Immune-clinical-pathologic spectrum of leishmaniasis.
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Biomedical subjects
Publications and source records attributed to R D Azulay.
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Five patients living in Rio de Janeiro, Brazil, were found to have Lyme disease. These are among the first known cases in South America.
One hundred and twenty Brazilian patients with several forms of hanseniasis were tested with DNCB. The results were the following: 1) the sensitization of patients with hanseniasis to DNCB was lower than that seen in the general population; 2) the sensitization of the borderline and virchowian forms of hanseniasis were lower than that seen in the indeterminate and tuberculoid forms.
The authors present a new classification for photodermatosis in five groups: 1. Primary toxic photodermatosis that means lesions produced in all human beings by non-ionized radiation. 2. Photodermatosis induced by drugs, with two subgroups--phototoxic and photoalergic--according to the mechanism of action of the drug. 3. Idiopathic photodermatosis in which the photonic effects are known but the chromophores are unknown; four conditions are included here polymorphous actinic eruption, solar urticaria, actinic reticuloid and hidroa vacciniforme. 4. Miscelanea group which includes several conditions of unknown mechanism which are not included in the other groups, such as: actinic cheilitis, actinic poikiloderma, actinic ceratoses, epitheliomas, melanomas and others. 5. Conditions precipitated or aggravated by solar radiation with two sub-groups: hereditary (xeroderma pigmentosum, Hartnup's syndrome and other) and acquired (lupus erythematosus, pellagra and other). In group 1, the authors propose the designation of actinic elastotic dermatosis to unify different conditions described by several authors such as: diffuse elastosis, citrein skin, cutis rhomboidalis, and others.
The authors discuss the several aspects of the co-sensibilization in the infections produced by M. Tuberculosis and M. hanseniae. Attention is called to Rabello's pioneer works written in 1935 and the subsequent works written by several Argentinian and Brazilian authors. Special emphasis is made to the experimental works in animals by Azulay. The authors discuss the aspects of competitiveness, protection and the crossed granulomatosis answers to the infections.
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I have given the name autoaggressive hanseniasis to a syndrome with immunopathologic and clinical pictures resembling autoaggressive systemic diseases observed in some cases of lepromatous and borderline hanseniasis. It is probably caused by B cell stimulation by antigenic complex of Mycobacterium leprae plus autologous tissue, along with a dysfunction of the T-suppressor lymphocytes.
A case of primary visceral virchowian hanseniasis is presented. The onset and symptoms of the disease made one think that it was a lymphoma because of the severe enlargement of the liver, spleen, and lymph nodes. Biopsies of the liver, lymph nodes, and bone marrow revealed virchowian infiltration with acid-fast bacilli and globi. The skin was free of lesions and negative to bacilli, and there were no neural symptoms.
A case of DAT is presented and the literature is reviewed. The authors verify the limitation of the present therapeutics and they discuss the possible pathogenic mechanism. They also say that "unspecific" lesions resistant to conventional therapy, and mostly localized in the trunk of middle-aged patients may suggest the diagnosis of DAT if biopsy is performed in these cases there probably will be a higher incidence of the disease. As far as we know this is the first brazilian case of DAT reported.
A case of mycosis fungoides (MF) that began with cutaneous eritemato-papular lesions leading to death with neurological symptoms is reported. Cutaneous histophatology was typical to MF and the liquoric citology showed Sézary cells. Necropsy evidenced extra-cutaneous dissemination of the tumor involving lymphnodes, heart, digestive system, bladder, liver, bone marrow and leptomeninges. The uncommon clinical manifestations and evolution are discussed.
The authors had studied the results obtained from the mycologic analysis of skin scales, hair and nails at the Mycology Laboratory of the Clinic Pathology Service of Hospital Universitário-Universidade Federal do Rio de Janeiro, in the period of june, 1978 to may, 1983. The incidence of superficial mycoses were reported as well the incidence of Candida sp. and dermatophytes in the differents areas of the skin. The results had been compared with the current litterature.
Recently we have seen three patients with a clinically characteristic hypersensitivity reaction to phenytoin two to four weeks after they started these therapy. The picture simulated a severe infectious exanthem; it was characterized by a generalized erythematous macular eruption, massive edema of the face, fever, generalized lymphadenopathy and hepatic involvement. The laboratory findings revealed leukocytosis with atypical lymphocytes, eosinophilia and altered liver function. Involution of the eruption was characterized by exfoliation similar to that observed in scarlet fever. There was prompt and good response to treatment with systemic steroids.
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This is a case report of an Atrophic Juvenile Erythema Multiform that has occurred in a ten year old white girl. She has been having symptoms since age three, presenting severe flares of lesions that looked like multiform erythema. When the lesions healed a loose scar was left involving the whole skin. Some of the histological and pathogenic mechanisms of the disease are discussed.
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