eMedicine Specialties > Dermatology > Parasitic Infections

Onchocerciasis (River Blindness): Multimedia

Author: Jason F Okulicz, MD, Assistant Professor of Medicine, Uniformed Services University of the Health Sciences; Staff, Infectious Disease Service, Brooke Army Medical Center
Coauthor(s): Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center; Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Contributor Information and Disclosures

Updated: Feb 13, 2009

Multimedia

Leopard-spot pattern of depigmentation on the shi...
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Media file 1: Leopard-spot pattern of depigmentation on the shins. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.
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Leopard-spot pattern of depigmentation on the shi...

Leopard-spot pattern of depigmentation on the shins. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.

Dermatitis associated with microfilaria. Courtesy...
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Media file 2: Dermatitis associated with microfilaria. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.
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Dermatitis associated with microfilaria. Courtesy...

Dermatitis associated with microfilaria. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.

Hanging groin sign. Courtesy of Brooke Army Medic...
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Media file 3: Hanging groin sign. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.
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Hanging groin sign. Courtesy of Brooke Army Medic...

Hanging groin sign. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.

Hanging groin sign. Courtesy of Brooke Army Medic...
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Media file 4: Hanging groin sign. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.
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Hanging groin sign. Courtesy of Brooke Army Medic...

Hanging groin sign. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.

Onchocercoma. Courtesy of Brooke Army Medical Cen...
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Media file 5: Onchocercoma. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.
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Onchocercoma. Courtesy of Brooke Army Medical Cen...

Onchocercoma. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.

Onchocercoma. Courtesy of Brooke Army Medical Cen...
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Media file 6: Onchocercoma. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.
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Onchocercoma. Courtesy of Brooke Army Medical Cen...

Onchocercoma. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.

Photomicrograph of a skin biopsy specimen from a ...
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Media file 7: Photomicrograph of a skin biopsy specimen from a patient with onchocerciasis. A worm is shown in cross-section. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.
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Photomicrograph of a skin biopsy specimen from a ...

Photomicrograph of a skin biopsy specimen from a patient with onchocerciasis. A worm is shown in cross-section. Courtesy of Brooke Army Medical Center teaching file. All images are in the public domain.

Photomicrograph from a gravid female worm (hemato...
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Media file 8: Photomicrograph from a gravid female worm (hematoxylin and eosin]). Courtesy of Brooke Army Medical Center. All images are in the public domain.
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Photomicrograph from a gravid female worm (hemato...

Photomicrograph from a gravid female worm (hematoxylin and eosin]). Courtesy of Brooke Army Medical Center. All images are in the public domain.

More on Onchocerciasis (River Blindness)

Overview: Onchocerciasis (River Blindness)
Differential Diagnoses & Workup: Onchocerciasis (River Blindness)
Treatment & Medication: Onchocerciasis (River Blindness)
Follow-up: Onchocerciasis (River Blindness)
Multimedia: Onchocerciasis (River Blindness)
References
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References

  1. Saint Andre A, Blackwell NM, Hall LR, et al. The role of endosymbiotic Wolbachia bacteria in the pathogenesis of river blindness. Science. Mar 8 2002;295(5561):1892-5. [Medline].

  2. Martin-Tellaeche A, Ramirez-Hernandez J, Santos-Preciado JI, Mendez-Galvan J. Onchocerciasis: changes in transmission in Mexico. Ann Trop Med Parasitol. Apr 1998;92 Suppl 1:S117-9. [Medline].

  3. Murdoch ME, Hay RJ, Mackenzie CD, Williams JF, Ghalib HW, Cousens S, et al. A clinical classification and grading system of the cutaneous changes in onchocerciasis. Br J Dermatol. Sep 1993;129(3):260-9. [Medline].

  4. Stingl P. Onchocerciasis: clinical presentation and host parasite interactions in patients of southern Sudan. Int J Dermatol. Jan 1997;36(1):23-8. [Medline].

  5. Stingl P, Ross M, Gibson DW, Ribas J, Connor DH. A diagnostic "patch test" for onchocerciasis using topical diethylcarbamazine. Trans R Soc Trop Med Hyg. 1984;78(2):254-8. [Medline].

  6. Toe L, Adjami AG, Boatin BA, Back C, Alley ES, Dembele N, et al. Topical application of diethylcarbamazine to detect onchocerciasis recrudescence in west Africa. Trans R Soc Trop Med Hyg. Sep-Oct 2000;94(5):519-25. [Medline].

