This cross-sectional study was conducted in Antananarivo, Madagascar, from June to September 2012. We aim to evaluate the misuse of TC on the face for cosmetic purpose and the adverse effects due to its application. A questionnaire-based analysis was done among females who use topical corticosteroids on the face for cosmetic purpose. Of the 770 women questioned, 384 (49,8%) used topical corticosteroids for cosmetic purpose whose mean age was 38 years (range 16–73 years). Two hundred and sixty-one females (68%) used TC combined with handcrafted cosmetics, and 123 (32%) used TC alone. “Pandalao,” which contains salicylic acid, peppermint oil, lanolin, powder of Juanes de Vigo (mercury powder), and Vaseline, is the most handcrafted cosmetic combined with TC in our study (used by 29,4% respondents). Only one (0,26%) had obtained the TC by physician's prescription, 234 (61%) from cosmetic retailers, 92 (23%) directly from local pharmacies, 49 (12%) from beauticians, and 15 (4%) from unspecified sources. Lightening of skin color was the main reason for using TC in 44,8% of respondents in the absence of any primary dermatosis. Pigmentation disorders (63,2%) and cutaneous atrophy (52,1%) were the most adverse effects noted.

Background: Little is known about the epidemiology and associated factors of childhood AD in the markedly different, low-income, tropical environment like Madagascar. Methods: We aim to assess the epidemiology and associated factors of AD in individuals fewer than 15 years of age in Antananarivo Madagascar. It was a retrospective and descriptive study over a period of 7 years (2010 to 2016) in children 6 months to 14 years in the Department of Dermatology, Joseph Raseta Befelatanana Antananarivo Madagascar. The diagnosis of AD was based on clinical data. Results: The prevalence of AD was 5.6% in children aged 6 months to 14 years. The details of 151 cases of atopic dermatitis were analyzed. The mean age of patients was 4 years. There was a female preponderance (sex ratio: 0.7). A family history of AD was noted in 56 cases (37%). No association between breast-feeding and AD was found. The age of onset of AD was before the age of 3 months in 7.5% and between 6 months to 5 years in 70%. Children born in March (dry season) had the highest risk of AD. Consultations for AD increased during the winter (from July to October; p = 0.005). However, the prevalence of AD was similar in urban and rural areas. Conclusion: Weather may have an impact on the prevalence of atopic dermatitis in Madagascar. No significant correlation was found between the duration of breastfeeding and AD, as well as urbanization.

Background. Psoriasis is a chronic, inflammatory, and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision-making along with the effectiveness and the harmlessness of the treatments. Objective. To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales. Methods. A cross-sectional study from January to June 2018 was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, including patients more than 18 years old with mild to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales. Results. 80 patients were included, their mean age was 36.5 years, and the male to female was 1.5 : 1. The mean DLQI score was 13.8. Symptoms, feelings, and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0.36). Furthermore, the clinical presentation of psoriasis did not influence the patient’s QoL (p=0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0.2). The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0.002). Furthermore, the higher the PASI, the more QoL is altered (p=0.002). Conclusion. Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.

Background: Lupus erythematosus (LE) is a chronic autoimmune disease that affects more women than men. The quality of life (QoL) of patients with lupus erythematosus and skin manifestations is impaired, but little is known about Malagasy patients. Objective: This study aimed to assess the impact of cutaneous lesions on the QoL of patients who present with LE. Methods: A transversal study, during 3 months, was conducted in patients who presented with LE and cutaneous lesions at the University Hospital Antananarivo. QoL was assessed using the Dermatology Life Quality Index (DLQI) scales. Results: The impact of cutaneous lesions on the QoL was assessed in 37 patients with LE, of whom 34 were women. The mean age of patients was 37.32 years. The mean DLQI was 5.43 ± 4.67 (range, 0–21). Of the patients, 2.7% had a very important effect (DLQI >21), 18.9% reported a great effect of skin symptoms of LE in their QoL (DLQI: 11–20), 18.9% had a moderate effect (DLQI: 6–10), 40.4% had a small effect (DLQI: 2–5), and 18.9% had no effect of cutaneous lesions on their QoL. Daily activities, symptoms, and feelings were the most altered dimensions. The alteration in patients’ QOL was influenced by high monthly income, severe medical history, and localization of the cutaneous lesions on the face and neckline. No correlation was found between sex and QoL. Conclusion: This study shows that significant impairment of QoL was found in patients with LE and cutaneous manifestations, which affected their sense of well-being.

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.