Epidemiologic, clinical, and therapeutic features of acne in Dakar, Senegal

Acne, a chronic inflammatory dermatosis of the pilosebaceous follicle, is very widespread worldwide, affecting 75-80% of adolescents, with an impact on their quality of life. The etiologic factors are not always the same, and the treatments proposed are not always well tolerated in black individuals.

To determine how acne affects the black population in Dakar, Senegal, and to assess the results of and tolerance to treatment.

This was a prospective study conducted on a sample of patients who attended consultations for acne in our dermatology department between December 2002 and March 2003, and who agreed to take part in the study (informed consent was obtained). An anonymous questionnaire was used as a support.

Ninety-three patients were included in the study, with a hospital frequency of 5.3% and an average age of onset of acne of 25.58 years. In 75% of cases, the acne sufferers were young women, 76.3% of whom were single. Acne was of the superficial inflammatory type in 76.3%, retentional in 67.7%, and nodulocystic in 12.9% (Some patients who have acne vulgaris may have pustules, papules and nodules or cystic lesions so the percentages add up to 100). Signs of hyperandrogeny were observed in 19.1%, with hirsutism in 93.8%. Artificial depigmentation was noted in 38.7%. Stress was found in 89.2% and a depressive state in 3.4%. Solar exposure aggravated the lesions in 52.7%. In terms of therapy, only 1.1% received oral retinoids. An improvement was noted in 67.2%, and resistance was observed in 7.3%.

In Dakar, Senegal, patients with acne consult later than elsewhere. The majority of cases are women, contrary to certain other studies. The inflammatory forms predominate in adult women. The most frequent location is on the face. An evolution to pigmentary disorders is found in 67.7%. Predisposing factors include the use of depigmenting cosmetic products and sun exposure. Local treatment, such as benzoyl peroxide and topical retinoids, which promote melanoderma in black skin, is widely used. The exorbitant cost of oral retinoids considerably limits their use in Senegal.

Acne, an adolescent pathology, is increasingly being observed in adults using depigmenting cosmetics. The multiple clinical forms are dominated by inflammatory acne. The many relapses and cost of treatment have a detrimental effect on the quality of life of patients.