What are the Skin Neglected Tropical Diseases in the Philippines?

By: Arielle Dado Severino, MD & Belen L Dofitas, MD FPDS

Leprosy, also known as Hansen’s disease, is a complex, chronic infection mainly of the peripheral nerves, skin, and linings of the eyes, mouth, nose, and the upper airways. It is only mildly infectious, transmitted by inhaling bacteria Mycobacterium leprae or M. lepromatosis.  Whitish or reddish skin discoloration combined with loss of skin sensation or progressive muscle weakness (nerve damage) occur and may lead to chronic disability and deformities if left untreated.

Lymphatic filariasis, locally known as “tibak”, is caused by roundworms that can stay in the skin or lymphatics. It is transferred through the bites of mosquitoes that carry the microfilaria parasite. Legs and arms can swell because of the blocked lymphatics, which is the basis of its other name, Elephantiasis.

Scabies, Head lice, and skin parasites:  Scabies (“galis”) is a parasitic infection by microscopic mites (Sarcoptes scabiei var hominis) that results in intense itchy bumps, usually involving the fingers, wrists, underarms and around the genitalia. Itching is usually worse at night, and other people in a household would have the same condition because it is easily passed on by skin contact and other objects (ex. blankets). 

Head lice (Pediculosis capitis; “kuto”) is a very common parasitic infestation of the scalp and hair caused by a wingless insect, Pediculus humanus capitis, that feeds on the blood from the skin. The scalp becomes very itchy as a reaction to the bites and the hair becomes dotted with the eggs (nits) of the head lice.

Yaws: (“Bakataw” in Maguindanaon language) is a bacterial infection caused by Treponema pallidum subspecie pertenue that affects the skin and bones. Yaws first appears in children as yellow-crusted pink bumps that slowly develop deep wounds, usually on the legs and ankles. The wounds heal after 3-6 months, replaced by scars. A few weeks or 2 years later, more wounds can appear, this time with pain in bones or joints. It is in the first two stages that treatment will be most effective.

Mycetoma is a fungal or bacterial infection where multiple, painless lumps on the feet, legs, or hands appear after minor injury (ex. thorn prick), followed by draining wounds with tiny grains, and enlargement of the foot or affected body part. 

Cutaneous Leishmaniases is a protozoan infection transmitted by the bite of sand flies or “nik-nik”. These are large bumps with ulcers (“volcano-like”) that can be seen on exposed parts of the body such as the face, arms and legs. These ulcers heal with scarring, resulting in serious disability. Filipino overseas workers get infected abroad and return to the Philippines with these non-healing wounds. However, the sand flies in our country may still be able to transmit the infection locally.





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