Interdigital skin lesions of the lower limbs among patients with lymphoedema in an area endemic for bancroftian filariasis
Identifieur interne : 007D85 ( Main/Exploration ); précédent : 007D84; suivant : 007D86Interdigital skin lesions of the lower limbs among patients with lymphoedema in an area endemic for bancroftian filariasis
Auteurs : Gerusa Dreyer [Brésil] ; David Addiss [États-Unis] ; Patricia Gadelha [Brésil] ; Eduardo Lapa [Brésil] ; John Williamson [États-Unis] ; Annelies Dreyer [États-Unis]Source :
- TM & IH. Tropical medicine & international health [ 1360-2276 ] ; 2006.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Brésil (épidémiologie), Dermatoses parasitaires (épidémiologie), Dermatoses parasitaires (étiologie), Femelle, Filariose lymphatique (), Filariose lymphatique (épidémiologie), Humains, Lymphadénite (épidémiologie), Lymphadénite (étiologie), Lymphangite (épidémiologie), Lymphangite (étiologie), Maladie aigüe, Maladies du pied (parasitologie), Maladies du pied (épidémiologie), Maladies endémiques, Mâle, Orteils, Sujet âgé, Sujet âgé de 80 ans ou plus.
- MESH :
- parasitologie : Maladies du pied.
- épidémiologie : Brésil, Dermatoses parasitaires, Filariose lymphatique, Lymphadénite, Lymphangite, Maladies du pied.
- étiologie : Dermatoses parasitaires, Lymphadénite, Lymphangite.
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
- Acute, Acute Disease, Adolescent, Adult, Aged, Aged, 80 and over, Brazil (epidemiology), Elephantiasis, Filarial (complications), Elephantiasis, Filarial (epidemiology), Endemic Diseases, Female, Foot Diseases (epidemiology), Foot Diseases (parasitology), Human, Humans, Lower limb, Lymphadenitis (epidemiology), Lymphadenitis (etiology), Lymphangitis (epidemiology), Lymphangitis (etiology), Lymphatic filariasis, Lymphedema, Male, Middle Aged, Skin Diseases, Parasitic (epidemiology), Skin Diseases, Parasitic (etiology), Skin disease, Toes, Tropical medicine, Wuchereria bancrofti.
- MESH :
- geographic , epidemiology : Brazil.
- complications : Elephantiasis, Filarial.
- epidemiology : Elephantiasis, Filarial, Foot Diseases, Lymphadenitis, Lymphangitis, Skin Diseases, Parasitic.
- etiology : Lymphadenitis, Lymphangitis, Skin Diseases, Parasitic.
- parasitology : Foot Diseases.
- Acute Disease, Adolescent, Adult, Aged, Aged, 80 and over, Endemic Diseases, Female, Humans, Male, Middle Aged, Toes.
Abstract
OBJECTIVES An estimated 15 million persons suffer from lymphoedema of the leg in filariasis-endemic areas of the world. A major factor in the progression of lymphoedema severity is the incidence of acute dermatolymphangioadenitis (ADLA), which is triggered by bacteria that gain entry through damaged skin, especially in the toe web spaces ('interdigital skin lesions'). Little is known about the epidemiology of these skin lesions or about patients' awareness of them. METHODS We interviewed and examined 119 patients (89% women) with lymphoedema of the leg in Recife, Brazil, an area endemic for bancroftian filariasis. RESULTS We detected 412 interdigital skin lesions in 115 (96.6%) patients (mean, 3.5 lesions per patient, range 0-8). The number of interdigital skin lesions was significantly associated with lymphoedema stage (P < 0.001) and frequency of ADLA (P < 0.0001). Only 20 (16.8%) patients detected their own interdigital skin lesions or considered them abnormal. Patients reported a mean of 3.6 ADLA episodes during the previous 12 months (range, 0-20); reported ADLA incidence was associated with lymphoedema stage (P < 0.0001) and the number of interdigital skin lesions detected by the examining physician (P < 0.0001). CONCLUSIONS These data suggest that interdigital skin lesions are a significant risk factor for ADLA and that persons with lymphoedema in filariasis-endemic areas are unaware of their presence or importance. Prevention of ADLA through prompt recognition and treatment of interdigital skin lesions will require that patients be taught to identify lesions, especially between the toes and to recognize them as abnormal.
