American cutaneous leishmaniasis: In situ immune response of patients with recent and late lesions

TNF-α, IFN-γ, IL-10, IL-17, CD68 and CD57 were evaluated in biopsies of patients with American cutaneous leishmaniasis living in Sorocaba, Brazil. The analyses were performed considering the time of lesions from 23 patients with recent lesions (Group I) and 19 patients with late lesions (Group II). All patients were infected with Leishmania (Viannia) braziliensis. Immunostaining cells for CD68, CD57, TNF- α, IFN-γ, IL-10 and IL-17 were performed by immunohistochemistry. Except for CD68 and IL-17, the distribution of in situ for CD57, IL-10, TNF-α and IFN-γ showed that patients with recent lesions expressed higher levels than those with late lesions. The comparison of cytokine expression/group showed that IL-10 was significantly higher than IL-17 and IFN-γ (similar data were shown in IL-17 compared with TNF-α), suggesting an immunological balance between inflammatory-anti-inflammatory agents. This balance was similar for two groups of patients. In conclusion, these data suggested that (i) patients from Group I had recent lesions (in the beginning of chronic phase) compared to those from Group II and (ii) the modulation of inflammatory response in patients with recent American cutaneous leishmaniasis was correlated with IL-10 expression in skin lesions preventing the development of mucosal forms. The parasite treatment also prevented the evolution of severe forms

American cutaneous leishmaniasis: In situ immune response of patients with recent and late lesions.

TNF-α, IFN-γ, IL-10, IL-17, CD68 and CD57 were evaluated in biopsies of patients with American cutaneous leishmaniasis living in Sorocaba, Brazil. The analyses were performed considering the time of lesions from 23 patients with recent lesions (Group I) and 19 patients with late lesions (Group II). All patients were infected with Leishmania (Viannia) braziliensis. Immunostaining cells for CD68, CD57, TNF- α, IFN-γ, IL-10 and IL-17 were performed by immunohistochemistry. Except for CD68 and IL-17, the distribution of in situ for CD57, IL-10, TNF-α and IFN-γ showed that patients with recent lesions expressed higher levels than those with late lesions. The comparison of cytokine expression/group showed that IL-10 was significantly higher than IL-17 and IFN-γ (similar data were shown in IL-17 compared with TNF-α), suggesting an immunological balance between inflammatory-anti-inflammatory agents. This balance was similar for two groups of patients. In conclusion, these data suggested that (i) patients from Group I had recent lesions (in the beginning of chronic phase) compared to those from Group II and (ii) the modulation of inflammatory response in patients with recent American cutaneous leishmaniasis was correlated with IL-10 expression in skin lesions preventing the development of mucosal forms. The parasite treatment also prevented the evolution of severe forms.

American cutaneous leishmaniasis: In situ immune response of patients with recent and late lesions

TNF­α, IFN­Î³, IL­10, IL­17, CD68 and CD57 were evaluated in biopsies of patients with American cutaneous leishmaniasis living in Sorocaba, Brazil. The analyses were performed considering the time of lesions from 23 patients with recent lesions (Group I) and 19 patients with late lesions (Group II). All patients were infected with Leishmania (Viannia) braziliensis. Immunostaining cells for CD68, CD57, TNF­ α, IFN­Î³, IL­10 and IL­17 were performed by immunohistochemistry. Except for CD68 and IL­17, the distribution of in situ for CD57, IL­10, TNF­α and IFN­Î³ showed that patients with recent lesions expressed higher levels than those with late lesions. The comparison of cytokine expression/group showed that IL­10 was significantly higher than IL­17 and IFN­Î³ (similar data were shown in IL­17 compared with TNF­α), suggesting an immunological balance between inflammatory­anti­inflammatory agents. This balance was similar for two groups of patients. In conclusion, these data suggested that (i) patients from Group I had recent lesions (in the beginning of chronic phase) compared to those from Group II and (ii) the modulation of inflammatory response in patients with recent American cutaneous leishmaniasis was correlated with IL­10 expression in skin lesions preventing the development of mucosal forms. The parasite treatment also prevented the evolution of severe forms.

