RESUMO
BACKGROUND: Leprosy is an infection by Mycobacterium leprae, which influenced by cellular immunity. Leprosy tends to occur in low socio-economic and nutrition groups. Researchers try to prove the role of nutrition in the pathogenesis of leprosy. Insulin-like growth factor-1 (IGF-1) as a marker of nutritional status shown to play a role in cellular immunity. OBJECTIVE: To evaluate the correlation between IGF-1 with bacterial index (BI) on leprosy patients in Bali. METHODS: Cross-sectional study in Sanglah Public General Hospital, Denpasar of patients with paucibacillary (PB) and multibacillary (MB) leprosy were assessed for BI using slit-skin smear. All patients were tested for plasma IGF-1 using chemiluminescent immunometric assay Immulite. All data were analyzed using IBM SPSS ver. 24.0. The study has been approved by local Institutional Review Board with ethical clearance number 2017.02.1.0356. RESULTS: Our study involved 44 MB and 2 PB leprosy. The common age group affected was between 31~40 years old (23.9%), male (60.9%), and normal body mass index (BMI) (65.2%). Mean plasma IGF-1 level in PB leprosy was higher (91.07±0.74 ng/ml) than MB (82.74±6.44 ng/ml). The mean IGF-1 level decreases as BI increases in both groups (CI 95%=81.16~85.04; p<0.001). Pearson correlation test shows strong negative correlation (Pearson r=-0.976; p<0.001) with determinant coefficient (R2) showing 95.2% (p<0.001). CONCLUSION: In Balinese leprosy patients, severity of disease status measured by BI were found to be strongly correlated with the plasma IGF-1 level which may help preventing transmission in household contacts by improving nutritional status.
RESUMO
BACKGROUND: Psoriasis is a chronic inflammatory disease mediated by the immune system with increased proliferation of keratinocytes. The exact cause is unknown but as a multifactor, such as infection, trauma and psychological stress have been thought to play a role in its pathophysiology. Dopamine and serotonin are believed to have a strong role in stress conditions and also directly play a role in psoriasis. AIM: This study aimed to evaluate the role of dopamine, serotonin, and psychological stress in psoriasis. METHODS: This study used a case-control design involving 30 patients with psoriasis (as a case group) and 30 healthy controls in the Dermatology and Venereology Polyclinic of Sanglah General Hospital Denpasar during the period December 2016 to February 2017. All samples were taken for venous blood examination serum dopamine and serotonin and analysed using the ELISA method. Statistical analysis using an independent t-test, partial correlation, receiver operator characteristic (ROC) curve, and logistic regression model. RESULT: There were significant differences in serotonin, dopamine, and stress index levels between groups with psoriasis and non-psoriasis (102.68 ± 25.44 Vs. 154.17 ± 20.90; p < 0.001), (437.13 ± 164.83 Vs. 138.11 ± 89.51; p < 0.001), and (138.5 ± 27.80 Vs. 92.55 ± 42.97; p < 0.001). Significant negative correlation was found between serotonin level and stress index (r = -0.366; p = 0.016) and between serotonin and dopamine (r = -0.634; p < 0.001) but a positive correlation was found between dopamine and stress index (r = 0.459; p = 0.042). Serotonin and dopamine showed that it could be used as a biochemical predictive model for psoriasis (AUC > 0.7). Multivariable risk analysis model high serum dopamine was the most important risk factor for the occurrence of psoriasis (adjusted OR: 7.8; 95% CI: 3.45-15.57; p = 0.024). CONCLUSION: Serotonin and dopamine have a significant role in the pathophysiology of the occurrence of psoriasis, and psychological stress can affect psoriasis through its influence on serotonin and dopamine.
RESUMO
Angiolymphoid Hyperplasia with Eosinophilia (ALHE) is a benign tumor of the skin which may mimic other benign or malignant lesion of the skin. Practitioners should consider this diagnosis as a differential when encounter such lesion as papule or nodule on the face and scalp area.