[Verroucous papules on the back of the hands].
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Biomedical subjects
Publications and source records attributed to Juan J Vilata.
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We present the case of a 26-year-old Ecuadorian woman who presented with multiple hypertrophic scars along the lower left limb, secondary to a cutaneous process that she had had for 11 years, previously diagnosed and treated in her country as cutaneous leishmaniasis. It had been clinically worsening for 9 months with suppuration through the scars in the groin and thigh, associated with local pain and systemic symptoms. As we suspected cutaneous tuberculosis, we performed a number of complementary examinations to confirm the diagnosis and rule out bone involvement. Finally, a lymph node culture confirmed that it was scrofuloderma.
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BACKGROUND: Leprosy is a chronic infectious disease that is considered to be declining, though it still remains prevalent in many parts of the world. A study was made to explore the health and socioeconomic factors that most influenced the trend of the disease in a typical Mediterranean country. MATERIALS AND METHODS: An ecological study was conducted, investigating possible social, economic and health factors related to the evolution of leprosy incidence. The time period considered was 50 years--the second half of the twentieth century in Spain. RESULTS: The variables showing the strongest correlation to evolution of the incidence of the disease were employment, the number of physicians, and the gross domestic product (GDP), with negative coefficients--while tuberculosis showed a positive coefficient. However, the GDP showed the highest coefficient (0.5). The model that best explained the evolution of leprosy over the last 50 years comprised a 6-year lag period between the socioeconomic factors and the incidence of leprosy--explaining 57% of the data obtained. The annual decrease in leprosy incidence was 1.6%. CONCLUSIONS: Socioeconomic development, assessed in terms of the GDP, was the most important factor in explaining the evolution of leprosy incidence.
Scleredema of Buschke is characterized by a thickening of the dermis with mucin deposits among the collagen fibers, which manifests as a hardening of the skin, predominantly on the upper trunk. It has been associated with long-standing, poorly controlled diabetes mellitus, monoclonal gammopathies and streptococcus infections. We studied patients with a clinical diagnosis of scleredema confirmed by means of a histopathological study, and associated with diabetes mellitus. We reviewed associated diseases, clinical and histopathological characteristics, evolution and response to treatment. Scleredema is characterized by hardening of the skin, affecting the upper trunk. A large proportion of cases are associated with long-standing, poorly controlled diabetes mellitus, with little response to treatment.