Parasitology Department

Medical Faculty of USU

 Parasitic

dermatitis can be caused by

filaria
schistosoma
Leishmania

Dewi M Darlan

06/09/15

Causative agent: Onchocerca volvulus

Insect vector: Black flies, Simulium sp.
Distribution: Tropical Africa, Central America,
spread to Arabian Peninsula.
The damage caused to the skin by
microfilariae
This probably due to immune and possibly
directly irritative mechanisme.

Dewi M Darlan

06/09/15

Histopathology consist of light infiltration

with inflammation with inflammatory cells
around the dermal vessels.
These include lymphocytes, histiocytes,
plasma cells, and eosinophils but not
neutrophils.

Dewi M Darlan

06/09/15

 Reactive

form (Sowda):

single limb,
hyperpigmentation,
pruritus (giant ulcer ;
lizardskin), papules,
lympadenitis.
Few microfilariae

Dewi M Darlan

06/09/15

Non-reactive form:

Symmetric
involvement of
limb/trunk
Tropical Africa &
Latin America
Numerous
microfilariae

Dewi M Darlan

06/09/15

Diagnosis
Histologic
examination of skin
snip
Smear of aspirate
from skin incision
Slit-lamp examination
Serological method
PCR has role in
monitoring
chemotherapy

DEC is contarindicated
Ivermectin is the drug
of choice
Single dose of
150ugm/kg
Microfilaricidal, need to
repeat dose

Dewi M Darlan

06/09/15

Is due to avian
Schistosome,
Trichobilharzia
ocellata.
Require intermediate
host a snail for
developing.
Human can be infected
by cercarial
penetration.

Dewi M Darlan itch

06/09/15
Swimmers

Erythema of the invaded area with a prickling

or nettling sensation and highly sensitive
individuals by local or generalized urticaria.
This symptoms will develop after 24 hours
exposure and may last for 2 to 3 days.
This reaction is intensified by repeated
exposure.

Dewi M Darlan

06/09/15

The initial irritation characteristically soon

subsides, leaving a minute macule at each
penetration, but is followed shortly by
intense itching o/t region with transformation
or the macule into papules.
The height of the reaction is usually reached
on 2nd & 3rd day, then gradually subsides, but
symptoms are reactivated by rubbing of the
involve areas.

Dewi M Darlan

06/09/15

10

Trimeprazine orally and

local application of
palliatives to reduce the
itching and sedation
when indicated

Exposure to the
freshwater type of the
disease can be greatly
reduced during the
bathing season by use of
copper sulfate or other
suitable molluscicide
along the shores of
freshwater lakes or ponds
in effective
concentrations.
Dewi M Darlan

06/09/15

11

Is due to Leishmania
tropica
Its morphology is identical
with L.donovani
This parasites found in the
skin at the endothelial cells
of the capillaries of the
infected area, nearby
lymph nodes.
Vectors are sandfly
(Phlebotomus sp)

Dewi M Darlan

06/09/15

12

When the promastigote stage of Leishmania is

introduced into skin, the parasites are engulfed
by local white cells.
In neutrophilic leucocytes phagocytosis is
usually successful, but in macrophages, the
parasites develop to amastigote form, multiply.
In the early stages, the lesion is characterized
by the proliferation of macrophages that
contain numerous amastigote

Dewi M Darlan

06/09/15

13

The overlying epithelium shows acanthosis and

hyperkeratosis, which are followed by necrosis
and ulceration.
As the lesion heals, the macrophages and
organisms gradually decrease in number and
the lymphocytes and plasma cells increase.
Ulceration follows, and healing occurs in the
presence of a nonspecific granulation tissue.

Dewi M Darlan

06/09/15

14

The incubation o Oriental sore has been

reported varying from a few days- 6 months.
The clinical features:

Papules and nodules

Ulcers
Relapsing Lesions

Secondary infections with bacteria are

common.

Dewi M Darlan

06/09/15

15

Diagnosis

Treatment

Dewi M Darlan

06/09/15

16

Dewi M Darlan

06/09/15

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