RESUMO
BACKGROUND: The mucocutaneous clinical profile of patients with amyloidosis in Latin America has been scarcely reported. OBJECTIVE: To describe clinical characteristics of skin and mucosal manifestations in systemic amyloidosis in a tertiary care center in Mexico City. METHODS: A cross sectional, retrospective analytical study was performed in patients with systemic amyloidosis over a 15-year period. Statistical analysis was done. RESULTS: A total of 98 patients were included (53 [54%] men; overall median age = 49 years old). Acquired systemic immunoglobulin light chain amyloidosis (AL) was the most common (49%) type, followed by (24.5%) wild-type transthyretin amyloidosis (H-TTR) (24.5%), undetermined cases (21%), and reactive systemic amyloidosis (AA) (6.1%). There were mucocutaneous manifestations in 34.7% of cases, mostly multiple myeloma-related AL (ALMM). Head and neck was the most often affected site (38.2%), and purpuric macules were the most common morphology (44.1%). Mucocutaneous affectation was predominantly observed in AL (50.0%) compared to other types (20.0%) of amyloidosis (P = 0.01). Likewise, involvement of organs was also significantly different among the diverse amyloidosis types (P < 0.05). The most frequent comorbidities were hypertension (18.3%) and hypothyroidism (18.3%). CONCLUSION: The clinical spectrum of manifestations in amyloidosis is wide. Involvement of skin and mucosa in amyloidosis is common; significant differences were observed concerning distribution of mucocutaneous amyloid manifestations among the different types of amyloidosis.
Assuntos
Amiloidose de Cadeia Leve de Imunoglobulina/patologia , Mucosa/patologia , Mieloma Múltiplo/patologia , Pele/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Hipotireoidismo/epidemiologia , Amiloidose de Cadeia Leve de Imunoglobulina/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Mieloma Múltiplo/epidemiologia , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricosRESUMO
Histoplasmosis usually presents primarily as lung infection. Occasionally, mainly in immunocompromised hosts, it can spread and cause systemic manifestations. Skin lesions have been reported in 10 to 15 percent of cases of disseminated histoplasmosis, and panniculitis has been described as an unusual form of presentation in affected patients. We present the case of a patient with systemic lupus erythematosus who presented cellulitis due to disseminated histoplasmosis.
Assuntos
Histoplasmose/patologia , Lúpus Eritematoso Sistêmico/complicações , Paniculite/patologia , Biópsia , Celulite/imunologia , Celulite/microbiologia , Celulite/patologia , Feminino , Histoplasma/isolamento & purificação , Histoplasmose/imunologia , Humanos , Imunocompetência , Pessoa de Meia-Idade , Paniculite/imunologia , Paniculite/microbiologiaRESUMO
Abstract: Histoplasmosis usually presents primarily as lung infection. Occasionally, mainly in immunocompromised hosts, it can spread and cause systemic manifestations. Skin lesions have been reported in 10 to 15 percent of cases of disseminated histoplasmosis, and panniculitis has been described as an unusual form of presentation in affected patients. We present the case of a patient with systemic lupus erythematosus who presented cellulitis due to disseminated histoplasmosis.
