RESUMEN
Reserpine-induced orofacial dyskinesia is a model that shares some mechanists' aspects with tardive dyskinesia whose pathophysiology has been related to oxidative stress. The present study was aimed to explore neuroprotective effects of nebivolol, an antihypertensive agent, on reserpine-induced neurobehavioral and biochemical alterations in rats. Reserpine (1mg/kg, s.c.) was used to induce neurotoxicity. Administration of reserpine for 3 days every other day significantly increased the vacuous chewing movements (VCMs), tongue protrusions (TPs) and reduced the locomotor activity in rats. Pre-treatment with nebivolol (5 and 10mg/kg, p.o. for 5 days) showed dose dependant decrease in VCMs and TP induced by reserpine. Nebivolol also showed significant improvement in locomotor activity. Reserpine significantly increased lipid peroxidation and reduced the levels of defensive antioxidant enzymes like catalase (CAT), superoxide dismutase (SOD) and reduced glutathione (GSH) in rat brain. Nebivolol reversed these effects of reserpine on oxidative stress indices; indicating amelioration of oxidative stress in rat brains. The results of the present study indicated that nebivolol has a protective role against reserpine-induced orofacial dyskinesia. Thus, the use of nebivolol as a therapeutic agent for the treatment of tardive dyskinesia may be considered.
Asunto(s)
Antihipertensivos/farmacología , Conducta Animal/efectos de los fármacos , Benzopiranos/farmacología , Etanolaminas/farmacología , Reserpina/farmacología , Animales , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Discinesias/fisiopatología , Glutatión/metabolismo , Peroxidación de Lípido/efectos de los fármacos , Masculino , Actividad Motora/efectos de los fármacos , Nebivolol , Ratas , Ratas WistarAsunto(s)
Ciclosporina/administración & dosificación , Epidermólisis Ampollosa Adquirida/diagnóstico , Epidermólisis Ampollosa Adquirida/tratamiento farmacológico , Prednisolona/administración & dosificación , Adulto , Quimioterapia Combinada , Estudios de Seguimiento , Humanos , Masculino , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
A 26-year-old Libyan woman presented with asymptomatic nodulo-ulcerative skin lesions present for 1 year. Three years prior to presentation, she had experienced a nasal discharge followed by the development of a nodule in the nasal cavity and a plaque on the hard palate. These lesions had gradually increased in size and ulcerated, resulting in perforation of the nasal septum and palate. Two years later, the patient noticed the appearance of skin lesions: a nodule on the right thumb and numerous nodulo-ulcerative lesions on the extremities. General physical examination was normal with no significant lymphadenopathy. Examination of the oral cavity revealed perforation of the distal nasal septum, with a perforated nodular plaque involving the entire palate, associated with subluxation of the upper incisors (Fig. 1a). On skin examination, multiple firm nodules and nodulo-ulcerative lesions with a central eschar and raised margins were observed. The lesions ranged in size from 0.5 to 5 cm and were distributed on the right hand and fingers, left upper arm (Fig. 1b), left calf, and right thigh. Routine laboratory investigations (liver function tests, serum calcium, electrolytes, lipid profile, urine and stool culture studies) were normal. Immunoelectrophoresis disclosed normal levels of immunoglobulins IgG, IgA, and IgM. Serologic studies for human immunodeficiency virus (HIV) and syphilis, and a tuberculin test, were all negative. A Giemsa-stained tissue smear was negative for Leishmania tropica organisms. Radiological studies disclosed a slight haziness of the maxillary sinuses with perforation of the nasal septum. A chest X-ray was normal. Histopathologic examination of biopsies taken from both the palate and from ulcerated and nonulcerated skin lesions was performed, and all showed similar findings. The biopsy of a nonulcerated skin lesion showed pseudoepitheliomatous epidermal hyperplasia with neutrophilic microabscesses (Fig. 2a). A dermal diffuse and nodular granulomatous mixed infiltrate of lymphocytes, histiocytes, giant cells, numerous eosinophils, and neutrophilic microabscesses was seen in all tissues examined. Septate hyphae were present both within giant cells and free in the dermis (Fig. 2b). The hyphae were branching at a 45 degrees angle and were positive on periodic acid-Schiff and Grocott methenamine silver stains (Fig. 2c). Fungal culture studies of material taken from an ulcerated skin lesion grew Aspergillus flavus. Blood cultures were negative for Aspergillus sp. or other microorganisms. The patient was treated with intravenous amphotericin B, but the medication was discontinued due to her intolerance to the drug. She was subsequently lost to follow-up.
