Pemphigus in Mali: a study of 30 cases

Area of Science:

• Dermatology
• Epidemiology
• Immunology

Background:

• Pemphigus epidemiology and clinical presentation vary significantly across different global regions.
• Limited data exists on pemphigus in Africa, necessitating further research into regional patterns.

Purpose of the Study:

• To investigate the epidemiological and clinical characteristics of pemphigus in Bamako, Mali.
• To compare the observed pemphigus pattern in Mali with established patterns in North America, Europe, and Brazil.

Main Methods:

• Retrospective analysis of 30 pemphigus cases diagnosed clinically, histopathologically, and via direct immunofluorescence.
• Estimation of annual incidence in the Bamako region.
• Detailed characterization of patient demographics, ethnic background, clinical subtypes, and specific clinical features.

Main Results:

• An estimated annual incidence of 0.29 cases per 100,000 inhabitants was recorded.
• The disease predominantly affected women (80%), particularly those over 40 (mean age 46.7 years), and the Fulani ethnic group (33%).
• Pemphigus foliaceus (PF) was the most common subtype (83%), with notable features including pustules with hypopyon (37%), verrucous changes (erythrodermic PF and treatment-induced lesions), and eosinophilic spongiosis (50%).

Conclusions:

• Pemphigus in Mali exhibits a unique epidemiological and clinical profile, distinct from North American/European and Brazilian patterns.
• While sharing a predilection for superficial forms with the Brazilian pattern, the Malian pemphigus presents significant differences.
• Further research is warranted to understand the specific factors contributing to this distinctive pattern in West Africa.