Lecciones aprendidas en el control de Aedes aegypti para afrontar el dengue y la emergencia de chikungunya en Iquitos, Perú / Lessons learned in the control of Aedes aegypti to address dengue and the emergency of chikungunya in Iquitos, Peru

El dengue ha afectado a Iquitos desde 1990 causando varios brotes de gran impacto en la salud pública y por el que se desplegaron grandes esfuerzos para su control temporal. Actualmente, ante la expansión del virus chikungunya en las Américas y la amenaza de la emergencia del virus en Iquitos, reflexionamos a modo de lecciones aprendidas las actividades emprendidas en el área del control vectorial; la vigilancia epidemiológica; el diagnóstico y el manejo clínico durante los periodos de brotes de dengue, de modo que nos permita enfrentar mejor la amenaza de un brote del virus chikunguña en la ciudad más grande de la Amazonía peruana.

Dengue has affected Iquitos since 1990 causing outbreaks of major impact on public health and for this reason great efforts have been made for its temporal control. Currently, with the expansion of the chikungunya virus in the Americas and the threat of the emergence of the virus in Iquitos, we reflect on lessons learned by way of the activities undertaken in the area of vector control; epidemiological surveillance, diagnosis and clinical management during periods of outbreaks of dengue, in a way that will allow us to better face the threat of an outbreak of chikungunya virus in the largest city in the Peruvian Amazon.

Hiperqueratosis epidermolítica / Epidermolytic hyperkeratosis / Hiperqueratose epidermolítica

Existe un grupo de desórdenes hereditarios de la cornificación, caracterizado por una excesiva acumulación de escamas en la piel, que varía desde leve y asintomático hasta amenazar la vida. El término ictiosis es derivado de la raíz griega "icti" que significa pescado. La Hiperqueratosis Epidermolítica (HE), también conocida como eritrodermia ictiosiforme congénita, es un desorden autosómico dominante de la cornificación, con una prevalencia de 1:100.000-300.000. Esta patología se evidencia al nacer o al poco tiempo por la presencia de ampollas y de eritrodermia. Existe un gran número de tipos de ictiosis, de los cuales, la mayoría son extremadamente raros. Entre los cuatro más comunes se encuentran: Ictiosis vulgar, Ictiosis ligada al gen X, Ictiosis lamelar, hiperqueratosis epidermolítica. Se presenta el caso de un paciente de 13 años, con diagnóstico clínico de hiperqueratosis epidermolítica que es llevado a consulta médica por compromiso severo de la piel.

There is a group of hereditary disorders of cornification characterized by an excessive accumulation of scales in the skin, which can range anywhere from mild and non-symptomatic to life threatening. The term ichthyosis derives from the Greek root "icti", which means fish. Epidermolytic hyperkeratosis (EHK), also known as bullous congenital ichthyosiform erythroderma, is an autosomal dominant disorder of cornification with a prevalence of 1:100,000 ­ 300,000. EHK is evident at birth or soon thereafter, characterized by blistering and erythroderma. There are numerous types of ichthyosis, of which the majority are extremely rare. Vulgar ichthyosis, X-linked ichthyosis, lamellar ichthyosis, and epidermolytic ichthyosis are amongst the 4 most common types. The case report presented involves a 13-year-old patient with a clinical diagnosis of Epidermolytic hyperkeratosis who was taken to medical consultation presenting severely compromised skin.

Existe um grupo de desordens hereditárias da cornificação, caracterizados por uma excessiva acumulação de escamas na pele; a qual varia desde leve e assintomático até ameaçar a vida. O termo ictiosis é derivado da raiz grega "icti" o qual significa peixe. A Hiperqueratose epidermolítica (HE) também conhecida como eritrodermia ictiosiforme congênita, é uma desordem autossômico dominante da cornificación, com uma prevalência de 1:100.000 ­ 300.000. Esta patologia se evidência ao nascer ou ao pouco tempo deste; pela presença de ampolas e de eritrodermia. Existe um grande número de tipos de ictiosis, dos quais a maioria são extremamente raros. Entre os 4 mas comuns se encontram: Ictiosis vulgar, Ictiosis unida ao gene X, Ictiosis lamelar, hiperqueratose epidermolítica. Apresentasse-se o caso de um paciente de 13 anos, com diagnóstico clínico de hiperqueratose epidermolítica que é levado a consulta médica por compromisso severo da pele.

Manifestaciones cutáneas de amiloidosis sistémica en tres pacientes / Cutaneous manifestations in three patients with systemic amyloidosis / Manifestações cutâneas de amiloidosis sistémica em três pacientes

La Amiloidosis Sistémica (AS) es un grupo heterogéneo de enfermedades caracterizadas por el depósito de proteínas fibrilares en los tejidos. Se presentan tres casos con compromiso cutáneo. Se revisan las amiloidosis sistémicas y se enfatiza en las características clínicas, especialmente las manifestaciones cutáneas, que son muy floridas en los pacientes reportados y consideradas clave para el diagnóstico temprano y el impacto en el pronóstico de esta patología.

Systemic amyloidosis is a group of heterogeneous diseases caused by tissue deposition of misfolded proteins. We report 3 cases of patients with systemic amyloidosis. Diagnosis in all cases was confirmed by biopsy. Here, we also briefly review the pathogenesis, diagnosis, treatment, and clinical manifestations, with a particular focus on cutaneous manifestations. Since such lesions appear early in the disease, we consider that accurately identifying them can have an impact on the prognosis of this affection.

A Amiloidosis Sistémica (AS) é um grupo heterogêneo de doenças caracterizadas pelo depósito de proteínas fibrilares nos tecidos. Apresentam-se três casos com compromisso cutâneo. Revisam-se as amiloidose sistémicas e se enfatiza nas características clínicas, especialmente as manifestações cutâneas, que são muito floridas nos pacientes reportados e consideradas clave para o diagnóstico precose e o impacto no prognóstico desta patologia.

Further observations on clinical tuberculosis among BCGd Filipino children

For about 12 years now (i.e., since the year 1947), we have been conducting mass BCG inoculation here in the Philippines. Many thousands, and perhaps over half a million of our infants and young children have already been subjected to this procedure. With inadequate or no follow-up of these children, we have heard and continue to hear favorable reports resulting from this procedure On the other hand, in the clinic, we encounter active cases of clinical tuberculosis among these BCGd babies and young children. This last report, together with the previous two, seems to show that BCG inoculation does not protect our poor and undernourished children from developing severe manifestations of tuberculosis, and the supposedly attenuated or harmless BCG bacilli may at times produce a severe BCG-itis. (Summary and Conclusion)