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Tropical dermatology: Part II
Clinics in Dermatology (2007) 25, 157
Commentary
Tropical dermatology: Part II It has been said that a good book should be opened with expectation and closed with profit. The same aphorism could be applied to medical journals, and it has been my task to ensure that the reader will gain intellectual nourishment from the chapters compiled in this, the second issue dedicated to the scintillating topic of tropical dermatology. It is just over a century since the first powered flight by the Wright brothers. Since then, commercial flight has made the world a much smaller place. Travel broadens the mind by rewarding the traveler with previously unimaginable experiences, but it may also gift the traveler with unexpected souvenirs. Tungiasis and myiasis are ectoparasitic infestations that occur commonly in developing countries. Despite recent progress in the treatment and prevention of tungiasis and myiasis, diagnosis can be a challenge to those unfamiliar with these conditions, especially when they present in a nonendemic setting. Leprosy and tuberculosis are diseases that have plagued mankind since antiquity. Despite the utility of multidrug regimens for the treatment of these mycobacterial diseases, they remain a major public health problem, as in biblical times. Patients may present many years after they have left an endemic area. Leprosy, in particular, is notorious for being diagnosed late in the developed world, sometimes the patient having been seen by a neurologist and/or ear, nose, and throat specialist before arriving at the dermatology consulting rooms. Cutaneous tuberculosis continues to be one of the most elusive and more difficult diagnoses to make for dermatologists practicing in tropical settings, not only because of its manifold presentations, but also because of the wider differential diagnosis to be considered coupled with the difficulty in obtaining a microbiological confirmation. We are sincerely grateful to Professors Eduardo Gotuzzo and Francisco Bravo for their erudite contribution on this topic.
0738-081X/$ – see front matter D 2007 Elsevier Inc. All rights reserved. doi:10.1016/j.clindermatol.2006.05.010
Tropical mycoses are seen regularly as imported dermatoses. Patients may present many years after they have left an endemic area, and it is important to consider the diagnosis in individuals who have visited such regions. Included in this issue are chapters on sporotrichosis (the most common although least severe of the deep mycoses), chromoblastomycosis, and mycetoma. These chapters supplement the chapter on Fungal Infection by Professor Roderick J. Hay that appeared in part I. The cutaneous manifestations of leishmaniasis are as diverse as they are complex, being dependent on a host of parasite and host factors that are poorly understood. I therefore congratulate Drs Mark Bailey and Diana Lockwood of the London School of Hygiene and Tropical Medicine for their excellent presentation of this fascinating topic. Viral exanthems are at least as common in the tropics as they are in nontropical settings. Not only do people living in hot countries have to contend with the usual suspects of chicken pox, measles, Epstein-Barr virus and the like, but they also carry the risk of exposure to diseases such as dengue, yellow fever, West Nile fever, Marburg disease, and Lassa fever. Awareness of these exotic exanthematic diseases has become necessary as dermatologists are increasingly challenged by such cases returning from exotic locales. As one of my professors said, our knowledge is but a match lit in intergalactic darkness. It is hoped that this flickering light will shine a little brighter as a result of this issue and that this journal will, at least partly, fulfill its objective to profit the reader with the power that is knowledge over ignorance. Samuel H. Allen, MD (Guest Editor) Imperial School of Medicine Department of Medicine Chelsea and Westminster Hospital London, UK E-mail address: [email protected]
Commentary
Tropical dermatology: Part II It has been said that a good book should be opened with expectation and closed with profit. The same aphorism could be applied to medical journals, and it has been my task to ensure that the reader will gain intellectual nourishment from the chapters compiled in this, the second issue dedicated to the scintillating topic of tropical dermatology. It is just over a century since the first powered flight by the Wright brothers. Since then, commercial flight has made the world a much smaller place. Travel broadens the mind by rewarding the traveler with previously unimaginable experiences, but it may also gift the traveler with unexpected souvenirs. Tungiasis and myiasis are ectoparasitic infestations that occur commonly in developing countries. Despite recent progress in the treatment and prevention of tungiasis and myiasis, diagnosis can be a challenge to those unfamiliar with these conditions, especially when they present in a nonendemic setting. Leprosy and tuberculosis are diseases that have plagued mankind since antiquity. Despite the utility of multidrug regimens for the treatment of these mycobacterial diseases, they remain a major public health problem, as in biblical times. Patients may present many years after they have left an endemic area. Leprosy, in particular, is notorious for being diagnosed late in the developed world, sometimes the patient having been seen by a neurologist and/or ear, nose, and throat specialist before arriving at the dermatology consulting rooms. Cutaneous tuberculosis continues to be one of the most elusive and more difficult diagnoses to make for dermatologists practicing in tropical settings, not only because of its manifold presentations, but also because of the wider differential diagnosis to be considered coupled with the difficulty in obtaining a microbiological confirmation. We are sincerely grateful to Professors Eduardo Gotuzzo and Francisco Bravo for their erudite contribution on this topic.
0738-081X/$ – see front matter D 2007 Elsevier Inc. All rights reserved. doi:10.1016/j.clindermatol.2006.05.010
Tropical mycoses are seen regularly as imported dermatoses. Patients may present many years after they have left an endemic area, and it is important to consider the diagnosis in individuals who have visited such regions. Included in this issue are chapters on sporotrichosis (the most common although least severe of the deep mycoses), chromoblastomycosis, and mycetoma. These chapters supplement the chapter on Fungal Infection by Professor Roderick J. Hay that appeared in part I. The cutaneous manifestations of leishmaniasis are as diverse as they are complex, being dependent on a host of parasite and host factors that are poorly understood. I therefore congratulate Drs Mark Bailey and Diana Lockwood of the London School of Hygiene and Tropical Medicine for their excellent presentation of this fascinating topic. Viral exanthems are at least as common in the tropics as they are in nontropical settings. Not only do people living in hot countries have to contend with the usual suspects of chicken pox, measles, Epstein-Barr virus and the like, but they also carry the risk of exposure to diseases such as dengue, yellow fever, West Nile fever, Marburg disease, and Lassa fever. Awareness of these exotic exanthematic diseases has become necessary as dermatologists are increasingly challenged by such cases returning from exotic locales. As one of my professors said, our knowledge is but a match lit in intergalactic darkness. It is hoped that this flickering light will shine a little brighter as a result of this issue and that this journal will, at least partly, fulfill its objective to profit the reader with the power that is knowledge over ignorance. Samuel H. Allen, MD (Guest Editor) Imperial School of Medicine Department of Medicine Chelsea and Westminster Hospital London, UK E-mail address: [email protected]