Antoine Mahé - Academia.edu (original) (raw)

Papers by Antoine Mahé

International journal of …, 2002

1. Int J Lepr Other Mycobact Dis. 2002 Jun;70(2):119-21. Irrational use of skin-bleaching product... more 1. Int J Lepr Other Mycobact Dis. 2002 Jun;70(2):119-21. Irrational use of skin-bleaching products can delay the diagnosis of leprosy. Mahé A, Ly F, Badiane C, Baldé Y, Dangou JM. PMID: 12211896 [PubMed - indexed for MEDLINE]. Publication Types: Case Reports; Letter. ...

PLOS ONE, 2015

We conducted a comprehensive, systematic review of the global childhood population prevalence of ... more We conducted a comprehensive, systematic review of the global childhood population prevalence of impetigo and the broader condition pyoderma. PubMed was systematically searched for impetigo or pyoderma studies published between January 1 1970 and September 30 2014. Two independent reviewers extracted data from each relevant article on the prevalence of impetigo. Sixty-six articles relating to 89 studies met our inclusion criteria. Based on population surveillance, 82 studies included data on 145,028 children assessed for pyoderma or impetigo. Median childhood prevalence was 12·3% (IQR 4·2-19·4%). Fifty-eight (65%) studies were from low or low-middle income countries, where median childhood prevalences were 8·4% (IQR 4·2-16·1%) and 14·5% (IQR 8·3-20·9%), respectively. However, the highest burden was seen in underprivileged children from marginalised communities of high-income countries; median prevalence 19·4%, (IQR 3·9-43·3%). Based on data from studies published since 2000 from low and low-middle income countries, we estimate the global population of children suffering from impetigo at any one time to be in excess of 162 million, predominantly in tropical, resource-poor contexts. Impetigo is an under-recognised disease and in conjunction with scabies, comprises a major childhood dermatological condition with potential lifelong consequences if untreated.

International journal of dermatology, 2007

Pyoderma (bacterial superficial skin infection) is an extremely common disorder in tropical devel... more Pyoderma (bacterial superficial skin infection) is an extremely common disorder in tropical developing countries. In these settings, Streptococcus pyogenes is considered to be the main etiological agent. Apart from epidemics of poststreptococcal glomerulonephritis where mass treatment with intramuscular benzathine-penicillin is recommended, no recommendation exists for the treatment of pyoderma in this setting. The aim of this study was to evaluate the efficacy of oral amoxicillin in the treatment of pyoderma in Mali, by comparison with oral erythromycin. In Bamako, 132 patients with pyoderma, diagnosed and graded as "severe" on clinical grounds, were randomly assigned to an oral treatment by either amoxicillin (50 mg/kg per day) or erythromycin; infections of the follicular appendage were excluded. Both drugs were associated with the topical application of povidone iodine. The patients were evaluated openly at the seventh day of treatment for cure or marked improvement of...

Bulletin of the World Health Organization, 2005

To evaluate, in a developing country, the effect of a short training programme for general health... more To evaluate, in a developing country, the effect of a short training programme for general health care workers on the management of common skin diseases--a neglected component of primary health care in such regions. We provided a one-day training programme on the management of the skin diseases to 400 health care workers who worked in primary health care centres in the Bamako area. We evaluated their knowledge and practice before and after training. Before training, knowledge about skin diseases often was poor and practice inadequate. We found a marked improvement in both parameters after training. We analysed the registers of primary health care centres and found that the proportion of patients who presented with skin diseases who benefited from a clear diagnosis and appropriate treatment increased from 42% before the training to 81% after; this was associated with a 25% reduction in prescription costs. Improved levels of knowledge and practice persisted for up to 18 months after t...

In assigning health priorities, skin diseases are sometimes thought of, in planning terms, as sma... more In assigning health priorities, skin diseases are sometimes thought of, in planning terms, as small-time players in the global league of illness compared with diseases that cause signif- icant mortality, such as HIV/AIDS, community-acquired pneu- monias, and tuberculosis. However, skin problems are generally among the most common diseases seen in primary care settings in tropical areas, and in some regions

Leukemia, 2000

The combination of the anti-viral agents, zidovudine (AZT) and interferon-alpha (IFN), is a poten... more The combination of the anti-viral agents, zidovudine (AZT) and interferon-alpha (IFN), is a potent treatment of HTLV-I-associated adult T cell leukemia/lymphoma (ATL). In this study we investigate the possible mechanism of action of this combination by examining several cellular parameters including cell proliferation, cell cycle distribution and apoptosis. The ATL-derived T cell lines HuT-102 and MT-2 served as models. HTLV-I negative T cell lines (CEM and Jurkat) were used as controls. No significant modification of cell growth was observed except at suprapharmacological doses of AZT and IFN. Moreover, these effects were less pronounced in HTLV-I-infected cell lines compared to control cell lines. AZT and IFN treatment did not induce any significant modification of the expression of bcl-2 and p53. Interestingly no in vitro cytotoxic effect of AZT/IFN combination was observed on fresh leukemic cells derived from an acute ATL patient at diagnosis despite achievement of in vivo compl...

