RESUMO
BACKGROUND: In Ethiopia, lymphatic filariasis and podoconiosis are the two neglected tropical diseases planned to be mapped together within the recently launched Ethiopian neglected tropical diseases master plan (2013-2015). However, other disorders cause tropical lymphedema, and this report aims to identify clinical epidemiological aspects of limb swelling in northern Ethiopia and to provide an algorithm orienting the clinical diagnosis. METHODS: Medical records of patients with lower limb elephantiasis attending the Italian Dermatological Centre of Mekele, Tigray capital city, over a 4-year period (2005-2009) were retrospectively analyzed. Nine variables were collected from the charts comprising demographic data, job, origin, literacy, clinical, histopathologic, microscopic, and cultural findings. RESULTS: Over a total of 511 patients, lymphedema resulted from trauma (40.7%), chronic venous insufficiency (12.5%), deep mycoses (10.8%), lymphatic filariasis (9.2%), elephantiasis nostras verrucosa (7.0%), tropical ulcer (6.3%), leprosy (4.9%), recurrent infections (3.1%), podoconiosis (1.8%), tuberculosis (1.0%), malignancy (1.3%), Kaposi's sarcoma (1.0%), leishmaniasis (0.2%), and neurofibromatosis (0.2%). CONCLUSIONS: Advanced-stage elephantiasis, chronic osteomyelitis, and podoconiosis not previously reported in Tigray were observed. Further epidemiological investigation and training programs addressed to healthcare providers at the peripheral level are needed to detect elephantiasis early, prevent disabilities, and improve patients' quality of life.
Assuntos
Elefantíase/epidemiologia , Elefantíase/etiologia , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/etiologia , Adolescente , Adulto , Escolaridade , Elefantíase/diagnóstico , Filariose Linfática/diagnóstico , Filariose Linfática/epidemiologia , Etiópia/epidemiologia , Feminino , Humanos , Leishmaniose/complicações , Hanseníase/complicações , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Micoses/complicações , Doenças Negligenciadas/diagnóstico , Neurofibromatoses/complicações , Ocupações/estatística & dados numéricos , Estudos Retrospectivos , Sarcoma de Kaposi/complicações , Tuberculose/complicações , Insuficiência Venosa/complicações , Ferimentos e Lesões/complicações , Adulto JovemRESUMO
The coexistence of leprosy with neurofibromatosis is a rare finding and can pose a diagnostic dilemma. Neurofibromatosis coexisting with borderline tuberculoid leprosy has previously not been reported. We report such a case in a 13-year-old boy where biopsy of clinically uninvolved nerve revealed the presence of acid-fast bacilli. A careful diagnostic workup is needed in such cases to ensure proper treatment. Both disorders affect Schwann cells and their relationship merits further consideration.