatologist and plastic surgeons. The first challenge is underastanong
and evaluation of the aging face, dermatologist should take into
consideration the volumetric changes inherited in the aging process, the
effect of a life time of photo exposure and the photodamage, and the loss of
structure and support and resultant geometric changes in the contour of the
face that accompany advancing age. In reading the face, it's important to
distinguish between the 3 key features that bother our patients most sagging, wrinkles and atrophy- as the solution can be very different. Many
patients will require more than one technique to give them the facial
appearance that they are looking form, and it's up to the physician to propose
the optimal combination of treatment.
Facial expressions is a key component of how people relate to and interact
with those around them when their face is at rest and when it's smiling,
concentrating, laughing, frowning, tense and relax. Using of Botox the most
important non invasive procedure in the world now. They are used to
accomplish many goals including specific feature enhancement (lip
augmentation), regional contouring for rejuvenation (cheeks, perioral
region), and restoration of aging facial geometric alteration such as dermal
atrophy, lipoatrophy or biometric volume loss as well facial changes caused
by trauma, disease or drug.
The experience of El Khalifa Suleiman Hospital in the
use Laser indark skin
Mahdi Shamad
Use of Laser in dermatology started recently in Sudan. We are presenting the
experience of El Khalifa Suleiman Specialized Hospital in the use of
Nd:YAG Laser - 1064 nm in the treatment of different skin conditions.
Results were excellent in hair removal, steroidal striae and atrophic scars,
and satisfactory in other skin diseases. We will share our experience
showing the before and after photos.
Updates in Psoriasis, what is in the basket?
Abdelazim Almalik
Psoriasis is a chronic immune-mediated inflammatory disorder. The
objective of this short prenestion includes common tools to score psoriasis.
This scoring is most useful in patient with moderate to severe psoriasis.
There was an intense discussion among all experts worldwide to define
moderate to severe plaque psoriasis using PSA, PASI, and DLQI. Life
quality index (DLQI) and skin index are represented in a consensus program
for academic and clinical use. The following important points will be in the
basket:
• Objective and organization of European consensus program.
• Delphi process and definition of the consensus.
• How should moderate to severe psoriasis be defined?
• European consensus: definition of psoriasis severity.
• Treatment goals and decisions.
• Definition of induction phase.
• Definition of maintenance phase.
• Definition of treatment failure
• New Updates in Biologics.
Also, this lecture discusses the need to educate patients about their treatment
options, addressing psychosocial concerns, characterizing the severity of the
disease to help guide treatment, and treatment algorithm to promote safe and
effective treatment.
Scarf wearing as a risk factor for hair loss in female medical
students of Khartoum University
Khalifa Hassan
No Abstract
Laser treatment for Dermatosis Papulosa Nigra (DPN) in
dark skin
Muhamad Tome Abdelmajeed
Dermatosis Papulosa Nigra (DPN) is a benign cutaneous condition common
among blacks. It is usually characterized by multiple, small,
hyperpigmented, asymptomatic papules on the face of adults. Histologically,
DPN resembles seborrheic keratoses. The condition is cosmetically
undesirable to many patients. Many techniques have been used to treat DPN,
curettage, cryotherapy &electrodessication, but the potential hazard of
pigmentary changes & scarring remain there, especially in dark skin.
Long pulse Nd.Yag laser was used for the treatment of DPN in a group of
Sudanese patients. The parameters used, the technique applied &the clinical
results will be presented in a 20 min. talk.
