title: [Cutaneous diphtheria in returning vacationers--mirror of inappropriate vaccination practice?].
abstract: The causative agent for diphtheria is Corynebacterium diphtheriae, which is transmitted from person to person from the throat of carriers or from patients with active cutaneous diphtheria. The disease occurs in preexisting ulcers, but it may also appear on apparently normal skin. Although primary cutaneous diphtheria starts as a vesicle or pustule, most patients feature a reddish ulcer with undermined borders. The lesion is tender but hypesthesia develops after 2 weeks. The clinical diagnosis is based on the history of travelling in endemic regions and bacteriological studies. The current increase of diphtheria in the Western world is partly caused by rising tourism and a decline of booster vaccination in adults. After trauma with ulcerations of the skin we suggest to perform a booster vaccination not only for tetanus but also for diphtheria. In addition, persons travelling to endemic regions should receive a booster vaccination for tetanus and diphtheria, which is available as a combined preparation.
authors.affiliation: Dermatologische Poliklinik, Abteilung für Bakteriologie, Universitätsklinik Basel.
authors.forename: P H
authors.initials: PH
authors.lastname: Itin
authors.forename: H
authors.initials: H
authors.lastname: Grob
authors.forename: A J
authors.initials: AJ
authors.lastname: Bircher
authors.forename: R
authors.initials: R
authors.lastname: Frei
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004165:Diphtheria / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*; D004168:Diphtheria Toxoid / Q000008:administration & dosage*; D006801:Humans; D007117:Immunization, Secondary; D008297:Male; D008875:Middle Aged; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*; D013557:Switzerland; D014195:Travel
chemical_list: D004168:Diphtheria Toxoid