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On Leopards, Cheetahs, and the Cutaneous Stigmata of Onchocerciasis

Evan Rieder, MD1
[+] Author Affiliations
1The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
JAMA Dermatol. 2015;151(7):742. doi:10.1001/jamadermatol.2015.0386.
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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).

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Figure.
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.

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