Low Level Laser Therapy in Treatment of Keloid
(Comparative study)
Mahasin Belo, B.O.Elbashir, N.Z.Malati
Keloids and hypertrphic scars are skin diseases which cause disfigurement,
itching which may be severe and when it is present in the chest. It can cause
tightness and pain especially if it is big in size. This study was done in the
Institute of Laser-Sudan University of Science and Technology, KhartoumSudan, from January to April 2009. The objective of this study was done to
evaluate the effectiveness of Low Level Laser Therapy (DIODE LASER
820 nm) in treatment of keloids (group1) compared with laser +
penicillamine (group 2). Twelve patients from both sexes had been selected
aged from 4 to 72 years. The number of sessions ranged between 8 to 12 sets
(8 patients from group1 and 4 from group 2).They had been received multi
pulse treatment with frequencies of 20,73,and 700 Hz. The duration was 30s
with energy density (48 j/cm2) by probe 1 (820nm) and 2 minutes(9.6j/cm2)
by probe 2 (cluster probe) .The exposure time and probes were selected
according to the site and size of the lesion .The improvement was assessed
by Vancouver burn scar score. Statistically it has been found that there was a
significant improvement in symptoms, color, height, and pliability in the two
groups after treatment. Clinically the improvement was more rapid in group
2 patients. By using Fisher’s Exact to compare between the two groups of
treatment, it has been found that there was no significant difference.
Updates in male infertility: The FSH therapy
Michel Abou Abdallah
Many aspects of male factor infertility are poorly understood and not deeply
investigated. The high fertilization and pregnancy rates achieved with ICSI
have led to the almost complete discontinuation of efforts to improve sperm
parameters in vivo.
ICSI bypasses physiological selection processes, allowing sperm with severe
structural abnormalities and/or increased aneuploidy rates to fertilize
oocytes. An increased rate of De Novo chromosomal abnormalities in the
offspring of the patients was observed in several reports.
The justified enthusiasm for the use of ICSI as the treatment of choice for
male factor infertility should not prevent the fertility specialists from
improving sperm quality and thereby achieving better results in both IVF
and ICSI.
There is a general consensus on the need for FSH in regulating and
maintaining quantitative and qualitative spermatogenesis in animals and
humans.
FSH is responsible for the quality of the spermatozoa in general and for the
sperm-zona pellucida interaction in particular accounting for the
improvement in the fertilization rates.
The aim of this review is to demonstrate the positive influence of FSH
therapy on testicular function by improving: 1- sperm parameters, 2- sperm
ultrastructure.
Improvement of inhibin B levels after therapy is the result of exogenous
FSH action on testicular paracrine activity; the integrity of sperm organelles
(crucial for embryonic growth) are improved; the Acrosome and sperm
nuclear regions are mostly restored, which many influence fertilization and
implantation rates and potential before IVF/ICSI.
The efficacy of Neodimmium-YTrium –aluminium Garnet
(Nd:YAG) 1064nm laser in the treatment of pseudofolliculitis
Barbae and acne keloidals Nuchae (in Sudanese patients)
Halima Ahmed Salih Abu Samra, Babikir Osman El Bashir ,Yousif SafiEldin
Keloid formation is often a problem in affected skin especially in African
Background It is often chronic and can be disfiguring.
Folliculitis keloidalis (acne keloidalis nuchae):is a chronic inflammatory
process involving the hair Follicles of the nape of neck and occipital scalp
Leading to hypertrophic scarring in papules and plaques.
Objective To determine the efficacy of Neodimmium –yttrium –aluminium
garnet {Nd:yAG}1064nm laser as a means of hair removal (hair reduction)
in the treatment of pseudo folliculitis barbae and acne keloidalis nuchae in
sudanese patients.
Materials and Method Nine male patients; four clinically diagnosed as
cases of pseudo folliculitis barbae ,four patients with acne keloidalis nuchae
and one patient with the two disorders. Laser system used was Nd:YAG
laser of 1064nm wave-length manufactured by Dornier Medilas. Parametrs
used were the standard mode ,non contact application (bare fibre) and
exposure duration0.2 second, with power 20-60 w. Patients were submitted
to weekly sessions, changes in number and appearance of the lesions were
recorded in each follow up visit. The treatment results were assessed
according to reduction in the number of papules and pustules as well as the
side effects encountered during the study.
