Hi Eric,

I am sending this out to every doctor I know. I will keep sending to anyone who may be able to help. Somebody out there must know what this is.

Melissa

Hi Melissa,

Thank you very much for offering to send this out. I am also sure somebody out there could help because this is of great concern to me. Looking forward to positive responses from those who may know and those who can offer some help.

Eric

Hi Eric,

No answers yet, but I have sent it to a few people I found by researching the local hospitals. They have been passing it onto people they think may be able to help. I will keep on top of this and let you know as soon as I hear anything at all that might help. The more people in the medical field that I can get this out to, the better the chance that somebody might recognise it.

If there is anyone else out there reading this, and you can spare the time, could you possibly just copy Erics story above and email it to any medical people you can find? I found their email addresses on websites for hospitals and research facilities in Australia. Just make sure you include a link to this page because some of their servers will block the image. At this point in time appears it may be a dermatologist that is required so that is the field I am concentrating on.

Melissa

Hi Melissa,

Thank you very much for your efforts. I also received an email message from a lady called Betty Karimi who read this man's story and was very concerned with his situation. She is trying to send this out to friends who know people who may help. One person already responded from South Africa and asked me to take more photos of the man from all angles and closely to help him diagnose the problem. She also asked if the man had already seen a consultant oncologist and where exactly the man comes from. So i happen to think this could be the province of oncologists (i don't know).Lastly she asked if the abnormal growth grow and then regress or they keep enlarging.

I managed to get all these information to her. I will take more photos of the man and send her and also post here.

Thank very much and keep trying.

Eric

That's great news Eric. It is good to know that people are out there trying to help. I initially thought it might be cancer (not being in any way medically trained), but have been steered towards dermatology and the fact that it may be a skin disease.

Just for your reference....

Oncologist - study of tumors (cancer)
Dermatologist - study of skin and its diseases

Between the two fields we should have it covered. I am guessing that it is either cancerous growths or some sort skin disease.

It would be great if you could include any further pictures or information you get here, as the links I include in my emails are to this page, so anyone who gets one of my emails will be able to see the updated information. If the growths do grow and then regress, or just keep enlarging, could be a vital piece of information in diagnosing this. Can you post the answer to that on here as well?

I will keep trying to find someone who can help.

Good luck!

Melissa

I received this message from Betty Karimi who received it from a Consultant Oncologist from the Royal Marsden Hospital in London.

"What a sad case. From the picture, I would presume he has some sort of
lymphoma. The only way to sort it out would be to get a sample from one of the
lumps and send it for histology. It must be something fairly Œlow grade¹ as he
has had it for so long and it hasn¹r killed him yet. Trouble is, if it is a
low grade lymphoma, I suppose no chemo would be available there. However, in
the event that it is an odd infection/ parasite which has invaded the nodes,
histology would still be helpful as it may be that he would just need a
specific antibiotic."

I thank Betty for the efforts she has made so far to help learn more about this growth and how this man can be helped. We welcome all those willing to help with information and or treatment. Thank you.

Eric

Eric, how far is he from medical help? I presume that the nearest place capable of doing the histology that this person spoke of would be Kisimu? Can you look into how much it would cost to get him there, and how much the procedure would cost?

I have no idea about the costs of such procedures in Kenya, but if we have some idea of the cost it is a starting point in getting him some help.

Melissa

Hi Melissa,

I will look into these costs and give you the feedback. The nearest place where this could be done as you say is Kisumu which is approximately 60 kilometres away. So it is possible to take him there once we know what can be done and what it would cost.

Thank you,

Eric

I have an uncle(maternal) who has similar problem which they call "keloids". His were so severe that they developed after he did shaving. so both chicks developed serous "keloids". However, he was taken to a major hospital( some years back) an operation was conducted but he was required to be going back for review(chemotherapy). He never went back., so the "keloids" grew again , although not so severe as before. They said their rate of growth reduces as one grows older. Todate he is a man of about 60 years.

These keloids sometimes form pus which give the person high fever and pain until this pus is got out and the wound treated.

When i try to inquire about this kind of condition, it is said that it is hereditary. indeed most of my maternal relatives have "keloids" although not so big as his.