Transactions of the Royal Society of Tropical Medicine and Hygiene, 2005

In order to help primary health care (PHC) workers in developing countries in the care of common ... more In order to help primary health care (PHC) workers in developing countries in the care of common skin diseases, an algorithm for the management of pyoderma, scabies, superficial mycoses, contact dermatitis and referral of early leprosy cases (based on the identification of diseases through the presence of objective key signs, and on treatments by generic drugs) was elaborated. One thousand patients were seen by trained dermatologists, who established diagnoses and treatments; in addition, there was systematic recording of each key sign, according to the successive algorithm steps. We compared the diagnostics and treatments obtained for several combinations of diagnostic signs, with those of the dermatologists. Sensitivity, specificity, positive predictive value and negative predictive value of defined combinations were high for pyoderma, scabies and superficial mycoses. Values were less exact for dermatitis and leprosy, but were considered sufficient for the level of health care targeted. The apportionment of treatments between the algorithm and the dermatological approaches was considered appropriate in more than 80% of cases; mismanagement was possible in 7% of cases, with few predictable harmful consequences. The algorithm was found satisfactory for the management of the dermatological priorities according to the standards required at the PHC level.

Background Kaposi sarcoma (KS) is a complex tumor of uncertain clonality. Studying the viral clon... more Background Kaposi sarcoma (KS) is a complex tumor of uncertain clonality. Studying the viral clonality of the human herpesvirus 8 (HHV-8) in KS to determine clonality of the tumors, a strategy that has been used previously with Epstein - Barr virus and its associated tumors, may elucidate whether multicentric (disseminated) KS lesions correspond to metastatic lesions or to expansions of

International Journal of Dermatology, 2005

International Journal of Dermatology, 1998

Bamako, Republic of Mali and Unité Background Skin diseases have only recently been considered as... more Bamako, Republic of Mali and Unité Background Skin diseases have only recently been considered as a possible public de Dermatologie, CHU de Pointe-àhealth problem in developing countries. Data supporting this matter are scarce. The aim Pitre, 97159 Pointe-à -Pitre Cedex, of this study is to report the experience of a specialized dermatologic center in Bamako Guadeloupe, French West Indies (Mali) in order to complete two previous studies conducted in the Bamako area: a Correspondence prevalence study in the general population and a study in nonspecialized health centers Antoine Mahé , MD of Bamako. It is our intention to provide a comprehensive picture of the problem of skin Dermatologie diseases in an African developing country. CHU de Pointe-à -Pitre Methods We retrospectively collected all cases of skin diseases diagnosed during 97159 Pointe-à -Pitre Cedex consultations provided at the Institut Marchoux in Bamako, the only center specializing in Guadeloupe French West Indies dermatology in Mali, during the year 1993.

The Lancet, 1996

Erythrodermic diffuse cutaneous leishmaniasis with Sézary syndrome. By - A Mahé, A Gessain, M Hue... more Erythrodermic diffuse cutaneous leishmaniasis with Sézary syndrome. By - A Mahé, A Gessain, M Huerre, F Pratlong, JP Dedet.

Transactions of the Royal Society of Tropical Medicine and Hygiene, 1995

In order to estimate the importance as a public health problem of skin diseases, we investigated ... more In order to estimate the importance as a public health problem of skin diseases, we investigated the prevalence and severity of skin diseases in a representative sampfe of children in Mali. 1817 children were randomly selected in 30 clusters by probability-proportional-to-size sampling in Koulikoro region. The mean prevalence (+2 SD) of skin diseases was 34i4%. The most frequent dermatoses were pyoderma (12.3+ 1*6%), tinea capitis (9*5+2.5%), pediculosis capitis (4.7-t 1.4%), scabies (4.3* 1*5%), and molluscum contagiosum (3.6f 1%). The most troublesome dermatoses were scabies and severe pyoderma, Pyoderma was the only dermatosis associated with poor individual or household hygiene. Public health services were little used by the population for skin diseases, probably because of the lack of an adequate response by the services and the lugh cost of treatment. The high prevalence and the severity of many of the lenons, and the discomfort caused, make pyoderma and scabies a significant public health problem in Mali.

