Venereal
diseases :
- Gonorrhoea
is the most common venereal
disease seen in Arab population. The main
complaint is milky discharge from the
penile urethra ("Gaddaa Min
Zib" or "Bukhit").
Often they have had injections and a
course of antibiotic capsules.
More often they suffer from mixed
infections of gonorrhoea and organisms
causing non-specific urethritis syndrome.
These patients continue to complain of
slight discharge per urethra. Smear
examinations of the secretions, no more
show any evidence of gram negative
diplococci. Though it is difficult to
culture, chlamydia organisms, in a few
patients, staphylococcus aureus is grown
on culture showing sensitivity to
gentamycin and cephalosporidine group of
drugs. But these organisms are invariably
resistant to penicillin.
Often these patients harbour infection in
the deep pockets of the prostate gland
and do not get completely cured. Some of
them develop symptoms of "urethritis
syndrome" and
stricture urethra and run from doctor to
doctor. Many of them also develop
superadded neurosis.
- Syphilis
: This venereal disease is not common
in Arabs. It is uncommon for an Arab to
present with a chancre, though once in a
way all the venerealogists have treated a
primary chancre. This low incidence
cannot be explained by the half hearted
treatment, often given by some general
practitioners, for treating gonococcal
infection. Often in the latter case,
penicillin is not administered and they
are treated with broad spectrum
antibiotics, which have no known action
on spirochaetes.
Hardly ever has any skin specialist or
venerealogist seen a case of secondary
syphilis in an Arab. Also, hardly ever a
case of cardiovascular syphilis or
neuro-syphilis has been seen in my clinic
during the last fifteen years.
- V.D.R.L.
Test : I must have asked for
this blood test in more than a thousand
Arab patients (in those with a history of
exposure) and got it done at different
laboratories. On a dozen occasions, the
test was positive and often this was a
residual, low titre positive result,
after a full course of treatment in the
past. At the pathology laboratory of
Jaslok Hospital, in 500 Arab patients in
whom blood V.D.R.L. test was asked for,
it was found positive only in 4.4 per
cent. In a similar number of Indian
patients, this incidence was 7.6 per
cent.
- Chancroid
: Although this is the
most common venereal disease amongst the
local Indian patients, it is rare in
Arabs.
- Viral
venereal infections seem to be
common. These present as venereal warts
or herpes progenitalis. Although the
latter appears to be more common in
Indian population, the reverse is true in
Arab population.
- Venereal
warts are often seen in the
perianal region and very few are noticed
on the genitalia.
- Herpes
progenitalis is seen off and on
in this population. Very often it is
associated with symptoms of neurosis and
impotence. In spite of the extensive
treatment advised by a number of skin
specialists, the response is poor and the
eruptions continue to appear.
Skin
diseases :
The skin
diseases commonly encountered in Arabs are Tinea
Versicolor, Candidiasis, Ringworm Infection,
Acne, Dandruff, Atopic Dermatitis, Allergic
Contact Dermatitis and Verruca Vulgaris.
- Tinea
Versicolor : Majority of the
Arabs, more commonly males, have this
superficial fungal infection. It is seen
as hypopigmented, scaly, sometimes
pruritic eruptions on the chest, back,
upper arms and neck. Only occasionally a
patient comes with more extensive
involvement, on the lower extremities.
This is obviouslydue to climatic
environment, excessive sweating and use
of synthetic garments. Basically there
are two types of Arab patients. There are
those who do not complain of this skin
lesion even though it may be extensive.
They consider it as part of their normal
health! There are others who become
neurotic, because this
"disease" has persisted inspite
of lot of treatment!!
This affection is recurrent and the
patients have to be assured that it is
harmless. Some of them come back
complaining of a mild reaction, noted
more after treatment with 'selsun
shampoo'.
- Candidiasis
: This fungal infection is
noticed commonly in the overweight and
fat female Arabs. The clinical picture is
in the form of red erythematous, chapped
areas in the groins and perianal regions
(around the anus) and under the pendulous
breasts. Only about one-third of the
patients are diabetics.
- Ringworm
is comparatively less common than Tinea
Versicolor. It is sometimes seen in obese
and diabetic Arabs. The duration of the
infection is from a few days to few
months. The lesions seen are on the
gluteal region, abdomen, groins and feet.
Rarely, other sites may be affected, but
it is uncommon to find involvement of the
nails or scalp in adults.
- Acne
: Patients with acne are the
young adult males and females, usually
Bahrainis. Some of the most pretty young
faces are scarred due to acne. I am also
surprised at the cool attitude of these
women to their skin condition. Sometimes
they do not even complain of the lesions.
Although all stages of acne are seen,
majority have Grade I and 11 only i.e.
black heads, papules and pustules.
- Atopic
dermatitis : In the adults, the
lesions are on the antecubital and
popliteal fossae and are often
lichenified. A variant of atopic
dermatitis is seen in the form of
bilateral, lichenified lesions on the
ankles, which are of a few years in
duration.
- Allergic
contact dermatitis is seen more
commonly than atopic dermatitis. A
detailed history reveals allergy to
detergents.
- Dry
eczymatous patches above the
ankles, seen very often do not bother
most of the Arabs. Usually these have
been present for a few years and itch off
and on.
- Pruritus
:Many Arabs, especially Yemenis
complain of generalised pruritus ("Hakk")
for no obvious reason. Often they
complain of it, only when asked as a
leading question.
- Vitiligo
:The incidence of vitiligo seems
to be increasing In Arab population.
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