First confirmed case of bovine besnoitiosis in Rwanda.

An-eighteen months (one and half years) old heifer was presented with a progressive loss of weight leading to cachexia and was attended to by a team of doctors from the ambulatory clinic of the School of Animal Science and Veterinary Medicine, University of Rwanda. Clinical examination revealed scleroderma of both sides of the neck and pinpoint cysts in the sclera and conjunctiva as well as corneal opacity of the left eye. Histological examination of skin biopsy showed a mononuclear dermatitis with several cysts of 100-300 µm filled up with bradyzoites in the subcutis and dermis. These lesions are consistent with bovine besnoitiosis, a disease caused by Besnoitia besnoiti in cattle. To the best of our knowledge, this is the first confirmed case of bovine besnoitiosis in Rwanda.

Efficacy of bosentan in treatment of unresponsive cutaneous ulceration in disabling pansclerotic morphea in children.

Disabling pansclerotic morphea (PM) of childhood is a rare and debilitating variant of localized scleroderma. We describe a 4-year-old girl with rapid progression of deep cutaneous fibrosis extending into the muscle fascia with disabling joint contractures of the hips, knees, ankles, and fingers and recalcitrant ischemic ulcerations. Within the first months of therapy with dual oral endothelin receptor antagonist bosentan (31.25 mg qd for 4 weeks [DOSAGE ERROR CORRECTED], then 31.25 mg bid) limb ulcers improved, with resolution of the widespread sclerotic skin lesions. Joint mobility improved, and a substantial decrease of skin thickness was noted. No side effects were noted. In the context of other data in scleroderma, bosentan may be a promising option in the treatment of PM.