Results The results were evaluated clinically and were classified as follows:
Good results there is significant reduction in number of papules and pustules
without hypo pigmentation (approximately 80% of the preexisting lesions
disappeared).
Moderate results: There is moderate reduction in the number of papules and
pustules with or without hypo pigmentation (approximately 60% of the pre
existing lesions disappeared)
Poor results: No clinically evident improvement. Patients who showed good
results were 6 patients. Patients who showed moderate results were 3
patients. All patients were satisfied with the improvement.
Conclusion The results of this study proved that Nd.YAG laser 1064nm is
an effective treatment for pseudo folliculitis barbae and acne keloidalis
nucha in skin photo type V. Regarding the response of skin photo type VI
Nd-YAG laser may not be the optimum treatment.
Utilization of Nd: YAG Laser (1064 nm) in the Treatment of
Dermatosis Papulosa Nigra in Sudanese
patients
Shaza Mohammed Yousif, Nafie A. Al-Muslet and Nagi Zarif Malati
Introduction Ethnic skin represents the majority of the world's population.
Clinically, the features of photoaging in African can include fine wrinkling,
mottled pigmentation, and dermatosis papulosa nigra (DPN). Studies have
all confirmed the effectiveness and low risk of complication associated with
use of Nd: YAG laser in dark skin patients.
Study Objectives This study aimed to detect the effectiveness of Nd: YAG
laser, 1064 nm, with specific laser parameters, in the treatment of dermatosis
papulosa nigra (DPN) in some Sudanese patients.
Materials and methods Twenty patients, clinically diagnosed as cases of
dermatosis papulosa nigra, were selected from different dermatology clinics
in Khartoum state and were considered as study population. Nd: YAG laser,
with 1064 nm wavelength, was used in this study. The laser parameters
were: non-contact applications of bare fiber, power of 25 Watt and duty
cycle of 0.2 second. The number of exposure intervals delivered per lesion
was chosen according to the size of papules. The data was analyzed using
SPSS 15.0, and p-value of p<0.05 had been used.
Results Relationship of the treatment response and Northern tribes was
found with (p value <0.05). Three and six weeks after the last session,
evaluation of patients response was as following:
• Excellent response in 17 patients (85%)
• Very good in 3 patients (15%)
• Good (0.0%)
• Bad (0.0%)
• Poor (0.0%)
• No response (0.0%)
Conclusions This study proved that the use of Nd: YAG laser 1064 nm,
with certain parameters could achieve dramatic and very good results in
almost all patients.
Clinical and laboratory Study of a photodynamic
therapy(PDT) and flash Lamp Pulsed Dye laser (FLPDL)
treatment for chronic plaque Psoriasis in Sudanese patients in
Comparison with Conventional Topical PUVA Therapy
Abdelmoniem Elwidaa Osman,
Psoriasis is a chronic disease characterized by dermal inflammation and
keratinocytes hyperproliferation.
Psoriasis has long presented therapeutic challenge to the physicians'
especially the chronic plaque type.
The aim of this study is an attempt to provide new ways of treatment of
chronic plaque psoriasis using FLPDL, and PDT therapy and compare the
results with conventional topical PUVA 35 patients were included in this
study. 24 patients were treated with PDT, 8 patients treated with PUVA
therapy and 3 patients were treated with FLPDL.
This fractional experiment showed that the chronic plaque psoriasis
responded well to the treatment by the 595nm FLPDL. Treatment by
photodynamic therapy achieved different results, while topical PUVA
therapy showed no effect.
The success and failure of these methods were recorded and will be
discussed.
The Magnificent Wart :
Different Human Papilloma Virus Infection, Different
Morphology, Different & characteristic, Histopathology,
Different Prognosis
Abbas Omer
Originally all warts were assumed to be due to a single human papilloma
virus (HP V) responsible for the different types of warts.
