PubMed Health⌕ Search

Biomedical subjects

B Leppard

Publications and source records attributed to B Leppard.

At least 19 recordsLinked to original sources
PubMed2000

The use of ivermectin in controlling an outbreak of scabies in a prison.

BACKGROUND: Ivermectin is a potentially useful treatment for scabies. OBJECTIVES: We aimed to evaluate the efficacy of ivermectin in the treatment of scabies in an institutional environment. METHODS: A single dose of ivermectin 150 microg kg-1 was given under supervision to 1153 prisoners in a prison in northern Tanzania where there was an outbreak of scabies. RESULTS: Thirty per cent of the prisoners were cured after 1 week, 88% after 4 weeks and 95.5% after 8 weeks. Of 16 prisoners with crusted scabies, seven (44%) still had scabies after 8 weeks. Those who were not cured were then treated with 1% lindane lotion topically, as were the prison staff who had scabies. This regimen eradicated scabies from the prison for the next 2 years. CONCLUSIONS: Ivermectin is an effective and safe treatment for scabies, particularly in a closed community, such as a prison, where it is easy to administer and avoids problems with compliance. It was of limited efficiency in crusted scabies as a single dose and we recommend that for such patients oral ivermectin is used in combination with a topical scabicide.

Adolescent↗
PubMed2000

Herpes zoster and HIV infection in Tanzania.

Two hundred consecutive patients with herpes zoster attending the skin clinic at the Kilimanjaro Christian Medical Centre (KCMC) were examined and checked for HIV infection. They ranged in age from 10 months to 86 years with the majority in their 20s and 30s. The dermatomes involved were thoracic (97), trigeminal (50), cervical (37), lumbar (19) and sacral (3). Six (3%) had more than one dermatome involved and 2 (1%) had disseminated disease. Only 2 (1%) had severe ulceration of the skin and all healed in less than 4 weeks. In children under the age of 10 years and in adults between the ages of 20 and 49 years virtually 100% were HIV positive; even in the age group 50-59 more than three-quarters were HIV positive. We conclude that the presence of herpes zoster at any site is a good indication that the patient is HIV positive except in the teens and the very elderly.

Adolescent↗
PubMed1998

Prevalence of skin disease in rural Tanzania and factors influencing the choice of health care, modern or traditional.

OBJECTIVES: To determine the prevalence of skin disease in a rural Tanzanian community and to investigate the health-seeking behavior of this community. DESIGN: The study was in 3 parts: (1) 120 heads of households were interviewed to determine the factors that influence the families' health-seeking behavior; (2) the 800 members of these families were examined for evidence of skin disease; and (3) a focus group discussion was held with influential members of the community to get a broader view of health-seeking behavior. SETTING: A rural village in the southwestern area of Tanzania: Individuals were interviewed and examined in their own homes. RESULTS: A total of 34.7% of 800 villagers had one or more skin diseases, the most common of which were tinea capitis, tinea corporis, scabies, acne, and eczema. Modern and traditional health facilities were equally used, but heads of the households older than 55 years who had never been to school and individuals who were not Christians favored traditional medicine. It was cheaper to go to a traditional healer, but modern medicine was thought to be more scientific. CONCLUSIONS: Skin disease was a problem in this village and was perceived to be a problem by both individuals and the community. There is a need to assess the clinical and diagnostic skills of both modern and traditional health practitioners and to instigate a preventive health education program to eradicate the common infections and infestations.

Adolescent↗
PubMed1995

Actinic damage and skin cancer in albinos in northern Tanzania: findings in 164 patients enrolled in an outreach skin care program.

Persons with albinism are particularly vulnerable to the deleterious effects of UV light on their skin. We obtained histories and performed skin examinations on 164 albino patients living in equatorial Africa to determine their sun exposure, sun protection, and sun damage. Many patients did not wear hats and most wore short-sleeved shirts. Except for four infants, all patients had sunburned skin. Actinic cheilitis, actinic keratoses, and skin cancers were detected in many patients. Sun protection methods will be important for prevention of skin damage in albino patients.

Adolescent↗
PubMed1995

Chrysiasis revisited: a clinical and pathological study.

