Etiology

It is caused by M. tuberculosis, the Koch's bacillus. In humans 95 of tuberculosis is caused by hominis variety, rarely by bovis. The bacillus is acid-fast. It measures 2.5-3.5 m. Infection in humans occurs mainly by inhalation, less often by ingestion or inoculation. Skin involvement depends on virulence of the microorganism, the number of infecting bacteria, the individual's general health, host reactivity, as well as the mechanisms through which the bacteria is introduced into the skin. The...

Geographic Distribution

The ailment is endemic of 18 nations from India, the Middle East and numerous African countries, especially on the west coast. This is perhaps the only parasitosis that may be eradicated. According to the World Health Organization, this will be accomplished by the end of this century. There has been important progress in the last decade. Before the international eradication campaign, the annual incidence was 10 million cases it has been reduced to about 2 million. The elimination of this...

Laboratory Data

Acid-fast smears are performed by incision of lesions, knuckle pads, lobule of the ear, and nasal mucous. They are negative in tuberculoid leprosy and in indeterminate cases. They are positive in lepromatous leprosy and sometimes in borderline cases (BL and BB). Biopsy in lepromatous leprosy reveals dermal infiltrates composed of numerous vacuolated histiocytes (Virchow cells). In the nodular form there is a subepidermal band of connective tissue (Unna's band). In the diffuse form of leprosy,...

Clinical Features

Cutaneous amebiasis is characterized by rapidly growing, necrotic ulcers with severe pain, regional adenopathy, fever and malaise. The ulcers have a central granulation zone covered by purulent exudates or fibrin with necrotic tissues and an intensely erythematous halo and well-defined margins. Although classically presenting as a single lesion, one of our cases had multiple ulcers affecting the same area (Fig. 47.1). Some lesions are vegetative, verrucous or hyperkeratotic (Clinical Tropical...

Clinical Picture

The dermatosis occurs only on the palms, soles and interdigitally. It is characterized by nonerythematous vesicles of sudden appearance, encased in the epidermis that gives the impression of sago grains. If they coalesce, they form blisters (Fig. 60.2). In general, they do not break they occur as outbreaks and relapses. They leave a collarete of scales of 1-3 mm that give rise to erythemato-squamous lesions with lichenification and sometimes pruritus. The appearance of pustules indicates...

Treatment

There is no single or ideal treatment. In severe cases, therapy is often unsuccessful. The best results have been achieved with 5-fluocytosine at a dose of 100-150 mg day or with itraconazale 200-300 mg day (J Am Acad Dermatol 1994 31 S91-92). The duration of treatment varies, but it always is long. For small lesions, complete excision by electrodessication, radiotheraphy, and cryosurgery with liquid nitrogen can be used. At the current time cryosurgery combined with medical treatment is...

Mycetoma Madura Foot

Mycetoma is an chronic inflammatory process which affects subcutaneous tissue, but sometimes also bones, and rarely viscerae. The most frequent site of involvement is the foot, with tumefaction, deformities, and draining sinus tracts which discharge a seropurulent exudate with parasitic granules. It begins with traumatic abrasion of the skin and the inoculation of a fungus or an actino-mycete, and is known as eumycetoma or actinomycetoma, respectively. The highest incidence is in the rural...

Reactions to Contact with Marine Animals

In order to limit such a wide-ranging subject, I shall limit my considerations here to the Coelenterates, a group including a large number of marine organisms responsible for a wide and recurring variety of reactions. Not to be neglected, however, and hence at least worth mentioning, are dermatitis caused by contact with Echinoderms and with several other animals (mollusks, arthropods, sponges, water worms, fish). Cutaneous pathology caused by Coelenterates is yet another example of how...

Anthrax

Anthrax is an infectious zoonosis which is systemic and severe in both wild and domesticated animals. Humans acquire it accidentally through transcutaneous contact, inhalation or ingestion. In the skin it can cause malignant edema or anthrax (malignant pustule). The latter is characterized by one vesicle surrounded by a necrotic zone where Bacillus anthracis is found. The inhaled form is rare and given its rapid progression and the limited response of the causative agent to treatment, it is...

Coccidioidomycosis

This systemic mycosis was first reported in 1892 by Alejandro Posadas and Roberto Wernicke in Buenos Aires. These authors described the infection in Domingo Escurra, a soldier from the Gran Chaco in Argentina. In 1894 in the United States, Rixford and Gilchrist described a similar case in California in a Portuguese worker, observing the organism which corresponded to the etiologi-cal agent and thought, as did Posadas, that it was a case of Coccidia and calling the organism Coccidioides immitis....

