Document Detail


Extra-anogenital bilharziasis cutanea tarda revisited.
MedLine Citation:
PMID:  19519608     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Even in schistosomiasis-endemic areas, extra-anogenital bilharziasis cutanea tarda (E-BCT) is rare. To date, the occurrence of E-BCT in pre-existing cutaneous pathology is undocumented. The study was undertaken to document the expanded clinicopathological spectrum and to comment on the putative pathogenetic mechanisms of a Schistosoma hematobium-associated E-BCT. METHODS: Eight-year clinicopathological appraisal of E-BCT. RESULTS: The clinical details are as follows. Seventeen specimens from 16 patients formed the study cohort. All specimens showed granulomatous inflammation with eosinophils, aggregates of terminal-spined S. hematobium ova and variable fibrosis. Copulating worms were identified in three biopsies. In 12/16 patients, E-BCT occurred in pre-existing pathology, including recurrent squamous papilloma (1), bilateral hidradenitis suppurativa (1) and scar tissue (10) with 7 showing a keloidal morphology. Prior and current urinary schistosomiasis was present in nine and seven patients, respectively. CONCLUSION: E-BCT, a reflection of prior, re-infective or inadequately treated urinary schistosomiasis, is deemed to be a function of egg-laying consequent to the aberrant pathway of worms. Based on E-BCT occurrence in pre-existing extra-anogenital cutaneous fibroinflammatory and cicatricial processes and the presence of adult worms in three extra-anogenital biopsies in the present study, it is hypothesized that altered tissue mesenchymal repair reactions may promote extra-anogenital cutaneous worm entrapment and egg-laying.
Authors:
Pratistadevi K Ramdial; Eduardo Calonje; Bhugwan Singh; Yetish Sing; Prashni Govender
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cutaneous pathology     Volume:  36     ISSN:  1600-0560     ISO Abbreviation:  J. Cutan. Pathol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-12     Completed Date:  2009-08-18     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0425124     Medline TA:  J Cutan Pathol     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  766-71     Citation Subset:  IM    
Copyright Information:
(c) 2009 The Authors. Journal Compilation (c) 2009 Blackwell Munksgaard.
Affiliation:
Department of Anatomical Pathology, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, KwaZulu Natal, South Africa. ramdial@ukzn.ac.za
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Animals
Biopsy
Cohort Studies
Humans
Male
Middle Aged
Schistosoma haematobium*
Schistosomiasis / pathology*
Skin Diseases, Parasitic / pathology*

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