Prototecose cutânea: registro do segundo caso brasileiro

The present report describes a case of cutaneous protothecosis caused by Prototheca wickerhamii in a non-immunocompromised female from the state of Bahia, Brazil. This is the second case described in Brazil. Dermatological examination revealed diffusely infiltrated erythematous plaques on the flexor aspect of the right arm and forearm. The authors emphasize the pathological aspects that can lead to misdiagnosis this condition. The patient was successfully treated with fluconazole.O presente relato descreve um caso de prototecose cutânea causada por Prototheca wickerhamii em uma mulher não imunodeprimida do estado da Bahia, Brasil. Este é o segundo caso descrito no Brasil. O exame dermatológico revelou placas eritematosas infiltradas na superfície flexora do braço e antebraço direitos. Os autores enfatizam os aspectos anatomopatológicos que podem levar a erro diagnóstico. A paciente foi tratada com sucesso com fluconazole

The linkage between psoriasis and non-alcoholic fatty liver disease: a literature review

Psoriasis is a chronic systemic inflammatory disease mainly affecting the skin. Population-based surveys have shown a higher prevalence of non-alcoholic fat liver disease (NAFLD) in patients with psoriasis compared with the general population, especially in those with a greater psoriasis area and severity index (PASI). It is speculated that similar pathogenic bases may play a role in this association, highlighting insulin resistance and the release of inflammatory cytokines as the most likely causes. In the present work, we review basic aspects of the relationship between psoriasis and NAFLD.</p

Enhanced Leishmania braziliensis Infection Following Pre-Exposure to Sandfly Saliva

Parasites of the genus Leishmania cause a variety of diseases known as leishmaniasis, that are transmitted by bites of female sand flies that, during blood-feeding, inject humans with parasites and saliva. It was shown that, in mice, immunity to sand-fly saliva is able to protect against the development of leishmaniasis. We have investigated, in the present study, whether this finding extends the sand fly species Lutzomyia intermedia, which is responsible for transmission of Leishmania braziliensis, a parasite species able to cause destructive skin lesions that can be fatal if left untreated. We observed that mice injected with sand fly saliva develop a specific immune response against salivary proteins. Most importantly, however, this immune response was unable to protect mice against a challenge infection with L. braziliensis, indicating that exposure to this sand fly saliva is harmful to the host. Indeed, subjects with cutaneous leishmaniasis have a higher immune response against L. intermedia saliva. These findings indicate that the anti-saliva immune response to sand fly saliva plays an important role in the outcome of leishmaniasis caused by L. braziliensis, in both mice and humans, and emphasize possible hurdles in the development of vaccines based on sand fly saliva

