1/8. onchocerciasis presenting with lower extremity, hypopigmented macules.onchocerciasis, or river blindness, is a parasitic infection caused by the filarial nematode, onchocerca volvulus. It infects 18 million people worldwide, but is rarely seen in the united states. It is one of the leading causes of blindness in the developing world. Although onchocerciasis is also known as river blindness, it is not just a disease of the eyes, but rather a chronic multisystem disease. Clinically, onchocerciasis takes three forms: 1) eye disease; 2) subcutaneous nodules; and 3) a pruritic hypopigmented or hyperpigmented papular dermatitis. We present an 18-year-old African female with a 5-year history of asymptomatic, hypopigmented, slightly atrophic macules on her anterior tibiae. pathology revealed a scant perivascular inflammatory infiltrate with mononuclear cells, eosinophils, and rare microfilariae in the papillary dermis. ivermectin is the treatment of choice for onchocerciasis and was initiated in this patient. We present this interesting patient with onchocerciasis to expand our differential of hypopigmented macules, especially in the African population. In addition, we discuss both the diagnosis and the treatment of onchocerciasis in expatriate patients living in nonendemic areas.- - - - - - - - - - ranking = 1keywords = onchocerciasis (Clic here for more details about this article) |
2/8. onchocerciasis (river blindness).A 37-year-old African man presented for excision of a dermal nodule after a diagnosis of ocular onchocerciasis (river blindness). A nodule from the patient's left buttock contained several adult filarial worms, and results from adjacent skin biopsy specimens revealed numerous dermal microfilariae. The patient was admitted to the hospital and treated with one dose of ivermectin. Recommendations were made for ivermectin treatments every 6 months for up to 10 years. The history, clinical presentation, diagnosis, and treatment of onchocerciasis are discussed.- - - - - - - - - - ranking = 0.4keywords = onchocerciasis (Clic here for more details about this article) |
3/8. Cutaneous onchocerciasis in an American traveler.A case report of cutaneous onchocercias acquired during travels to Africa is presented. The salient epidemiologic, clinical, diagnostic, and therapeutic aspects are reviewed. Clinical and laboratory differences between onchocerciasis patients who are inhabitants of endemic areas and those who are occasional visitors to such areas are discussed. Parasitic infections, including onchocerciasis, should be considered in the differential diagnosis of pruritic eruptions in patients with a history of foreign travel to africa, central and south america.- - - - - - - - - - ranking = 1.2keywords = onchocerciasis (Clic here for more details about this article) |
4/8. Possible transplacental transmission of onchocerca volvulus.In a recent epidemiological study on onchocerciasis on the lower Jos Plateau in nigeria, a 7-month-old baby delivered by a mother suffering from onchocerciasis showed early clinical signs of the disease: pruritus was present all over the body. The infant's skin snip on incubation revealed microfilariae of onchocerca volvulus. These findings were confirmed 3 months later when the child was re-examined. No onchocercal nodule was found, but pruritus persisted.- - - - - - - - - - ranking = 0.4keywords = onchocerciasis (Clic here for more details about this article) |
5/8. Cutaneous onchocerciasis.onchocerciasis was diagnosed when a skin biopsy specimen immersed in saline revealed microfiliariae. The patient was a 22-year-old student from cameroon, West Africa, complaining of small, recurrent, pruritic papules on his thighs. Chemotherapy with ivermectin, an established antiparasitic agent with newly recognized anti-onchocercal potential, was well tolerated, and microfilariae were not detected in post-therapy skin biopsy specimens. The diagnosis of onchocerciasis should be entertained in individuals returning or emigrating from endemic areas.- - - - - - - - - - ranking = 1keywords = onchocerciasis (Clic here for more details about this article) |
6/8. Pigmented basal cell epithelioma arising in the scar of an onchocerciasis nodule.Pigmented basal cell epithelioma (BCE) arose in the scar of an onchocercoma nodule in a 45-year-old white man. There were extensive fibrosis, inflammation, epidermal hyperplasia, and nests of basal cancer cells. The authors believe that the development of epithelioma in this case was more than a chance occurrence. There is little doubt that the malignant change was subsequent to the scarring-proliferative process of the disease. To the authors' knowledge, this complication has not been reported previously.- - - - - - - - - - ranking = 0.8keywords = onchocerciasis (Clic here for more details about this article) |
7/8. onchocerciasis in israel.A 15-year-old boy with onchocerciasis had severe generalized pruritus of five months' duration. He had been born and raised in ethiopia and had emigrated to israel one year earlier. A biopsy specimen of an area of depigmentation on the right thigh disclosed microfilaria of onchocerca volvulus in the dermis. The discovery of an unusual disease in a nonendemic area is an example of the increased complexity of differential diagnosis resulting from the ease of travel from one geographic region to another.- - - - - - - - - - ranking = 0.2keywords = onchocerciasis (Clic here for more details about this article) |
8/8. Subcutaneous nodules as a manifestation of onchocerciasis. A rare condition in the united states.Although infection with tissue nematodes is a significant health problem in many parts of the world, such cases are unusual in the continental united states. This report describes a case of onchocerca volvulus infection, acquired by a 38-year-old female missionary in northern brazil, that manifested as subcutaneous nodules in the groin and flank two years after the patient's return to the united states. A year previously, a wrong diagnosis of wuchereria bancrofti was made at biopsy. At that time, treatment with diethylcarbamazine citrate had to be discontinued because of intense pruritus. Examination of a wet saline impression smear of a new biopsy specimen showed the adult worms to have regularly arranged outer annular ridges, which, together with the pruritus after treatment with diethylcarbamazine (a positive Mazzotti test), led to the diagnosis of onchocerciasis. retreatment with diethylcarbamazine again caused pruritus, but this was tolerated as were subsequent treatments.- - - - - - - - - - ranking = 1keywords = onchocerciasis (Clic here for more details about this article) |