[Leish-l] FW: PRO/EDR> Undiagnosed skin disease - Nigeria: (SO)

Tue Oct 12 23:03:47 BRT 2010

Subject: Fwd: PRO/EDR> Undiagnosed skin disease - Nigeria: (SO)
From: marizashaw at gmail.com
To: jayusp at hotmail.com

---------- Forwarded message ----------
From: ProMED-mail <promed at promed.isid.harvard.edu>

Date: 2010/10/6
Subject: PRO/EDR> Undiagnosed skin disease - Nigeria: (SO)
To: promed-edr at promedmail.org

UNDIAGNOSED SKIN DISEASE - NIGERIA: (SOKOTO)

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A ProMED-mail post

<http://www.promedmail.org>

ProMED-mail is a program of the

International Society for Infectious Diseases

<http://www.isid.org>

Date: Mon 4 Oct 2010

Source: AllAfrica, Daily Trust report [edited]

<http://allafrica.com/stories/201010041232.html> [edited]

A strange skin disease that eats deep into the human body has broken

out in Sokoto, affecting a large number of the people. The disease

which is defying medical solution, is nicknamed "Mallam Fatori",

after a desert town in Borno State where it was said to have emanated from.

Victims suffering from the disease, who spoke to Daily Trust, said

they had been carrying the ailment for 5 to 9 months now and have

visited several hospitals including the Usman Danfodio University

Teaching Hospital, Sokoto (UDUTH), but could not get any solution.

Speaking exclusively to Daily Trust in Sokoto, 2 victims, [a

27-year-old man] and a woman, said in separate interviews that the

ailment started with different parts of their body itching [? from]

mosquito bites and developed rashes when they scratched the place

which turns into deep wounds.

The [man] said, "I noticed the ailment about 5 months ago. It is

affecting 8 different parts of my body as you can see. Since then I

have been to a leprosy hospital in Kaduna, the leprosy hospital in

Amanawa near Sokoto, UDUTH, and many other hospitals, but they do not

seem to know much about it and so could not offer any positive treatment.

"I know about 50 people that are suffering from the sickness in

Sokoto including women and children. Many of the patients watch

helplessly as the disease eats into their bodies without medical

solution. But at Amanawa hospital, the doctors said they were

suspecting it was the result of [leishmaniasis]," he said.

[The woman], who said she was infected with the disease in 2

different places on her body, said she had been suffering from it for

about 9 months now and was yet to find a cure after visiting 5

hospitals including UDUTH.

"My problem started with the affected parts itching me. When I

scratched it, boils came out. The boils remained small on the

surface, but inside my flesh, the wound had eaten deep. But the wound

does not [hurt] at all even though it keeps expanding internally. You

can see how small the boil is on the surface but this big, round

black mark is evidence that the wound has expanded internally," she said.

When Daily Trust visited UDUTH, the head of the medicine department

of the hospital, Professor Isezua, said arrangements were being made

to properly examine one of the patients suffering from the disease to

enable him to understand it before commenting on it.

The Sokoto State commissioner for information, Alhaji Dahiru

Maishanu, said the state government did not know about the disease.

But he said the state had mobile clinics that could be deployed to

any part to handle the emergence of any type of sickness reported to

government.

[Byline: Shehu Abubakar]

--

Communicated by:

ProMED-mail

<promed at promedmail.org>

[The text mentions leishmaniasis and cutaneous leishmaniasis is a

possibility resulting in sores at the site of the bite by the

sandfly. Cutaneous leishmaniasis is found in northern Nigeria, but it

usually does not expand deep into the subcutaneous tissue. Diagnosis

is based on microscopy of fluid expressed from the edge of the wound,

which is supposed to be a well-known procedure in an endemic area.

Another possibility is tropical ulcer caused by fusiform bacteria. It

is surprising however, that this would spread as an epidemic, and it

would be possible to treat with proper antibiotics. Infection with

fusiform bacteria can spread through the subcutaneous tissue and

deeper through fascia, but the slow course over months is surprising

although it can develop into a chronic form.

A 3rd possibility is Buruli ulcer, caused by _Mycobacterium

ulcerans_, which causes a long standing chronic ulceration that can

also expand through subcutaneous tissue and penetrate fascia. This is

probably the most likely explanation for the described disease. (More

information on Buruli ulcer can be found at

<http://www.who.int/mediacentre/factsheets/fs199/en/>).

The reservoir for _Mycobacterium ulcerans_ and the transmission route

to humans are not known, but a recent study from Australia suggests

that contact with mammals is a possibility (Fyfe JA et al: A major

role for mammals in the ecology of _Mycobacterium ulcerans_. PLoS

Negl Trop Dis. 2010 Aug 10; 4(8): e791; available at

<http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0000791>).

- Mod.EP]

[Sokoto state, in north western Nigeria, can be located on the maps at

<http://www.un.org/Depts/Cartographic/map/profile/nigeria.pdf> and

<http://healthmap.org/r/0bXT>. - Sr.Tech.Ed.MJ]

...................................ep/mj/dk

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