Asunto(s)
Aspergilosis/patología , Aspergillus flavus/aislamiento & purificación , Dermatomicosis/patología , Inmunocompetencia , Enfermedades de los Senos Paranasales/patología , Adulto , Aspergilosis/microbiología , Dermatomicosis/microbiología , Femenino , Humanos , Enfermedades de los Senos Paranasales/microbiologíaRESUMEN
OBJECTIVE: Incidence of head and neck squamous cell carcinoma seems to be relatively high in Yemen but not well documented. The purpose of this study is to analyze the clinical profile of the Yemeni patients of squamous cell carcinoma of the head and neck and to evaluate the possible relationship to kath chewing. METHODS: With the help of a special protocol, all the patients of head and neck squamous cell carcinoma seen between October 1997 and December 1998 at the Ear, Nose and Throat and Dermatology Clinics of Saudi Hospital, Hajjah, Yemen Republic were subjected to detailed analysis. The diagnosis was confirmed by histopathologic studies in all the cases. RESULTS: All the 36 patients (23 male and 13 female) were Yemani nationals, aged 18 to 80 years (median age 50 years). Thirty patients were Kath addicts. The tumor was localized to the oral cavity in 17 (47%) patients, oropharynx in 1 (3%) patient, nasopharynx in 15 (42%) patients and larynx in 3 (8%) patients. CONCLUSION: The incidence of head and neck squamous cell carcinoma seems to be relatively high, especially the oral squamous cell carcinoma, all of whom had a habit of kath chewing, which may be considered as an important contributing factor.
Asunto(s)
Carcinoma de Células Escamosas/inducido químicamente , Carcinoma de Células Escamosas/epidemiología , Estimulantes del Sistema Nervioso Central/efectos adversos , Neoplasias de Cabeza y Cuello/inducido químicamente , Neoplasias de Cabeza y Cuello/epidemiología , Extractos Vegetales/efectos adversos , Trastornos Relacionados con Sustancias/complicaciones , Salud Urbana/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Catha , Femenino , Neoplasias de Cabeza y Cuello/patología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Factores de Riesgo , Distribución por Sexo , Yemen/epidemiologíaRESUMEN
A 22-year old female patient presented with recurrent episodes of erythema multiforme-like eruption in association with systemic lupus erythematosus. Laboratory findings included leucopenia, anaemia, positive LE cell phenomenon, positive rheumatoid factor and mild proteinuria. The features included most of the criteria of Rowell's syndrome.
RESUMEN
BACKGROUND: Cutaneous leishmainiasis is widespread in the Yemen, but has not been fully documented. METHODS: We have studied 42 cases from the Hajjah and Amran Governorates of the Yemen Republic. The clinical profile of these cases was recorded in a special protocol. The diagnosis was based on positive slit skin smear and histopathologic studies when needed. RESULTS: The age of the patients ranged between 1 and 65 years (median age, 19 years) and the duration of the disease ranged between 2 months and 12 years (median duration, 6 months). Most of the patients had a single lesion. Slit skin smear was positive for parasites in 35 cases (highly positive in 15). From the analysis of features, the disease could be classified into dry type (31 patients), wet type (seven patients), and chronic cutaneous leishmaniasis (four patients). Most of the patients required prolonged (4-6 weeks) treatment with sodium stibogluconate; the smear was still positive in eight patients, seven of whom were further treated successfully with a combination of rifampicin and isoniazid for 2-3 months. One who was treated successfully with intralesional injections of sodium stibogluconate. CONCLUSIONS: Cutaneous leishmaniasis in this region seems to be endemic, has a long chronic course, shows a highly positive smear even 1-6 years after onset, and gives an inadequate response to prolonged systemic therapy. Further epidemiologic studies and taxonomic differentiation of the species are required.