The most important and interesting finding in this field is the demonstration
of different types of human papilloma viruses responsible for the different
types of warts which showed characteristic histologic pictures.
Warts in patients infected human HPV’s 3 & 5 showed unique histological
changes & some of these patients developed malignancies of the Bown type
on the sun exposed areas. (EV).
Rare but can be encountered (Case report)
Hussein Salman, Waiel Osman
A man age 42 years, a merchant, married ,has 3 kids ,from Gezira province
(Rufa"s tribe) ,well &healthy , his wife is a cousin . He complains of itchy
disfiguring rough skin pimples involving ventral & dorsal aspect of hands &
feet, elbows & knees are also involved for 3 years.His condition is started on
the feet & progressed to involve the other sites,. There was similar attack at
11years ,but remit spontaneously, no family history of similar condition or
other dermatological conditions. Patient sought medical advice abroad in
vain for diagnosis & therapy. Differential diagnosis based on history
&clinical examination is: Acrokeratosis verruciformis of Hopf, Erythema
elevatum ditiunum, Acrokertoelastosis of costa, Actinic keratosis, Arsenical
keratosis, Colloid millum, Cowden"s disease, Darrier"s disease,
Epidermodysplasia verruciformis, Common wart, Granuloma annulare,
Lichen planus, Seborrheic keratosis.
Diagnosis was confirmed to be acrokeratosis verruciformis of Hopf. By
histopathology(characteristic church spires)..
The treatment was prescribed ,patient came twice for follow up .Puva was
tried ,but he developed irritation &stop.
Adult Letterer Siwe Langerhans Cell Histiocytosis (LCH)
associated with H. pylori infection:Single case report
Adil HH Bashir and AM El Hassan.
Langerhans cell histiocytosis is defined as a clonal proliferation of
Langerhans phenotypic-like cells. Letterer-Siwe disease is the most common
and serious of these entities, affecting mainly infants up to two years of age.
We report an interesting and rare, previously misdiagnosed and relapsing
case of adult skin limited LCH in a female patient, 25 years old, presented
with well defined erythematous dry scaly plaques in the face, trunk and
extremities for 10 years duration, and then remains stable over time. The
case is diagnosed and confirmed histopathologically, considered to be the
second case of LCH and first case as adult Letterer Siwe been reported in
Sudan.
Serum Ige and Atopic Dermatitis:
Suzan I. Ayed and Mahmoud A. Abdulla
BACKGROUND:. :. Atopic dermatitis is a common chronic disease that
starts early in infancy and may continue into adolescence presenting a
consistent problem to the patient and in severe cases to the whole family.
Many hypotheses claimed to explain the clinical course of Atopic Dermatitis
by attributing a central role to serum IgE levels. Yet despite the fact that
high IgE levels are detected in 80%-90% of cases of atopic dermatitis,
normal levels of serum IgE do not rule out the presence of the disease. Very
few studies were done among Africans to measure the serum IgE levels in
children with atopic dermatitis. This is a cross-sectional, hospital –based
study, done in Khartoum Dermatology and Venereal Teaching Hospital,
during the period from June 2009 to February 2010. It has been planned to
probe into the role of IgE in the clinical course and severity of Atopic
Dermatitis in Sudanese Children.
METHODS: A total of 54 patients with Atopic Dermatitis diagnosed
clinically according to the criteria of the American Academy of dermatology
were included in the study. Of those 37(69%) were males, and 17(31%)
were females. All Patients were cross examined and the severity index
according to the objective SCORAD index was determined. Total serum IgE
levels were measured by immunoassay.
RESULTS: The total serum IgE level according to age-specific upper limit
was found to be high among 74.1%. This level was found to correlate
significantly with the SCORAD index values (using regression test).
CONCLUSIONS: Our study concluded that total serum immunoglobulin
(Ig) E does have much predictive value for the diagnosis of AD and can be
used as an important marker in the assessment of the disease severity and is
important for the follow-up of children with AD.