TNF-α, IFN-γ, IL-10, IL-17, CD68 e CD57 foram avaliados em biópsias de pacientes com leishmaniose tegumentar americana residentes em Sorocaba, Brasil. As análises foram realizadas considerando o tempo de lesão de 23 pacientes com lesões recentes (Grupo I) e 19 pacientes com lesões tardias (Grupo II). Todos os pacientes foram infectados com Leishmania (Viannia) braziliensis. As células de imunocoloração para CD68, CD57, TNF-α, IFN-γ, IL-10 e IL-17 foram realizadas por imuno-histoquímica. Exceto para CD68 e IL-17, a distribuição in situ de CD57, IL-10, TNF-α e IFN-γ mostrou que pacientes com lesões recentes expressavam níveis mais altos do que aqueles com lesões tardias. A comparação da expressão / grupo de citocinas mostrou que a IL-10 foi significativamente maior que a IL-17 e IFN-γ (dados semelhantes foram mostrados na IL-17 em comparação com o TNF-α), sugerindo um equilíbrio imunológico entre agentes inflamatórios e anti-inflamatórios . Esse equilíbrio foi semelhante para dois grupos de pacientes. Em conclusão, esses dados sugeriram que (i) pacientes do grupo I apresentavam lesões recentes (no início da fase crônica) em comparação com os do grupo II e (ii) a modulação da resposta inflamatória em pacientes com leishmaniose tegumentar americana recente estava correlacionada com Expressão da IL - 10 em lesões cutâneas impedindo o desenvolvimento de formas mucosas. O tratamento do parasita também impediu a evolução de formas graves.

[Papular plaque-type blue nevus]. / Naevus bleu papuleux en plaque.

INTRODUCTION: Rare clinical presentations of common diseases are sometimes worth of publication. Their knowledge may help to avoid diagnostic mistakes. OBSERVATION: In a 6 year-old boy a cluster of pigmented blue papules spread slowly on the inner aspect of his left foot. The extension over years and the linear arrangement of the plantar papules suggested the possibility of a malignant melanoma. However the histological examination of 2 biopsies showed the structure of a common blue nevus. DISCUSSION: About a dozen cases of such papular plaque-type blue nevi have been described. Histologically they disclose the same cellular types than common blue nevi. In all the reported cases the course was benign; in our case the decision of abstention was sustained by this information.

Polycystic hydatid disease (Echinococcus vogeli). Clinical, laboratory and morphological findings in nine Brazilian patients.

Polycystic hydatid disease occurs in neotropical zones and is caused by Echinococcus vogeli. The paca, a wild rodent, is the intermediate host and the final host is the dog. Seven cases of polycystic hydatid disease autochthonous to the Brazilian Amazon region are described. The disease was polycystic in all cases and diagnosis was based on anatomopathological findings. E. vogeli was identified by the shape and dimensions of the rostellar hooks. The liver was the organ most often involved (6/7), followed by the lungs (2/7) and mesentery (2/7), spleen (1/7) and pancreas (1/7). The main clinical manifestations were abdominal pain, hepatomegaly, jaundice, weight loss, anemia, fever, hemoptysis, palpable abdominal masses and signs of portal hypertension. Hepatic calcifications were detected in four cases. Two cases from the hinterland of the State of São Paulo are also reported. Both had calcified round structures in the liver, highly suggestive of calcified polycystic hydatids. The aim of the present report was to report on this relatively unknown hydatid disorder of Tropical America and to disseminate its clinical, ultrasound and radiological features.

Polycystic hydatid disease (Echinococcus vogeli): clinical and radiological manifestations and treatment with albendazole of a patient from the Brazilian Amazon region.

We present a case of polycystic hydatid disease produced by Echinococcus vogeli in a tapper of rubber trees from the State of Acre, Brazil. The most relevant clinical data were pain, increased abdominal volume caused by palpable painful masses, fever and poor clinical condition. Laboratory tests showed anemia, eosinophilia, hypoalbuminemia, hypergammaglobulinemia and increased plasma levels of alkaline phosphatase. Computerized tomography revealed diffuse cysts throughout the peritoneal cavity up to the pelvis, and inside the liver, pancreas and spleen. Anatomopathological examinations of cysts obtained by laparotomy confirmed the etiological diagnosis. Treatment with 10 mg/kg Albendazole for 6 months caused complete regression of the disease.