Tropical Ulcer

Tropical ulcer or tropical phagedenic ulcer is a synergistic bacterial infection caused by a combination of organisms, one of which is a Fusobacterium species, known as F. ulcerans other bacteria which have been implicated include spirochetes and other aerobic and anaerobic bacteria (Br J Dermatol 1987 1616 31-37 Int Rev Trop Med 1963 2 267-291). The disease shares striking similarities with cancrum oris (noma) or the veterinary disease, foot rot of sheep. Tropical ulcer is mainly a disease of...

Staphylococcal Scalded Skin Syndrome Ritters Disease

One of the manifestations of staphylococcal skin infection is the scalded skin syndrome, which is one of its more severe forms. Together with bullous impetigo and scarlatiniform eruption, it has been related directly to epidermolytic toxins produced by Staphylococcus aureus, a group II phage which includes types 57, 71, 3A, 3B and 3C (Semin Dermatol 1982 1 101). Ritter von Rittershain called it dermatitis exfoliativa neonatorum, and it is also known as pemphigus neonatorum because it more...

Dracunculosis

Dranunculosis is also known as dracontiasis, or Medina's worm or Guinea worm disease. It is a parasitosis caused by the nematode Dracunculus medinensis. It is a very old ailment since it is mentioned in the Turin Manuscrupt in the 15th century B.C. The Indian Rig-Veda also refers to it, and a recent examination of an Egyptian mummy revealed a calcified worm that corresponded to Dracunculus. In 1870 Alexei Fedchenko described the life cycle of the parasite and identified the Copepods cyclops as...

Verruga Peruana An Infectious Endemic Angiomatosis

Verruga peruana (VP) is the eruptive phase of human bartonellosis (HB) or Carrion's disease, which follows an acute hematic phase known as Oroya Fever (OF). HB has been present in Peru since ancient times, as depicted in pre-Inca monoliths. In 1885 a medical student named Daniel A. Carrion decided to prove a common origin for OF and VP. He inoculated himself with the blood of verruga and twenty-one days later he developed OF and died. This experiment proved that OF and VP are two distinct...

Other Filariasis

A dozen filarias can cause illness in man. All have a cycle requiring a vector (Culex, Aedes) and symptoms characteristic of the nature of the adult nematodes and the immune response to the microfilariae. Prophylaxis, requiring massive chemoprophylaxis and treatment of the vectors, is almost impossible. Lymphangitic filariasis is estimated that there are about 90 million people affected worldwide. It predominates in China, India, Indonesia and tropical Africa. It also occurs in Brazil, Guayana...

Geographical Distribution

Tropical ulcer is common throughout the hot and humid tropical regions of the world, in some of which, e.g. northern Papua New Guinea (J Hyg Trop Med 1989 92 215-220), it is the commonest skin disease. Notwithstanding its common distribution, it may be patchy leading to a pattern of disease in which endemic areas may occur close to other areas where the infection is seldom if ever seen. Endemic foci occur in both rural and urban populations and generally the climate associated with the disease...

Granuloma Inguinale Donovanosis

Granuloma inguinale (GI) or donovanosis is a chronic, granulomatous disease that affects the skin of the anogenital and inguinal regions. It is usually acquired by sexual contact and is characterized by ulcers that are moderately painful and progressively destructive. It is the least common of the venereal diseases. It is a sexually transmitted disease (STD) in which malignant transformation can be observed when diagnosed in young individuals. Its relation to penile cancer is unclear. Because...

Library of Congress Catalogingin Publication Data

Tropical Dermatology edited by Roberto Arenas, Roberto Estrada. p.cm. Vademecum. Includes bibliographical references and index. ISBN 1-57059-493-7 (alk. paper) 1. Skin--Diseases--Handbooks, manuals, etc. 2. Tropical Medicine-Handbooks, manuals, etc. I. Arenas, Roberto. II. Estrada, Roberto, 1943- . DNLM 1. Skin diseases handbooks. 2. Tropical Medicine handbooks. WR 39 T856 2001 RD598.H286 2001 616.5'00913--dc21 While the authors, editors, sponsor and publisher believe that drug selection and...

Reactions to Arthropods Scorpions

Scorpions are eight-legged arthropods that live mainly in warm climates. There are 650 species worldwide. The poisonous species are in North Africa, Androctonus australis in Turkey and North Africa, A. crassicauda in the Mediterranean, Buthus occitanus in Trinidad and Venezuela, Tityus trinitatis in Brazil and Argentina, T. serrulatus in California, New Mexico, Arizona, Baja California, Centruroides sculpturatus and in Mexico, C. suffusus and C. noxius.

