ABSTRACT
Abstract A 44-year-old male patient presented with nodules that evolved with inflammation, following drainage of seropurulent secretion and ulceration. The patient had a 6 year-history of alcohol addiction and reported contact with cats. At the physical examination, the patient had skin-colored and erythematous nodules, and ulcers covered with thick, blackened crusts on the face, trunk and limbs. A culture of a nodule fluid revealed growth of Sporotrix sp. He also had pulmonary involvement and therefore the disease was classified as systemic sporotrichosis, a rare form that usually affect patients infected with HIV. Chronic alcohol abuse was considered the factor of immunosuppression for the patient.
Subject(s)
Humans , Male , Adult , Sporotrichosis/immunology , Sporotrichosis/pathology , Immunocompromised Host , Alcoholism/complications , Alcoholism/immunology , Immunocompetence , Sporotrichosis/chemically induced , Sporothrix/isolation & purification , Erythema/immunology , Erythema/pathologyABSTRACT
El eritema polimorfo solar es la fotodermatosis más frecuente y suele aparecer en primavera con la primera exposición intensa al sol. Sus manifestaciones cutáneas son variadas y el diagnóstico se basa en la clínica junto al antecedente de exposición solar. En los casos leves, la fotoprotección suele ser suficiente para el control de la enfermedad, pero en formas más graves se requieren otras terapéuticas, como corticoides, antihistamínicos, o fototerapia, que genera una "fotoadaptación" de las áreas de piel afectadas. Presentamos un caso típico de erupción polimorfa solar que respondió de forma adecuada a medidas de fotoprotección. (AU)
The polymorphic solar eruption is the most frequent photodermatosis, and usually appears in spring with the first intense exposure to the sun. It has multiple cutaneous manifestations, and its diagnosis is based on the clinic and the antecedent of solar exposition. In mild cases, photoprotection is usually enough to control the disease, but in more severe forms, other therapies are required, such as corticosteroids, antihistamines, or phototherapy to generate a "photo-adaptation" of the affected skin areas. We present a typical case of polymorphic solar eruption that responded adequately to photoprotection measurements. (AU)
Subject(s)
Humans , Female , Adult , Photosensitivity Disorders/diagnosis , Sunlight/adverse effects , Erythema/diagnosis , Phototherapy , Photosensitivity Disorders/immunology , Photosensitivity Disorders/pathology , Quality of Life , Seasons , Sunscreening Agents/therapeutic use , Azathioprine/therapeutic use , Thalidomide/therapeutic use , Ultraviolet Rays/adverse effects , Ultraviolet Therapy , Adrenal Cortex Hormones/therapeutic use , Cholecalciferol/therapeutic use , Erythema/etiology , Erythema/immunology , Erythema/pathology , Histamine Antagonists/therapeutic use , Antimalarials/therapeutic useABSTRACT
Aim and Objective: This study was carried out with the primary aim of correlating oral changes and general changes of HIV-infected patients with their CD4 count. Materials and Methods: 124 patients were selected, and after taking their informed consent, they were subjected to detailed history taking and thorough clinical examination. Specific oral lesions and general physical changes were recorded. Every patient was subjected to laboratory investigation for CD4 count. All these findings were tabulated. The clinical observation and laboratory findings were subjected to critical analysis and correlated. Statistical test, i.e. Student's " t" test, was applied and objective conclusions were drawn. Result: Out of 124 patients, 40 had oral candidiasis, 6 had oral hairy leukoplakia, 12 had periodontal disease, 20 had xerostomia, 30 had melanin pigmentation, while 4 had HSV2, and atypical ulceration. Out of 40 patients with oral candidiasis, 28 patients had CD4 count <200 (group A), 10 patients were in group, B (CD4 count 200-500 cell/mm 3 ) and 2 patients in group C(CD4 >500 cell/mm 3 ). Oral hairy leukoplakia occurred in equal proportions in group A and B. These periodontal diseases were more commonly in group B; xerostomia and melanin pigmentation was equally seen in group A and B. Conclusion: Oral candidiasis, oral hairy leukoplakia, linear gingival erythema, necrotizing ulcerative gingivitis, and necrotizing ulcerative periodontitis are specific oral indicators which will definitely suggest to the dental surgeon that the disease is running a rapid downhill course and due to this the oral physician is in a position to raise a suspicion and alert the general physician regarding the declining immune status of patient.