Affiliations:
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i1="01"><s1>Núcleo de Ensino, Pesquisa e Assistência em Filariose-NEPAF, Universidade Federal de Pernambuco</s1><s2>Recife</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Brésil</country><wicri:noRegion>Recife</wicri:noRegion></affiliation></author><author><name sortKey="Addiss, David" sort="Addiss, David" uniqKey="Addiss D" first="David" last="Addiss">David Addiss</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Division of Parasitic Diseases, Centers for Disease Control and Prevention</s1><s2>Atlanta, GA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Gadelha, Patricia" sort="Gadelha, Patricia" uniqKey="Gadelha P" first="Patricia" last="Gadelha">Patricia Gadelha</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Núcleo de Ensino, Pesquisa e Assistência em Filariose-NEPAF, Universidade Federal de Pernambuco</s1><s2>Recife</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Brésil</country><wicri:noRegion>Recife</wicri:noRegion></affiliation></author><author><name sortKey="Lapa, Eduardo" sort="Lapa, Eduardo" uniqKey="Lapa E" first="Eduardo" last="Lapa">Eduardo Lapa</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Núcleo de Ensino, Pesquisa e Assistência em Filariose-NEPAF, Universidade Federal de Pernambuco</s1><s2>Recife</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Brésil</country><wicri:noRegion>Recife</wicri:noRegion></affiliation></author><author><name sortKey="Williamson, John" sort="Williamson, John" uniqKey="Williamson J" first="John" last="Williamson">John Williamson</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Division of Parasitic Diseases, Centers for Disease Control and Prevention</s1><s2>Atlanta, GA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 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Tropical medicine & international health</title><title level="j" type="abbreviated">TM IH, Trop. med. int. health</title><idno type="ISSN">1360-2276</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">TM & IH. Tropical medicine & international health</title><title level="j" type="abbreviated">TM IH, Trop. med. int. health</title><idno type="ISSN">1360-2276</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute</term><term>Acute Disease</term><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Brazil (epidemiology)</term><term>Elephantiasis, Filarial (complications)</term><term>Elephantiasis, Filarial (epidemiology)</term><term>Endemic Diseases</term><term>Female</term><term>Foot Diseases (epidemiology)</term><term>Foot Diseases (parasitology)</term><term>Human</term><term>Humans</term><term>Lower limb</term><term>Lymphadenitis (epidemiology)</term><term>Lymphadenitis (etiology)</term><term>Lymphangitis (epidemiology)</term><term>Lymphangitis (etiology)</term><term>Lymphatic filariasis</term><term>Lymphedema</term><term>Male</term><term>Middle Aged</term><term>Skin Diseases, Parasitic (epidemiology)</term><term>Skin Diseases, Parasitic (etiology)</term><term>Skin disease</term><term>Toes</term><term>Tropical medicine</term><term>Wuchereria bancrofti</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Brésil (épidémiologie)</term><term>Dermatoses parasitaires (épidémiologie)</term><term>Dermatoses parasitaires (étiologie)</term><term>Femelle</term><term>Filariose lymphatique ()</term><term>Filariose lymphatique (épidémiologie)</term><term>Humains</term><term>Lymphadénite (épidémiologie)</term><term>Lymphadénite (étiologie)</term><term>Lymphangite (épidémiologie)</term><term>Lymphangite (étiologie)</term><term>Maladie aigüe</term><term>Maladies du pied (parasitologie)</term><term>Maladies du pied (épidémiologie)</term><term>Maladies endémiques</term><term>Mâle</term><term>Orteils</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Brazil</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Elephantiasis, Filarial</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Elephantiasis, Filarial</term><term>Foot Diseases</term><term>Lymphadenitis</term><term>Lymphangitis</term><term>Skin Diseases, Parasitic</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphadenitis</term><term>Lymphangitis</term><term>Skin