Transactions of the Royal Society of Tropical Medicine and Hygiene, 2007

Many women of childbearing age from sub-Saharan Africa use topical skin lighteners, some of which... more Many women of childbearing age from sub-Saharan Africa use topical skin lighteners, some of which present a risk of toxic systemic effects. The goals of this study were to evaluate, in this environment, the frequency of this practice during pregnancy, as well as eventual consequences on pregnancy. Ninety-nine women from 6 to 9 months pregnant were randomly selected among those attending a standard maternal centre in Dakar for a prenatal visit. Investigations consisted of questions about the use of skin lighteners, a standard clinical examination, follow-up until delivery and a morning blood sample for plasma cortisol levels. Sixty-eight of the 99 selected women used skin lighteners during their current pregnancy, the main active ingredients being hydroquinone and highly potent steroids (used by 64 and 28 women, respectively). No difference in the main outcomes of pregnancy were found between skin-lightener users and the others; however, women using highly potent steroids, when compared with those who did not, had a statistically significant lower plasma cortisol level and a smaller placenta, and presented a higher rate of low-birth-weight infants. Skin lightening is a common practice during pregnancy in Dakar, and the use of steroids may result in consequences in the mother and her child.

Leukemia, 1998

Cutaneous T cell lymphomas (CTCL) are rare lymphoproliferative diseases, which are frequently sus... more Cutaneous T cell lymphomas (CTCL) are rare lymphoproliferative diseases, which are frequently suspected to be of viral origin. As very few data were available concerning cutaneous T cell lymphomas in tropical Africa, we undertook a clinical, histopathological, immunological and viro-molecular study of patients with a clinical diagnosis of cutaneous lymphoma, in Bamako, Mali. While prior to this study, no case of CTCL had been reported in this country, 14 patients (five women, nine men; mean age 58 years) with a diagnosis of cutaneous lymphoma were seen over a period of 30 months (1992-1994) in the only dermatological department in Mali. Clinically, the most frequent pattern was an infiltrated erythrodermia similar to Sezary syndrome. Nodular lesions and/or plaques were rarely observed. All these cutaneous tumors were T cell lymphoproliferations, only one expressing the CD8+ antigen. A comprehensive analysis of all the available data permitted characterization of three cases of adult T cell leukemia/lymphoma (ATL) associated with HTLV-I (one definitive case, of leukemic type, with demonstration of clonal integration of HTLV-I proviral genome and two probable ATL cases), three cases of Sezary syndrome (SS), two cases of mycosis fungoides (MF) and five cases of pleomorphic cutaneous lymphoma. In one case, the differentiation between MF and pleomorphic cutaneous lymphoma could not be established. HTLV-I serological and/or molecular markers were restricted to the three ATL cases. From the unique definitive ATL case, a T cell line was established from culture of peripheral blood mononuclear cells and sequence analysis of the env gene and the U3-LTR region demonstrated that the virus present in this patient belonged to the cosmopolitan subtype A. Thus, we report here the first evidence of HTLV-I infection and associated ATL in Mali. This is the second ATL case described for the whole Sahelian region (one ATL of the lymphoma type was reported previously in a Mauritanian patient). Furthermore, we demonstrate that the main types of CTCL described in Europe and North America are also present in this African area and that the prevalence of these diseases is greatly underestimated in such regions. Furthermore, no association was observed between HTLV-I/II infection and SS, MF or pleomorphic cutaneous lymphoma in Mali in contrast to other studies.

Journal of the American Academy of Dermatology, 1995

Systemic mastocytosis is a rare disease that shows marked heterogeneity in clinical manifestation... more Systemic mastocytosis is a rare disease that shows marked heterogeneity in clinical manifestations and prognosis. It may be associated with hematologic disorders. We describe a patient with systemic mastocytosis associated with chronic myelomonocytic leukemia accompanied by ascites, pleural effusion, and development of skin lesions along a surgical scar. The disease responded well to interferon alfa therapy. This is the second report of successful treatment of mastocytosis with interferon alfa and the first associated with a hematologic malignancy.

