Blastogenic response with autologous plasma and Mitsuda's reaction in leprosy patients and their unaffected sibs.

Many investigators have evaluated the influence of genetic constitution on the susceptibility to leprosy in studies linked to different types of research. To determine the possible existence of a family trait linked to the lymphoproliferation and to lepromin reactivity we studied the blastogenic response to phytohaemagglutinin, lepromin and M. leprae and the Mitsuda's reaction in leprosy patients and their unaffected sibs. Sixty-eight individuals were studied, 34 were leprosy patients (17 lepromatous and 17 tuberculoid leprosy) and the remaining were their sibs previously matched by sex and age. The indices of blastogenesis and lepromin reactivity were lower in lepromatous than in tuberculoid patients, that confirmed the immunological polarity of the two types of leprosy. Both the lymphoproliferation and Mitsuda's reaction results suggest different cell immune responses in leprosy patients and their unaffected sibs, so that the hypothesis of a family trait favouring the similarity of responses to these tests among sibs becomes unlikely.

Censo Epidemiológico de lesôes e afeccôes cutâneas em escolares de Ribeirâo Prêto, S. P., Brasil / Epidemiologieal census of cutaneous lesions in schoolchildren of R. Preto, S.P., Brazil

Um total de 5150 escolares de 6 a 16 anos foram examinados em uma cidade subtropical. Excluídas cicatrizes e lesôes traumáticas a prevalência de dermatoses foi de 72%. As mais comun (>2%) foram nevos pigmentados (72%),cicatrizes e lesôes residuais (36%), efélides (19,6%), pediculose (19,6%), dermatite seborréica (19,5%), dermatoviroses (18,6%), acne (15,7%), lesôes traumáticas (9,5%), pitiríase capitis (5%), piodermites (4,3%), dermatite eozematosa (2,6%), estrófulo + picada de inseto (3,1%), ceratose palmar el ou plantar (2,1%) e disidrose (2%). Muitos doentes apresentaron dois ou mais tipos de lesoes ou affeccôes cutâneas. A prevalencia de vibix, estomatite angular, dermatoses actínicas, ictiose, pele xerótica, intertrigo, milia, livedo reticular, hipertricosee escabiose foi menor porén relativamente elevada (de 1,61 a 0,66%). A prevalencia foi discretamente maior em escolares de sexo masculino que no feminino e as diferencas estatisticamente significantes (p<0,001). A diferenca de prevalência entre os grupos etarios nâo foi significante para masculinos e femininos. As meninas aprentaron taxa mais elevada de pediculose, enquanto em meninos prevaleceram pitiríase alba (dartro volante), pitiríase versicolor e piodermites. As condicôes sócioeconômicas parecen ter tido influencia nas taxas de prevalênia de pediculose, pitiríase alba e "tinea pedis", mas nâo nas de dermatoviroses, pitiríase versicolor e piodermite. Os resultados e comentários sâo válidos para uma àrea subtropical semelhante à de Ribeirâo Prêto, com as mesmas características ecológicas, socio-econômicas e de populacâo. Quando se planeja um programa de saúde pública em escolas é importante realizar antes um censo epidemiológico ou estudo piloto, a fim de obter as relevantes informacôes bàsicas.

Alguns aspectos psicológicos, sociais e econômicos relacionados com a lepra / Some psychological, social and economical aspects related to leprosy

O A. considera certos aspectos psicológicos, sociais e econcômicos em relaçäo à história, manifestaçöes clínicas, evoluçäo dos conhecimentos e tratamento da moléstia. Eles resultariam principalmente da estigmatizaçäo do doente e familiares, e de sua rejeiçäo pela comunidade e até pelos próprios parentes. Estigma e atitude da populaçäo associam-se particularmente à ignorância sobre contagiosidade, aspecto e evoluçäo da doença, e atenuaram-se de modo acentuado, a partir do advento das sulfonas (1941) e de outras drogas. A ampliaçäo de conhecimentos e progresso no tratamento determinaram, em pouco menos de meio século, enfoque mais humano do problema e melhora considerável dos métodos de controle, com benefício enorme para doentes e familiares, e pronunciada reduçäo do impacto psicológico, social e econômico da moléstia

Ultrastructure of lymphocytes from patients with paracoccidioidomycosis in the lymphocyte transformation test by phytohemagglutinin.

