[Lyell's syndrome and its ophthalmologic manifestations in Cameroon]

Abstract

Background: To study basic epidemiological datas and ocular involvment during toxic epidermal necrolysis (T.E.N.) in Cameroonian patients.

Methods: Ten consecutive patients in the Central Hospital of Yaounde were included during a 4 years period. Anamnesis, clinical features, dermatological, ophthalmological and pathological examinations were done. Minimal follow up of 3 months.

Results: Mean age: 20.1 +/- 11.4 yrs (SD); culprit drugs: sulfadoxin (5/10), sulfamethoxazol (3/10); phenytoin (1/10). Mean of skin detachment: 41 +/- 17%. 2 patients died with sulfadoxin as culprit drug. Early ocular findings: conjunctivitis (all patients), symblepharon (1/8), ankyloblepharon (3 patients over 8 with sulfadoxin as culprit drug). All cases with ankyloblepharon (3) evoluated toward formation of a fibrovascular precorneal membrane with blindness. Two of the patients received a kerothoprosthesis on one eye. The 3 patients had a severe dry eye syndrome.

Conclusion: TEN appears to be uncommon in Cameroon. Use of sulfonamides for treatment and prevention of malaria and AID'S opportunistic infections may increase the incidence of disease in tropical african areas. Ophthalmologists should be aware of early management of ocular manifestations in Lyell syndrome to avoid severe sequelae. That sequelae may be due to usual intensive healing in African patients. Severe corneal damages can be corrected only by keratoprosthesis.