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On Leopards, Cheetahs, and the Cutaneous Stigmata of Onchocerciasis

On Leopards, Cheetahs, and the Cutaneous Stigmata of Onchocerciasis Onchocerciasis is a tropical disease affecting the eye and the skin and is caused by transmission of the parasitic worm Onchocerca volvulus. Acute cutaneous stigmata of onchocerciasis include subcutaneous nodules and papular dermatitides. In chronic onchocerciasis, skin may become thickened, wrinkled, or hypopigmented to-depigmented. Pigmentary alteration patterns may occur in a spectrum of phenotypes, ranging from spotty depigmented macules to the most advanced stage, which features large patches of depigmented skin with islets of perifollicular sparing.1 In 1952, Rodhain2 first described the classic cutaneous stigmata of chronic onchocerciasis as “peau léopardée,” or “leopard skin.” This terminology is now commonly cited in the medical literature, including dermatology textbooks (Figure). Figure. View LargeDownload Onchocerciasis, Leopard, and Cheetah A, Numerous depigmented macules on the shin of a patient with onchocerciasis. Photograph courtesy of the Australian Society for Parasitology and the Pugh Collection. B, African leopard with yellow coat featuring classic black rosettes palisading around brown central patches. Copyright Otto du Plessis/Dollar Photo Club, http://www.dollarphotoclub.com. C, African cheetah with yellow coat featuring well-demarcated black spots. Copyright Otto du Plessis/Dollar Photo Club, http://www.dollarphotoclub.com. The big cats, particularly those found in sub-Saharan Africa, are majestic creatures demonstrating stunning coat patterns that are commonly confused, in particular, the patterns in the leopard and the cheetah. Perhaps the most elusive big cat, the leopard (Panthera pardus) typically has a coat of pale yellow to deep gold. Although there is some variability to its exact pattern, a defining feature of the leopard coat is the black rosette. Rosettes often surround a patch of lighter brown-colored hair and are regularly spaced over the animal’s back and lateral torso. The world’s fastest land animal, the cheetah (Acinonyx jubatus), features a similarly pale yellow to tan coat. Contrastingly, the cheetah’s coat demonstrates multiple, regularly spaced, well-demarcated black spots of varied sizes without rosettes. As onchocerciasis progresses, its pigmentation pattern may appear mottled and at times as pseudorosettes from a distance. However, on closer inspection, the actual pattern is one of scattered and coalescing hypopigmented to depigmented macules without classic rosettes. Thus, the skin of chronic onchocerciasis may be more precisely considered as more analogous to that of the cheetah than that of the leopard. Back to top Article Information Corresponding Author: Evan Rieder, MD, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 E 38th St, 11th Floor, New York, NY 10016 (evan.rieder@nyumc.org). References 1. Nelson SA, Warschaw KE. Protozoa and worms. In: Bolognia JL, Jorrizo JL, Schaffer JV, eds. Dermatology. Vol 1. Philadelphia, PA: Elsevier Saunders; 2012. 2. Rodhain J. Les adenolymphocèles du Congo Belge. Mem Inst R Colon Belge Sci Nat. 1952;211-58.Google Scholar http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Dermatology American Medical Association

On Leopards, Cheetahs, and the Cutaneous Stigmata of Onchocerciasis

JAMA Dermatology , Volume 151 (7) – Jul 1, 2015

On Leopards, Cheetahs, and the Cutaneous Stigmata of Onchocerciasis

Abstract

Onchocerciasis is a tropical disease affecting the eye and the skin and is caused by transmission of the parasitic worm Onchocerca volvulus. Acute cutaneous stigmata of onchocerciasis include subcutaneous nodules and papular dermatitides. In chronic onchocerciasis, skin may become thickened, wrinkled, or hypopigmented to-depigmented. Pigmentary alteration patterns may occur in a spectrum of phenotypes, ranging from spotty depigmented macules to the most advanced stage, which features large...
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Publisher
American Medical Association
Copyright
Copyright © 2015 American Medical Association. All Rights Reserved.
ISSN
2168-6068
eISSN
2168-6084
DOI
10.1001/jamadermatol.2015.0386
pmid
26153634
Publisher site
See Article on Publisher Site

Abstract

Onchocerciasis is a tropical disease affecting the eye and the skin and is caused by transmission of the parasitic worm Onchocerca volvulus. Acute cutaneous stigmata of onchocerciasis include subcutaneous nodules and papular dermatitides. In chronic onchocerciasis, skin may become thickened, wrinkled, or hypopigmented to-depigmented. Pigmentary alteration patterns may occur in a spectrum of phenotypes, ranging from spotty depigmented macules to the most advanced stage, which features large patches of depigmented skin with islets of perifollicular sparing.1 In 1952, Rodhain2 first described the classic cutaneous stigmata of chronic onchocerciasis as “peau léopardée,” or “leopard skin.” This terminology is now commonly cited in the medical literature, including dermatology textbooks (Figure). Figure. View LargeDownload Onchocerciasis, Leopard, and Cheetah A, Numerous depigmented macules on the shin of a patient with onchocerciasis. Photograph courtesy of the Australian Society for Parasitology and the Pugh Collection. B, African leopard with yellow coat featuring classic black rosettes palisading around brown central patches. Copyright Otto du Plessis/Dollar Photo Club, http://www.dollarphotoclub.com. C, African cheetah with yellow coat featuring well-demarcated black spots. Copyright Otto du Plessis/Dollar Photo Club, http://www.dollarphotoclub.com. The big cats, particularly those found in sub-Saharan Africa, are majestic creatures demonstrating stunning coat patterns that are commonly confused, in particular, the patterns in the leopard and the cheetah. Perhaps the most elusive big cat, the leopard (Panthera pardus) typically has a coat of pale yellow to deep gold. Although there is some variability to its exact pattern, a defining feature of the leopard coat is the black rosette. Rosettes often surround a patch of lighter brown-colored hair and are regularly spaced over the animal’s back and lateral torso. The world’s fastest land animal, the cheetah (Acinonyx jubatus), features a similarly pale yellow to tan coat. Contrastingly, the cheetah’s coat demonstrates multiple, regularly spaced, well-demarcated black spots of varied sizes without rosettes. As onchocerciasis progresses, its pigmentation pattern may appear mottled and at times as pseudorosettes from a distance. However, on closer inspection, the actual pattern is one of scattered and coalescing hypopigmented to depigmented macules without classic rosettes. Thus, the skin of chronic onchocerciasis may be more precisely considered as more analogous to that of the cheetah than that of the leopard. Back to top Article Information Corresponding Author: Evan Rieder, MD, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 E 38th St, 11th Floor, New York, NY 10016 (evan.rieder@nyumc.org). References 1. Nelson SA, Warschaw KE. Protozoa and worms. In: Bolognia JL, Jorrizo JL, Schaffer JV, eds. Dermatology. Vol 1. Philadelphia, PA: Elsevier Saunders; 2012. 2. Rodhain J. Les adenolymphocèles du Congo Belge. Mem Inst R Colon Belge Sci Nat. 1952;211-58.Google Scholar

Journal

JAMA DermatologyAmerican Medical Association

Published: Jul 1, 2015

References