  7. Toe L, Boatin BA, Adjami A, Back C, Merriweather A, Unnasch TR. Detection of Onchocerca volvulus infection by O-150 polymerase chain reaction analysis of skin scratches. J Infect Dis. Jul 1998;178(1):282-5. [Medline].

  8. Rodriguez-Perez MA, Dominguez-Vazquez A, Mendez-Galvan J, et al. Antibody detection tests for Onchocerca volvulus: comparison of the sensitivity of a cocktail of recombinant antigens used in the indirect enzyme-linked immunosorbent assay with a rapid-format antibody card test. Trans R Soc Trop Med Hyg. Sep-Oct 2003;97(5):539-41. [Medline].

  9. Weil GJ, Steel C, Liftis F, et al. A rapid-format antibody card test for diagnosis of onchocerciasis. J Infect Dis. Dec 2000;182(6):1796-9. [Medline].

  10. Ayong LS, Tume CB, Wembe FE, et al. Development and evaluation of an antigen detection dipstick assay for the diagnosis of human onchocerciasis. Trop Med Int Health. Mar 2005;10(3):228-33. [Medline].

  11. Baraka OZ, Mahmoud BM, Ali MM, et al. Ivermectin treatment in severe asymmetric reactive onchodermatitis (sowda) in Sudan. Trans R Soc Trop Med Hyg. May-Jun 1995;89(3):312-5. [Medline].

  12. Burnham G. Ivermectin treatment of onchocercal skin lesions: observations from a placebo-controlled, double-blind trial in Malawi. Am J Trop Med Hyg. Mar 1995;52(3):270-6. [Medline].

  13. Ogbuagu KF, Eneanya CI. A multi-centre study of the effect of Mectizan treatment on onchocercal skin disease: clinical findings. Ann Trop Med Parasitol. Apr 1998;92 Suppl 1:S139-45. [Medline].

  14. Pacque M, Elmets C, Dukuly ZD, et al. Improvement in severe onchocercal skin disease after a single dose of ivermectin. Am J Med. May 1991;90(5):590-4. [Medline].

  15. Debrah AY, Mand S, Marfo-Debrekyei Y, Larbi J, Adjei O, Hoerauf A. Assessment of microfilarial loads in the skin of onchocerciasis patients after treatment with different regimens of doxycycline plus ivermectin. Filaria J. 2006;5:1. [Medline].

  16. Hoerauf A, Specht S, Marfo-Debrekyei Y, et al. Efficacy of 5-week doxycycline treatment on adult Onchocerca volvulus. Parasitol Res. Jan 2009;104(2):437-47. [Medline].

  17. Hoerauf A, Marfo-Debrekyei Y, Buttner M, et al. Effects of 6-week azithromycin treatment on the Wolbachia endobacteria of Onchocerca volvulus. Parasitol Res. Jul 2008;103(2):279-86. [Medline].

  18. Specht S, Mand S, Marfo-Debrekyei Y, et al. Efficacy of 2- and 4-week rifampicin treatment on the Wolbachia of Onchocerca volvulus. Parasitol Res. Nov 2008;103(6):1303-9. [Medline].

  19. Awadzi K, Opoku NO, Attah SK, et al. The safety and efficacy of amocarzine in African onchocerciasis and the influence of ivermectin on the clinical and parasitological response to treatment. Ann Trop Med Parasitol. Apr 1997;91(3):281-96. [Medline].

  20. Hoerauf A, Volkmann L, Hamelmann C, et al. Endosymbiotic bacteria in worms as targets for a novel chemotherapy in filariasis. Lancet. Apr 8 2000;355(9211):1242-3. [Medline].

  21. Hoerauf A, Mand S, Adjei O, Fleischer B, Buttner DW. Depletion of wolbachia endobacteria in Onchocerca volvulus by doxycycline and microfilaridermia after ivermectin treatment. Lancet. May 5 2001;357(9266):1415-6. [Medline].

  22. Borsboom GJ, Boatin BA, Nagelkerke NJ, et al. Impact of ivermectin on onchocerciasis transmission: assessing the empirical evidence that repeated ivermectin mass treatments may lead to elimination/eradication in West-Africa. Filaria J. Mar 24 2003;2(1):8. [Medline].

  23. Bandi C, Trees AJ, Brattig NW. Wolbachia in filarial nematodes: evolutionary aspects and implications for the pathogenesis and treatment of filarial diseases. Vet Parasitol. Jul 12 2001;98(1-3):215-38. [Medline].

  24. Boatin BA, Toe L, Alley ES, Dembele N, Weiss N, Dadzie KY. Diagnostics in onchocerciasis: future challenges. Ann Trop Med Parasitol. Apr 1998;92 Suppl 1:S41-5. [Medline].

