Egon Luiz Rodrigues Daxbacher

Hanseníase em menores de 15 anos: a importância do exame de contato

OBJETIVO: Describir dos casos de enfermedad de Hansen en menores de 15 anos, siendo uno de paciente con 18 meses de edad y otro de 13 anos, diagnosticados por modos de deteccion distintos, subrayando la importancia de examinar a los contactos. DESCRIPCION DEL CASO: Uno de los casos tuvo diagnostico temprano mediante examen de contactos intradomiciliares, mientras que el otro fue diagnosticado por demanda espontanea despues de cuatro anos de surgimiento de las lesiones y, a pesar de ser contacto de un ex-paciente, no fue examinado en la epoca. COMENTARIOS: En paises endemicos, la alta deteccion de enfermedad de Hansen en menores de 15 anos revela la persistencia en la transmision del bacilo y las dificultades de los programas de salud para el control de la enfermedad. El mayor tiempo para diagnostico ocasiona secuelas y deformidades y, de ese modo, la busqueda por los contactos constituye importante metodo para el diagnostico temprano de la enfermedad en la infancia, cuando las senales clinicas no siempre son faciles de identificarse y hay gran diversidad de formas clinicas en que la enfermedad puede presentarse.ABSTRACT Objective : To describe two cases of leprosy in children un-der 15 years old, being one patient aged with 18 months and other 13 years, diagnosed by different modes of detection, emphasizing the importance of examining the contacts. Case description : One of the cases was diagnosed early by examining household contacts, while the other was diag-nosed by spontaneous demand, after four years of the onset of lesions, although he had been a former patient contact who was not examined at the time. Comments : In endemic countries, the high detection of leprosy in children under 15 years old reveals the persistence of the bacillus transmission and the difficulties encountered by public health programs to control the disease. Delay in leprosy diagnosis leads to sequels and deformities and, thus, the search for contacts is important as an effective method for early diagnosis of the disease in childhood, where clinical signs are not always easy to be identified due to the great variety of clinical forms in which the disease may occur.

Type 2 leprosy reaction with Sweet's syndrome-like presentation.

Leprosy is a chronic disease characterized by manifestations in the peripheral nerves and skin. The course of the disease may be interrupted by acute phenomena called reactions. This article reports a peculiar case of type 2 leprosy reaction with Sweets syndrome-like features as the first clinical manifestation of leprosy, resulting in a delay in the diagnosis due to unusual clinical presentation. The patient had clinical and histopathological features reminiscent of Sweets syndrome associated with clusters of vacuolated histiocytes containing acid-fast bacilli isolated or forming globi. Herein, it is discussed how to recognize type 2 leprosy reaction with Sweets syndrome features, the differential diagnosis with type 1 leprosy reaction and the treatment options. When this kind of reaction is the first clinical presentation of leprosy, the correct diagnosis might be not suspected clinically, and established only with histopathologic evaluation.

Cutaneous involvement by cytomegalovirus in a renal transplant recipient as an indicator of severe systemic infection

Cytomegalovirus is an opportunistic virus that commonly affects immunosuppressed patients. Cutaneous involvement by this virus is rare and occurs in significantly immunocompromised hosts, with a poor prognosis. Skin ulcers may represent the first sign of systemic infection by cytomegalovirus in these patients. Herein, a case of a systemic infection by Cytomegalovirus presenting as genital and oral ulcers in a kidney-transplant recipient is reported.

Leprosy in children under 15 years: the importance of early diagnosis

OBJETIVO: Describir dos casos de enfermedad de Hansen en menores de 15 anos, siendo uno de paciente con 18 meses de edad y otro de 13 anos, diagnosticados por modos de deteccion distintos, subrayando la importancia de examinar a los contactos. DESCRIPCION DEL CASO: Uno de los casos tuvo diagnostico temprano mediante examen de contactos intradomiciliares, mientras que el otro fue diagnosticado por demanda espontanea despues de cuatro anos de surgimiento de las lesiones y, a pesar de ser contacto de un ex-paciente, no fue examinado en la epoca. COMENTARIOS: En paises endemicos, la alta deteccion de enfermedad de Hansen en menores de 15 anos revela la persistencia en la transmision del bacilo y las dificultades de los programas de salud para el control de la enfermedad. El mayor tiempo para diagnostico ocasiona secuelas y deformidades y, de ese modo, la busqueda por los contactos constituye importante metodo para el diagnostico temprano de la enfermedad en la infancia, cuando las senales clinicas no siempre son faciles de identificarse y hay gran diversidad de formas clinicas en que la enfermedad puede presentarse.ABSTRACT Objective : To describe two cases of leprosy in children un-der 15 years old, being one patient aged with 18 months and other 13 years, diagnosed by different modes of detection, emphasizing the importance of examining the contacts. Case description : One of the cases was diagnosed early by examining household contacts, while the other was diag-nosed by spontaneous demand, after four years of the onset of lesions, although he had been a former patient contact who was not examined at the time. Comments : In endemic countries, the high detection of leprosy in children under 15 years old reveals the persistence of the bacillus transmission and the difficulties encountered by public health programs to control the disease. Delay in leprosy diagnosis leads to sequels and deformities and, thus, the search for contacts is important as an effective method for early diagnosis of the disease in childhood, where clinical signs are not always easy to be identified due to the great variety of clinical forms in which the disease may occur.

