Onchocerciasis was diagnosed when a skin biopsy specimen immersed in saline revealed microfiliariae. The patient was a 22-year-old student from Cameroon, West Africa, complaining of small, recurrent, pruritic papules on his thighs. Chemotherapy with ivermectin, an established antiparasitic agent with newly recognized anti-onchocercal potential, was well tolerated, and microfilariae were not detected in post-therapy skin biopsy specimens. The diagnosis of onchocerciasis should be entertained in individuals returning or emigrating from endemic areas.
Large congenital melanocytic nevi both present a cosmetic problem and may predispose to the development of a melanoma. We present a series of three patients in whom the tissue expander was employed to facilitate a large excision with primary closure and excellent cosmesis.
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