Diagnostic Accuracy of the Leishmania OligoC-TesT
and NASBA-Oligochromatography for Diagnosis of
Leishmaniasis in Sudan
Farazdag Agaid
Background:
The
Leishmania
OligoC-TesT
and
NASBAOligochromatography (OC) were recently developed for simplified and
standardised molecular detection of Leishmania parasites in clinical
specimens. We here present the phase II evaluation of both tests for
diagnosis of visceral leishmaniasis (VL), cutaneous leishmaniasis (CL) and
post kala-azar dermal leishmaniasis (PKDL) in Sudan.
Methodology: The diagnostic accuracy of the tests was evaluated on 90
confirmed and 90 suspected VL cases, 7 confirmed and 8 suspected CL
cases, 2 confirmed PKDL cases and 50 healthy endemic controls from
Gedarif state and Khartoum state in Sudan.
Principal Findings: The OligoC-TesT as well as the NASBA-OC showed a
sensitivity of 96.8% (95% CI: 83.8%–99.4%) on lymph node aspirates and
of 96.2% (95% CI: 89.4%–98.7%) on blood from the confirmed VL cases.
The sensitivity on bone marrow was 96.9% (95% CI: 89.3%–99.1%) and
95.3% (95% CI: 87.1%–98.4%) for the OligoC-TesT and NASBA-OC,
respectively. All confirmed CL and PKDL cases were positive with both
tests. On the suspected VL cases, we observed a positive OligoC-TesT and
NASBA-OC result in 37.1% (95% CI: 23.2%–53.7%) and 34.3% (95% CI:
20.8%–50.9%) on lymph, in 72.7% (95% CI: 55.8%–84.9%) and 63.6%
(95% CI: 46.6%–77.8%) on bone marrow and in 76.9% (95% CI: 49.7%–
91.8%) and 69.2% (95% CI: 42.4%–87.3%) on blood. Seven out of 8 CL
suspected cases were positive with both tests. The specificity on the healthy
endemic controls was 90% (95% CI: 78.6%–95.7%) for the OligoC-TesT
and 100% (95% CI: 92.9%–100.0%) for the NASBA-OC test.
Conclusions: Both tests showed high sensitivity on lymph, blood and tissue
scrapings for diagnosis of VL, CL and PKDL in Sudan, but the specificity
for clinical VL was significantly higher with NASBA-OC.
Disseminated cutaneous leishmaniasis: a case report
Mahasen Mohamed Elhassen
No Abstract
The psychological impact of vitiligo in adult Sudanese
patients
AM Osman
Objective: Vitiligo is a chronic skin disease that causes loss of pigment,
resulting in irregular pale patches of skin. The disease has profound
psychological consequences. These effects range from mild embarrassment
to a severe loss of self-confidence and social anxiety, especially for those
who have lesions on exposed skin. The study sought to determine the
psychological impact of vitiligo in Sudanese patients.
Method: This study is a cross-sectional, clinical-epidemiological and
hospital-based study, underatken in Khartoum Dermatologic Hospital
(KDH). The data was collected between June 2007 and November 2007. 111
adult patients were enrolled sequentially during the study period and they
were tested using the 12-item General Health Questionnaire (GHQ-12).
Results: Psychological disturbances as a consequence of vitiligo were found
in 36 (31 %) adult patients. Patients with mild psychological disturbances
were found in 20 of these patients and severe disturbances in 16.
Conclusion: Psychological consequences are common in patients with
vitiligo
Immunofluorescence Techniques in the Diagnosis of Bullous
Diseases
Nossiba Sayed A Elkariem
Autoimmune blistering diseases are common in dermatological practice.
Direct immunofluorescence study is considered gold standard for the
diagnosis of this group. Objective of this study was to evaluate the role DIF
of techniques, and their relevance to the diagnosis of the blistering diseases.
