scholarly journals Clinical diversity and treatment results in Tegumentary Leishmaniasis: A European clinical report in 459 patients

2021 ◽  
Vol 15 (10) ◽  
pp. e0009863
Author(s):  
Romain Guery ◽  
Stephen L. Walker ◽  
Gundel Harms ◽  
Andreas Neumayr ◽  
Pieter Van Thiel ◽  
...  
Keyword(s):  
Latin America ◽  
Local Therapy ◽  
Skin Lesions ◽  
Lower Limbs ◽  
Clinical Report ◽  
High Cure ◽  
Systemic Treatments ◽  
Mucosal Involvement ◽  
Mucosal Lesions ◽  
Cure Rates

Background Cutaneous leishmaniasis (CL) is frequent in travellers and can involve oro-nasal mucosae. Clinical presentation impacts therapeutic management. Methodology Demographic and clinical data from 459 travellers infected in 47 different countries were collected by members of the European LeishMan consortium. The infecting Leishmania species was identified in 198 patients. Principal findings Compared to Old World CL, New World CL was more frequently ulcerative (75% vs 47%), larger (3 vs 2cm), less frequently facial (17% vs 38%) and less frequently associated with mucosal involvement (2.7% vs 5.3%). Patients with mucosal lesions were older (58 vs 30 years) and more frequently immunocompromised (37% vs 3.5%) compared to patients with only skin lesions. Young adults infected in Latin America with L. braziliensis or L. guyanensis complex typically had an ulcer of the lower limbs with mucosal involvement in 5.8% of cases. Typically, infections with L. major and L. tropica acquired in Africa or the Middle East were not associated with mucosal lesions, while infections with L. infantum, acquired in Southern Europe resulted in slowly evolving facial lesions with mucosal involvement in 22% of cases. Local or systemic treatments were used in patients with different clinical presentations but resulted in similarly high cure rates (89% vs 86%). Conclusion/Significance CL acquired in L. infantum-endemic European and Mediterranean areas displays unexpected high rates of mucosal involvement comparable to those of CL acquired in Latin America, especially in immunocompromised patients. When used as per recommendations, local therapy is associated with high cure rates.

Paracoccidioides brasiliensis

2012 ◽  
pp. 171-173
Author(s):  
Janis E Blair
Keyword(s):  
Latin America ◽  
South America ◽  
Central America ◽  
Paracoccidioides Brasiliensis ◽  
Skin Lesions ◽  
Diagnosis And Treatment ◽  
Subtropical Forests ◽  
Mucosal Lesions

Paracoccidioides brasiliensis is found only in Latin America. It is endemic in Mexico, Central America, and South America. Most cases (80%) have been reported from Brazil, followed by Venezuela, Colombia, Ecuador, and Argentina. Most cases occur in tropical and subtropical forests, where temperatures are mild and humidity is high throughout the year. Infection can be asymptomatic or can cause mucosal lesions involving the mouth, lips, tongue or nose. It can also cause lymphadenopathy, dyspnea, cough, and skin lesions. Diagnosis and treatment are also reviewed.

scholarly journals 766. Everything Old is New Again-A Case Series of New World Leishmaniasis in African Children in Portland, Maine

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S428-S428
Author(s):  
Jennifer Jubulis ◽  
Amanda Goddard ◽  
Elizabeth Seiverling ◽  
Marc Kimball ◽  
Carol A McCarthy
Keyword(s):  
Latin America ◽  
Cutaneous Leishmaniasis ◽  
New World ◽  
Pediatric Patients ◽  
Data Extraction ◽  
Clinical Manifestations ◽  
Case Series ◽  
Surgical Excision ◽  
Skin Lesions ◽  
Travel History