  25. Burnham G. Onchocerciasis. Lancet. May 2 1998;351(9112):1341-6. [Medline].

  26. Connor DH, Williams PH, Helwig EB, Winslow DJ. Dermal changes in onchocerciasis. Arch Pathol. Feb 1969;87(2):193-200. [Medline].

  27. Duke BO. Onchocerciasis. Br Med Bull. Jan 1972;28(1):66-71. [Medline].

  28. Edgeworth JD, Abiose A, Jones BR. An immunohistochemical analysis of onchocercal nodules: evidence for an interaction between macrophage MRP8/MRP14 and adult Onchocerca volvulus. Clin Exp Immunol. Apr 1993;92(1):84-92. [Medline].

  29. Enk CD. Onchocerciasis--river blindness. Clin Dermatol. May-Jun 2006;24(3):176-80.

  30. Hagan M. Onchocercal dermatitis: clinical impact. Ann Trop Med Parasitol. Apr 1998;92 Suppl 1:S85-96. [Medline].

  31. Kale OO. Onchocerciasis: the burden of disease. Ann Trop Med Parasitol. Apr 1998;92 Suppl 1:S101-15. [Medline].

  32. Lazarov A, Amihai B, Sion-Vardy N. Pruritus and chronic papular dermatitis in an Ethiopian man. Onchocerciasis (chronic papular onchodermatitis). Arch Dermatol. Mar 1997;133(3):382-3, 385-6. [Medline].

  33. Little MP, Breitling LP, Basanez MG, Alley ES, Boatin BA. Association between microfilarial load and excess mortality in onchocerciasis: an epidemiological study. Lancet. May 8 2004;363(9420):1514-21. [Medline].

  34. Martinez RM, Saracho AO. Intramuscular onchocercoma. Case report. J Craniomaxillofac Surg. Aug-Sep 1992;20(6):261-3. [Medline].

  35. Maso MJ, Kapila R, Schwartz RA, Wiltz H, Kaminski ZC, Lambert WC. Cutaneous onchocerciasis. Int J Dermatol. Nov 1987;26(9):593-6. [Medline].

  36. Meyers WM, Neafie RC, Connor DH. Onchocerciasis: invasion of deep organs by Onchocerca volvulus. Am J Trop Med Hyg. Jul 1977;26(4):650-7. [Medline].

  37. Richards F, Hopkins D, Cupp E. Programmatic goals and approaches to onchocerciasis. Lancet. May 13 2000;355(9216):1663-4. [Medline].

  38. Richards FO, Miri E, Meredith S, et al. Onchocerciasis. Bull World Health Organ. 1998;76 Suppl 2:147-9. [Medline].

  39. Rozenman D, Kremer M, Zuckerman F. Onchocerciasis in Israel. Arch Dermatol. Apr 1984;120(4):505-7. [Medline].

  40. Somorin AO. Onchocerciasis. Int J Dermatol. Apr 1983;22(3):182-8. [Medline].

  41. Vernick W, Turner SE, Burov E, Telang GH. Onchocerciasis presenting with lower extremity, hypopigmented macules. Cutis. May 2000;65(5):293-7. [Medline].

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Further Reading

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Keywords

onchocerciasis, river blindness, African river blindness, blinding filariasis, Robles disease, craw-craw, Onchocerca volvulus, O volvulus, Simulium species, Simulium damnosum, Simulium neavei, Simulium metallicum, Simulium ochraceum, Simulium exiguum, black fly, microfilariae, onchocercal dermatitis, hanging groin, leopard skin, sowda, onchocercal dermatitis, acute papular onchodermatitis, APOD, chronic papular onchodermatitis, CPOD, lichenified onchodermatitis, LOD,

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Contributor Information and Disclosures

Author

Jason F Okulicz, MD, Assistant Professor of Medicine, Uniformed Services University of the Health Sciences; Staff, Infectious Disease Service, Brooke Army Medical Center
Jason F Okulicz, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Coauthor(s)

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

Donald Belsito, MD, Clinical Professor, Department of Internal Medicine, Division of Dermatology, University of Missouri at Kansas City; Private Practice, American Dermatology Associates, LLC
Donald Belsito, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, Dermatology Foundation, Kansas Medical Society, Noah Worcester Dermatological Society, Phi Beta Kappa, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey Meffert, MD, Assistant Clinical Professor of Dermatology, University of Texas Health Science Center-San Antonio
Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

William D James, MD, Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System
William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology
Disclosure: elsevier Royalty Other; american college of physicians Honoraria Other

 
 
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