ABSTRACT
BACKGROUND: The causative agents of leprosy are the well-known Mycobacterium leprae and the newly discovered Mycobacterium lepromatosis. This agent was found in 2008, and it was found to be the cause of diffuse lepromatous leprosy in two Mexican patients. OBJECTIVE: The objective of this work was to determine if M. leprae and M. lepromatosis were present in formalin-fixed and paraffin-embedded skin samples from cases from different regions in Mexico. METHODS: A total of 41 skin samples were obtained from 11 states of Mexico. All patients' samples were diagnosed by clinical and histopathological analyses. Total DNA was isolated using a Qiagen-DNeasy blood and tissue kit and molecular identification was achieved by two semi-nested polymerase chain reactions. RESULTS: The 41 patient included 33 samples from men and 8 samples from women; 29 samples were polymerase chain reaction (PCR)-positive to Mycobacterium and 12 samples were PCR-negative. From those 29 samples, 13 were PCR-positive to M. leprae, 8 to M. lepromatosis and 8 were positive to both species. The histopathological diagnosis included; Nodular lepromatous leprosy (NLL); Diffuse lepromatous leprosy (DLL); and Borderline leprosy (BL). The 29 PCR-positive samples were classified as follow: 14 NLL, 4 DLL, and 11 BL. In the 12 samples negative to Mycobacterium, 7 showed the NLL, 2 DLL and 3 BL. CONCLUSION: These findings add evidence to the M. leprae and M. lepromatous distribution, clinical forms and participation of dual infections in Mexico.
ABSTRACT
BACKGROUND: Peripheral artery disease (PAD) is quite common, particularly among the elderly. In advanced phases, it has an important impact in the quality of life, so it is recommended to identify this disease on early stages. Onychodystrophy is a deformity of the nail plate of any origin. Up to 50% are caused by fungal infection, the rest is mainly secondary to inflammatory processes. Nail inspection is a very accessible task, and valuation of PAD with the ankle-brachial index (ABI) is a noninvasive affordable technique. PATIENTS AND METHODS: One hundred two self-reported healthy participants were recruited, and the ABI was obtained, as well as inspection of the toenails in search of onychodystrophy. RESULTS AND CONCLUSIONS: Sixty-seven patients had abnormal ABI measurements. Of these, 39 were diagnosed as having onychodystrophy. These results are statistically significant to support the fact that onychodystrophy may be an early marker of asymptomatic PAD, allowing prompt intervention to ameliorate or stop disease progression.
