Biomedical subjects
Publications and source records attributed to W K Jacyk.
A 13-year-old South African Indian boy who presented with oral mucosal lesions and skin blisters due to juvenile pemphigus vulgaris is described. Treatment with high-dose oral corticosteroids produced a prompt clinical response. Pemphigus vulgaris is rare in the young and this may lead to misdiagnosis and inappropriate therapy.
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2 African patients (sisters) suffering from lepromatous leprosy had epidermodysplasia verruciformis. Both patients had in addition recalcitrant superficial fungal infections and extensive relapsing scabies. The question is raised whether a generalized impairment of cell-mediated immunity, found in lepromatous leprosy, predisposes towards other particularly viral infections.
The clinical features of 8 Nigerian cases of sarcoidosis are presented. All of them had skin lesions and at least one other organ involved. Great variability in morphology of skin lesions was found and patients with discoid lupus erythematosus-like changes, cicatricial alopecia, xanthelasma-like lesions and an annular lichen planus-like picture were observed. Review of the literature revealed only 11 previously reported cases of cutaneous sarcoidosis in West Africa. The question of the rarity of sarcoidosis in West Africa in the light of its high frequency in American Negroes who predominantly descended from West Africans is discussed.
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Thirteen cases of deep mycoses were found among 12,506 new patients attending two University clinics in Northern Nigeria. Patients with chromoblastomycosis due to Cladosporium carrionii, paracoccidioidomycosis, rhinophycomycosis, and sporotrichosis appear to be the first cases of these conditions recognized in the Savanna region of West Africa. The literature on systemic mycoses in Nigeria is reviewed and a need for a greater awareness of the problem is stressed.
Patients with psoriasis constituted 0.8% of all (9806) new cases seen in two skin clinics in Northern Nigeria in five years. The findings on proportional rates, age and sex distribution and clinical characteristics of psoriasis in Nigerians are compared with those of other areas of Africa. The proportional rate of psoriasis in Northern Nigeria appears to be lower than that observed in East Africa.
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An African patient with a hypopigmented plaque on the face, suggesting clinically tuberculoid leprosy or sarcoidosis, is described. Histology revealed palisading granulomas surrounding ova of Schistosoma mansoni.
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One hundred thirty-eight Nigerian patients with pityriasis rosea were studied. Patients with the condition constituting 2.4% of all patients seen in two skin clinics in Northern Nigeria in a period of over three years. The proportional rate of pityriasis rosea parallels figures from other African studies, and is higher than values obtained in European series. Pyriasis rosea in Nigerians appears to be more florid and has a greater tendency to overstep the classic boundaries of distribution on the body, to affect the face and involve the oral cavity. The sex and age distribution was similar to European series, although some lowering of the age of onset of the condition was observed. No relationship between the frequency of pityriasis rosea and season was found.
A 45-year-old Nigerian female with Bowen's disease (BD) on the left palm is presented. She appears to be the first African case of BD in this unusual location.
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Results of a detailed clinical and laboratory study of 37 Nigerian patients with chronic discoid lupus erythematosus are presented. Patients with chronic discoid lupus erythematosus constituted 0.46% of all out-patients seen in the skin clinic between May 1974 and December 1977. A preponderance of females was noticed (female/male ratio of 5:1), while the age distribution of African patients corresponded to values characteristic for the condition seen in other geographical regions. Several morphological types of the condition have been seen. The vitiligoid variant of chronic discoid lupus erythematosus seems to be common in West Africans. Sixteen out of 37 patients presented laboratory abnormalities considered as markers of the association between chronic and systemic lupus erythematosus. Their significance, however is, uncertain as it has been demonstrated on several occasions that in a tropical milieu heavy parasitic infections produce marked immunological disturbances. The problem of the relationship between chronic and systemic lupus erythematosus is discussed and the literature on the incidence of chronic discoid lupus erythematosus in various African countries is reviewed.
An analysis of the clinical and pathologic characteristics of 12 Nigerian patients with epidermodysplasia verruciformis (EV) is presented. Two morphological variants have been observed, typical wart-like flat-topped papules and larger confluent plaques. Seborrhoeic keratoses were observed in patients with the second morphological variety of EV. Solar elastosis was found in biopsies taken from EV lesions in this subgroup of patients. A particular rarity of seborrhoeic keratosis in Africans is emphasized as no single African case of seborrhoeic keratosis was found apart from patients with EV. No malignant epithelial skin tumours were found in the whole group. Factors underlying an apparently more benign course of EV in Africans are discussed, and the literature on EV in African is reviewed.
Lichen sclerosus et atrophicus has been considered very rare in the native African population. Only seven cases, all among the Bantu, have been described to date. Five cases are now reported and these cases are believed to be the first from West Africa.
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A Nigerian case of progressive systemic sclerosis is described. Special attention is drawn to the rarity of this condition in Africans.