RESUMO
RESUMEN Introducción: Colombia es un país endémico para tuberculosis (TB), con una prevalencia de 26 casos por millón. Sin embargo, no se cuenta con datos recientes y claros respecto a la prevalencia de tuberculosis latente (TBL) en la población con artritis reumatoide (AR) candidata a terapia biotecnológica. Metodología: Estudio de corte transversal con componente analítico para determinar la pre-valencia de TBL en pacientes con AR candidatos a terapia biotecnológica. Resultados: La prevalencia de TBL en pacientes con AR candidatos a terapia biotecnológica es alta, del 18,3% (IC 95% 14,7-21,9), y en los cruces exploratorios se encontró una relación entre TBL y la variable género masculino (p ≤ 0,001), hallazgos anormales en la radiografía de tórax (p = 0,039) y el tabaquismo (p = 0,028). Conclusión: La prevalencia de TBL en pacientes con AR candidatos a terapia biotecnológica es alta. Se requieren estudios prospectivos para evaluar la incidencia de TB en este grupo de pacientes y así corroborar su asociación.
ABSTRACT Introduction: Although tuberculosis (TB) is endemic in Columbia, with a prevalence of 26 cases per million, there are no recent and clear data regarding the prevalence of latent tuberculosis (LBT) in the population with rheumatoid arthritis (RA), candidates for biotechnological therapy. Methodology: A cross-sectional study with an analytical component to determine the prevalence of LBT in patients with RA who are candidates for biotechnological therapy. Results: The prevalence of LTB in RA patients who are candidates for biotechnological therapy is high, 18.3% (95% CI: 14.7-21.9). In the exploratory analysis, a relationship between LBT and male gender was found (P ≤ .001), as well as abnormal findings on chest radiography (P = .039), and smoking (P = .028). Conclusion: The prevalence of LTB in patients with RA who are candidates for biotechnological therapy is high. Prospective studies are needed to evaluate the incidence of TB in this group of patients and corroborate this association.
Assuntos
Humanos , Adulto , Infecções Bacterianas e Micoses , Infecções por Bactérias Gram-Positivas , Tuberculose Latente , InfecçõesRESUMO
BACKGROUND: Palmoplantar hyperkeratosis is a cutaneous manifestation that had not been clearly associated with infection by the human T-cell lymphotropic virus, which is a retrovirus that in most cases does not develop clinical pathologies and its symptoms may be undetected. The skin is one of the most affected organs, however until now only seborrheic dermatitis, xerosis/ichthyosis and infective dermatitis associated with HTLV-1 have been described as cutaneous clinical manifestations of this disease. CASE PRESENTATION: We present the case of a 36-year-old male patient with serologically documented HTLV-1 infection, who presented symptoms of diarrhea, malabsorption due to Strongyloides stercoralis, and in whom a physical examination revealed an association with generalized xerosis and palmoplantar keratoderma confirmed by skin biopsy. Other infectious etiologies and malignancy were ruled out. This clinical manifestation was managed with dermal hydration, and skin care which improved the thickened skin and make it less noticeable. CONCLUSIONS: According to our experience, this is the first reported case of palmoplantar keratoderma associated with a human lymphotropic virus infection. This is a skin manifestation that has not been confirmed in conjunction with HTLV-I before. This implies that palmoplantar keratoderma is a new clinical manifestation of this infection, that should be considered in the initial approach of patients in endemic areas with these dermatological characteristics.
