RESUMO
BACKGROUND: Skin diseases among indigenous populations have been poorly described in the literature. Risk factors linked to habits, cultural practices, genetics, and environmental characteristics can influence the frequency and clinical presentation of these diseases. METHODS: This was a cross-sectional study conducted through a review of dermatological medical records. Data were obtained over three visits to Xingu Indigenous Park (XIP). Main dermatoses were compared by gender, age, ethnicity, and village. Diseases were classified into four groups: infectious, inflammatory, neoplastic, and other. RESULTS: Of the 398 patients included in the study, 54.2% were female. The participants ranged in age from 1 to 75 years (median, 10 years). The predominant ethnic group was Caiabi (49.7%), followed by Ikpeng (14.3%) and Kamaiurá (10.0%). The primary village studied was Diauarum, followed by Moigú and Morena. Infectious dermatoses were the most frequent (43.8%), followed by inflammatory (33.7%), neoplastic (15.5%), and other skin diseases (7.0%). Infectious diseases were predominant in Caiabi and Kamaiurá Indians, whereas inflammatory skin diseases were more frequent in Ikpeng and Juruna populations. We also observed a high frequency of malignancy in the Ikpeng and Trumai ethnic groups. Infectious skin diseases, except for fungal infections, were frequent in younger age groups. This trend was not replicated for neoplastic skin diseases. Uncommon dermatoses such as Heck's disease, lichen striatus, and aquagenic urticaria were also observed. Jorge Lobo's disease was not included in this analysis. CONCLUSION: Improved knowledge of the distribution of common dermatoses among different ethnic groups and villages in XIP will aid in the prevention of skin infections and skin cancer. This improved knowledge will also allow the development of skin disease guidelines that can help local indigenous health professionals.
Assuntos
Etnicidade , Indígenas Sul-Americanos , Dermatopatias/etnologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Dermatite/etnologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Dermatopatias Infecciosas/etnologia , Neoplasias Cutâneas/etnologia , Adulto JovemRESUMO
BACKGROUND: A study on HIV/AIDS-related mucocutaneous manifestations has been carried out in three different ethnic and geographic areas, namely Brazil, Denmark, and Thailand. METHODS: The Brazil cohort comprised 110 patients, the Danish cohort 150, and the Thai cohort 206 patients. The majority of the Brazil and Thai cohort patients belonged to groups III and IV according to the CDC clinical staging system, whereas the patients in Denmark called their doctors earlier and only 8% were classified in groups III and IV. RESULTS: In all three areas the number of mucocutaneous diseases correlated well with the progression of the HIV disease. Ethnic differences were not identified, whereas geographic differences related to skin infections were marked. In the Asian cohort a generalized fungal infection was detected with characteristic mucocutaneous symptoms caused by Penicillium marneffei. CONCLUSIONS: Teaching efforts about mucocutaneous signs as markers of HIV infection may be of value, particularly in developing areas, to allow earlier diagnosis. In future guidelines for classification of HIV/AIDS-related mucocutaneous diseases geographic considerations should be included.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Infecções por HIV/complicações , Dermatopatias Infecciosas/etnologia , Adulto , Brasil/epidemiologia , Estudos de Coortes , Dinamarca/epidemiologia , Dermatomicoses/complicações , Dermatomicoses/epidemiologia , Dermatomicoses/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Boca/epidemiologia , Doenças da Boca/etnologia , Doenças da Boca/etiologia , Mucosa Bucal , Penicillium , Sarcoma de Kaposi/epidemiologia , Sarcoma de Kaposi/etnologia , Sarcoma de Kaposi/etiologia , Dermatopatias Infecciosas/complicações , Dermatopatias Infecciosas/epidemiologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etnologia , Neoplasias Cutâneas/etiologia , Tailândia/epidemiologiaRESUMO
An outbreak of at least 21 cases of cutaneous anthrax occurred in rural Paraguay. A case-control study revealed that disease was associated with touching the raw meat of an ill cow (odds ration = 16.5, P = .02). Serum drawn from 12 cases and 16 colony and 2 noncolony controls 6 w after the outbreak were analyzed by electrophoretic-immunotransblots (EITB) to detect serum antibodies to the protective antigen (PA) and lethal factor components of anthrax toxin. Serum was also tested by enzyme-linked immunosorbent assay (ELISA) for the presence of antibodies to poly-D-glutamic acid capsule. Of 12 cases, 11 had a positive PA screen, for a sensitivity of 91.7% (76.1%-100%, 95% confidence interval [CI]) whereas none of the 18 controls was positive for a specificity of 100% (84.8%, one-sided binomial 95% CI). Only 6 (50%) of 12 cases (21.7%-78.3%, 95% CI) had positive lethal factor titers; all controls were negative. At a cutoff of greater than or equal to 1:32 for antibodies to capsule, 11 (91.7%) of 12 (76.1%-100%, 95% CI) were positive; 16 (88.9%) of 18 controls (74.5%-100%, 95% CI) were negative. These data suggest that the EITB for detection of antibody to PA, and ELISA for detection of anticapsule antibodies are both sensitive for the retrospective diagnosis of anthrax. Both tests were specific, but EITB may be more so than ELISA.