Protothecosis

Victor Fernando Munoz-Estrada and Jorge A. Mayorga-Rodriguez Protothecosis is a primary or opportunistic chronic infection caused by achlorophyllic algae of the genus Prototheca. These algae enter through minor trauma or surgical incisions. Protothecosis is a uncommon disease with clinical manifestations that vary and with systemic, cutaneous, subcutaneous and bursal involvement. It is diagnosed without difficulty by histopathology and culture. There is no specific treatment. However, triazolic...

Classification

1) Primary infection cutaneous tuberculous primary complex. a) Fixed or localized forms Tuberculosis colliquativa cutis colicuativa (Scrofuloderma, tuberculous pseudomycetoma, lymphangiitic gummas, hematogenous gummas). Lupus (Lupus vulgaris, lupus-warty tuberculosis, tuberculosis caused by BCG). Verrucous (prosector's wart, tuberculosis verrucosa cutis) Ulcerative, vegetative or ulcerovegetative, miliary. b) Hematogenous forms, recurrent or tuberculids Bazin's indurated erythema and the...

Penicilliosis Due to Penicillium marneffei

Penicillium marneffei is a thermally dimorphic fungus that is thought to be endemic to southeast Asia (Am J Trop Med Hyg 1984 33 637-644) and southern China (Rev Infect Dis 1988 10 640-652.). It is capable of causing life-threatening disseminated illness involving the skin, bone marrow, liver, lymph nodes, bones and lungs in immunocompromised and immunocompetent persons. Penicillio-sis, previously a rare disease, has now emerged as one of the most common systemic opportunistic infection among...

Geographic Distributon

Dermatophytosis, especially tinea capitis, tinea corporis and tinea cruris, occurs worldwide but is very common in tropical countries. Ninety-eight percent of tinea capitis is seen in children there are occasional cases in adult women. From 3-28 of children from low social-economic groups have tinea capitis. Fa-vus is a tinea found only in Africa and South America. Tinea imbricata is endemic in the Pacific Islands, some parts of Malaysia, India and Latin America. Tinea cruris and tinea pedis...

Ashy Dermatologist Treatment

The following have been used Antihistamines, vitamins, glucocorticoids, antibiotics, diaminodiohenylsulfone, isoniazid, griseofulvin, chloroquine, estrogens and placebo. Clofazimine 50-100 mg 3 times a week for 3-5 months yields the best results (Int J Dermatol 1989 28(3) 198-200). Fig. 65.4. Ashy dermatosis, histpathology (H.E. 20X). Fig. 65.4. Ashy dermatosis, histpathology (H.E. 20X). 1 Arenas R, Bautista M et al. Dermatosis cenicienta estudio de 8 pacientes...

Entomophtoromycosis

Mayorga Rodriguez and Fernando Munoz Estrada Entomophtoromycosis, or subcutaneous phycomycosis, is a chronic infection caused by the Entomophtorales fungi of the genuses Basidiobolus and Conidiobolus. It is characterized by firm, subcutaneous nodules which rarely ulcerate. In 1925, Van Overeen reported the infection in a horse. In 1956 in Indonesia, Lei-Kian Joe described the first cases in humans the infectious agent was Basidiobolus ranarum. In 1961, Emmons and Bridges defined the...

Que Es Inllersion Repodral

Cutaneous leishmaniasis may heal spontaneously, yet the following treatments yield good results trivalent antimonials administered parenterally such as repodral and anthiomalin 2-3 ml 0.02-0.03 g on alternate days in 12-20 doses and the pentavalents like glucantime meglumine antimoniate 10-20 mg kg for 12 days to 3 weeks or until the lesions have healed. Another medication, pentostam sodium stibogluconate 20 mg kg day may be given for 20 days. For cutaneous disease antimonials may be injected...

Trichinosis

Rafael Herrera-Esparza and Esperanza Avalos-Diaz This is a parasitic disease caused by Trichinella spiralis filum nematode, aphasmidia class, superfamily Trichinelloidea . The family has eight groups of genes T1-T8 and at least four of them can be identified in a species. The genome of the parasite is composed of six haploid chromosomes with a total of 2.4 x 10-8 pb Parasitol Today 1992 8 299-306 . The larval morphology varies according to the five stages of postembryonic development. At birth...