Onchocercal depigmentation

Abstract

A characteristic cutaneous depigmentation is described, associated uniquely with prolonged exposure to Simulium bites and with long-standing onchocerciasis. It is frequently accompanied by the following triad: sclerosing hypertrophic inguinc-crural lymphadenopathy, severe onchodermatitis and (in advanced cases) posterior segment lesions in the eye. The suggestion is made that the depigmentation — like the other conditions — is an anaphylactic phenomenon due to toxins arising from onchocercal microfilariae or adult worms.