Assuntos
Eritema Nodoso/epidemiologia , Hanseníase Virchowiana/epidemiologia , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Feminino , Humanos , Hanseníase Dimorfa/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: Mycetoma is recognized as a neglected tropical disease and there are still therapeutic challenges, especially in cases recalcitrant to standard therapy or with high risk of dissemination. Subcultures have been used previously to decrease the virulence of human pathogens. Previous reports have demonstrated that after carrying out 200 subcultures of Nocardia brasiliensis, a decrease in virulence was observed. AIM: To evaluate the effect of attenuated N. brasiliensis strains on the development of lesions in an established mycetoma infection. METHODS: Female 8-12-week-old BALB/c mice were injected with N. brasiliensis suspension to establish a mycetoma. Sixty mice were selected and divided into three groups: two of these groups were inoculated in the dorsum with N. brasiliensis subcultured 200 and 400 times, respectively, while the third group served as control. The thickness of each lesion was measured with calipers every week for 12 weeks. RESULTS: After 12 weeks, we observed that inoculation of 1 × 105 colony-forming units of attenuated N. brasiliensis strains was able to modify the natural history of the infection, with a decrease in the size of the lesions, particularly with P400, compared with the control group (P < 0.01). CONCLUSION: In this experimental evaluation of an immunomodulatory therapy with attenuated N. brasiliensis strains in a murine model, there was a greater stability in the size of the lesion over time in BALB/c mice inoculated with the P400 strain. This treatment could open the possibility of using the attenuated strain as immunomodulatory therapy in patients recalcitrant to standard therapy, with high risk of dissemination or who develop drug-related adverse effects.
Assuntos
Imunomodulação , Micetoma/terapia , Nocardia/patogenicidade , Animais , Modelos Animais de Doenças , Feminino , Camundongos , Camundongos Endogâmicos BALB C , Micetoma/imunologia , Micetoma/microbiologia , VirulênciaAssuntos
Osteossarcoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Pele/patologia , Adulto , Biópsia , Humanos , Masculino , Osteossarcoma/patologia , Osteossarcoma/cirurgia , Pele/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Parede Torácica , Tomografia Computadorizada por Raios X , Resultado do TratamentoAssuntos
Hansenostáticos/uso terapêutico , Hanseníase/diagnóstico , Mycobacterium leprae/isolamento & purificação , Parestesia/etiologia , Pele/patologia , Idoso , Biópsia , Quimioterapia Combinada , Feminino , Humanos , Hanseníase/complicações , Hanseníase/tratamento farmacológico , Hanseníase/microbiologia , México , Parestesia/tratamento farmacológico , Pele/microbiologia , Texas , Resultado do TratamentoAssuntos
Alopecia/genética , Expressão Gênica , Prostaglandina-E Sintases/genética , Receptores Imunológicos/genética , Receptores de Prostaglandina/genética , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Oxirredutases Intramoleculares/genética , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Pele , Adulto JovemRESUMO
BACKGROUND: Histological diagnosis of a clinically suspected nonmelanoma skin cancer (NMSC) is recommended before treatment. For NMSC, concordance between the histological subtype of the preoperative biopsy and the excision specimen of basal cell carcinoma (BCC) has been reported to range from 10% to 81%. No large study on the concordance between NMSC histology seen in a preoperative biopsy with the following tumour specimen from Mohs micrographic surgery (MMS) has been performed in a Latin American population. OBJECTIVE: The aim of this study was to analyse and compare the histological subtype of the incisional biopsies reviewed by the dermatopathologist with the histological subtype of the tumour specimen obtained during MMS interpreted by the dermatopathologist and the Mohs surgeon. METHODS: A retrospective analysis of 320 NMSC was performed. The interobserver correlation was based on kappa values. RESULTS: The mean weighted kappa value between the preoperative NMSC biopsy and intraoperative histological subtype of the tumour specimen from MMS analysed by the Mohs surgeon and the dermatopathologist was 0.22 and 0.24, respectively. The correlation in the histologic subtype of the intraoperative tumour specimen from MMS that was interpreted by the dermatopathologist and Mohs surgeon was 0.58. CONCLUSIONS: Dermatologists need to be aware of the limited value of incisional biopsies to accurately diagnose the histological subtype of a NMSC. The concordance rate in the histological diagnosis of the tumour specimens that were obtained from MMS between the Mohs surgeon and the dermatopathologist is moderate. However, the correlation is low compared with incisional biopsy subtypes.
