Microfilariae elicit the onchocerciasis syndrome, which includes blindness, lymphadenitis, and dermatitis. No well-described racial differences in the incidence of onchocerciasis or susceptibility to the disease exist. Socioeconomic differences clearly have been identified as a contributing factor. Although no reported differences of exposure exist between men and women, men may have been afflicted more due to farm and field occupations. A detailed history and complete ophthalmologic examination should be performed whenever possible.
Skin manifestations The earliest skin involvement is mild pruritus.
This may be followed by papular rash, erosions, and lichenification. The classic dermal lesion is referred to as leopard skin, which represents islands of hyperpigmented skin around hair follicles with surrounding depigmentation, most commonly located on the shins. These cutaneous manifestations affect mobility and social acceptability. Ocular manifestations By slit lamp biomicroscopy, the microfilariae can be seen within the cornea, migrating in the anterior chamber and the vitreous humor freely. Although live microfilariae cause minimum reaction, dead microfilariae are associated with severe inflammatory response.