Aspectos clínico-epidemiológicos e imunológicos da Leishmaniose tegumentar

Submitted by Repositório Arca ([email protected]) on 2019-09-04T17:22:02Z No. of bitstreams: 1 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2019-09-05T16:53:09Z (GMT) No. of bitstreams: 2 Ivonise Follador 2003.pdf: 8727033 bytes, checksum: 6bd7f6aff6bca9fce43ec2d03dc60f4a (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Made available in DSpace on 2019-09-05T16:53:09Z (GMT). No. of bitstreams: 2 Ivonise Follador 2003.pdf: 8727033 bytes, checksum: 6bd7f6aff6bca9fce43ec2d03dc60f4a (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2003Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil.A leishmaniose tegumentar americana (LTA) continua sendo um problema de Saúde Pública no mundo. No Brasil, no período de 1985 a 2001, a leishmaniose tegumentar americana (LTA) vem apresentando coeficientes de detecção que oscilam entre 10,45 a 21,23 por 100.000 habitantes. Em 1993, um surto de LTA foi detectado no povoado rural de Canoa, município de Santo Amaro, Bahia. Um estudo observacional prospectivo foi delineado, com objetivo de determinar as taxas de freqüência e caracterizar clinicamente a doença. Foram acompanhados 555 indivíduos, registrando-se 29 casos de LTA. A prevalência de LTA na população avaliada no período de estudo foi de 5,2% (29/555). A espécie de leishmânia envolvida na área foi caracterizada como Leishmania braziliensis. sendo o flebotomíneo a Lutzomva intermedia. Foram detectados cães e equídeos infectados por leishmânia. Esses dados foram publicados no trabalho. No segundo trabalho os aspectos clínico-epidemiológicos e imunológicos dos 104 indivíduos documentados como portadores de infecção subclínica foram comparados com os 29 indivíduos que desenvolveram leishmaniose cutânea (LC). A infecção subclínica foi definida como indivíduo sadio, durante os 4 anos de acompanhamento clínico, sem lesão ativa cutâneo ou mucosa, sem cicatriz sugestiva de doença passada e que apresentaram o teste de hipersensibilidade tardia positivo. 0 grupo de indivíduos com doença clinicamente evidente (n=29) era mais jovem (19,4 ± 12,8 anos), apresentava reação cutânea com enduração significativamente maior (17,6±1,4 mm) assim como maior proporção de sorologia positiva (16/29; 55,2%) ao ser comparado (p0,05) que o observado nos casos de LC (26 ± 41 pg/ml; 0-85). Os dados sugerem que os indivíduos que não desenvolvem a doença talvez tenham a habilidade de modular melhor a resposta imune, prevenindo-os contra o dano tecidual e desenvolvimento de lesão cutânea. No terceiro trabalho foram estudados os dados da resposta imune de 56 militares voluntários e sadios à vacinação com antígeno de leishmania (Leishvacin®) com uma ou duas doses. A reação de Montenegro não foi utilizada para seleção para evitar possível sensibilização. Esse estudo de intervenção (duplo cego e randomizado) comparou, além da resposta isolada à vacina, a utilização do Fator Estimulador de Colônias de Granulócitos e Macrófagos sintético (rhGM-CSF) como adjuvante. Houve significativo (p0,05). Os níveis de IL-5, no dia 21, foram ligeiramente maior no grupo da vacinação associada ao adjuvante quando comparados ao grupo que utilizou a vacina com placebo, porém sem significância estatística. Na avaliação do dia 42 os níveis de IFN-y e de IL-5 foram similares nos dois grupos. A produção de IL-10 manteve-se baixa nos dois grupos em todas as etapas do estudo. A reação de Montenegro realizada no dia 42 foi positiva em 44 dos 51 indivíduos testados (86%). 0 número de indivíduos com uma reação de hipersensibilidade tardia positiva foi maior no grupo que utilizou o placebo associado à Leishvacin® (24/25; 96%) quando comparado com o grupo que utilizou 0 rhGM-CSF associado à vacina (20/25; 77%). A vacina tanto com uma ou duas doses foi capaz de induzir resposta imune , assim como o adjuvante ampliou essa resposta em intensidade e precocidade.American tegumentary leishmaniasis (ATL) continues to represent a worldwide public health problem. In Brazil, the estimated rate of ATL was 10.45 to 21.23 per 100,000 inhabitants during the period from 1985 to 2001. In 1993, an ATL outbreak was detected in the rural area of Canoa, municipality of Santo Amaro, Bahia. A prospective, observational study was conducted to determine the frequency of ATL and to clinically characterize the disease. A total of 555 individuals were followed up and 29 cases of ATL were recorded, corresponding to a 5.2% prevalence of ATL in the population analyzed during the study period. The leishmania species involved in the area was characterized as Leishmania braziiiensis, with the phlebotomine fly being Lutzomyia intermedia. Dogs and equines were found to be infected with Leishmania. These data were published in the first study. In the second study, clinicoepidemiological and immunological data from 104 individuals reported to be carriers of a subdinical infection were compared to those obtained for 29 individuals who developed cutaneous leishmaniasis (CL). Subdinical infection was defined to be present when the individual did not show active cutaneous or mucosal lesions or scars suggestive of a past disease and when the delayed-type hypersensitivity (DTH) reaction was positive. The group of individuals with a clinically evident disease (n=29) was younger (19.4 ± 12.8 years) and showed a cutaneous reaction with a significantly greater induration (17.6 ± 1.4 mm) as well as a greater proportion of positive serology (16/29, 55.2%) (p0.05) in individuals with subclinical infection (105 ± 160 pg/ml, 0-679) than in patients with CL (26 ± 41 pg/ml, 0-85). The data suggest that individuals who do not develop the disease might be able to better modulate the immune response, thus preventing tissue damage and the development of cutaneous lesions. In the third study, we analyzed the immune response elicited in 56 healthy military volunteers by vaccination with one or two doses of leishmania antigen (Leishvacin®). The Montenegro reaction was not used for selection to avoid possible sensitization. In this double-blind, randomized intervention study, in addition to determining the isolated response to vaccination, we also compared the use of synthetic granulocyte-macrophage colony-stimulating factor (rhGM-CSF) as adjuvant. A significant increase (p0.05). IL-5 levels on day 21 were slightly higher in the group receiving the adjuvant than in the group treated with the vaccine plus placebo, with no significant difference between groups. On day 42, IFN-y and IL-5 levels were similar in the two groups. IL-10 production was low in the two groups during all phases of the study. The Montenegro reaction performed on day 42 was positive in 44 of 51 (86%) individuals tested. The number of individuals with a positive DTH reaction was larger in the group vaccinated with Leishvacin® plus placebo (24/25, 96%) than in the group receiving rhGM-CSF in combination with the vaccine (20/25, 77%). The vaccine administered in one or two doses was able to induce an immune response, and the adjuvant intensified this response and led to its earlier onset

Anais Brasileiros de Dermatologia

p.335-338O Acinetobacter baumanni é patógeno oportunista antigamente considerado de baixa virulência. Atualmente está envolvido em processos infecciosos que acometem pacientes imunocomprometidos,grandes queimados e pacientes em unidades de terapia intensiva que fazem uso de ventilação mecânica. Esse relato de caso chama atenção para infecção cutânea rara por essa bactéria em paciente imunocompetente.Rio de Janeir