Abstract Background Leishmaniasis has many clinical manifestations and treatment regimens, dependent on species and host. Old world leishmaniasis is found primarily in Africa and Asia, and is associated with visceral disease, while new world disease, seen primarily in Latin America, is more commonly mucocutaneous. We present a case series of pediatric African patients with New World cutaneous leishmaniasis (NWCL). Methods Data extraction was performed via chart review, analyzing travel history, clinical presentation, diagnosis, and management in children with cutaneous leishmaniasis presenting to the pediatric infectious diseases clinic in Portland, ME. Biopsy specimens were sent to the federal CDC for identification by PCR and culture. Results Five cases of NWCL were diagnosed in pediatric patients in Maine from November 2018 through February 2020. Median age of patients was 10 years (range 1.5-15 years). Four cases (80%) occurred in children from Angola or Democratic Republic of Congo, arriving in Maine via Central/South America, with one case in a child from Rwanda who arrived in Maine via Texas. Three patients had multiple skin lesions and two had isolated facial lesions. Leishmaniasis was not initially suspected resulting in median time to diagnosis of 5 months (range 1-7 months). Four patients were initially treated with antibacterials for cellulitis and one was treated with griseofulvin. After no improvement, patients underwent biopsy with 2 patients diagnosed with L panamensis, 1 with L braziliensis, 1 with mixed infection (L panamensis and L mexicana), and 1 with Leishmania species only. One patient was managed with surgical excision, 3 with ketoconazole, and 1 was observed off therapy. Four patients were referred to otolaryngology. All continue to be followed in infectious disease clinic. Conclusion We present five cases of new world cutaneous leishmaniasis in African pediatric patients arriving to Maine through Latin America or Texas. Patients were diagnosed with cellulitis, tinea corporis or atopic dermatitis initially, underscoring importance of high index of suspicion in migrant patients. Detailed travel history and epidemiologic knowledge is essential to diagnosis, as patients may present with illness not congruent with country of origin. Optimal therapy remains unclear. Disclosures All Authors: No reported disclosures

scholarly journals An evaluation of the treatment of parapsoriasis with phototherapy

2013 ◽  
Vol 88 (2) ◽  
pp. 306-308 ◽  
Author(s):  
Ida Alzira Gomes Duarte ◽  
Karen Levy Korkes ◽  
Vanessa Alice M. Amorim ◽  
Clarice Kobata ◽  
Roberta Buense ◽  
...  
Keyword(s):  
T Cell ◽  
Early Stage ◽  
Cutaneous Lymphoma ◽  
General Tendency ◽  
Cure Rate ◽  
High Cure ◽  
The Subject ◽  
Cure Rates

Whether parapsoriasis represents an early stage of T-cell cutaneous lymphoma is still the subject of controversy. We evaluated the efficacy of phototherapy in the treatment of parapsoriasis and its relation with TCCL. Patients diagnosed with parapsoriasis and treated with phototherapy PUVA or UVB-NB were selected. Between 1 to 8 years following treatment the evolution of their disease was evaluated. In 62 patients the cure rate was 79.3% and 17.2% showed improvement of the lesions. Only two patients developed full blown T-cell cutaneous lymphoma. Phototherapy is an excellent treatment for parapsoriasis, with high cure rates, regardless of the type of phototherapy employed. Of the 62 patients under study, parapsoriasis showed no general tendency to progress to T-cell cutaneous lymphoma.

scholarly journals Seventeen years of American cutaneous leishmaniasis in a Southern Brazilian municipality

2012 ◽  
Vol 54 (4) ◽  
pp. 215-218 ◽  
Author(s):  
Wilsandrei Cella ◽  
Simone Cristina Castanho Sabaini de Melo ◽  
Cátia Millene Dell Agnolo ◽  
Sandra Marisa Pelloso ◽  
Thaís Gomes Verzignassi Silveira ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Rural Area ◽  
Prevalence Rate ◽  
Endemic Area ◽  
Skin Lesions ◽  
Lower Limbs ◽  
Age Group ◽  
American Cutaneous Leishmaniasis ◽  
Incomplete Filling ◽  
Residence Location