Diseases, Parasitic</term></keywords><keywords scheme="MESH" qualifier="parasitologie" xml:lang="fr"><term>Maladies du pied</term></keywords><keywords scheme="MESH" qualifier="parasitology" xml:lang="en"><term>Foot Diseases</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Brésil</term><term>Dermatoses parasitaires</term><term>Filariose lymphatique</term><term>Lymphadénite</term><term>Lymphangite</term><term>Maladies du pied</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Dermatoses parasitaires</term><term>Lymphadénite</term><term>Lymphangite</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Acute Disease</term><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Endemic Diseases</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Toes</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Filariose lymphatique</term><term>Humains</term><term>Maladie aigüe</term><term>Maladies endémiques</term><term>Mâle</term><term>Orteils</term><term>Peau pathologie</term><term>Lymphoedème</term><term>Filariose lymphatique</term><term>Membre inférieur</term><term>Homme</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Wuchereria bancrofti</term><term>Aigu</term><term>Médecine tropicale</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Brésil</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">OBJECTIVES An estimated 15 million persons suffer from lymphoedema of the leg in filariasis-endemic areas of the world. A major factor in the progression of lymphoedema severity is the incidence of acute dermatolymphangioadenitis (ADLA), which is triggered by bacteria that gain entry through damaged skin, especially in the toe web spaces ('interdigital skin lesions'). Little is known about the epidemiology of these skin lesions or about patients' awareness of them. METHODS We interviewed and examined 119 patients (89% women) with lymphoedema of the leg in Recife, Brazil, an area endemic for bancroftian filariasis. RESULTS We detected 412 interdigital skin lesions in 115 (96.6%) patients (mean, 3.5 lesions per patient, range 0-8). The number of interdigital skin lesions was significantly associated with lymphoedema stage (P < 0.001) and frequency of ADLA (P < 0.0001). Only 20 (16.8%) patients detected their own interdigital skin lesions or considered them abnormal. Patients reported a mean of 3.6 ADLA episodes during the previous 12 months (range, 0-20); reported ADLA incidence was associated with lymphoedema stage (P < 0.0001) and the number of interdigital skin lesions detected by the examining physician (P < 0.0001). CONCLUSIONS These data suggest that interdigital skin lesions are a significant risk factor for ADLA and that persons with lymphoedema in filariasis-endemic areas are unaware of their presence or importance. Prevention of ADLA through prompt recognition and treatment of interdigital skin lesions will require that patients be taught to identify lesions, especially between the toes and to recognize them as abnormal.</div></front></TEI><affiliations><list><country><li>Brésil</li><li>États-Unis</li></country><region><li>Géorgie (États-Unis)</li><li>Texas</li></region></list><tree><country name="Brésil"><noRegion><name sortKey="Dreyer, Gerusa" sort="Dreyer, Gerusa" uniqKey="Dreyer G" first="Gerusa" last="Dreyer">Gerusa Dreyer</name></noRegion><name sortKey="Gadelha, Patricia" sort="Gadelha, Patricia" uniqKey="Gadelha P" first="Patricia" last="Gadelha">Patricia Gadelha</name><name sortKey="Lapa, Eduardo" sort="Lapa, Eduardo" uniqKey="Lapa E" first="Eduardo" last="Lapa">Eduardo Lapa</name></country><country name="États-Unis"><region name="Géorgie (États-Unis)"><name sortKey="Addiss, David" sort="Addiss, David" uniqKey="Addiss D" first="David" last="Addiss">David Addiss</name></region><name sortKey="Dreyer, Annelies" sort="Dreyer, Annelies" uniqKey="Dreyer A" first="Annelies" last="Dreyer">Annelies Dreyer</name><name sortKey="Williamson, John" sort="Williamson, John" uniqKey="Williamson J" first="John" last="Williamson">John Williamson</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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