[Diffuse infiltration of the external ear in a 59-year-old Brazilian patient. "New world" cutaneous leishmaniasis (leishmaniasis tegumentar Americana)].
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Biomedical subjects
Publications and source records attributed to S Talhari.
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Lobomycosis, caused by the fungal pathogen Lacazia loboi, is a chronic deep mycosis and is only found in Central and South America. Clinically the disease is characterized by shiny keloidal nodules appearing mainly on the exposed parts such as face and the upper and lower extremities. Therapeutically the surgical removal of the lesions is considered as the only successful treatment. We describe the therapeutic response of a patient with Lobo's disease treated for one year with a combination of clofazimine (100 mg/day) and itraconazole (100 mg/day). A complete clinical and histopathological remission of the disease was observed. The patient has been followed for three years.
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The occurring resurgence of endemic treponematoses warrant the renewal of WHO mass campaigns. These various infections, pinta, yaws, bejel and endemic syphilis, are due to a treponema apparently identical to the venereal syphilis one. These different treponematoses do act upon epidemiology of venereal syphilis. The recent outbreak of treponematoses justify the current researches in the development of a treponemal vaccine.
The clinical and immunological evolution of lesions in cutaneous leishmaniasis was assessed after treatment with human recombinant gamma interferon (rIFN-gamma). 3 weeks after rIFN-gamma treatment of lesions due to Leishmania braziliensis guyanensis, 12/13 had become smaller compared with 6/13 control lesions; only 4 treated lesions were free of parasites. 9 of 13 L tropica lesions treated with rIFN-gamma resolved completely within 4-8 weeks of treatment. An acute inflammatory reaction around treated lesions was more common in lesions due to L tropica. There were no other local or systemic adverse reactions. Histological and immunohistochemical studies indicate that local application of rIFN-gamma enhances cell-mediated immune responses and thus promotes healing of cutaneous leishmaniasis.
Patients with deep mycoses diagnosed in dermatologic clinics of Manaus (state of Amazonas, Brazil) were studied from November 1973 to December 1983. They came from the Brazilian states of Amazonas, Pará, Acre, and Rondônia and the Federal Territory of Roraima. All of these regions, with the exception of Pará, are situated in the western part of the Amazon Basin. The climatic conditions in this region are almost the same: tropical forest, high rainfall, and mean annual temperature of 26C. The deep mycoses diagnosed, in order of frequency, were Jorge Lobo's disease, paracoccidioidomycosis, chromomycosis, sporotrichosis, mycetoma, cryptococcosis, zygomycosis, and histoplasmosis.
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A case of Jorge Lobo's disease is described. According to the references consulted the case presented is the second in Peru. The patient is a native of the Peruvian jungle (River Madre de Dios, State Madre de Dios). The disease was restricted to the left ear. Clinical and histopathological aspects were typical of Lobo's disease.
During the period from April 1978 to May 1980 some 10,178 school children in the city of Manaus, State of Amazonas, Brazil, were examined. 22 cases of Hansen's disease were discovered, 16 presented with the tuberculoid form of the disease, 5 lepromatous and 1 indeterminate case were found. The most frequent dermatological conditions were dermatozoonosis, superficial mycosis, disorders of keratinization, naevus and bacterial infections.
The demonstration of Sporothrix schenkii in cutaneous biopsies of two patients is reported. The importance of the histopathologycal analysis to the diagnosis of this mycosis is enphasized.
A case of Generalized Perforating Granuloma Annulare of 15 years duration is described. The rarity of the disease is emphasized and the similarity of the lesions to those observed in papulonecrotic tuberculid noted. The lesions responded well to systemic and locally applied cortisone.
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The Author describes two cases of Jorge Lobo's disease, with disseminated lesions and plantar invasion, originating from Cruzeiro do Sul, state of Acre and Manaus, state of Amazonas. In both cases, the disease was of long duration, 30 and 55 years respectively. In the second patient described the disease began 9 years before Jorge Lobo described this condition. In spite of the duration of the illness in this patient 76 years of age, he was in good physical condition without any apparent suggesting dissemination of the mycosis.
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