I think this may be a similar problem. I believe it can be treated.

--
"If you do not stand up for something, then you might fall for anything"

Dear Grace,

Thank you grace for this information and i am happy to know that somebody had this and it was treated. In this man's immediate family nobody has a history of this. If it is hereditary, then a distant relative we do not know may have had it. May be he got it through shaving because he was not born with it. I hope help will come to him and i am very impressed you gave this information. I will carry out a detailed google search on keloids.

Thanks,

Eric

Grace,

You are an angel!!! :O)

This picture is too big to attach, but here is a link to it.
http://asps.confex.com/asps/2007am/techprogram/paper_12939.htm

The image below is "a man with keloids. Those of African descent are particularly susceptible to keloids, which often occur at the site of a skin injury."

http://www.totheleastofthese.org/prospere_clinic.htm
The picture is at the bottom of the page.

Here is another image of a more extreme case. They do look very similar. I have not done a lot of research on treatment. One website said that sometimes they operate, but if you do, they usually grow back. I will have to do some more research.

Melissa

Found a lot of information about Keloids, Sorry no time to read it all but maybe it will be useful for you

General information
http://en.wikipedia.org/wiki/Keloid
http://www.medicinenet.com/keloid/article.htm
http://health.nytimes.com/health/guides/disease/keloids/overview.html

Treatment
http://skinverse.com/skinverse-guide-to-keloids.html/
http://www.realself.com/question/what-best-keloid-treatment
http://www.plasticsurgery.co.za/scars.htm
-
Warm regards, Lotte

Melissa,

Thank you very much for the lots of information and pictures you have provided. They have been very helpful. I showed them to Dalmas today and recorded the bravery that sat in his eyes knowing that he is not alone.

He took a long time looking at this man because this seems to be a more extreme case and he did not utter any words as comments attributed to this photograph.When i was leaving he told me that he wanted to be helped to remove the keloids, even if they manage to grow again.He said he felt that they might not be as big as they are now when they grow again and it will take time allowing him to continue with his normal life.

I have not found a place to ask the cost of histology tests, once i do so i will let you and everyone know.

Thank you very much for the interest you have shown in this.

Eric

Melissa, Lotte,

Thank you very much for these wealth of information and photos you have dug up. Seeing some of these photos makes my man's case seem like child's play. The photo of the man with hanging keloids testifies to the severity and pain of this condition. It makes you want to thank God a number of times each day for the small favours he has done to preclude you from so many of life's trials.People are shouldering great burdens in different parts of the world and surely, we are not better than them that we are spared such conditions. We need to show gratitude to our maker.

I have attached here more photos of Dalmas Oriango since a well wisher wanted to see more photos to help her clearly diagnose the condition.

A big thank you to all who are working on this and in their own small way helping us learn more about this condition and possibly helping this man smile again.

Eric

Hi Eric,

I am just hoping that they actually are Keloids. We need to get him to a doctor who can diagnose this. They do look very much like the pictures, but until a doctor takes a proper look at him, we will not know.

I have searched the internet and come up with the following hospital in Kisumu. I have sent them an email enquiry to find out what is required to get someone to see Dalmas. I will let you know as soon as I get a response (assuming they respond).

The Aga Khan Hospital, Kisumu
Otieno Oyoo Street
Kisumu
Kenya

Mailing address:
P. O. Box 530 , 40100
Kisumu
Kenya

Switchboard +254 57 2020005 / 2021009/2022558

Fax +254 57 2024312/202312

Mobile + 254 722 203622 / +254 733 637566

Hi Eric,
I wrote to Doctors Without Borders on your behalf. I know they are working in western Kenya right now and thought maybe they can direct Dalmas to some help. If/when I hear back I will share the response.
Jen

Great thinking Jennifer! Why didn't I think of that? DOH! :O)

Eric, I can't contact the hospital by email (my email keeps getting returned). You may have to speak to them directly. It may be that Jennifers contact with "Doctors without Borders" will be more beneficial. They may be able to diagnose him without the expensive process of going through the hospital system.

