Risk factors associated with necrotizing fasciitis of the lower limbs: A multicenter case-control study.

Autor: Pitché P; Department of Dermatology, Sylvanus Olympio University Hospital, Université de Lomé, Lomé, Togo. Electronic address: ppitche@yahoo.fr., Diata AB; Department of Dermatology, Le Dantec University Hospital, Université Cheik Anta Diop, Dakar, Senegal., Faye O; Department of Dermatology-STD, Donka University Hospital, Université de Conakry, Conakry, Guinea., Tounkara TM; Department of Dermatology, CNAM, Université de Bamako, Bamako, Mali., Niamba P; Department of Dermatology, Yaldago Ouédraogo University Hospital, Université de Ouagadougou, Ouagadougou, Burkina Faso., Mouhari-Toure A; Department of Dermatology, Kara University Hospital, Université de Kara, Kara, Togo., Ly F; Department of Dermatology, Le Dantec University Hospital, Université Cheik Anta Diop, Dakar, Senegal., Soumah MM; Department of Dermatology-STD, Donka University Hospital, Université de Conakry, Conakry, Guinea., Some-Korsaga N; Department of Dermatology, Yaldago Ouédraogo University Hospital, Université de Ouagadougou, Ouagadougou, Burkina Faso., Akakpo AS; Department of Dermatology, Sylvanus Olympio University Hospital, Université de Lomé, Lomé, Togo., Diané BF; Department of Dermatology-STD, Donka University Hospital, Université de Conakry, Conakry, Guinea., Cissé M; Department of Dermatology-STD, Donka University Hospital, Université de Conakry, Conakry, Guinea., Niang S; Department of Dermatology, Le Dantec University Hospital, Université Cheik Anta Diop, Dakar, Senegal., Traore A; Department of Dermatology, Yaldago Ouédraogo University Hospital, Université de Ouagadougou, Ouagadougou, Burkina Faso., Saka B; Department of Dermatology, Sylvanus Olympio University Hospital, Université de Lomé, Lomé, Togo.
Jazyk: angličtina
Zdroj: Annales de dermatologie et de venereologie [Ann Dermatol Venereol] 2021 Sep; Vol. 148 (3), pp. 161-164. Date of Electronic Publication: 2021 Feb 05.
DOI: 10.1016/j.annder.2020.08.056
Abstrakt: Objective: The aim of this case-control study was to identify risk factors associated with necrotizing fasciitis (NF) of the lower limbs.
Patients and Methods: We conducted a prospective case-control study in hospital dermatology departments in 5 sub-Saharan African countries over a 2-year period (April 2017 to July 2019). The cases were patients with NF of the lower limbs and the controls were patients with leg erysipelas. Each case was matched with two controls for age (±5 years) and sex. We analyzed local and general factors.
Results: During the study period, 159 cases (73 females, 86 males) were matched with 318 controls. The mean age was 48.5±15.8 years for cases and 46.5±16.2 years for controls (P=0.24). The main local signs of NF were cutaneous necrosis (83.7%), pain (75.5%) and induration (42.1%). Multivariate analysis showed the following to be independent risk factors associated with NF of the lower limbs: obesity (odds ratio [OR]=2.10; 95% confidence interval [CI]: 1.21-3.42), diabetes (OR=3.97; 95% CI: 1.95-6.13), nicotine addiction (OR=5.07; 95% CI: 2.20-11.70), use of non-steroidal anti-inflammatory drugs (NSAIDs) (OR=7.85; 95% CI 4.60-14.21) and voluntary cosmetic depigmentation (OR=2.29; 95% CI: 1.19-3.73).
Conclusion: Our study documents the role of NSAID use at the onset of symptoms as a risk factor for NF of the lower limbs. However, the originality of our study consists in the identification of voluntary cosmetic depigmentation as a risk factor for NF of the lower limbs in sub-Saharan Africa patients. Our results also identified typical overarching factors such as diabetes, obesity and nicotine addiction. Knowing these factors and taking them into account will enable optimization of management strategies for these conditions.
(Copyright © 2021 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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