American tegumentary leishmaniasis: correlations among immunological, histopathological and clinical parameters.

BACKGROUND: American tegumentary leishmaniasis has an annual incidence of 1 to 1.5 million cases. In some cases, the patient's immune response can eliminate the parasite, and the lesion spontaneously resolves. However, when this does not occur, patients develop the disseminated form of the disease. OBJECTIVE: To investigate the association between clinical, laboratory and pathological findings in cases of American tegumentary leishmaniasis. METHODS: A retrospective study of the medical records of 47 patients with American cutaneous leishmaniasis. Clinical, laboratory and epidemiological data were collected, and semi-quantitative histopathological analyses were performed using the Spearman correlation coefficient (p <0.05). RESULTS: Mean patient age was 40.5 years. A total of 29.7% individuals were female and 70.2% were male, and 40.4% of the patients were farmers. The ulcerative form was found in 53.2% of patients, of whom 59.6% had lesions in the limbs. The average time to diagnosis was 22.3 months. The following positive correlations were significant: age and duration of the disease, Montenegro reaction, degree of granulomatous transformation and epithelioid cell count; duration of disease, Montenegro reaction and number of lymphocytes; epithelial hyperplasia and edema, hemorrhaging, and epithelial aggression; number of plasmocytes and number of parasites. The main negative correlations found were as follows: age and serology; time and parasite load; epithelial hyperplasia and degree of granulomatous transformation. CONCLUSION: The long duration of the disease could be explained by the fact that lesions were relatively asymptomatic, and therefore ignored by patients with low literacy levels. Individuals may have simply waited for spontaneous healing, which proved to be dependent on the activation of hypersensitivity mechanisms.

American tegumentary leishmaniasis: correlations among immunological, histopathological and clinical parameters

BACKGROUND: American tegumentary leishmaniasis has an annual incidence of 1 to 1.5 million cases. In some cases, the patient's immune response can eliminate the parasite, and the lesion spontaneously resolves. However, when this does not occur, patients develop the disseminated form of the disease. OBJECTIVE: To investigate the association between clinical, laboratory and pathological findings in cases of American tegumentary leishmaniasis. METHODS: A retrospective study of the medical records of 47 patients with American cutaneous leishmaniasis. Clinical, laboratory and epidemiological data were collected, and semi-quantitative histopathological analyses were performed using the Spearman correlation coefficient (p <0.05). RESULTS: Mean patient age was 40.5 years. A total of 29.7% individuals were female and 70.2% were male, and 40.4% of the patients were farmers. The ulcerative form was found in 53.2% of patients, of whom 59.6% had lesions in the limbs. The average time to diagnosis was 22.3 months. The following positive correlations were significant: age and duration of the disease, Montenegro reaction, degree of granulomatous transformation and epithelioid cell count; duration of disease, Montenegro reaction and number of lymphocytes; epithelial hyperplasia and edema, hemorrhaging, and epithelial aggression; number of plasmocytes and number of parasites. The main negative correlations found were as follows: age and serology; time and parasite load; epithelial hyperplasia and degree of granulomatous transformation. CONCLUSION: The long duration of the disease could be explained by the fact that lesions were relatively asymptomatic, and therefore ignored by patients with low literacy levels. Individuals may have simply waited for spontaneous healing, which proved to be dependent on the activation of hypersensitivity mechanisms. .

Curativo de hidrofibra com prata: opção de tratamento para pênfigo vulgar / Hydrofiber dressing with silver: a treatment option for Pemphigus vulgaris

O pênfigo vulgar é doença grave, que se caracteriza pelo aparecimento de bolhas e erosões mucocutâneas, tratadas sistêmica e topicamente. Alguns pacientes apresentam no tegumento lesões resistentes às terapias disponíveis. A hidrofibra com prata é curativo retentor e umidificador com amplo espectro bacteriano eficaz no tratamento de feridas e doenças bolhosas. Relata-se caso de PV com lesões na face e na região cervical que, tratado com curativo de hidrofibra com prata, apresentou melhora das lesões em dez dias.

Pemphigus vulgaris is a serious condition characterized by blisters and mucocutaneous erosions, which is treated systemically and topically. Some affected patients present lesions in the integument that are resistant to available therapies. Hydrofiber with silver is a retainer and humidifier dressing with broad bacterial spectrum, which is effective in treating wounds and bullous diseases. The authors describe a case of Pemphigus vulgaris with lesions on the face and neck that was treated with hydrofiber with silver dressing. There was an improvement in the lesions within 10 days.