Asunto(s)
Enfermedades Endémicas/estadística & datos numéricos , Leishmaniasis Cutánea/diagnóstico , Leishmaniasis Cutánea/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Niño , Preescolar , Países en Desarrollo , Femenino , Humanos , Incidencia , Leishmaniasis Cutánea/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Factores de Riesgo , Distribución por Sexo , Yemen/epidemiologíaRESUMEN
BACKGROUND: A preliminary study of 24 cases of xeroderma pigmentosum (XP) was presented in 1990 and later published in 1992. Since then we have seen 18 further cases. OBJECTIVE: To study the clinical profile of Libyan cases of XP. METHODS: With the help of a special protocol, all 42 cases (23 girls and 19 boys from 29 families) treated and followed between 1981 and 1994 were subjected to detailed analysis. RESULTS: A history of consanguinity was present in the parents of 39 patients. XP in Libya is characterized by a relatively high incidence (approximately 15-20 per million of the population), early onset of initial manifestations (median age, 12 months) and malignant tumors (median age, 8 years), severe ocular and oral lesions in a high percentage of patients, and early death (median age, 15.5 years). The malignant skin tumors seen were squamous cell carcinoma (SCC) in 23 patients, basal cell carcinoma (BCC) in 17 patients, and basosquamous carcinoma in two patients. Malignant melanoma was not seen, but lentigo maligna was found in one case. SCC of the tongue, carcinoma of the thyroid, and lymphatic leukemia affected individual patients. Subnormal physical growth was observed in six patients, but none of the patients had significant neurologic abnormalities. The results of etretinate therapy in nine patients revealed that it is an effective preventive agent against carcinogenesis, but not a curative one. CONCLUSIONS: Severe ophthalmic manifestations affected a higher percentage of patients at an early age. Malignant melanoma did not develop in any case, except for lentigo maligna in one patient.
Asunto(s)
Piel/patología , Xerodermia Pigmentosa/patología , Edad de Inicio , Anemia/complicaciones , Carcinoma Basocelular/patología , Carcinoma Basocelular/terapia , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Fármacos Dermatológicos/uso terapéutico , Etretinato/uso terapéutico , Oftalmopatías/complicaciones , Femenino , Trastornos del Crecimiento/complicaciones , Humanos , Hipotiroidismo/complicaciones , Cálculos Renales/complicaciones , Libia , Masculino , Neoplasias de la Boca/patología , Neoplasias de la Boca/terapia , Radioterapia , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/terapia , Análisis de Supervivencia , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/terapia , Tuberculosis Pulmonar/complicaciones , Xerodermia Pigmentosa/complicaciones , Xerodermia Pigmentosa/terapia , Óxido de Zinc/uso terapéuticoRESUMEN
Three cases of cutaneous leishmaniasis with unusual presentation seen at Central Hospital Tripoli, Libya are described. Case No. 1 and 2 had 102 and 109 noduloulcerative lesions with generalized almost bilaterally symmetrical distribution, suggestive of dissemination. Case No. 3 had large verrucous carcinoma but histopathology suggested lupoid (chronic cutaneous) leishmaniasis. Patient No. 2 developed hypersensitivity reaction to sodium stibogluconate after 10 days but responded well to the treatment. Case No. 2 did not tolerate the above treatment and was treated successfully with combination of rifampicin and INH. Case No. 3 was treated successfully with liquid nitrogen cryotherapy by Cryosurg-Frigitonics, using special open probes.
RESUMEN
A 24-year old male patient developed multiple lesions of keratoacanthoma in the epidermal verrucous naevus. He also had multiple papillomatous lesions on the lips, buccal mucosa, gingiva and tongue, with positive family history of similar lesions. He also had multiple skin tags and patchy palmoplantar keratoderma and minimal kyphoscoliosis.
RESUMEN
We have treated 4 cases of pyoderma gangrenosum in infancy and childhood in past 2 years. The ages at onset were 6 months, 8 months, 6 months and 11.5 years respectively. Initial lesions were papulopustular in 3 and nodular in 1 patients but later on all of them developed ulcerative lesions with erythematous, violaceous, infiltrated or undermined edges. The lesions were numerous in 3 patients but few in 1 patient. The first patient had very high leucocyte count. In the second patient skin lesions of PG followed measles vaccinations. We could not reveal any association in the other two patients. None of the patient responded to antibiotic therapy. Three patients were treated successfully with dapsone and one with a combination of dapsone and prednisolone. We conclude that pyoderma gangrenosum is not so rare in infancy and it is more likely to occur without associated systemic diseases.
RESUMEN
Three Libyan patients developing clinical manifestations of erythropoietic protoporphyria (EPP) at 5 years, 7 years and 3 years of age are reported. All of them had variable degree of photosensitivity leading to pitted scarring. Red blood cells in peripheral blood smear revealed positive pink fluorescence in all. First patient responded well with chloroquine therapy and the 3rd patient showed improvement with oral beta-carotene therapy, but the second patient did not show significant response to either.