Subject(s)
AIDS-Related Opportunistic Infections/etiology , AIDS-Related Opportunistic Infections/immunology , CD4 Lymphocyte Count , Candidiasis, Oral/etiology , Candidiasis, Oral/immunology , Erythema/etiology , Erythema/immunology , Gingival Diseases/etiology , Gingival Diseases/immunology , Gingivitis, Necrotizing Ulcerative/etiology , Gingivitis, Necrotizing Ulcerative/immunology , HIV Infections/immunology , Herpesvirus 2, Human/immunology , Humans , Leukoplakia, Hairy/etiology , Leukoplakia, Hairy/immunology , Melanosis/etiology , Melanosis/immunology , Mouth Diseases/etiology , Mouth Diseases/immunology , Oral Ulcer/etiology , Oral Ulcer/immunology , Periodontal Diseases/etiology , Periodontal Diseases/immunology , Stomatitis, Herpetic/etiology , Stomatitis, Herpetic/immunology , Xerostomia/etiology , Xerostomia/immunologyABSTRACT
Red Baby Syndrome is a new disease seen in infants and young children. Dramatic onset of clinical symptoms with high intensity, short duration and lack of similarity with other cutaneous lesions makes it distinct. Of 50 such patients studied over a period of 5 years, half were below one year of age. Abrupt onset of high fever and generalized erythema involving the entire skin, which is swollen and tender is characteristic. These children were highly irritable and had paradoxical cry when cuddled. Rapid resolution of symptoms occurred in 7-10 days with extensive desquamation. Routine investigations were normal, C-reactive protein was raised only in 10 patients. Human Parvo virus B-19 IgM antibodies were positive in 15 out of 24 patients. Real time polymerase chain reaction was positive for human parvovirus B 19 DNA in one. Histopathological changes in the skin biopsy showed post infectious vascular injury pattern.
Subject(s)
Antibodies, Viral/blood , Antigens, Viral/immunology , C-Reactive Protein/metabolism , Child, Preschool , DNA, Viral/analysis , Erythema/genetics , Erythema/immunology , Erythema/pathology , Female , Humans , India/epidemiology , Infant , Infant, Newborn , Male , Parvoviridae Infections/genetics , Parvoviridae Infections/pathology , Parvovirus B19, Human/genetics , Parvovirus B19, Human/immunology , Parvovirus B19, Human/isolation & purification , Polymerase Chain Reaction , Skin/pathology , SyndromeABSTRACT
El eritema elevatum diutinum (EED) es una forma localizada, crónica e infrecuente de vasculitis leucocitoclástica cutánea, caracterizada clínicamente por lesiones papulonodulares de color eritematovioláceo, pardas o amarillentas. Histopatológicamente evoluciona hacia una fibrosis concéntrica. Su causa es desconocida, pero se presume que se debe al depósito de inmunocomplejos en los vasos. Se lo asocia a múltiples enfermedades y también a HIV. Describimos el primer paciente con esta asociación en la Argentina, actualizamos el tema efectuando una revisión bibliográfica y confrontamos las características clínicas, histopatológicas, inmunológicas y terapéuticas de nuestra paciente con los pacientes de la literatura.
Subject(s)
Humans , Male , Adult , Acquired Immunodeficiency Syndrome/complications , Vasculitis, Leukocytoclastic, Cutaneous/diagnosis , Vasculitis, Leukocytoclastic, Cutaneous/pathology , Erythema/etiology , Erythema/immunology , Erythema/pathology , Skin/pathologyABSTRACT
El Eritema Discrómico Perstans (EDP) o Dermatosis Cenicienta es una condición poco común y se caracteriza por máculas grisáceas bien definidas y de contornos policíclicos. En la histopatología los hallazgos son característicos, pero no patognomónicos, y corresponden a una dermatitis liquenoide. La causa del EDP continúa siendo un misterio; se han propuesto causas infecciosas, alteraciones del sistema inmune, e incluso, factores ambientales. Para el diagnóstico, la mayoría de las veces el cuadro clínico es muy típico. Aún no existe un tratamiento efectivo probado para el EDP, sin embargo, la clofazimina parece ser la mejor alternativa.
