Buruli Ulcer - Infection that Consumes Skins

Buruli Ulcer is a disease caused by infection by the Mycobacterium ulcerans. It is one of the most neglected disease in the world, specifically in the developing countries. Mycobacterium (other bacteria of the same family) is also the bacteria that causes tuberculosis and leprosis; however, Buruli ulcer has received the least attention.

Infection of this disease occurs mainly in tropical areas such as Australia, West Africa, Southeast Asia and New Guinea. Among which, this disease has the largest impact in developing countries, mainly due to the lack of knowledge in the disease.

It has been reported that the mycobacteria strives within aquatic environments (such as small aquatic animals, biofilms). Transmission mode to humans is still under investigation. Thus, Buruli ulcers usually occurs near water sources, infecting children under 15 years mainly. There is no evidence that this disease can be transmitted from person to person.

A young boy with Buruli ulcers
Picture Source: click here

Symptoms in General

Buruli ulcer begins with a painless mobile swelling in the skin (any part of the body). The more severe infection can be painful. Buruli ulcer is a long term, necrotizing disease that slowly destroys the skin and soft tissue by the toxin secreted by the mycobacteria.Without treatment, massive ulcerations take place and if the bone is affected, gross deformities will be the consequence.  If the ulcers develop on the limbs, the movement of the patients will be greatly restricted; even after the lesions have healed, the massive scarring will affect the mobility of the patients. In more severe cases, lifetime disabilities are norm in the patients. Can you imagine the pain the patients are enduring?

Treatment And Prevention

The most efficient treatment of Buruli ulcer is the surgical removal of the ulcers. For disease in more advanced stage, prolonged treatment with skin grafting will be necessary. However, surgical practice is scarcely available in developing countries. A combination of antibiotics can be used to reduce the requirement for surgery.

Bacille Calmette–Guérin (BCG) vaccination has been observed to provide short-term protection against the disease. Although only limited protection is available, it will still be useful by ensuring a complete coverage of this vaccine in the heavily affected regions. Once again, people in developing countries have very minor chances to receive such vaccination due to extreme poverty as well as lack of knowledge in diseases.

Living with Elephant's Body Parts

The "Elephant-syndrome", elephantiasis, by the name of it, patients develop thickening of skin and and underlying tissues (resembling the elephant's trunks) in the body parts. The areas of thickening of skin and tissues can occur in face, legs and even male genitals. The disease results in the affected body parts to swell up to the size of a fist or head. The abnormalities triggered by the disease not only lead to great inconvenience in the patients' daily lives, and also agony in the patients.

Extreme case of lower limb swelling.

The disease is initiated by thread-like parasitic worms with Wuchereria bancrofti being the most common cause, and is transmitted by mosquitoes. As the mosquito sucks blood from a human, it introduces the larvae of the parasitic worms which will travel to the human lymphatic system and develop into adult worms to a length ranging 1 to 4 inches. The worms will be living within the infected person for years (usually about 7 years), the longest ever recorded is 40 years.

A woman with enlarged arms.

The sexually matured worms will mate and release millions of microscopic larvae into the blood stream. As the adult worms live within the lymphatic, obstruction of the vessels will lead to swelling, especially in the lower body especially the legs and the genital areas. Therefore, the parasites, as well as the body immune system, contribute to the development of elephantiasis which takes years to show. On the other hand, the disease may develop without being infected by the parasites.

Picture source: click here

The picture shows an enlarged scrotum, affected about 4% of the infected males.

It has been evident that if a pregnant woman got infected by W. bancrofti, her child will have the chance to be infected as well. This can be explained by the parasite's antigens being passed to the fetus' blood circulation. Another scenario will be the fetus becomes tolerant to the parasites' antigens. In future, parasite infection (of the same antigens as the one presented in fetus stage) will be able to evade the host immune system of that child and leading to the development of elephantiasis more easily.

Currently, the medication available is only able to kill the adult worms within the lymphatic system, while the larvae not responsive to treatment.

Gosh! What's On Your Eyelashes!

I believe that many people know that there are tiny bugs living in the human hair called 'mites'. Do you know that there are also lots of mites living in the roots of your eyelashes? Don't be surprise, everyone has mites on the eyelashes, including you and me.

Close up view of a Demodicid

The scientific name of these tiny mites is Demodex folliculorum, also known as demodicid. They are very small, only about 0.4mm in length. They live in pores and hair follicles on the face. There are countless of them nesting on our faces!

A female mite will lay about 25 eggs in a hair follicle, which will hatch and mature and move to other follicles. These disgusting mites live head down in a follicle, dead skin is their food source. If there are too many of them living in a single follicle, the hair shaft will fall off, that's one of the reason for your precious eyeslashes falling off!

The white color tips are the tails of the mites, 3 of them!

If these mites are living in the pores on the face, the outcome may be skin disorder or acne formation. Mites have tiny mouth which feed on the dead skin cells. The fortunate thing is that, mites do not poop, as they only have one opening on them which is the mouth.

Don't get freak out, everyone of us have them on our body, not ten, not hundreds, but millions of them!

Blue Skin Disorder

When you first see Paul Karason, you may think that he is putting up lots of make up to have the “look”, well, he is definitely not. The 57-year-pld Paul Karason has the appearance of every ordinary middle aged man, except for his distinct skin color. And yes, he is all blue, literally.

The-Blue-Man, Paul Karason. 

Karason’s condition is the result of silver poisoning, with the medical name Argyria. Karason has had bad arthritis problem on his shoulders, to ease the pain he started taking *colloidal silver. The arthritis was cured along with a side effect which gradually changed his skin color till what he looks like today. The color changed was so gradual that even Karason himself did not discover it in the first place.

Argyria is caused by excessive exposure to silver be it through contacts, ingestions or inhalation. Long term of exposure will result in the discoloration of skin. This symptom is very hard to treat once develops. Other than the blue skin, severe complications may be the consequences of continued exposure to silver, such as the paralysis of respiratory system which could be fatal.

Karason's case is induced by taking colloidal silver, there are people who are born with blue skin naturally!

They were the family of Fugates. The ancester of this blue skin family was Martin Fugate who settled near Kentucky in 1800, after several generations, his descendants still appear to have blue skin. This blue skin condition remained active for over 1 century.

Family of Fugates, 1800s.

The Fugates suffer from a kind of rare disorder where they have a missing enzyme to convert methemoglobin into haemoglobin, and the medical term for this disorder is called Methemoglobinemia. Methemoglobin (blue in color) is a form of haemoglobin that does not bind to oxygen, when exist in high level in a person, the body is deprived of adequate supply of oxygen. As a result, the skin turn blue or purplish in color.

For the Fugates, their heriditary methemoglobinemia is caused by a reccessive gene. With this gene, the body fails to produce a kind of enzyme named cytochrome b5-reductase, in which its role is to convert methemoglobin back to haemoglobin in red blood cells.

Methylene blue is one of the medicines that is used to treat this conditon. Another medicine that can be used to treat this disorder is ascorbic acid.

*Colloidal silver is a liquid suspension of microscopic particles of silver.