IntroductionLa tuberculose est la mycobactériose la plus fréquente en Afrique subsaharienne. La localisation cutanée est rare et sous diagnostiquée à cause de son polymorphisme clinique et la faiblesse du plateau technique. Le but de cette étude était de décrire les aspects épidémiologiques, cliniques, histopathologiques de la tuberculose cutanée à Bamako (Mali).MéthodesDe janvier 1991 à décembre 2008 nous avons réalisé une étude transversale descriptive. L’étude s’est déroulée dans le service de Dermatologie du Centre National d’Appui à la lutte contre la Maladie et le service de Pneumo-phtisiologie au l’hôpital du Point G. Ont été inclus dans l’étude les cas de tuberculose confirmés par l’histologie et ou la biologie.RésultatsSur 4269 dossiers, 61 cas de tuberculose cutanée étaient recensées (1,43%). Les hommes représentaient 59% des cas (36 malades) et les femmes 41 % soit (25 cas); soit un sex-ratio de 1,44. L’âge des malades variait de 3 mois à 61 ans pour une moyenne de 27,56 ± 36 ans. La durée d’évolution était en moyenne de 10,9 ± 10 mois. Les formes cliniques recensées étaient le scrofuloderme (41 cas), la forme ulcéreuse (13 cas), la forme verruqueuse (4 cas), et le lupus tuberculeux (3 cas). La tuberculose était associée au VIH dans 7 cas, à la lèpre dans 3 cas. ConclusionLa tuberculose cutanée est sous diagnostiquée au Mali. Des efforts sont nécessaires pour améliorer l’accessibilité et le plateau technique des services spécialisés, pour mener une étude approfondie interdisciplinaire sur cette pathologie.

Kaposi's disease in children with HIV is rarely reported in everyday practice. This is a case study of cutaneous Kaposi's disease revealing HIV in a 5-year-old child with polymorphic eruption of papules and nodules on the face, trunk, back, and limbs. Histopathological examination confirmed the diagnosis of Kaposi's disease. The child's HIV serology was positive with a CD4 count of 240/mm, normochromic and normocytic anemia, and a hemoglobin level at 8.5 g/dl. It was found that the child, after early weaning from his HIV-negative mother, had repeatedly suckled his healthy grandmother, who had no skin lesions but was HIV1 positive. Both grandmother and child were referred for treatment in their locality. The case is noteworthy for the way in which the HIV1 virus infected the child during weaning and then being suckled by his grandmother. The child already had an initial dental flare that could have injured his grandmother. Thus, in our case, there is a contamination by HIV1 virus most likely from the grandmother and contamination by the HHV8 virus, source unidentified as a technical plateau was reached.

We report a 62-year-old farmer who consulted with multiple chronic wounds over his limbs and chest. Physical examination revealed multiple ulceration, madarosis and infiltration of ear lobes. Slit skin smear showed numerous acid-fast bacilli consistent with a diagnosis of lepromatous leprosy associated with Lucio's phenomenon. Administration of thalidomide together with MDT resulted in a huge improvement.

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Squamous cell carcinomas are favored by repeated sun exposure, especially in fair-skinned people who easily get sunburned. There are also genetic diseases including albinism which can promote their appearance early in life and multiple forms. We report the first observation of frontal squamous cell carcinoma with resection and reconstruction using the H-shaped flap in an albino (in Mali). Oculo -cutaneous albinism consulted for a frontal ulceration evolving for 3 years. The initial lesion was an erythematous macula which progressively evolved into a dragging ulceration. She had been treated with three sessions of cryotherapy (liquid nitrogen) without success. Physical examination found a slightly crusty ulceration, circumscribed (2 x 1.6 cm), painful and non-itchy. Otherwise the rest of the clinical examination was normal. A biopsy for pathological examination was performed. The diagnosis of invasive squamous cell carcinoma was confirmed. Surgical treatment was performed (resection and reconstruction with the H-shaped flap) with simple postoperative course and satisfactory results from an aesthetic point of view.