@article{fdi:010066861,
  title = {{D}ifferential diagnosis of skin ulcers in a {M}ycobacterium ulcerans endemic area : data from a prospective study in {C}ameroon},
  author = {{T}rellu, {L}. {T}. and {N}kemenang, {P}. and {C}omte, {E}. and {E}hounou, {G}. and {A}tangana, {P}. and {M}boua, {D}. {J}. and {R}usch, {B}. and {T}abah, {E}. {N}. and {E}tard, {J}ean-{F}ran{\c{c}}ois and {M}ueller, {Y}. {K}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {C}linical diagnosis of {B}uruli ulcer ({BU}) due to {M}ycobacterium ulcerans can be challenging. {W}e aimed to specify the differential diagnosis of skin lesions in a {BU} endemic area. {M}ethod {W}e conducted a prospective diagnostic study in {A}konolinga, {C}ameroon. {P}atients presenting with a skin ulcer suspect of {BU} were included. {M}. ulcerans was detected using swabs for {Z}iehl-{N}eelsen staining, {PCR} and culture. {S}kin punch biopsies were taken and reviewed by two histopathologists. {P}hotographs of the lesions were taken and independently reviewed by two dermatologists. {F}inal diagnosis was based on consensus, combining the results of laboratory tests and expert opinion. {R}esults/{D}iscussion {B}etween {O}ctober 2011 and {D}ecember 2013, 327 patients with ulcerative lesions were included. {M}edian age was 37 years (0 to 87), 65% were males, and 19% {HIV}-positive. {BU} was considered the final diagnosis for 27% of the lesions, 85% of which had at least one positive laboratory test. {D}ifferential diagnoses were vascular lesions (22%), bacterial infections (21%), post-traumatic (8%), fistulated osteomyelitis (6%), neoplasia (5%), inflammatory lesions (3%), hemopathies and other systemic diseases (2%) and others (2%). {T}he proportion of {BU} was similar between {HIV}-positive and {HIV}-negative patients (27.0% vs. 26.5%; p = 0.940). {H}alf of children below 15 years of age were diagnosed with {BU}, compared to 26.8% and 13.9% among individuals 15 to 44 years of age and above, respectively (chi2 p< 0.001). {C}hildren had more superficial bacterial infections (24.3%) and osteomyelitis (11.4%). {C}onclusion {W}e described differential diagnosis of skin lesions in a {BU} endemic area, stratifying results by age and {HIV}-status.},
  keywords = {{CAMEROUN}},
  booktitle = {},
  journal = {{P}los {N}eglected {T}ropical {D}iseases},
  volume = {10},
  numero = {4},
  pages = {e0004385 [12 p.]},
  ISSN = {1935-2735},
  year = {2016},
  DOI = {10.1371/journal.pntd.0004385},
  URL = {https://www.documentation.ird.fr/hor/fdi:010066861},
}