The diagnostic value and the patterns of DIF in autoimmune bullous diseases
will also be described.
62 patients of autoimmune bullous diseases were included in this study.
Histopathology and DIF were performed in all of these patients. There were
16 (25.8 %) male and 46 (74.2%) female patients .The male to female ratio
in bullous pemphigoid was 1:3.3. In pemphigus group was 1:4. In DH was
1:1.In CBC was 0:1.The result of clinical diagnosis: Bullous pemphigoid
was the most common diagnosis n=20 (32.2%), two of them (10%) has
negative DIF. Followed by pemphigus vulgaris n= 10 (16.1%), all of them
have positive DIF. Then pemphigus foliaceus n=8 (12.9%) all of them have
positive DIF, among 8 patient (12.9%)who diagnosed clinically as
pemphigus vegetans tow (25%)of them have negative DIF and in one of
them (12.5%)the diagnosis of paraneoplastic pemphigus was made by DIF .
Dermatitis herpetiformis have the same frequency n= 8 (12.9%) but four of
them (50%)diagnosed by DIF as bullous pemphigoid and three of them(
37.5%)as herpes gestation the remaining one patient (12.5%) have negative
DIF. Then chronic bullous diseases of childhood n=4 (6.5%) but this
diagnosis was not support by DIF. The least frequent is the herpes gestation
n=4 (6.5%) in tow of them (50%) the diagnosis was support by DIF, while in
the other tow (50%) the DIF is negative. DIF is a novel technique for the
diagnosis of autoimmune bullous diseases.
Variants of Kaposi’s sarcoma case series in Omdurman
Military Hospital, Sudan
Safiedin Elnur Ali, Mohammed M.A.M Ibnouf, Einas Seed Ahmed ELHassan
Background: Kaposi’s sarcoma (KS) is a complex neoplasm characterized
by angio-proliferative multifocal tumours of the skin, mucosa and viscera.
There are four different epidemiological forms of KS: classic (sporadic)
(cKS),
African
(endemic),
AIDS-associated
(epidemic),
and
immunosupression-associated (iatrogenic).
Objectives: In this paper we report for the first time types of Kaposi’s
sarcoma as seen in Dermatology Military Hospital.
Patients and methods: Three, two and one cases are AIDS related, endemic
type and iatrogenic type of Kaposi’s sarcoma were presented respectively.
Results: We report a series of Kaposi’s sarcoma in six Sudanese patients.
Mean age 66.7 year, five of them were males and a female.
The AIDS associated KS patients showed good response to management and
are under follow-up on HAART.
The endemic type cases have been improved with chemotherapy. The single
case of iatrogenic KS could not be traced.
Conclusion: KS is an important disease that should not be missed and has to
be well classified.
Cutaneous Malignancy in Sudanese HIV Patients
Safiedin Elnur Ali, Mohammed M.A.M Ibnouf, Einas Seed Ahmed ELHassan
Background: Certain skin cancers occur with increased frequency or
altered course in patients infected with HIV; Malignant Melanoma,
Squamous Cell Carcinoma & Basal cell carcinoma are examples seen
frequently whereas cutaneous T cell lymphoma(CTCL) appears rare in this
population.
Objective: To address Cutaneous Malignancies with HIV in Sudanese
patients in Omdurman Military Hospital Sudan.
Methods: Retrospective study of patients presenting with HIV & diagnosed
as having cutaneous malignancy to Omdurman Military Dermatology
Hospital in the period between 1998—2010
Results: The total number of cases identified with cutaneous malignancies
and HIV /AIDS was 16 (15 Males (93.8 %) and a single female (6.3 %).The
net result was depending on certain factors such as; Demographic factor,
clinical conditions, associated symptoms and signs, characteristics of Kaposi
sarcoma, geographic residence of patients, outcome of the disease and
distribution of patients according to the year of presentation.
Limitations: The number of the patients was relatively small & the CD4
viral load was not available for them.