Subject(s)
Humans , Erythema/diagnosis , Erythema/etiology , Erythema/drug therapy , Pigmentation Disorders/diagnosis , Pigmentation Disorders/etiology , Pigmentation Disorders/drug therapy , Clofazimine/therapeutic use , Diagnosis, Differential , Erythema/immunology , Pigmentation Disorders/immunologyABSTRACT
This is a retrospective study of 276 patients consisting of 157 active and 119 reactive patients of borderline leprosy. They were followed up for 10 years after sulphone monotherapy. The presenting symptoms were carefully examined from the records and systematically presented. Frequency of reactions was least in BT cases and most in BL cases. Risk factors of reaction appear to be the type of leprosy, multiplicity of lesions, high BI and, possibly, psychological stress. Biopsy of skin lesions was performed in all cases initially, and at the subsidence of the disease. Histological findings closely correlated with clinical classification. While all the cases showed clinical subsidence, histological subsidence was found in 200 (73%) cases, and the condition was static in 36 cases (13%). Immunological upgrading was seen in 110%, while 4% showed downgrading. Bacteriological status and lepromin reaction of active and reactive cases were compared. All these factors need to be taken into consideration for instituting prompt and proper treatment.
Subject(s)
Biopsy , Disease Progression , Erythema/immunology , Female , Follow-Up Studies , Humans , Lepromin/immunology , Leprosy, Borderline/drug therapy , Leprosy, Lepromatous/drug therapy , Leprosy, Tuberculoid/drug therapy , Male , Mycobacterium leprae/growth & development , Peripheral Nerves/immunology , Retrospective StudiesABSTRACT
Annular erythema (AE) associated with anti-Ro (SSA) and/or La (SSB) autoantibody in patients with Sjogren syndrome (SS) or with SS/systemic lupus erythematosus overlap syndrome (SS/SLE), has recently been described in Orientals, and it may be a counterpart of annular skin lesion of the subacute cutaneous LE seen mostly in Caucasians. The author examined five Korean AE patients in respect to dinical diversity. In this small-sample study, subtle differences appeared between individual cases regarding the serologic features and the diagnoses of the disease. Among the five cases, four had circulating anti-Ro and anti-La antibodies, and one had only anti-La. Regarding the diagnosis, one was SS/SLE, two were primary SS, and the remaining two were only "AE associated with anti-Ro/La antibody". There seem to be a wide clinical spectrum in the disease expression of AE associated with anti-Ro/La autoantibody than previously thought.
Subject(s)
Adult , Female , Humans , Male , Adolescent , Antibodies, Antinuclear/immunology , Erythema/immunology , Erythema/etiology , Lupus Erythematosus, Systemic/immunology , Lupus Erythematosus, Systemic/complications , Sjogren's Syndrome/immunology , Sjogren's Syndrome/complicationsABSTRACT
Los autores evalúan un grupo de pacientes (49), referidos en los últimos 10 años con el diagnóstico clínico de Eritema Discrómico Perstans a la consulta externa del Hospital Vargas (Instituto de Biomedicina). Se tomaron los siguientes parámetros: clínico, histopatológico, M. electrónica, subpoblaciones celulares en tejido, inmunofluorescencia, anticuerpos antinucleares y otros exámenes paraclínicos. Todos estos parámetros fueron tomados en cuenta con la finalidad de precisar aquellos pacientes con EDP típico en contraposición con aquellos pacientes atípico. Hacen consideraciones para reconocer el EDP típico como una entidad aparte, mientras que los pacientes con EDP atípico podrían ser una expresión de otra nosología
Subject(s)
Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Erythema/immunology , Erythema/classification , Erythema/therapyABSTRACT
