Onchocercoma of the scalp: A case report

Area of Science:

• Parasitology
• Dermatology
• Pathology

Background:

• Onchocerciasis, a neglected tropical disease (NTD), is caused by Onchocerca volvulus transmitted by Simulium black flies.
• The disease is experiencing a resurgence in parts of Burkina Faso.
• Onchocerciasis presents with skin, subcutaneous nodule, and ocular manifestations.

Observation:

• This report describes the anatomopathological findings of an onchocercoma from a scalp nodule biopsy in an 8-year-old boy.
• Histological examination revealed dermatitis with adult worms and eosinophilic infiltrate in the superficial dermis.
• The nodule (onchocercoma) consisted of fibrous, inflammatory tissue with adult worms, including gravid females containing microfilariae.

Findings:

• Histopathology of skin lesions shows dermatitis with adult Onchocerca volvulus in the superficial dermis.
• Subcutaneous onchocercomas are characterized by fibrous, inflammatory tissue with a predominance of eosinophils and adult worms.
• Ocular lesions progress from punctate keratitis to corneal opacification and blindness.

Implications:

• Understanding the anatomopathological features of onchocercomas is crucial for diagnosis and management.
• This case highlights the importance of recognizing onchocerciasis in endemic areas, even in pediatric populations.
• Accurate histopathological diagnosis aids in understanding disease progression and potential treatment strategies for river blindness.