We reviewed the records of 151 patients diagnosed with American cutaneous leishmaniasis (ACL) from 1993 to 2009 in the municipality of Japura, Paraná, Brazil. Gender, age, occupation, place of residence, location of lesions, type and number of lesions were analyzed. The prevalence rate of ACL was 11.5/10,000 hab, of which 84.7% were male, 58.3% lived in rural area and 49.0% were farmers. The most frequent age group was between 30 to 39 years (26.6%). Skin lesions occurred in 92.7% of the patients with predominance in the lower limbs (23.9%) and 49.1% of the records did not include the number of lesions location due to incomplete filling. A single ulceration was present in 44.4%. Japurá is an endemic area for ACL, requiring public actions and preventive education.

scholarly journals A clinicoepidemiological study of fixed drug eruptions at a tertiary centre of North India

2018 ◽  
Vol 7 (1) ◽  
pp. 151
Author(s):  
Rohini Sharma ◽  
Sameer Abrol
Keyword(s):  
Research Work ◽  
Developed Countries ◽  
Skin Lesions ◽  
North India ◽  
Drug Reactions ◽  
Tertiary Centre ◽  
Drug Eruptions ◽  
Culprit Drug ◽  
Mucosal Involvement ◽  
Fixed Drug

Background: Various studies have found the overall incidence of cutaneous adverse drug reactions (CADR’s) in developed countries as 1-3%, while the incidence in developing countries is thought to be higher between 2 and 5%. FDEs’ share is seen to be about 15 -30% of all CADR’s as reported in various studies. Aim of the research work was to study the clinical and epidemiological features of fixed drug eruptions and to identify probable culprit drug or drugs using Naranjo ADR probability scale and to provide information to the patient regarding the drug responsible for his/her drug rash.Methods: A total of 180 patients of fixed drug eruptions were taken up for study who presented to skin OPD at a tertiary centre of North India. Diagnosis was made on the basis of history of drug intake prior to drug eruption, repetition of similar lesions on same as well as new sites on intake of same drug with improvement of skin lesions on discontinuation of the causative drug. Further on examination, skin lesions with typical morphology compatible with FDE were seen. Causality of the FDE was assessed according to the NARANJO ADR probability scale.Results: A total of 180 patients of FDE were studied. Males outnumbered the females. The most common class of drug implicated was antimicrobials seen in 115 patients followed by NSAIDS 65 patients. Regarding the clinical presentation both skin and mucosal involvement was seen. The most common skin lesions were erythematous to hyperpigmented and violaceous macules followed by bullous FDE.Conclusions: In summary, early recognition of FDE is important not only for the dermatologists but also for the clinicians of other specialties, so that the culprit drug is recognized and stopped immediately. Drug reactions are a common reason for litigation and has medicolegal pitfalls.

P087 Polyarteritis nodosa: a case report

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
A Azirar ◽  
A Ghannam ◽  
A Elaouli ◽  
M Rkain ◽  
N Benaajiba ◽  
...  
Keyword(s):  
Polyarteritis Nodosa ◽  
Skin Lesions ◽  
Lower Limbs ◽  
Periarteritis Nodosa ◽  
Minimal Effective Dose ◽  
First Child ◽  
History Of ◽  
Inflammatory Syndrome ◽  
Made In

Abstract Background Polyarteritis nodosa is a necrotizing vasculitis of small and medium caliber arteries. Rarely described in children, its pathophysiology is complex and remains poorly elucidated. Two main forms were described in the literature: cutaneous and visceral. Material and results We report the cases of two boys, aged of 7 and 11 years old. They had a history of recurrent sore throat with a recurrent aphthosis in the 11-year-old child. Both boys presented with polyarthralgias, myalgias, polymorphous skin lesions made of livedo reticularis with subcutaneous nodosa on the lower limbs in the first child and distal necrosis of the toes with oedema of the lower limbs in the second. Patients suffered also of cough evolving in a context of alteration of the general state made of fever and asthenia. A biological inflammatory syndrome was present in both children and the skin histology confirmed periarteritis nodosa. The evolution was marked by the disappearance of arthralgias and myalgias after a corticosteroid-based treatment with progressive dose reduction until minimal effective dose. Conclusion The diagnosis of Polyarteritis nodosa should be made in any child presenting with the following signs: fever, altered general condition, myalgias, arthralgias and skin manifestations. The prognosis is usually benign but long-term surveillance is necessary.