I will keep my fingers crossed that she hears something back soon. :O)

Melissa

Melissa,

Thank you very much for trying to contact the Aga Khan Hospital in Kisumu. Aga Khan is a very good hospital in Kisumu. The problem is that it is a relatively expensive hospital such that if we do not get a big sponsor, the costs could be prohibitive.

I found a reputable laboratory (Cell Path laboratories-Kisumu) today that performs histology at a cost of $50. However they said that a surgeon has to remove a small tissue that would be taken for the histology test.

Consulting a surgeon and a consultant oncologist to give direction on this costs $40. I don't still know what it would cost a surgeon to remove a small tissue for histology. i can only know this after consulting the surgeon. Thereafter we will take the results to the oncologist/surgeon again for interpretation so they can give us the way forward.

Thank you

Eric

Hi Jennifer,

Thank you very much for taking time to write to Doctors without Borders. I believe they can help even with information on where or how to go about this. I appreciate your efforts and it is my sincere hope that a lot of good may come out of your contact with them.

Thanks

Eric

Hi,
There is also an other organisation active in your region: AMREF Flying Doctors. Maybe you can try to reach them if doctors without borders didn't answer yet?

This is their contact information:
www.amref.org

Nairobi Office

The Flying Doctors Society of Africa
P.O. Box 30125,00100 GPO Nairobi, Kenya
Tel: (254 20) 602495/6994409-13 Fax (254 20) 601594
Email: flying.doctors@amref.org

Also found the The Kenya Medical Research Institute http://www.kemri.org/
Centre for Global Health Research (CGHR)Physical Location: Kisumu, Western Kenya
Dr. J. M. Vulule
Director
JVulule@kisian.mimcom.net

--
Warm regards, Lotte

Hi Eric,

I am assuming that the amounts you quoted are in US Dollars? If not, can you let me know?

I kind of figured the Aga Khan would be expensive, just by their website and they also have many hospitals around the world.

I think Doctors Without Borders is probably going to be our best hope at this point in time. Do you think I should also try to contact them? Maybe if we all send emails it will highlight Dalmas and his problems?

I will try to contact the ones that Lotte has listed as well. Thanks again for your help Lotte :O)

Melissa

Hi Melissa,

The amounts are in US Dollars. I think we should all contact them. You can write to them. i will too.thanks

Eric

Hi Eric,

I have had a reply from a doctor I contacted in America who is doing a study on Keloids. His edited response is below and I will forward the email onto you (I did not want to post his name and email address on here without his permission).

Dear Ms. Ostoja,

http://www.healthlinks.net/cgi-bin/directory/hyperseek.cgi?Range=Any&Format=Standard&Terms=keloid

Eric,

Thanks for clarifying the amounts are in US Dollars. Poor Dalmas, no wonder he has struggled to get help for this. I imagine that amount of money would be outside his means, especially if he is trying to support two wives and five children!

I have written to the Doctors Without Borders office here in Australia, and also Amref (flying doctors) one that Lotte posted.

Melissa

I have received a reply from the Doctors Without Borders office here in Australia.

Unfortunately, whilst they are very sorry about Dalmas's situation, they can not help us. They only provide emergency medical support care to populations who have little or no access to medical services and can not cater to the individuals needs. :(

Hopefully somebody else will have some more luck.

Melissa

Melissa,

Thank you very much for this information. I trust that somebody will come up to help in any way.

Eric

Hello Eric,

I was just wondering if there was any progress for poor Dalmas? Has anyone else sent you anymore useful information etc.?

Where do we need to go from here? Should we be looking for a plastic surgeon who may be able to remove the growths?

Please let me know if there are any updates.

Melissa

Melissa,
Thank you very much.I have been searching for a doctor or surgeon who could remove a piece of the growth for histology and at what cost. Once i get that i would post accordingly.

Another way is to look for a plastic surgeon who can remove the growth though i know this can be very expensive. If we knew it could be treated by hemotherapy as a doctor from the UK suggested, it could be the easier option.

Eric

Thanks for the update Eric,

My fingers are crossed that we get help for Dalmas. I will keep trying to find out whatever I can.

Regards,
Melissa