Tropical Skin Conditions on the Rise, Difficult to Detect

Tinker Ready

June 10, 2019

MILAN — Dermatologists need to be alert for unfamiliar tropical diseases as climate change expands the range of vectors, like ticks and mosquitoes, according to specialists presenting here at the World Congress of Dermatology 2019.

For example, the type of mosquito capable of transmitting dengue and Zika is now found all over the United States, said Aisha Sethi, MD, from the Yale University School of Medicine in New Haven, Connecticut.

"A decade ago, you were seeing dengue only in people who traveled abroad to certain countries," she told Medscape Medical News. "Now we have cases of dengue in Florida and Texas in people who have not traveled outside of the United States."

In addition to an increase in the incidence and risk of conditions like dengue and Zika, specialists are also faced with potentially unfamiliar skin conditions in refugees.

Despite this, fewer courses on tropical diseases are offered in medical schools than in the past, said Sethi, who noted that the WHO website is an excellent source of information on infectious diseases that thrive in hot, humid conditions.

A panel on migrant health that Sethi will cochair will cover a range of dermatology concerns linked to tropical infections and skin issues in refugees in Europe, the Middle East, and North America.

Skin Diseases in Migrants

Skin diseases that emerge as a result of conflict and emigration will be addressed by Seyed Naser Emadi, MD, from the Tehran University of Medical Sciences in Iran. In 1987, when he was a soldier in the Iran–Iraq War, Emadi was exposed to victims of chemical weapons and to the chemicals themselves. He was involved in a study of 1100 Iranian veterans that established a link between a rare form of lymphoma and exposure to sulphur mustard gas (J Eur Acad Dermatol Venereol. 2017;31:432-437).

The chair of the panel — Aldo Morrone, MD, from the San Gallicano Dermatologic Institute in Rome — helped organize the International Symposium of Medicine on Dermatology, Oncology, and Diet (Food) held in Sulaymaniyah in Iraq in May. In a recent Facebook post, he wrote about his work with victims of chemical weapons in Iraq, and said that refugees from Aleppo, Syria "carry the marks on their skin of leishmaniasis, an infection that has the paradox of being called 'Aleppo button'," named long before the Syrian crisis.

The issue of tropical diseases in migrants will be discussed by Bernard Naafs, MD, PhD, who has worked on the issue of tropical dermatology since the 1970s and splits his time between the Netherlands and developing countries, such as Brazil, Ethiopia, Tanzania, and Zimbabwe.

Naafs, who is known for his work on leprosy, helped write a recent statement on the diagnosis, treatment, and follow-up of leprosy (J Eur Acad Dermatol Venereol. Published online April 3, 2019).

Little attention is paid to leprosy these days because attention shifted toward tuberculosis and HIV infections in the late twentieth century, he told Medscape Medical News. Even dermatologists are generally poorly trained in the area.

It was once believed that leprosy was eliminated, but it still affects about 250,000 new patients annually, he added.

Sethi, Emadi, Morrone, and Naafs have disclosed no relevant financial relationships.

World Congress of Dermatology (WCD) 2019. Migrant panel to be held June 11, 2019.

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