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Schistosomiasis: Paraplegia and Ectopic Skin Lesions as Admission Symptoms

Schistosomiasis: Paraplegia and Ectopic Skin Lesions as Admission Symptoms Abstract • A 33-year-old man, who had been a teacher in Africa from 1966 to 1969, was hospitalized in December 1973 for radiculomyelitis with progressive paraplegia and analgesia of the lower limbs. On his fourth day in the hospital, a pruritic, papular dermatitis appeared on both lower thoracic paraspinal areas. Microscopical examination of biopsy specimens of skin from those areas showed schistosome ova within many palisading granulomas in the dermis. The morphological features of the skin lesions, as seen by gross and microscopical examination, and the morphological and staining characteristics and the pathophysiology of the schistosome organism will be discussed. The longevity of the adult worm in the portal circulation is particularly important; a long interval may elapse between the time the patient leaves the area where he became infected and the time of appearance of the lesions. (Arch Dermatol 112:690-695, 1976) References 1. Wilcocks C, Manson-Bahr PEC: Manson's Tropical Diseases . Baltimore, Williams & Wilkins Co, 1972, pp 285-319. 2. Wallerstein RS: Longevity of Schistosoma mansoni: Observations based on a case . Am J Trop Med 29:717-722, 1949. 3. Garcia-Palmieri MR, Marcial-Rojas RA: The protean manifestations of schistosomiasis mansoni: A clinicopathological correlation . Ann Int Med 57:763-775, 1962.Crossref 4. Rook AJ, Wilkinson DS, Ebling FJ (eds): Textbook of Dermatology . Oxford, England, Blackwell Scientific Publications Ltd, 1968, pp 957-959. 5. Findlay GH, Whiting DA: Disseminated and zosteriform cutaneous schistosomiasis . Br J Dermatol 85:99-101, 1949. 6. Wakefield GS, Carroll JD, Speed DE: Schistosomiasis of the spinal cord . Brain 75:535-552, 1962.Crossref 7. Rosenbaum RM, Ishii N, Tanowitz IH, et al: Schistosomiasis mansoni of the spinal cord: Report of a case . Am J Trop Med Hyg 21:182-184, 1972. 8. McMullen DB, Brackett S: Studies on schistosome dermatitis: Distribution and epidemiology in Michigan . Am J Hyg 47:259-270, 1948. 9. Ramos SF: Late cutaneous bilharziasis . S Afr Med J 47:2103-2108, 1973. 10. Cahill KM, El Mofty AM: Extra-genital cutaneous lesions in schistosomiasis . Am J Trop Med 13:800-802, 1964. 11. Faust EC: An inquiry into the ectopic lesions in schistosomiasis . Am J Trop Med 28:175-199, 1948. 12. Convit J, Reyes 0: Ectopic skin lesions produced by Schistosoma mansoni . Am J Trop Med Hyg 22:482-484, 1973. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Schistosomiasis: Paraplegia and Ectopic Skin Lesions as Admission Symptoms

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Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1976.01630290038008
Publisher site
See Article on Publisher Site

Abstract

Abstract • A 33-year-old man, who had been a teacher in Africa from 1966 to 1969, was hospitalized in December 1973 for radiculomyelitis with progressive paraplegia and analgesia of the lower limbs. On his fourth day in the hospital, a pruritic, papular dermatitis appeared on both lower thoracic paraspinal areas. Microscopical examination of biopsy specimens of skin from those areas showed schistosome ova within many palisading granulomas in the dermis. The morphological features of the skin lesions, as seen by gross and microscopical examination, and the morphological and staining characteristics and the pathophysiology of the schistosome organism will be discussed. The longevity of the adult worm in the portal circulation is particularly important; a long interval may elapse between the time the patient leaves the area where he became infected and the time of appearance of the lesions. (Arch Dermatol 112:690-695, 1976) References 1. Wilcocks C, Manson-Bahr PEC: Manson's Tropical Diseases . Baltimore, Williams & Wilkins Co, 1972, pp 285-319. 2. Wallerstein RS: Longevity of Schistosoma mansoni: Observations based on a case . Am J Trop Med 29:717-722, 1949. 3. Garcia-Palmieri MR, Marcial-Rojas RA: The protean manifestations of schistosomiasis mansoni: A clinicopathological correlation . Ann Int Med 57:763-775, 1962.Crossref 4. Rook AJ, Wilkinson DS, Ebling FJ (eds): Textbook of Dermatology . Oxford, England, Blackwell Scientific Publications Ltd, 1968, pp 957-959. 5. Findlay GH, Whiting DA: Disseminated and zosteriform cutaneous schistosomiasis . Br J Dermatol 85:99-101, 1949. 6. Wakefield GS, Carroll JD, Speed DE: Schistosomiasis of the spinal cord . Brain 75:535-552, 1962.Crossref 7. Rosenbaum RM, Ishii N, Tanowitz IH, et al: Schistosomiasis mansoni of the spinal cord: Report of a case . Am J Trop Med Hyg 21:182-184, 1972. 8. McMullen DB, Brackett S: Studies on schistosome dermatitis: Distribution and epidemiology in Michigan . Am J Hyg 47:259-270, 1948. 9. Ramos SF: Late cutaneous bilharziasis . S Afr Med J 47:2103-2108, 1973. 10. Cahill KM, El Mofty AM: Extra-genital cutaneous lesions in schistosomiasis . Am J Trop Med 13:800-802, 1964. 11. Faust EC: An inquiry into the ectopic lesions in schistosomiasis . Am J Trop Med 28:175-199, 1948. 12. Convit J, Reyes 0: Ectopic skin lesions produced by Schistosoma mansoni . Am J Trop Med Hyg 22:482-484, 1973.

Journal

Archives of DermatologyAmerican Medical Association

Published: May 1, 1976

References