Objetivo: Analisar os principais efeitos colaterais do esquema medicamentoso padrão, poliquimioterapia, utilizada no tratamento para hanseníase. Métodos: Trata-se de estudo transversal descritivo, conduzido com 40 participantes, atendidos no Ambulatório de Dermatologia da Universidade do Estado do Pará. Os pesquisadores empregaram uma adaptação da Ficha para Investigação de Ocorrência de Efeitos Adversos na Poliquimioterapia (PQT) em hanseníase, com variáveis agrupadas em perfil social, dermatológico, laboratorial e reacional. Resultados: Os pacientes em sua maioria foram: homens, com mais de 60 anos de idade, aposentados, com apenas ensino fundamental. Quanto a classificação clínica, predominantemente, a forma dimorfa e multibacilar, em 12 meses de tratamento. Os sistemas orgânicos com maior relação com reações adversas foram: excretor, nervoso, tegumentar e respiratório, sobretudo mediante ao uso da dapsona. Entre os efeitos adversos, destaca-se o enjoo (32,50%) no uso de rifampicina, mialgia (65%) no uso de dapsona e hiperpigmentação cutânea (77,50%) no uso de clofazimina. Conclusão: O presente estudo demonstrou que as reações adversas mais frequentes foram leves e estão associadas ao uso de dapsona e clofazimina, sendo de suma importância a detecção precoce desses efeitos, para eficaz intervenção de eventos graves.
Background: Cutaneous leishmaniasis (CL) is an infectious disease caused by a protozoan of the genus Leishmania and is transmitted by the anopheline mosquito. This study focused on describe three cases of atypical clinical presentations on patients with American cutaneous leishmaniasis from Dermatology Department of the State University of the State of Pará. Methods and Findings: Three patients assisted at a referral service between 2017 and 2019 are reported, based on clinical interview, histopathological analysis and polymerase chain reaction. On the first patient, it was observed keratotic erythematous vegetative plaque measuring 10x8 cm, with satellite lesions, in the left lower limb; the second patient presented an erythematous infiltrated plaque with crusts, on left ear for 6 months, with progressive growth; the third patient showed erythematous infiltrated plaques, sometimes ulcerated, in the trunk and face, with a zosteriform aspect. All three patients had the diagnosis confirmed by polymerase chain reaction and histopathological analysis. Conclusions: The wide range of clinical manifestations may be related to factors such as: use of immunosuppressive drugs, concomitant infections with more than one variety of Leishmania spp. and association with other systemic diseases, with HIV co-infection and diabetes being the main associated diseases. Thus, it is always necessary to evaluate such comorbidities on patients with leishmaniasis suspection, in order to avoid misdiagnosis.
Introduction: The hyperendemicity of leprosy in the northern region permeates regional aspects, including its large territorial extension and waterways, which make it difficult to access health and, consequently, control the disease. So that, the objective of this project is to describe the demographic and clinical profile of patients with leprosy and to evaluate their intradomiciliary contacts. Methods and findings: Observational, descriptive study, type of case series, through interview and complementary analysis of the medical records of patients undergoing specific treatment and / or treatment of leprosy reactions followed at the Dermatology outpatient clinic of the University of the State of Pará, in the city of Belém-PA, from January 2015 to December 2017. With convenience sampling, we interviewed 83 patients that met the inclusion criteria and collected socioeconomic and demographic variables, as well as clinical aspects based on the Madrid classification. Descriptive and inferential statistical methods were applied as: tables, graphs and statistical measures of position and Test G, with alpha significance = 0,05 and reliability of 95%. The predominance of males was observed (60.24%), the most affected age group was between 30 and 44 years old and the majority with incomplete secondary education. The predominant family income was up to 1 minimum wage. The most frequent clinical type was Virchowian (38 patients). Most of the patients did not present leprosy reaction and those who presented, the type 1 reaction was the most frequent and the nerve most affected was ulnar. Conclusion: Prevalence of multibacillary cases is a reflex of late diagnosis. It is important that there be intensification of actions and monitoring and active search for new cases.
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