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What's your diagnosis?

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Onchocerciasis. Onchocerca volvulus, such as Tunga penetrans, Dracunculus medinensis, Wuchereria bancrofti, and Loa loa, is limited to parts of the developing world. All these metazoa infest deeply and are difficult to eradicate. The filarial elephantiasis caused by W bancrofti, the edema (Calabar swellings) around the eyes caused by the “African eye worm” (Loa loa), and the interdigital nodule, usually between toes, that harbors yards of the guinea worm (D medinensis) are endemic to varying regions of Africa, South America, and Asia.

Source: Prose NS, Kristal L. Weinberg's Color Atlas of Pediatric Dermatology, 5e; 2017. 

Leah Carton

Associate Editor - Pediatrics, Dermatology, Geriatrics , McGraw Hill