title: Late-onset onchocercal skin disease among Ethiopian immigrants.
abstract: BACKGROUND
  Onchocerciasis is an infectious disease caused by the filaria Onchocerca volvulus. Very little is known regarding onchocerciasis imported from endemic to nonendemic areas.
  
  
  OBJECTIVE
  To evaluate pruritic dermatitis simulating atopic dermatitis in Ethiopian immigrants in Israel.
  
  
  METHODS
  A retrospective study of 27 Ethiopian immigrants to Israel was conducted. Demographics and clinical and laboratory data were collected.
  
  
  RESULTS
  Of the group of 27 patients, 10 (37%) were men and 17 (63%) were women. The average age at referral was 29 years. All of the patients emigrated from Kuwara, Ethiopia. Diagnosis was done by either positive skin snip test or immunoglobulin (Ig) G4 serology of onchocerciasis in 14 patients. The most common presentation was a combination of lichenified onchodermatitis with atrophy and depigmentation (36%). Eosinophilia and elevated IgE levels were common. Seventeen patients were treated with a single administration of oral ivermectin 200 μg mg(-1). Thirteen patients responded to the treatment.
  
  
  CONCLUSIONS
  Immigrants from endemic regions to developed countries presenting with pruritic diseases, especially those with a clinical picture suggestive of atopic dermatitis, should be evaluated for possible onchocerciasis infection. Ivermectin, a relatively safe and low-cost treatment, should be considered even in the absence of a proven disease. Physicians should have a high index of suspicion in patients with the corresponding residential history.
authors.affiliation: Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Baum
authors.forename: S
authors.initials: S
authors.lastname: Greenberger
authors.forename: F
authors.initials: F
authors.lastname: Pavlotsky
authors.forename: M
authors.initials: M
authors.lastname: Solomon
authors.forename: C D
authors.initials: CD
authors.lastname: Enk
authors.forename: E
authors.initials: E
authors.lastname: Schwartz
authors.forename: A
authors.initials: A
authors.lastname: Barzilai
mesh_terms: D000293:Adolescent; D000328:Adult; D000977:Antiparasitic Agents / Q000627:therapeutic use; D002648:Child; D003876:Dermatitis, Atopic / Q000208:ethnology / Q000469:parasitology; D054242:Emigrants and Immigrants; D005002:Ethiopia / Q000208:ethnology; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007559:Ivermectin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009855:Onchocerciasis / Q000188:drug therapy / Q000208:ethnology*; D011537:Pruritus / Q000208:ethnology / Q000469:parasitology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000977:Antiparasitic Agents; D007559:Ivermectin