- Volume 70 , Number 2
- Page: 126–7
Regarding mohamed, facial lesions resembling to leprosy
To the Editor:
In a recent letter concerning patients with facial lesions mimicking leprosy, K. B. Mo-hamed (4) proposed a diagnosis combining gangosa and goundou syndrome in one case (no. 2). Gangosa syndrome is a destructive ulcerative rhinopharyngitis that can occur in the late stages of endemic treponematosis. In France, gangosa syndrome was ob-served at the end of the 19th century in asso-ciation with syphilis (1). The case presented in the letter is consistent with this condi-tion. However, the diagnosis of goundou syndrome seems unlikely in our opinion.
Goundou syndrome is a clinical form of recent yaws characterized by the presence of either a tumorous swelling involving the paranasal bones that is usually symmetrical or of diffuse hypertrophy of the whole na-sopalatine region, therefore, the name given to the condition in West Africa, i.e., N'goundou meaning "big nose" (Fig. 1 and 2). This treponeme-related osteoperiostitis begins in the early phase of primary infec-tion (usually during childhood) and slowly grows, ultimately causing obstruction of the visual field and, in diffuse forms, of the res-piratory and digestive tracts. Goundou syn-drome is not associated with bone necrosis and, to our knowledge, none of the 137 cases reported in the literature notably by P. Botreau-Roussel (2, 3) was associated with gangosa.
Fig. 1. Paranasal Goundou, Cote d'Ivoire. 1916(Coll. IMTSSA. Le Pharo, Marseille. France).
Fig. 2. Diffuse Goundou, Cote d'Ivoire. 1917 (Coll. IMTSSA, Le Pharo, Marseille, France).
Destruction of the nasal region in Dr. Mohamed's patient probably led to skin folding or may have been accompanied by a mild periosteal reaction, but there are no grounds for diagnosis of goundou syn-drome.
- Bertrand Mafart, M.D., Ph.D.
REFERENCES
1. Zuckerkandl, E. Anatomie normale et patho-logique des fosses nasales, ed Paris: Masson, 1895.
2. Botreau-Roussel, P. Ostéites pianiques "Goundou". ed Paris: Masson. 1925.
3. Botreau-Roussel, P. Clinique chirurgicale des pays chauds, ed Paris: Masson. 1938.
4. Mohamed, K. B. Facial lésions resembling leprosy. Int. J. Lepr. 69 (2001) 35-37.
Correspondence to:
B. Mafart. M.D., Ph.D.
Institut de Médecine Tropicale du Service de Santé des Armées, Le Pharo
Marseille, France
and UMR 6569, Labora-toire d'Anthropologie, Faculté de Médecine de Marseille, Méditerranée univ.
Bd Pierre-Dramard, 13916
Marseille Cedex 20, France
Tel: 334 91 15 04 44. Fax: 334 91 15 01 29.
E-mail: bmafart@aol.com