Journal of the American Academy of Dermatology, 1993

Journal of the American Academy of Dermatology, 1996

2. Tschen EH, Apisamthanarax P. Inflammatory metastatic carcinoma of the breast. Arch Dermatol 19... more 2. Tschen EH, Apisamthanarax P. Inflammatory metastatic carcinoma of the breast. Arch Dermatol 1981;117: 120-1. 3. Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol 1993;29:228-36. 4. Edelstein JM. Pancreatic carcinoma with unusual metastasis to the skin and subcutaneous tissue simulating ceUulitis. N Engl J Med 1950;242:779-81. 5. Reuter MJ, Nomland R. Inflammatory cutaneous metastatic carcinoma. Wis Med J 1941;40:196-201. 6. Hazelrigg DE, Rudolph AH. Inflammatory metastatic carcinoma: carcinoma erysipelatoides. Arch Dermatol 1977; 113:69-70. 7. Krishnan EU, Phillips AK, Randell A, et al. Bilateral metastatic inflammatory carcinoma in the breast from primary ovarian cancer. Obstet Gynecol 1980;55(suppl):94-6. 8. Schwartz RA, Rubenstein DJ, Raventos A, et al. Inflam-matory metastatic carcinoma of the parotid. Arch Dermatol 1984; 120:796-7. 9. Lever LR, Holt PJA. Carcinoma erysipeloides. Br J Dermatol 1991;i24:279-82. 10. Cox SE, Cruz PD Jr. A spectrum of inflammatory metastasis to skin via lymphatics: three cases of carcinoma erysipeloides.

JNCI Journal of the National Cancer Institute, 2007

Kaposi sarcoma (KS) is a complex tumor of uncertain clonality. Studying the viral clonality of th... more Kaposi sarcoma (KS) is a complex tumor of uncertain clonality. Studying the viral clonality of the human herpesvirus 8 (HHV-8) in KS to determine clonality of the tumors, a strategy that has been used previously with Epstein-Barr virus and its associated tumors, may elucidate whether multicentric (disseminated) KS lesions correspond to metastatic lesions or to expansions of independent clones. A series of 139 KS biopsies (from skin, lymph node, or tonsil) was obtained from 98 patients, with 59 biopsies from 18 patients with disseminated multicentric KS skin lesions. The degree of spindle cell infiltration in biopsies was established by direct observation of hematoxylin-eosin-stained sections, and HHV-8 viral load was quantified by real-time polymerase chain reaction. To determine cellular clonality, the size heterogeneity of the HHV-8-fused terminal repeat (TR) region was determined by probing of electrophoresed restricted genomic DNA from KS biopsies for the HHV-8 TR sequence. HHV-8 clonality analysis was performed on the 62 samples for which sufficient DNA was obtained. Most samples corresponded to histologically nodular lesions with high spindle cell infiltration and high viral load. A clonal HHV-8 pattern was determined for 59 samples; 11 were found to be monoclonal and 48 to be oligoclonal. The informative samples that were from disseminated KS skin lesions (n = 26, from six patients) were either monoclonal or oligoclonal, and the size of HHV-8 episomes varied between these samples. Although some tumor KS lesions were monoclonal expansions of HHV-8-infected spindle cells, most advanced lesions were oligoclonal proliferations. Furthermore, individual KS disseminated tumor skin lesions were found to represent distinct expansions of HHV-8-infected spindle cells. Thus, our results suggest that KS lesions, especially in patients with advanced skin tumors, are reactive proliferations rather than true malignancies with metastatic dissemination.

Journal of Clinical Microbiology, 2008

Human T-cell leukemia virus type 1 (HTLV-1) is highly endemic in areas of central Africa; mother-... more Human T-cell leukemia virus type 1 (HTLV-1) is highly endemic in areas of central Africa; mother-to-child transmission and sexual transmission are considered to be the predominant routes. To determine the prevalence and subtypes of HTLV-1/2 in pregnant women in Gabon, we conducted an epidemiological survey in the five main cities of the country. In 907 samples, the HTLV-1 seroprevalence was 2.1%, which is lower than that previously reported. Only one case of HTLV-2 infection was found. The HTLV-1 seroprevalence increased with age and differed between regions (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;/= 0.05), with the highest prevalence (5%) in the southeastern region. A wide range of HTLV-1 proviral loads was observed among the infected women. The level of the proviral load was correlated with a high HTLV-1 antibody titer (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;/= 0.02). Sequencing of HTLV-1 env and long terminal repeat fragments showed that all but one strain belonged to the central African subtype B; the outlier was of cosmopolitan subtype A. The new strains of subtype B exhibited wide genetic diversity, but there was no evidence of clustering of specific genomes within geographical regions of the country. Some strains were closely related to simian T-cell leukemia virus type 1 strains of great apes, suggesting that in these areas some HTLV-1 strains could arise from relatively recent interspecies transmission. The sole HTLV-2 strain belonged to subtype B. In this study we showed that the prevalence of HTLV-1 in the southeast is one of the highest in the world for pregnant women.