Luzia Veletzky, MD, PhD, DTM and Stefan Winkler, MD
Luzia Veletzky, MD, PhD, DTM and Stefan Winkler, MD
New England Journal of Medicine
Oct 23, 2025
1 min read
Luzia Veletzky, MD, PhD, DTM and Stefan Winkler, MD
Luzia Veletzky, MD, PhD, DTM and Stefan Winkler, MD
New England Journal of Medicine
October 23, 2025
1 min read
Luzia Veletzky, MD, PhD, DTM and Stefan Winkler, MD
Luzia Veletzky, MD, PhD, DTM and Stefan Winkler, MD
New England Journal of Medicine
October 23, 2025
1 min read
Topics
In this Images in Clinical Medicine from the New England Journal of Medicine, a man returns from Zimbabwe with a painful, crusted ulceration on his scalp.
The authors describe a man presenting with several days of fever and generalized weakness and a painful ulceration with underlying erythema on his parietal scalp after returning from Zimbabwe a week prior. After obtaining laboratory testing, his clinicians diagnosed him with human East African trypanosomiasis (HAT) — otherwise known as sleeping sickness.
The trypanosomal chancre seen on the patient is typically seen in the first stage of HAT. It can be mistaken for cellulitis or other insect or arachnid bites, but the chancre is usually larger than an eschar and does not necrose. The lesion later indurates or ulcerates, followed by peripheral desquamation and hyperpigmentation as it self-resolves. Aside from raising our suspicions for…
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The authors describe a man presenting with several days of fever and generalized weakness and a painful ulceration with underlying erythema on his parietal scalp after returning from Zimbabwe a week prior. After obtaining laboratory testing, his clinicians diagnosed him with human East African trypanosomiasis (HAT) — otherwise known as sleeping sickness.
The trypanosomal chancre seen on the patient is typically seen in the first stage of HAT. It can be mistaken for cellulitis or other insect or arachnid bites, but the chancre is usually larger than an eschar and does not necrose. The lesion later indurates or ulcerates, followed by peripheral desquamation and hyperpigmentation as it self-resolves. Aside from raising our suspicions for…