RESUMO
American cutaneous leishmaniasis is an endemic anthropozoonosis that exhibits a broad spectrum of clinical presentations. Intermediate/borderline disseminated cutaneous leishmaniasis is a distinct clinical condition that comprises cutaneous disease of a chronic nature, usually occurring as multiple lesions with or without mucosal involvement. The disease is usually caused by parasites of the subgenus Viannia, frequently occurs in context of an underlying disease, and is often resistant to standard antileishmanial therapy. We report a case that was refractory to standard therapy and other second-line drugs, but resolved after treatment with fluconazole, and review the use of fluconazole as a second-line drug in children.
Assuntos
Antifúngicos/uso terapêutico , Fluconazol/uso terapêutico , Leishmania braziliensis , Leishmaniose Cutânea/tratamento farmacológico , Criança , Feminino , Humanos , Leishmaniose Cutânea/parasitologia , Resultado do TratamentoRESUMO
American cutaneous leishmaniasis is an important endemic zoonotic disease in the New World that comprises a spectrum of clinical manifestations. Diffuse cutaneous leishmaniasis (DCL) is a rare form of the disease characterized by antigen-specific immunodeficiency that often presents with multiple disfiguring non-ulcerated confluent nodules or plaques that involve large areas of the skin, resembling lepromatous leprosy. Relapse is invariable in advanced stages, despite aggressive chemotherapy, and a plethora of drugs has been tested with unchanging results. We report on a severe an exceptional case that resolved after treatment with amphotericin B, a drug considered only mildly effective, and discuss the therapeutic approach to this disease.
Assuntos
Anfotericina B/uso terapêutico , Antiprotozoários/uso terapêutico , Leishmaniose Tegumentar Difusa/tratamento farmacológico , Adolescente , Dermatoses Faciais/tratamento farmacológico , Dermatoses Faciais/patologia , Humanos , Leishmaniose Tegumentar Difusa/patologia , MasculinoRESUMO
Chromoblastomycosis is a chronic infection caused by dematiaceous (dark-colored) fungi which affect the skin and subcutaneous tissues, and is characterized by a wide variety of clinical and dermatological features including papillomatous, verrucous and vegetating lesions. Although it has been described world-wide, most cases originate in tropical and sub-tropical areas. In general, present treatments of the disease are unsatisfactory as one of the most common etiologic agents, Fonsecaea pedrosoi is difficult to manage from a therapeutic point of view. We report a case of extensive chromoblastomycosis of 22 years duration caused by F. pedrosoi and review the clinical course, diagnosis and management of this disease.
Assuntos
Antifúngicos/uso terapêutico , Ascomicetos/patogenicidade , Cromoblastomicose/etiologia , Adulto , Anfotericina B/efeitos adversos , Anfotericina B/uso terapêutico , Antifúngicos/efeitos adversos , Ascomicetos/isolamento & purificação , Cromoblastomicose/tratamento farmacológico , Cromoblastomicose/patologia , Quimioterapia Combinada , Humanos , Itraconazol/efeitos adversos , Itraconazol/uso terapêutico , Masculino , Fungos MitospóricosRESUMO
El pioderma granulomatoso superficial es una variante del pioderma gangrenoso, caracterizada por la aparición de úlceras superficiales y vegetantes, con hallazgos granulomatosos en su histologías. Se asocia infrecuentemente a enfermedad sistémica. Se presenta un caso de aparición durante la gestación, con múltiples úlceras localizadas en miembros inferiores, que progresan rápidamente, sin alguna enfermedad subyacente. Se trata con prednisona 50 mg/día y posterior a la culminación del embarazo se asoció talidomina, clofazimina, daptona y terapia tópica oclusiva con bota de Unna y apósitos húmedos hidrocoloides, con cicatrización de las lesiones y sin recurrencias