Pattern of Skin diseases in Black Africans of Sierra Leone, West Africa

Background: Skin disorders are seen in all ethnic groups with varying frequency. This differential prevalence points towards some social, cultural, and environmental factors in addition to genetic factors in causation of these disorders. Aim of the Study: The purpose of the study was to see the patterns of skin diseases in Eastern province of Sierra Leone and to observe the role of ethnicity in causation of these disorders. Place and Duration of the Study: The study was carried out in Eastern province of Sierra Leone (Kenema) between November 2004 and September 2005. Type of Study: It was an observational study. Patients and Methods: Local black patients of all age groups having one or more skin disorders were included. After clinical history and physical examination, patients (lesions) were photographed. Laboratory investigations (macroscopic fungal examination, X-rays, USG, haematological profiles, STS, etc.) were also carried out when indicated. Non-black settlers in the area and UN troops were not included in the study. Data were recorded and analysed by Microsoft Excel. Results: A total of 2877 patients belonging to different local tribes having a variety of skin disorders were seen during the study period. Patients were of all ages, ranging from 1 month to 73 years, and of both sexes. Sex ratio was almost equal. Vast majority were from very low socioeconomic group. The most prevalent disorders seen were fungal infections (42.3%), followed by hair disorders (9.7%), sexually transmitted infections (9.2%), acne/folliculitis (7%), parasitic infections (6.6%), scars/keloidal disorders (5%), and pigmentary disorders (4.5%). Bacteria and viral infections were rare and so was the scabies. Onchodermatitis with all kinds of skin manifestations was seen in appreciable number of patients (> 6%). Conclusion: Pattern of skin disorders in black Africans of Sierra Leone is different from other regions, and these differences may significantly be attributed to unique environmental and cultural factors prevailing there.