RESUMEN
In order to quantify presence of residual BCC in patients with histologic positive margins after the first excision and to correlate the presence of residual tumor in re-excised lesions with the location of the positive margin on the first excision, a retrospective evaluation of 2053 surgically treated BCC was performed. Only 38.3% of the re-excised lesions showed residual tumor. In the group of re-excised lesions where residual BCC was found, 13% had lateral positive margin in the first excision, 39% had deep positive margin and 48% had both lateral and deep positive margins. In the group of re-excised lesions where no residual BCC was found, 49% of the primary excised lesions had lateral positive margin, 32% had deep positive margin and 19% had both deep and lateral positive margins. The association between residual tumor and positive margins was statistically significant (p = 0.01). Our findings confirm that presence of residual tumour is more likely when both lateral and deep margins are compromised.
Asunto(s)
Carcinoma Basocelular/patología , Carcinoma Basocelular/cirugía , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Humanos , Probabilidad , Reoperación , Estudios RetrospectivosAsunto(s)
Anticuerpos Monoclonales/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Psoriasis/tratamiento farmacológico , Adulto , Evaluación de Medicamentos , Quimioterapia Combinada , Femenino , Humanos , Infliximab , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Factor de Necrosis Tumoral alfa/antagonistas & inhibidoresRESUMEN
BACKGROUND: In order to identify intraspecific variations in Trichophyton rubrum and to correlate them to the immunological status of the host, sixty strains isolated from AIDS, HIV-positive and HIV-negative patients were compared for the production of extracellular enzymes and for their susceptibility to several antifungal drugs. METHODS: The isolates were tested for their ability to secrete keratinases, proteinases, phospholipases, lipases and DNases. Likewise, we investigated their susceptibility to amphotericin B, ketoconazole, ciclopiroxolamine, griseofulvin, miconazole and tolnaftate. RESULTS: Variations in the Minimal Inhibitory Concentration (MIC80)) values were observed for all antifungals tested, but they were similarly distributed among the three clinical groups. Griseofulvin showed the most prominent differences among the three groups of isolates. Regarding enzyme secretion, all samples secreted keratinases and DNases, while none secreted phospholipases. Proteinases and lipases were secreted by some of them. CONCLUSIONS: The differences among isolates of the three groups were not statistically significant and therefore could not be ascribed to a given clinical status. Intraspecific variations similarly occurred in each group, irrespective of the immunological status of the patients.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/microbiología , Antifúngicos/farmacología , Tiña/microbiología , Trichophyton/efectos de los fármacos , Trichophyton/enzimología , Brasil/epidemiología , Desoxirribonucleasas/metabolismo , Susceptibilidad a Enfermedades , VIH/patogenicidad , Humanos , Lipasa/metabolismo , Pruebas de Sensibilidad Microbiana , Péptido Hidrolasas/metabolismo , Fosfolipasas/metabolismo , Trichophyton/aislamiento & purificaciónRESUMEN
The serologic assay is an important tool in the diagnosis of leishmaniasis. One of the most commonly used tests is enzyme-linked immunosorbent assay (ELISA). Since total Leishmania promastigotes are used as antigen in the routine assay, false-positive reactions are frequent due to cross-reaction with sera from other diseases, mainly Chagas' disease. Therefore, an antigen that determines less cross-reactivity has been pursued for the serodiagnosis of leishmaniasis. In the present study we analyzed the use of recombinant Leishmania infantum heat shock protein (Hsp) 83 in ELISA for the serodiagnosis of cutaneous (N = 12) and mucocutaneous leishmaniasis (N = 14) and we observed the presence of anti-L. infantum Hsp 83 antibodies in all samples as well as anti-Leishmania total antigen antibodies. When cross-reactivity was tested, chronic Chagas' disease patients (N = 10) did not show any reactivity. Therefore, we consider this L. infantum Hsp 83 to be a good antigen for routine use for serodiagnosis of tegumentary leishmaniasis.
Asunto(s)
Anticuerpos Antiprotozoarios/sangre , Antígenos de Protozoos/sangre , Proteínas de Choque Térmico , Leishmania infantum/inmunología , Leishmaniasis Cutánea/diagnóstico , Proteínas Protozoarias , Animales , Anticuerpos Antiprotozoarios/inmunología , Antígenos de Protozoos/inmunología , Estudios de Casos y Controles , Enfermedad de Chagas/diagnóstico , Reacciones Cruzadas , Ensayo de Inmunoadsorción Enzimática , Epítopos , Técnica del Anticuerpo Fluorescente , Humanos , Pruebas Serológicas/métodosRESUMEN
The serologic assay is an important tool in the diagnosis of leishmaniasis. One of the most commonly used tests is enzyme-linked immunosorbent assay (ELISA). Since total Leishmania promastigotes are used as antigen in the routine assay, false-positive reactions are frequent due to cross-reaction with sera from other diseases, mainly Chagas' disease. Therefore, an antigen that determines less cross-reactivity has been pursued for the serodiagnosis of leishmaniasis. In the present study we analyzed the use of recombinant Leishmania infantum heat shock protein (Hsp) 83 in ELISA for the serodiagnosis of cutaneous (N = 12) and mucocutaneous leishmaniasis (N = 14) and we observed the presence of anti-L. infantum Hsp 83 antibodies in all samples as well as anti-Leishmania total antigen antibodies. When cross-reactivity was tested, chronic Chagas' disease patients (N = 10) did not show any reactivity. Therefore, we consider this L. infantum Hsp 83 to be a good antigen for routine use for serodiagnosis of tegumentary leishmaniasis.
Asunto(s)
Humanos , Animales , Anticuerpos Antiprotozoarios/sangre , Antígenos de Protozoos/sangre , Proteínas de Choque Térmico , Leishmania infantum/inmunología , Leishmaniasis Cutánea/diagnóstico , Proteínas Protozoarias , Anticuerpos Antiprotozoarios/inmunología , Antígenos de Protozoos/inmunología , Estudios de Casos y Controles , Reacciones Cruzadas , Enfermedad de Chagas/diagnóstico , Ensayo de Inmunoadsorción Enzimática , Epítopos , Técnica del Anticuerpo Fluorescente , Pruebas Serológicas/métodosRESUMEN
Chromoblastomycosis (CBM) is a chronic subcutaneous mycosis caused by a group of different dematiaceous fungi, first described by Rudolph in 1914. In Brazil there is a clear predominance of Fonsecaea pedrosoi. Sixty sera samples obtained from patients with F. pedrosoi-caused CBM were analysed. Sera obtained from 36 sporothricosis (SPT) patients, 34 cutaneous leishmaniasis (CL) patients and from 48 blood donors (HBD) were used as control. F. pedrosoi metabolic antigen was obtained from F. pedrosoi sample no. 884 (Instituto de Medicina Tropical de São Paulo Collection). IE reaction disclosed an anodic migrating arch, which was eluted and used as antigen. Both metabolic and eluate F. pedrosoi antigens were submitted to SDS-PAGE and two fractions, weighing approximately 54 and 66 kDa were identified. The 66-kDa fraction reacted against 43 of 60 CBM (71.7%) sera samples and was recognized by 10 SPT and eight CL sera (15.3%). No reactivity was observed against HBD sera. The 54-kDa fraction reacted against 58 of 60 CBM sera (96.7% sensitivity) and was not recognized by HBD, SPT nor CL sera (100% specificity). Such high sensitivity and specificity levels suggest this antigenic fraction is immunodominant and might prove a useful tool for further studies on F. pedrosoi-caused CBM.