Therapeutic observation of vitiligo

Advances in dermatology in sub-Saharan Africa in the past 20 years from workshops to the birth of the African Society of Dermatology and Venereology

BACKGROUND

Highly pigmented African skin and hair have distinct characteristics because of their unique physiology and structure. Twenty years ago, despite an increasing number of dermatology specialists in some African countries, there remained a paucity of collaborative research and workshops on African hair and skin, and there was a need for an inclusive African society to represent dermatologists from all English and French-speaking countries in sub-Saharan Africa.

METHODS

We documented significant research advances between 2000 and 2021 on African hair and skin physiology, as well as clinical dermatology, in sub-Saharan Africa.

RESULTS

The main advances documented include the launch of annual African hair and skin workshops in 2004, the introduction of African research grants and the Africaderm web platform in 2013, and the registration of the African Society of Dermatology and Venereology (ASDV) in 2015, which led to the inaugural scientific meeting of ASDV in 2016.

CONCLUSION

There have been significant research advances in African hair and skin over the past 20 years. As skin physiology and skin conditions are similar across sub-Saharan Africa, scientific and clinical partnerships between companies, academia, and public health care sectors have played a key role in translating new scientific findings on African hair and skin to ensure knowledge is shared. This information has helped educate African specialists, health care workers, and consumers, with a particular focus on the preventable nature of certain dermatoses like skin bleaching-related complications and traction alopecia.

Vitiligo Associated with Melanoma in a Malagasy Woman

Malignant melanoma is the first fatal skin cancer. Vitiligo is a leukoderma or a multifactorial depigmentation acquired but especially of autoimmune origin. We report the first Malagasy case affected by both melanoma and Vitiligo. The appearance of Vitiligo during a melanoma could testify to an immunological response against melanocytes. Despite the association of melanoma and Vitiligo, the prognosis of melanoma is still fatal.

Treatment responses in patients with vitiligo to very potent topical corticosteroids combined with vitaminotherapy in Madagascar

INTRODUCTION

Vitiligo is a refractory disease in which treatment modalities are not yet established. We aim to assess results obtained 10 years after the initiation of a therapeutic protocol which combines very potent topical corticosteroids (TCS), vitaminotherapy (B12 and C), and suppression of microtraumas in the management of nonsegmental vitiligo in Madagascar.

METHODS

It was a prospective and descriptive study over a period of 6 years (2011-2016) in the Department of Dermatology, Joseph Raseta Befelatanana, Antananarivo, Madagascar. The diagnosis of vitiligo was based on clinical data. Patients who agreed to follow the treatment protocol, which combined very potent TCS (two applications/day for 10 days, and then one application/day for the following 10 days), oral vitamin C 500 mg/day for 20 days, and oral vitamin B12 100 mg/day for 20 days, were included in the study. Two successive courses of treatment were made 10 days apart.

RESULTS

The details of 308 vitiligo patients were analyzed. The mean age of patients was 33.3 years. There was a female preponderance (sex ratio: 0.6). The duration of treatment in our patients varied from 3 to 18 months. Two hundred and thirty-nine patients had good therapeutic compliance and attended regular follow-up. Excellent repigmentation (more than 76% area repigmented) was noted in 50 patients (65.7%) less than 14 years of age. Lesions evolving in less than 1 year in 31 patients (36.9%) had excellent response to treatment. Localized lesions responded favorably to treatment with excellent repigmentation in 108 patients.

CONCLUSION

These results show that therapeutic response is better in young people, lesions less than 1 year of evolution, and for localization of vitiligo in the face and neck.