scholarly journals P52 Bilateral sacroiliitis in a patient with H syndrome

Rheumatology ◽  
2019 ◽  
Vol 58 (Supplement_4) ◽  
Author(s):  
Majeed Haider ◽  
Redha Ebrahim1 ◽  
Osama Alalwan
Keyword(s):  
Autosomal Recessive ◽  
Conflicts Of Interest ◽  
Autosomal Recessive Disorder ◽  
Insulin Dependent Diabetes Mellitus ◽  
Skin Lesions ◽  
Lower Limbs ◽  
Dependent Diabetes Mellitus ◽  
Insulin Dependent ◽  
New Feature ◽  
Slc29a3 Gene

Abstract Background Introduction H syndrome is a rare inherited form of histiocytosis. It is an autosomal recessive disorder caused by a mutation in SLC29A3 gene resulting in histiocytic infiltration of numerous organs. It becomes clinically apparent mostly during childhood with characteristic hyperpigmented hypertrichotic indurated skin lesions that mainly involve the lower limbs. Other reported features include Sensorineural hearing loss, heart anomalies, hepatosplenomegaly, lymphadenopathy, insulin dependent diabetes mellitus and flexion contractions of interphalangeal joints. We report sacroiliitis, a possible new feature, in a young girl diagnosed with H syndrome. Methods We report the case of a 16 year-old Syrian girl diagnosed to have H syndrome presented with inflammatory polyarthritis, bilateral sacroiliitis and bilateral anterior uveitis. She was managed with methotrexate and adalimumab with significant improvement. Results The findings in our patient raise the question whether she truly has a rheumatic illness beside H syndrome, or merely represent newly recognized manifestation of H syndrome. Conclusion H syndrome is a recently recognised autosomal recessive condition with characteristic dermatologic and systemic manifestation. Along with arthritis, sacroiliitis and uveitis could represent part of the phenotypic description of this rare entity. Conflicts of Interest The authors declare no conflicts of interest.

scholarly journals Evolution of the burden of active hepatitis C virus infection in England from September 2015 to September 2016: a repeated cross-sectional analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029066
Author(s):  
Laure Lacoin ◽  
Michael Hurst ◽  
Nathan R Hill ◽  
Jason Gordon ◽  
Anna Maria Geretti ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Study Cohort ◽  
Cross Sectional ◽  
High Cure ◽  
Cross Sectional Analysis ◽  
Chronic Hcv ◽  
Cure Rates ◽  
Sectional Analysis ◽  
The Impact

ObjectiveTo evaluate the impact of treatment with new direct-acting antivirals (DAAs) on the prevalent hepatitis C virus (HCV) population in England.DesignA repeated cross-sectional analysis.SettingFour secondary care hospitals in England.ParticipantsPatients who, in 2015 and/or 2016, had chronic HCV infection and were alive were eligible, regardless of the type of HCV intervention received.Outcome measuresData including intravenous drug use (IVDU) status, HCV genotype, cirrhosis status, HCV treatment history, vital status and treatment outcomes were collected at two time points in 2015 and 2016 using electronic case report forms.ResultsThere were 1605 and 1355 patients with active chronic HCV in 2015 and 2016, respectively. Between 2015 and 2016, the proportion of patients with current IVDU increased (10.3% vs 14.5%, respectively), while that of patients with cirrhosis (28.2% vs 22.4%) and treatment-experienced patients (31.2% vs 27.1%) decreased. Among patients whose treatment outcome was known by 2016, high cure rates were observed, with an overall sustained virological response rate of 93.2%. From 2015 to 2016, there was a progressive increase in the proportion of treated patients who were non-cirrhotic, with current IVDU and non-liver transplant recipients.ConclusionsThe characteristics of patients with HCV remaining in contact with specialised care evolved with a changing landscape of treatment and related health policy. With increasing access to DAAs in UK, high cure rates were achieved in the study cohort.

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