Professor Uwen Ekpo of Nigeria and his team in Ogun State have identified the first twenty adult women with FGS using the WHO Pocket Atlas for Female Genital Schistosomiasis (image). Fourteen of the 20 women had FGS (70·0%). Ten had grainy-sandy patches (image), 6 had homogenous yellow sandy patches. It is noteworthy that one patient was found to have rubbery papules as it is the first case outside Madagascar.