Facial hyperpigmentation: causes and treatment.

By midcentury, the U.S.A. will be more ethnically and racially diverse. Skin of colour will soon constitute nearly one-half of the U.S. population, and a full understanding of skin conditions that affect this group is of great importance. Structural and functional differences in the skin, as well as the influence of cultural practices, produce variances in skin disease and presentation based on skin type. In the skin of colour population, dyschromia is a growing concern, and a top chief complaint when patients present to the physician. A thorough understanding of the aetiology and management strategies of facial hyperpigmentation is of importance in caring for those afflicted and also in the development of new therapies.

Serologic Evidence of Zoonotic Alphaviruses in Humans from an Indigenous Community in the Peruvian Amazon.

Alphaviruses (Togaviridae, Alphavirus) are arthropod-borne single-stranded RNA pathogens that cause febrile and neurologic disease in much of Latin America. However, many features of Alphavirus epidemiology remain unknown. In 2011, we undertook a cross-sectional study in Nueva Esperanza, an indigenous community in the Peruvian Amazon. Here, we present the first serologic evidence of Mayaro (MAYV), Venezuelan equine encephalitis (VEE) complex alphavirus, Una (UNAV), and Madariaga (MADV) viruses reported in humans (24%, 16%, 13%, and 1.5%, respectively) from an Amazonian indigenous community in Peru. Hunting activity and cohabiting with hunters were the main risk factors for Mayaro seroconversion, but only hunting was associated with UNAV seropositivity. Our results suggest that alphavirus infection in this region is common, but we highlight the high UNAV seroprevalence found and corroborate the low MADV prevalence reported in this region. Furthermore, MAYV-neutralizing antibodies were also detected in stored samples from wild animals (18%) hunted by Nueva Esperanza inhabitants and another mestizo community located close to Iquitos. Further serological surveys of VEE complex alphaviruses, UNAV, and MADV in wild animals and assessing the ability of the MAYV seropositive species to transmit the virus will be relevant.

The 2005-2007 Chikungunya epidemic in Réunion: ambiguous etiologies, memories, and meaning-making.

From March 2005 to April 2007 the French overseas department and Indian Ocean island of Réunion was significantly affected by an epidemic of chikungunya. Chikungunya is a vector-spread disease (by the aedes albopictus mosquito) that leads to painful rheumatic symptoms. The disease infected approximately one third of the island's total population of 802,000 inhabitants (Rallu 2009 ). This article is a discussion of local etiological accounts of chikungunya. The primary topic raised by informants was whether chikungunya was a vector- or air-borne disease. Even though informants had access to substantial biomedical information concerning the disease and its transmission, some were convinced by it and others were not. In order to make meaning of the disease, the Réunionese drew on various types of medical knowledge from different health sectors simultaneously. To understand people's experiences with chikungunya, we must account for all of their etiological explanations.