Chrysiasis is a distinctive and permanent pigmentation of light-exposed skin resulting from the administration of parenteral gold salts. We report a study of 40 Caucasian patients with rheumatoid arthritis, treated with intramuscular sodium aurothiomalate, of whom 31 had chrysiasis. Visible changes develop above a threshold, equivalent to 20 mg/kg gold content, and their severity depends upon cumulative dose. Focal aggregates of particulate gold are deposited in the reticular and papillary dermis in amounts that correlate with the degree of pigmentation. Characteristically, initially the periorbital region is affected by a mauve discoloration, which intensifies and deepens into a blue/slate-grey colour, while extending to involve the face, neck and upper limbs. Although chrysiasis develops insidiously and patients may be unaware of the changes, positive identification is important in order to avoid misdiagnosis and medical mismanagement, and afford appropriate reassurance. Prevention is difficult, but measures to reduce sunlight exposure may be helpful.

Antirheumatic Agents↗
PubMed1992

The palisaded, encapsulated neuroma (solitary circumscribed neuroma).

We describe the clinical and pathological features of 41 palisaded encapsulated neuromas. They present as small, solitary, asymptomatic papules, predominantly on the face in middle age. No case had co-existent neurofibromatosis or multiple mucosal neuromas. Histologically, they have distinctive features, consisting of a proliferation of Schwann cells and large numbers of axons within a perineurial derived capsule, permitting simple and reliable distinction from schwannomas and neurofibromas. Overall, the palisaded encapsulated neuroma accounts for approximately 25% of all nerve sheath tumours of the dermis. True schwannomas rarely occur in the dermis. Despite their original name, many cases are incompletely encapsulated and we support the recent proposal to rename these lesions solitary circumscribed neuroma.

Adolescent↗
PubMed1982

Necrotizing fasciitis-a disease of temperate and warm climates.

Necrotizing fasciitis is a distinct clinical entity. It is usually due to Streptococcus pyogenes but may occasionally be caused by Staphylococcus aureus. It needs to be considered in relationship to other infections due to Streptococcus pyogenes, in which the clinical disease that occurs may be associated with the depth of inoculation of the coccus. Mild cases have been identified that are self-limiting as well as serious cases which would have succumbed without surgical debridement. It is likely that some cases of necrotic tropical ulcer are due to necrotizing fasciitis.

Fasciitis↗
PubMed1975

Epidermoid cysts, polyposis coli and Gardner's syndrome.

One hundred and ninety-six members of 15 families with Gardner's syndrome were investigated to determine the type of skin cyst that is part of this syndrome. These were shown to be epidermoid cysts and not pilar cysts or steatocystoma multiplex. They were solitary or multiple and seldom large and disfiguring. The skin cysts often occurred before the intestinal polyps were detectable. The presence of epidermoid cysts in children should be an indication for sigmoidoscopy when the child reaches the age of 14 years, and at 3-yearly intervals thereafter up to the age of 30 years, whether or not there is a family history of polyposis coli. At present it is not possible to say if Gardner's syndrome is the same as, or different from, familial polyposis. Until all patients with colonic polyps have a full clinical examination, looking for skin cysts and osteomas, X-rays of the skull and long bones to detect osteomas and dental X-rays for abnormalities of the teeth this question will remain unanswered.

Adolescent↗
PubMed1975

Milia occurring in lichen sclerosus et atrophicus.

Large numbers of milia were seen in areas of skin affected with bullae in a 68-year-old woman who had extensive lichen sclerosus et atrophicus. Although milia are frequently seen in other sub-epidermal bullous disorders, they have not previously been reported in lichen sclerosus et atrophicus.

Aged↗
PubMed1974

Subungual malignant melanoma: difficulty in diagnosis.

Subungual malignant melanoma developed on both great toes of a 61-year-old woman. The lesions had been diagnosed elsewhere as ingrowing toenails and had been treated as such for two years. The difficulty in clinical diagnosis is illustrated by the description of three other patients with subungual malignant melanoma. The tumour should be considered as a possible cause of any persistent abnormality of the nail bed or the nail itself, especially if it is pigmented.

Amputation, Surgical↗