RESUMEN
A 35-years-old female patient had generalized pruritic papular lesions, distributed like dermatitis herpetiformis for last 4 years. Histopathologic changes were typical of granuloma annulare with negative results of direct immunofluorescence. The patient did not have association of diabetes mellitus or any other systemic disease. She failed to respond to dapsone therapy and 13-cis-retinoic acid.
RESUMEN
BACKGROUND: Despite a high incidence of xeroderma pigmentosum, there is no previous publication from Libya. OBJECTIVE: The purpose was to study the clinical profile of Libyan cases of xeroderma pigmentosum. METHODS: With the help of a special protocol, 24 cases of xeroderma pigmentosum treated between 1981 and 1990 were subjected to detailed analysis. RESULTS: The age of onset of initial manifestations ranged between 6 and 18 months whereas that of malignant lesions ranged from 2 to 10 years. Malignant lesions observed were squamous cell carcinoma in 15 patients, basal cell carcinoma in 12, and basosquamous carcinoma in 2 patients; squamous cell carcinoma of the tongue, carcinoma of the thyroid, and lymphatic leukemia affected individual cases. None of our patients developed malignant melanoma. Six patients have died; the age at death ranged between 9 and 18 years. A history of consanguinity in the parents of patients was recorded in all but two patients. CONCLUSION: We observed early onset of severe ophthalmic lesions affecting a higher percentage of the patients.
Asunto(s)
Neoplasias Cutáneas , Xerodermia Pigmentosa , Adolescente , Adulto , Niño , Preescolar , Oftalmopatías/complicaciones , Femenino , Humanos , Lactante , Libia/epidemiología , Masculino , Enfermedades de la Boca/complicaciones , Piel/patología , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/patología , Xerodermia Pigmentosa/complicaciones , Xerodermia Pigmentosa/epidemiología , Xerodermia Pigmentosa/genética , Xerodermia Pigmentosa/patologíaRESUMEN
A 6 year old Libyan boy had diffuse erythema at birth and later developed pruritic, maculo-papular, papular, circinat c, double-edge, scaly lesions, suggestive of ichthyosis linearis circumflexa (ILC).Hisscalp hair were brittle and sparse with partial patchy alopecia, showing change of trichorrhexis invaginata, these -associations being characteristic of Netherton's syndrome. The boy had slightly stunted growth; a feature which has not been recorded in previously reported cases.
RESUMEN
Three Libyan patients with epidermolysis bullosa acquisita (EBA) had adult onset of the disease with tense vesiculo-bullous lesions on the sites of pressure and trauma, healing with atrophic scars and milia formation. None of the patients had family history of epidermolysis bullosa. The 'diagnosis was based on clinical and histopathogical features snowing subepidermal bullae, and exclusion of other vesiculo-burous disease. In addition, the diagnosis in case I was confirmed by direct immunofluorescence studies showing linear deposits of IgS and C3 at the basement membrane zone. Case 2 was already having systemic lupus erythematosus for the last 3 years when she developed EBA. Case 3 was having anemia, leucopenia, raised ESR and gamma globulin. Thus, association of SLE was suspected in this case too although the diagnosis could not be confirmed.
RESUMEN
In a study of 23 cases of Behcet's disease, we found male prepondrance (males 82.6%, females 17.4%) with commonest age of onset between 21-30 years in 70% cases. During the course of the disease, recurrent oro- genital ulcers were noticed in all the cases, nodosum in 5 and thrombophlebi7tis in 4), eye .involvement' in 10, joint involvement in 6, .0pididmitis in 2 cases and deep vein thrombosis, CNS involvement and oesophaga ulcers in one case each were also seen. Erythrocyte sedimentation rate was raised between 35 and 120 mm during the active, phase of the disease. In 15 cases, treatment with oral predisolone controlled all the manifestations while treatment with colchicine, relieved oro-genital and skin lesions in 7 patients. One patient with eye involvement and recurrent oesophageal ulcers improved well with a combination of prednisolone and cyclophosphamide. Progressive deterioration of vision was noticed in 2 patients in spite of regular treatment.
RESUMEN
Twenty six cases having pityriasis versicolor, were treated with 10 and 14 days courses of oral ketoconazole. Cure rate was higher with the 14 day schedule than with the 10-day schedule. Recurrence was observed in one patient. No significant side effect was noticed except in one patient who developed intolerable nausea after the first dose.
RESUMEN
Twenty-two cases of different dermatoses other than psoriasis, were treated with oral aromatic retinoid noid (Tigason). We observed complete or nearly complete remission in 9, moderate improvement in another 9 and slight improvement in 3 patients, while one patient did not show any response. Side effects were notice in 14 patients.