Filariasis

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Synonym(s)

Lymphatic filariasis; bancroftian filariasis; brugian filariasis; onchocerciasis; African river blindness; blinding filariasis; Robles' disease; loiasis; Loa loa

Definition

Disease group caused by nematode parasites of the order Filariidae, commonly called filariae

Pathogenesis

Lymphatic filariasis caused by Wuchereria bancrofti, Brugia malayi, and Brugia timori; cutaneous filariasis caused by Loa loa, Onchocerca volvulus, and Mansonella streptocerca; Microfilariae in insect host inoculated into vertebral host during feeding and completing their life cycle there

Clinical manifestation

Lymphatic filariasis - acute episode (ade-nolymphangitis): fever; inguinal or axillary lymphadenopathy; testicular and/or

Finger infection 239

Finasteride. Dermatologic indications and dosage

Disease

Adult dosage

Child dosage

Androgenetic

1 mg PO daily

Not indicated

alopecia in men

inguinal pain; limb or genital swelling; skin exfoliation of the affected body part usually occurring with resolution of an episode; recurrent episodes of inflammation and lymphedema leading to lymphatic damage with chronic swelling and elephantiasis of the legs, arms, scrotum, vulva, and breasts

Onchocerciasis: skin nodules over bony prominences (i.e., onchocercomas); other skin lesions including edema, pruritus, erythema, papules, altered pigmentation, and lichenification

Loiasis: large transient area of localized nonerythematous subcutaneous edema (Calabar swelling), most common around joints

Differential diagnosis

Scrotal or testicular trauma; lymphoma; lymphogranuloma venereum; Milroy disease; bacterial or fungal lymphadenitis; leprosy; non-filarial elephantiasis; hydrocele

Therapy

Lymphatic filariasis: diethylcarbamazine 6 mg per kg PO per day for 12-21 days* Oncocerciasis: ivermectin* Loiasis: diethylcarbamazine 6 mg per kg PO per day for 12-21 days*; albendazole

References

Taylor MJ, Hoerauf A (2001) A new approach to the treatment of filariasis. Current Opinion in Infectious Diseases 14(6):727-731

Generic available

Drug class

Type II 5 a-reductase inhibitor Mechanism of action

Inhibition of 5-a reductase causes reduced conversion of testosterone to dihydrotesto-sterone in hair follicles

Dosage form

1 mg tablet

Dermatologic indications and dosage

See table

Common side effects

Genitourinary: decreased libido, impotence, decreased ejaculate volume

Serious side effects

None

Drug interactions

None

Contraindications/precautions

Hypersensitivity to drug class or component

References

Messenger AG (2000) Medical management of male pattern hair loss. International Journal of Dermatology 39(8):585-586

Finasteride

Trade name(s)

Propecia

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