Conclusions: Skin malignancies especially AIDS-KS was significantly
increased with high morbidity & mortality. This was altered dramatically
with the introduction of HAART.
We reported the geographic residence of our patient which is clear that
although patients come from all regions of the country, certain region like
west and the east have high prevalence; both regions suffer social
instabilities and displaced population due war and foreign immigration.
The incidence & prevalence of skin malignancies especially Ks was not
documented in Sudan.
Adverse cutaneous Drug reactions in HIV positive
Sudanese patients on antiretroviral therapy
Dr. Rehab Omer Abass Ahmed Yassin
Background: The introduction of highly active antiretroviral therapy
(HAART) has led to significant reduction in acquired immune deficiency
syndrome (AIDS)-related morbidity and mortality. Significant number of
patients still present with skin pathology, some of which can be attributed to
antiretroviral therapy. For this the study idea came out.
Objective: To identify the adverse cutaneous drug reactions of antiretroviral
therapy among a group of Sudanese HIV positive patients.
Methods: The study areas were Voluntary center for testing and therapy
VCT centers (Omdurman Teaching Hospital & Military Hospital) both were
located in Omdurman Province. In a prospective, descriptive cohort study
from September 2007 to December 2008, all HIV-positive cases that were
newly started on antiretroviral therapy were included and were followed
prospectively for the development of any adverse drug reactions.
Results: The study sample consisted of 87 patients; mean age was 36.09
years with male patients’ slightly more than female patients (51.7%). Most
of the patients were originally from West states (48.3%) but they live in
Omdurman city (58.6%). (65.5%) of patients were married; with different
Varity of jobs and (35.6%) of them were housewives. The route of
transmission is exclusively sexual (98.9%). Adverse drug reactions were
observed in (17.2%). Most of these patients started the treatment which
include Nevirapine regimen and this drug is usually associated with skin
rash specially if the CD4 level is high, and this also proved to be an evidence
in which most patients were of low CD4 (62.0%) while most of affected one
had high CD4 with significant P value (0.00). The most common adverse
drug reactions were cutaneous (17.2%), rash was mainly due to Nevirapine.
Other common adverse drug reactions in this study were peripheral
neuropathy (6.9%).
Conclusions: Antiretroviral therapy is becoming increasingly effective.
Adverse effects of therapy may cause symptoms that affect a variety of
organ systems. Although current antiretroviral regimens are potent from an
antiviral perspective, they often fail because of patient non adherence. To
optimize adherence and hence efficacy, clinicians must focus on preventing
adverse effects whenever possible, and distinguishing those that are selflimited from those that are potentially serious. However, many issues are
discussed that still need to be addressed in future researches.
Executive
Committee
of
Sudanese
Association
of
Dermatologists
(March
2009
–
march
2011)
President:
Dr
Mahmoud
Abdulla
Vice‐president:
Prof
Yousif
Kordokani
General
Secretary:
Dr
Bakri
Elagraa
Financial
Secretary:
Dr
Haider
Mohamed
Ali
Academic
Secretary:
Dr
Mahdi
Shamad
Dr
Adil
Hamid
Cultural
Secretary:
Dr
Omer
Kombaly
Dr
Khalid
Osman
Social
Secretary:
Dr
Nadia
Hassenein
Dr
Zohair
Naeem
Dr
Reela
Awwad
Committees
of
the
13th
Scientific
Conference
Scientific
Committee:
Dr
Mahmoud
Abdulla
Prof
Yousif
Kordokani
Dr
Mahdi
Shamad
Dr
Adil
Hamid
Financial
Committee:
Dr
Bakri
Elagraa
Dr
Haider
Mohamed
Ali
Dr
Reela
Awwad
Social/Cultural
Committee:
Dr
Omer
Kombaly
Dr
Nadia
Hassenein
Dr
Zohair
Naeem
Dr
Khalid
Osman