Los estudios serologicos para inmunofluorescencia indirecta (IFD) como las bipsias de la piel para inmunofluorescencia directa (IFD) en las enfermedades vesicampollosas nos pueden dar una informacion diagnostica. Se describen las principales enfermedades ampollosas, como dermatitis herperiforme, penfigos, penfigoide, herpes gestationis, dermatits ampollosa de IgA lineal, etc., haciendo enfasis en la clase, caracteristicas y localizacion de los diferentes anticuerpos a nivel de la piel de estas entidades, como tambien la presencia de antigenos de histocompatibilidad. Se menciona como la toma de la biopsia de piel y mucosas difere para cada entidad para lograr una mayor positividad
Subject(s)
Humans , Male , Female , Skin Diseases, Vesiculobullous , Fluorescent Antibody Technique/instrumentation , Dermatitis Herpetiformis/immunology , Epidermolysis Bullosa/diagnosis , Epidermolysis Bullosa/pathology , Erythema/immunology , Erythema/physiopathology , Gingivitis/immunology , Gingivitis/physiopathology , Pemphigoid Gestationis/diagnosis , Pemphigoid Gestationis/pathology , Pemphigoid, Bullous , Porphyrias/physiopathology , Skin Diseases, Vesiculobullous/classification , Skin Diseases, Vesiculobullous/pathologyABSTRACT
El eritema discrómico perstans (EDP) y el vitiligo son dermatosis pigmentarias cutáneas de etiología desconocida, en las que existen evidencias que sugieren una importante participación del sistema inmune. En el presente trabajo, se estudiaron los infiltrados leucocitarios de ambas enfermedades. La caracterización linfocitaria in situ se realizó en pacientes con EDP mas clofazima y piel de voluntarios sin lesiones cutáneas aparentes. Los resultados obtenidos muestran que la administración de la droga estimula la acumulación de linfocitos T cooperador de las zonas afectadas de la piel
Subject(s)
Humans , Clofazimine/administration & dosage , Erythema/immunology , In Vitro Techniques , Lymphocytes/analysis , Vitiligo/immunologyABSTRACT
El Eritema Discrómico Perstans (EDP) y el Vitiligo son dos dermatosis pigmentarias cutáneas de etiología desconocida. En el presente estudio los infiltrados leucocitarios de EDP (n=10) y de Vitiligo (n=5) fueron estudiados, usando la técnica de la inmunoperoxidasa de avidinabiotina (ABC) y anticuerpos monoclonales que reconocen las siguientes subpoblaciones celulares: T-Supresor-Citotóxico (CD8=Leu-2), T-cooperadores (CD4=OKT4), T-Supresores (Leu-15), Pan T (Leu-4), Macrófagos (Leu-M3) y células de Langerhans (CD1=Leu-6); y marcadores celulares para antígeno la, Gamma Interferón, Interleucina-2 y receptor para Interleucina-2. El análisis inmunocitoquímico mostró una acumulación selectiva de células T-Citotóxicas Leu-4+, Leu-2+, Leu-15-en la epidermis tanto de EDP como de lesiones recientes de Vitiligo. Además, un aumento en el número de células de Langerhans epidérmicas Leu-6 se observó en algunos de los casos de EDP y de Vitiligo. La relación CD4/CD8 en las lesiones y en la piel no envuelta para ambos desórdenes no mostró diferencias significativas, no obstante valores menores que uno se apreciaron sólo en los infiltrados de piel lesionada. Los macrófagos en los infiltrados dérmicos de EDP se encontraban generalmente yuxtapuestos al pigmento melánico. Los linfocitos que expresaban en su superficie antígenos tipo TAC, IL-2 y Gamma Interferón, fueron muy pocas en los infiltrados dérmicos. Algunas células NK se encontraban también presentes en la epidermis enferma. Estas observaciones morfológicas sugieren una importante participación de la inmunidad celular en la discromia de diversos desórdenes pigmentarios cutáneos
Subject(s)
Adult , Humans , Erythema/immunology , Immunity, Cellular , Vitiligo/immunologyABSTRACT
Se realizó una actualización de eritema infeccioso, una enfermedad exantemática de la infancia que recientemente se ha asociado a parvovirus humanos y se presentan 2 casos en que se comprobó el diagnóstico por alza de IgM específica, mediante la técnica de Radioinmunoanálisis