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.
extrauterinos animals (post-natal) and articles which were published 10 years ago. As criteria for exclusion: articles with incomplete information and review articles (only original articles were included).
ResultsAccording to elegebility criteria, 17 articles were identified during the study period and are presented in Table 1, and 9 of these ones were published since 2011, showing that the issue is still current. As the place of origin of the articles, 8 of them are from South America, 4 from Europe, 1 from North America and 2 in Asia.In 17 articles, there was the analysis of different systems in search of positive and negative impacts of malnutrition. It was found 8 articles researching the relationship between malnutrition with the immune system and/or gastrointestinal system, while 5 articles analyzed the hematopoietic system and the skeletal system. Only one paper analyzed the cardiovascular system, one analyzed the cutaneous and 2 studies, just the malnutrition process.About the experimental animals used, 16 used mice and the pig was used in only one study. The time for induction of the malnutrition was 21 days in 4 studies, while less than 21 days in 5 studies and two weeks or less in 6 studies.To induction to malnutrition was used the low protein diet mainly, associating this with the low supply of calories in 4 studies. The study by Leite et al., we used 2 methods to get malnutrition, the
Background: The evaluation of leprosy patients requires a careful dermatological and neurological examination in order to monitor the possible damage to the peripheral nerves. This study focused on evaluate the sensitivity at the time of diagnosis and discharge of leprosy patients from Dermatology Department of the State University of the State of Pará.
Methods and Findings: this is a longitudinal, retrospective and descriptive study based on medical records that presented neurological assessment and degree of physical disability of 30 patients assisted at a referral service between 2016 and 2019, applying descriptive statistical analysis. Concerning neural involvement, 88.89% of the patients with neural damage were male, 100% of patients in this group were multibacillary (p-value: 0.02), 42.8% were borderliners (p-value: 0.04), 88.8% had some type of leprosy reaction (p-value: 0.02) and 44.4% of the patients had a diagnosis of leprosy with more than one year of disease evolution; most patients with neural involvement (N = 16) had more than one nerve affected, with the right tibial nerve being the most affected (24.14%); It was noted that a considerable portion of multibacillary patients did not improve or worsened (75%), and the borderline form was the one with the worst prognosis, showing 50% of patients did not respond to treatment.
Conclusions: Most of the patients with neural damage were multibacillary, and borderliners, with many of those without presenting improvement, or showing worsening of clinical condition after multidrug therapy. Thus, it is highlighted the primary role of longitudinal assessment of those patients, in view of the possibility of chronification and sequel development.
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