[Leishmaniasis of the genital organs]. / Leishmaniasis en órganos genitales.

Five cases of leishmaniasis in genital organs are exposed. The patients are males, farmers, with less than 30 years old (except one), residents of high leishmaniasis incidence zones. The majority of lesions were in penis, and of scabies ulcer type, destructive, painless and of slow evolution. In this cases generally, the clinic diagnosis was difficult to corroborate by the habitual laboratory methods and we insist that the principal differential diagnosis are the neoplastic process of the zone. The suspicion high index is important even to proceed to the therapeutic test and solve this kind of problems.

[Erythropoietic porphyria. Report of the 1st case in Costa Rica]. / Porfiria eritropoyética. Reporte del primer caso en Costa Rica.

Erythropoietic porphyria also known as Gunther's disease is the result of a deficiency of the enzyme uroporphyrinogen III cosynthetase. This abnormality deviates the biosynthesis of the porphyrins towards the formation of isomers belonging to the series I. These molecules are not utilized for the synthesis of the hem group and therefore accumulate in the tissues and body fluids, giving rise to the clinical and chemical findings of the disease. The present work constitutes the first report of this unusual genodermatosis in costa Rica. The propositus, a 46 years old woman, presented since childhood, a picture characterized by skin phototoxicity associated to hypertrichosis, erythrodontia, bone reabsorptions, distrophy of the nails, splenomegaly and elimination of urine that turned dark when exposed to sunlight. The laboratory findings were consistent with hemolytic anemia and the study of porphyrin metabolism revealed very significant increases in the urinary excretion of uroporphyrin and coproporphyrin, while the urinary excretion of delta aminolevulinic and porphobilinogen were normal.

[Foster homes in Costa Rica. An alternative in the closure of leprosaria]. / Hogares sustitutos en Costa Rica. Una alternativa en el cierre de las leproserías.

The actual knowledge about leprosy and its therapy determines it to be regarded and treated as any other disease. Leprosaria, dedicated to segregation and isolation the patient are not needed anymore. Accordingly, the only leprosarium that existed in Costa Rica, the "Sanatorio Nacional de las Mercedes", was closed on March 30, 1979. We are providing a historical account of the stages in the struggle against leprosy leading to the closure of the Sanatorio, as well as the main reasons supporting the inadequacy of having such an institution. We explain the meaning and advantages of the foster homes, where the last 30 remaining patients were replaced, thus facilitating the closure of the Sanatorio. Finally, three years later, we discuss the most significant results concerning the Hansen's disease control in Costa Rica.

Lepra lepromatosa difusa en Costa Rica. / Diffuse lepromatous leprosy in Costa Rica

De 1975 a 1979, se reportaron en Costa Rica, un total de 165 casos nuevos de lepra, de los cuales, 55 (33,35%) fueron de lepra lepromatosa difusa, llegando a constituirse esta forma clinica en la variedad mas frecuente en el pais. Dentro de ella, los casos puros y primitivos son los mas abundantes. Predomina ligeramente en el sexo masculino (1.5: 1); y la distribucion por grupos de edad es muy similar, con excepcion del grupo de 0-14 anos, que aparece como el menos afectado. El fenomeno de Lucio como forma de reaccion se presenta con menos frecuencia que el eritema nudoso, y es, como ya han constatado otros autores, mas frecuente en los enfermos puros y primitivos que en los secundarios. Ademas, se comprueba la tendencia a cambio en el tipo de reaccion en los enfermos que han estado en tratamiento

Lepra tuberculoide nodular en Costa Rica. (Estudio de 55 casos). / Nodular tuberculoid leprosy in Costa Rica. (Study of 55 cases)

Se revisan los casos de lepra tuberculoide nodular de Souza Campos en Costa Rica. Los primeros reportes datan de 1976 y hasta la fecha (octubre 1981), se conocen 55 pacientes que conforman un foco localizado en barrios colindantes en la ciudad de Liberia, distribuidos en 15 familias con un promedio de 3.67 enfermos por grupo familiar. La enfermedad es mas frecuente en el sexo masculino (63.64%), (relacion 1.75 a 1). La edad fue muy variable el menor de los pacientes de 18 meses de edad y el mayor de 58 anos; sin embargo se observo un franco predominio en menores de 15 anos (61.82%), a pesar de que tambien se encontro un considerable numero de casos en adultos, hecho que merece tomarse en cuenta porque esta variedad clinica de lepra fue originalmente descrita en ninos. Los 55 pacientes en total presentaron 154 lesiones (promedio 2.8), localizadas por orden decreciente de frecuencia en cara, miembros superiores, tronco, miembros inferiores y cuello