Assuntos
Biópsia , Carcinoma Basocelular/patologia , Cirurgia de Mohs , Neoplasias Cutâneas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/classificação , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Criança , Neoplasias Faciais/patologia , Neoplasias Faciais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Retrospectivos , Neoplasias Cutâneas/cirurgia , Adulto JovemAssuntos
Dermoscopia , Escabiose/diagnóstico por imagem , Adulto , Feminino , Humanos , Escabiose/patologiaRESUMO
Sweet syndrome is the most representative entity of febrile neutrophilic dermatoses. It typically presents in patients with pirexya, neutrophilia, painful tender erytomatous papules, nodules and plaques often distributed asymmetrically. Frequent sites include the face, neck and upper extremities. Affected sites show a characteristical neutrophilic infiltrate in the upper dermis. Its etiology remains elucidated, but it seems that can be mediated by a hypersensitivity reaction in which cytokines, followed by infiltration of neutrophils, may be involved. Systemic corticosteroids are the first-line of treatment in most cases. We present a concise review of the pathogenesis, classification, diagnosis and treatment update of this entity.
Assuntos
Síndrome de Sweet , Algoritmos , Humanos , Síndrome de Sweet/diagnóstico , Síndrome de Sweet/terapiaRESUMO
Skin manifestations associated with chronic kidney disease are very common. Most of these conditions present in the end stages and may affect the patient's quality of life. Knowledge of these entities can contribute to establishing an accurate diagnosis and prognosis. Severe renal pruritus is associated with increased mortality and a poor prognosis. Nail exploration can provide clues about albumin and urea levels. Nephrogenic systemic fibrosis is a preventable disease associated with gadolinium contrast. Comorbidities, such as diabetes mellitus and secondary hyperparathyroidism, can lead to acquired perforating dermatosis and calciphylaxis, respectively. Effective and innovative treatments are available for all of these conditions.
Assuntos
Insuficiência Renal Crônica/patologia , Dermatopatias/etiologia , Pele/patologia , Calciofilaxia/etiologia , Calciofilaxia/terapia , Comorbidade , Doenças do Cabelo/etiologia , Doenças do Cabelo/patologia , Doenças do Cabelo/terapia , Humanos , Doenças da Unha/etiologia , Doenças da Unha/patologia , Doenças da Unha/terapia , Dermopatia Fibrosante Nefrogênica/etiologia , Dermopatia Fibrosante Nefrogênica/terapia , Porfiria Cutânea Tardia/etiologia , Porfiria Cutânea Tardia/terapia , Prognóstico , Prurido/etiologia , Prurido/terapia , Insuficiência Renal Crônica/complicações , Dermatopatias/diagnóstico , Dermatopatias/patologia , Dermatopatias/terapia , Terapias em EstudoRESUMO
Leprosy is a chronic granulomatous disease caused by the bacillus Mycobacterium leprae. It primarily affects the skin and peripheral nerves and is still endemic in various regions of the world. Clinical presentation depends on the patient's immune status at the time of infection and during the course of the disease. Leprosy is associated with disability and marginalization. Diagnosis is clinical and is made when the patient has at least 1 of the following cardinal signs specified by the World Health Organization: hypopigmented or erythematous macules with sensory loss; thickened peripheral nerves; or positive acid-fast skin smear or skin biopsy with loss of adnexa at affected sites. Leprosy is treated with a multidrug combination of rifampicin, clofazimine, and dapsone. Two main regimens are used depending on whether the patient has paucibacillary or multibacillary disease.