Of 356 samples of human sera collected from native patients in two distinct zones of Somalia, 53% were positive (greater than or equal to 1:8) to the dye-test for Toxoplasma gondii antibodies. A significantly lower incidence (P less than 0.01) of infection was found in patients living in the arid Mogadishu area, compared to that in patients from villages on the river borders, situated in humid soil zones. Furthermore, in 4.2% of the river area cases the titres were over 300 I.U., indicating that acute T. gondii infection exists among the Somalian population. These differences were regarded as being due to climatic and geographical conditions rather than to diet or socio-economic conditions.

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We examined more than 1,400 dermatologic patients with clinically defined (but having unknown or presumably multiple etiology) affections. The investigation revealed the presence of antitoxoplasm antibodies in more than 50% of the patients, but in only 11% of the cases did the serological analyses give evidence of an active form of disease. It was possible to prove the toxoplasmic etiology of 29 cases of chronic prurigo and of 4 cases of dermohypodermitis. The same infection was involved in a few cases of different dermatoses and in two cases of dermatomyositis-like syndrome. Pseudotumoral granulomatous localizations occurred in immunosuppressed patients. We suggest an ‘immunological key’ to explain the polymorphism of the cutaneous manifestations. The practical interest of this new knowledge and its importance as a field of interdisciplinary studies are emphasized.

SUMMARY A woman had the typical clinical, cutaneous, and muscular picture of dermatomyositis but without some of the biochemical alterations of that disease. The positive serological investigations for toxoplasmosis, the presence in muscles of very numerous toxoplasms and their culture in mice, and the improvement after treatment with pyrimethamine and sulphamethoxypyridine demonstrated that the signs of dermatomyositis had been caused by infection with toxoplasmosis.

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