Onchocerciasis is a tropical disease affecting the eye and the skin and is caused by transmission of the parasitic worm Onchocerca volvulus. Acute cutaneous stigmata of onchocerciasis include subcutaneous nodules and papular dermatitides. In chronic onchocerciasis, skin may become thickened, wrinkled, or hypopigmented to-depigmented. Pigmentary alteration patterns may occur in a spectrum of phenotypes, ranging from spotty depigmented macules to the most advanced stage, which features large patches of depigmented skin with islets of perifollicular sparing.1 In 1952, Rodhain2 first described the classic cutaneous stigmata of chronic onchocerciasis as “peau léopardée,” or “leopard skin.” This terminology is now commonly cited in the medical literature, including dermatology textbooks (Figure).
Rieder E. On Leopards, Cheetahs, and the Cutaneous Stigmata of Onchocerciasis. JAMA Dermatol. 2015;151(7):742. doi:10.1001/jamadermatol.2015.0386