Onchocercoma of the scalp: A case report

Onchocerciasis or river blindness is a parasitic disease caused by Onchocerca volvulus transmitted to humans by the byte of a black fly of the species Simulium. This pathology, which is a part of the Neglected tropical Disease (NTDs), has been resurgent for some years in certain regions of Burkina Faso. We report a case of onchocercoma with the aim of describing the anatomopathological aspects of this pathology. These were two (02) biopsy fragments from a scalp nodule in an 8-year-old boy, received in the pathology laboratory for examination. In this case study, we recall that onchocerciasis is manifested mainly by skin lesions, subcutaneous nodules and ocular lesions. Histologically, the skin lesions present as a dermatitis with adult worms in the superficial dermis within a predominantly eosinophilic inflammatory infiltrate. Nodules or onchocercomas, usually subcutaneous, consist of fibrous, inflammatory tissue with a predominance of eosinophils and adult worms including females containing microfilariae. Ocular lesions begin with punctate keratitis with a snowflake image. Sclerosis with opacification of the cornea progressively sets in, causing blindness.