Associação de aciclovir oral e imiquimode no tratamento de herpes simples genital hipertrófico em paciente com sida: relato de dois casos

Chronic herpes simplex can present as exuberant clinical lesions, especially in HIV patients. The most probable mechanism of formation of these lesions is the invasion of the epidermal CD4 T cells by the herpes simplex virus. Due to the therapeutic difficulties and the high rates of treatment failure amongst these patients, new drugs are currently being discussed on the literature. Studies based on the immunophatology of these lesions have suggested that imiquimod might work as an adjuvant therapy to the antiviral drugs. Here we present two cases of excellent response to treatment with topical imiquimod as an adjuvant drug to acyclovir.Chronic herpes simplex can present as exuberant clinical lesions, especially in HIV patients. The most probable mechanism of formation of these lesions is the invasion of the epidermal CD4 T cells by the herpes simplex virus. Due to the therapeutic difficulties and the high rates of treatment failure amongst these patients, new drugs are currently being discussed on the literature. Studies based on the immunophatology of these lesions have suggested that imiquimod might work as an adjuvant therapy to the antiviral drugs. Here we present two cases of excellent response to treatment with topical imiquimod as an adjuvant drug to acyclovir.

Dermatomiofibroma: relato de caso de doença rara

Dermato myofibroma is included in the group of benign cutaneous mesenchymal neoplastic lesions of fibroblastic and myofibroblastic lineage. Its a rare disease and there are approximately only one hundred cases described worldwide in the medical literature up to now. The present study reports the case of a young woman with typical clinical cutaneous lesion and histopathological diagnosis of dermato myofibroma. Special stains were carried out which showed preserved collagen fibers and immunohistochemistry was positive for vimentin and negative for actin and S100. As it is a rare disease, the histopathological findings are of great importance but clinical suspicion is possible in typical cases such as this one.

Enfermedad de Hansen en menores de 15 años: la importancia del examen de contacto

OBJETIVO: Describir dos casos de enfermedad de Hansen en menores de 15 anos, siendo uno de paciente con 18 meses de edad y otro de 13 anos, diagnosticados por modos de deteccion distintos, subrayando la importancia de examinar a los contactos. DESCRIPCION DEL CASO: Uno de los casos tuvo diagnostico temprano mediante examen de contactos intradomiciliares, mientras que el otro fue diagnosticado por demanda espontanea despues de cuatro anos de surgimiento de las lesiones y, a pesar de ser contacto de un ex-paciente, no fue examinado en la epoca. COMENTARIOS: En paises endemicos, la alta deteccion de enfermedad de Hansen en menores de 15 anos revela la persistencia en la transmision del bacilo y las dificultades de los programas de salud para el control de la enfermedad. El mayor tiempo para diagnostico ocasiona secuelas y deformidades y, de ese modo, la busqueda por los contactos constituye importante metodo para el diagnostico temprano de la enfermedad en la infancia, cuando las senales clinicas no siempre son faciles de identificarse y hay gran diversidad de formas clinicas en que la enfermedad puede presentarse.ABSTRACT Objective : To describe two cases of leprosy in children un-der 15 years old, being one patient aged with 18 months and other 13 years, diagnosed by different modes of detection, emphasizing the importance of examining the contacts. Case description : One of the cases was diagnosed early by examining household contacts, while the other was diag-nosed by spontaneous demand, after four years of the onset of lesions, although he had been a former patient contact who was not examined at the time. Comments : In endemic countries, the high detection of leprosy in children under 15 years old reveals the persistence of the bacillus transmission and the difficulties encountered by public health programs to control the disease. Delay in leprosy diagnosis leads to sequels and deformities and, thus, the search for contacts is important as an effective method for early diagnosis of the disease in childhood, where clinical signs are not always easy to be identified due to the great variety of clinical forms in which the disease may occur.