Evidence of hidden leprosy in a supposedly low endemic area of Brazil

OBJECTIVES Show that hidden endemic leprosy exists in a municipality of inner São Paulo state (Brazil) with active surveillance actions based on clinical and immunological evaluations. METHODS The study sample was composed by people randomly selected by a dermatologist during medical care in the public emergency department and by active surveillance carried out during two days at a mobile clinic. All subjects received a dermato-neurological examination and blood sampling to determine anti-PGL-I antibody titers by enzyme-linked immunosorbent assay (ELISA). RESULTS From July to December 2015, 24 new cases of leprosy were diagnosed; all were classified as multibacillary (MB) leprosy, one with severe Lucio's phenomenon. Seventeen (75%) were found with grade-1 or 2 disability at the moment of diagnosis. Anti-PGL-I titer was positive in 31/133 (23.3%) individuals, only 6/24 (25%) were positive in newly diagnosed leprosy cases. CONCLUSIONS During the last ten years before this study, the average new case detection rate (NCDR) in this town was 2.62/100,000 population. After our work, the NCDR was raised to 42.8/100,000. These results indicate a very high number of hidden leprosy cases in this supposedly low endemic area of Brazil.

Efeitos da alta frequência no tratamento da acne vulgar em adolescentes / Effects of the high frequency in treatment of acne vulgaris in adolescents

Introdução: O tratamento da acne é baseado no grau de acometimento e um dos principais métodos de higienização é a limpeza de pele associado ao uso da alta frequência. Objetivo: Realizar limpeza de pele com o uso da alta frequência para avaliar sua eficácia na cicatrização da acne vulgar em adolescentes. Material e métodos: Foram selecionados dez pacientes com acne vulgar grau II divididos aleatoriamente em 2 grupos: G1 realizou limpeza de pele com aplicação da alta frequência e G2 realizou a conduta do G1, mas no lugar da alta frequência, aplicação de gel calmante. Os pacientes foram avaliados clínico-fotograficamente pelo programa Image J, quanto à qualidade de vida por meio do questionário The Cardiff Acne Desability Index I (CADI) e satisfação pessoal pela EVA modificada. Resultados: Na avaliação clínico-fotográfica, não houve melhora significativa comparando pré e pós-tratamento em nenhum dos grupos. Porém, na avaliação da qualidade de vida por meio do CADI, houve melhora significativa no G1 (p < 0,04) e no G2 (p < 0,01) na comparação pré e pós-tratamento. Na avaliação de satisfação pós-tratamento, os dois grupos apresentaram alto escore de satisfação, porém não houve diferença entre os grupos. Conclusão: Os resultados mostraram que os dois grupos apresentaram melhora na qualidade de vida e no grau de satisfação com o tratamento, portanto a utilização da alta frequência no tratamento de acne apresentou efeitos semelhantes ao grupo controle. (AU)

Introduction: The treatment of acne is based on the degree of impairment, and one of the main methods is the cleaning of the skin associated with the use of high frequency. Objective: To perform the cleansing of skin with high frequency to evaluate effectiveness in the healing of acne vulgaris in adolescents. Methods: 10 patients were selected with acne vulgaris grade II and randomly divided into two groups: G1 performed facials with application of high frequency and G2 performed the conduct of the G1, but in place of high-frequency used application of soothing gel. Patients were evaluated clinically, photographically by Image J program, the quality of life questionnaire through The Cardiff Acne Desability Index I (CADI) and personal satisfaction by the modified EVA. Results: The clinical and photographic assessment showed no significant improvement between pre and post treatment in both groups. However, when we evaluate quality of life through CADI, a significant improvement in G1 (p < 0.04) and G2 (p < 0.01) was found comparing pre and post treatment. Evaluation of satisfaction after treatment showed high satisfaction for both group, but there is no difference between groups. Conclusion: The results of both groups showed improvement in quality of life and satisfaction with treatment, therefore, the use of high frequency in the treatment of acne showed similar effects in the control group.(AU)

Prolonged viability of human organotypic skin explant in culture method (hOSEC)

Abstract BACKGROUND: Currently, the cosmetic industry is overwhelmed in keeping up with the safety assessment of the increasing number of new products entering the market. To meet such demand, research centers have explored alternative methods to animal testing and also the large number of volunteers necessary for preclinical and clinical tests. OBJECTIVES: This work describes the human skin ex-vivo model (hOSEC: Human Organotypic Skin Explant Culture) as an alternative to test the effectiveness of cosmetics and demonstrate its viability through cutaneous keratinocytes' proliferative capacity up to 75 days in culture. METHODS: The skin explants obtained from surgeries were cultured in CO2-humid incubator. After 1, 7, 30 and 75 days in culture, skin fragments were harvested for analysis with histomorphological exam (HE staining) on all days of follow-up and immunohistochemistry for Ck5/6, Ck10 and Ki-67 only on the 75th day. RESULTS: On the 7th day, the epidermis was perfect in the dermoepidermal junction, showing the viability of the model. On the 30th day, the epidermis was thicker, with fewer layers on the stratum corneum, although the cutaneous structure was unaltered. On the 75th day, the skin became thinner but the dermoepidermal junctions were preserved and epidermal proliferation was maintained. After the 75th day on culture, the skin was similar to normal skin, expressing keratinocytes with Ck5/6 on supra-basal layers; Ck10 on differentiated layers; and viability could be assessed by the positivity of basal cells by Ki-67. CONCLUSION: The hOSEC model seems a good alternative to animal testing; it can be used as a preclinical test analogous to clinical human skin test with similar effectiveness and viability proven by immunohistological analyses. .

Phototherapy promotes healing of cutaneous wounds in undernourished rats

BACKGROUND: Various studies have shown that phototherapy promotes the healing of cutaneous wounds. OBJECTIVE: To investigate the effect of phototherapy on healing of cutaneous wounds in nourished and undernourished rats. METHODS: Forty rats, 20 nourished plus 20 others rendered marasmus with undernourishment, were assigned to four equal groups: nourished sham, nourished Light Emitting Diode treated, undernourished sham and undernourished Light Emitting Diode treated. In the two treated groups, two 8-mm punch wounds made on the dorsum of each rat were irradiated three times per week with 3 J/cm2 sq cm of combined 660 and 890nm light; wounds in the other groups were not irradiated. Wounds were evaluated with digital photography and image analysis, either on day 7 or day 14, with biopsies obtained on day 14 for histological studies. RESULTS: Undernourishment retarded the mean healing rate of the undernourished sham wounds (p < 0.01), but not the undernourished Light emission diode treated wounds, which healed significantly faster (p < 0.001) and as fast as the two nourished groups. Histological analysis showed a smaller percentage of collagen in the undernourished sham group compared with the three other groups, thus confirming our photographic image analysis data. CONCLUSION: Phototherapy reverses the adverse healing effects of undernourishment. Similar beneficial effects may be achieved in patients with poor nutritional status. .