The morphology and ultrastructure of peripheral blood lymphocytes from patients with paracoccidioidomycosis (PCM) and from unaffected individuals (controls) were studied before and after Ficoll-Hypaque separation and at the end of culture, stimulated with phytohemagglutinin. Patient lymphocytes were cultured in medium with autologous plasma (from the patient himself) and with homologous plasma (from an unaffected donor), while donor lymphocytes were cultured in medium with plasma from a patient or with plasma from the donor himself. The Ficoll-Hypaque mixture caused no morphological or ultrastructural changes in the lymphocytes of patients or of unaffected donors. Patient lymphocytes cultured in medium with autologous plasma showed different degrees of cytoplasmic and nuclear alterations, such as organelle dissolution, vacuoles, amorphous masses, deformed nuclei, and absence of nucleoli. Lymphocytes from control individuals cultured in patient plasma also showed ultrastructural alterations, though they were less marked, and a reduced number of 'blasts'. Patient lymphocytes cultured in medium with homologous plasma (from a control individual) showed a morphology similar to that of lymphocytes from control individuals cultured in medium with their own plasma, although with a lower number of 'blasts'. On the basis of the results obtained using that methodology, we draw the following conclusions: separation by Ficoll-Hypaque does not seem to alter the ultrastructure of patient or donor lymphocytes; patients with diffuse PCM and more markedly impaired general condition can exhibit lymphocytes with morphological and ultrastructural alterations capable of affecting their biological systems and functionality.(ABSTRACT TRUNCATED AT 250 WORDS)

Lymphocyte transformation test in patients with paracoccidioidomycosis.

The lymphocyte transformation test (LTT) by phytohemagglutinin was carried out on lymphocyte cultures from patients with paracoccidioidomycosis, in medium with autologous plasma (from the patient) or homologous plasma (from an unaffected individual), and lymphocyte cultures from unaffected and apparently normal individuals, in medium with autologous plasma (from the individual) or homologous plasma (from a patient with paracoccidioidomycosis). Blastogenesis was evaluated morphologically by 'blast' percentage, and the results analyzed according to clinical form of the disease and general condition of the patient. In the medium containing autologous plasma, percentages below the lower limit of the confidence interval for the distribution of the values for apparently normal individuals were encountered more frequently among patients with diffuse extrapulmonary paracoccidioidomycosis and in poor general condition. When the lymphocytes from patients with the disease were cultured in medium containing homologous plasma, blastogenesis increased in most cases. The lymphocytes of unaffected individuals exhibited a lower response more frequently when cultured in medium containing plasma from patients with the disease than when cultured in medium containing their own plasma. These results suggest that existence of factor(s) inhibiting blastogenesis in the plasma of these patients. In addition to such factor(s), an intrinsic lymphocyte defect may also occur in some patients, which might prevent a greater response to phytohemagglutinin even in homologous plasma. Smears of lymphocytes cultured in autologous plasma and obtained from patients, especially those with diffuse extrapulmonary disease and in regular or poor general condition, and smears from most of the controls whose lymphocytes were cultured in the plasma of these patients revealed deeply stained cells with altered morphology and considerably reduced in number.(ABSTRACT TRUNCATED AT 250 WORDS)

[Comparative analysis of the clinical diagnosis of hanseniasis and the histopathological examinations performed according to the criteria of the Madrid and Ridley-Jopling classifications]. / Análise comparativa entre o diagnóstico clínico da hanseníase e os exames histopatológicos realizados segundo os critérios da classificação de Madrid e a de Ridley-Jopling.

A comparative study of the Ridley-Jopling's (RJ) and of the Congress of Madrid's (CM) pathological criteria was made in the different clinical types and groups of hanseniasis. A concordance between both criteria was found in the Indeterminate group and in the regressive phases of the Virchowian (V), Tuberculoid (T) and Reactional tuberculoid (RT) types. Clinical RT was confirmed by pathology in 81.2% of the cases according to CM, whereas 46.2% were considered "Borderline" according to RJ. Out of the 48 clinically V patients, 17 (35.4%) were "Borderline" (BL-2, BL-1 and BB), but practically all were also pathologically V according to CM. It is concluded that there is no practical convenience in the establishment of histopathological sub-groups that do not perfectly agree with clinical criteria. The Authors stress the importance of the study of the plasmocytes in the V infiltrates, of the lymphocytes in all granulomas and of the differences in the involvement of the neural ends, specially between the T and V poles. The dyeing of lipids by the Sudan III is useful to perfectly characterize the V pole, recognize residual V structures, separate the sub-groups BT, BB and BL, help in the early diagnosis of V infiltrations and differentiate the edematous, diffuse, non-granular cytoplasmatic vacuolization of RT.

Epidemiological survey of skin diseases in schoolchildren living in the Purus Valley (Acre State, Amazonia, Brazil).

A total of 9,955 schoolchildren aged 6-16 years have been examined in a tropical region. The prevalence of dermatosis varied from 21 to 87% in the municipalities surveyed. The most common dermatoses were pediculosis (prevalence 50%), nevi (16.8%), pityriasis versicolor (13.2%), pyoderma (12.2%), pityriasis alba (9.9%), dermatophytosis (6.2%), viral dermatosis (6.2%), scabies (3.0%) and acne vulgaris (2.7%). The prevalence of angular stomatitis, miliaria rubra, candidiasis, piedra nigra, keratosis pilaris, ephelides and geographic tongue is lower but still relatively high. Females had higher rates of pediculosis capitis and males higher prevalence of pityriasis alba. The prevalence of pityriasis versicolor, pigmented nevus and scabies was similar in males and females. Folliculitis, macular pigmented nevi and especially pityriasis versicolor tended to increase with age. Leprosy is hyperendemic in the surveyed area and its rate in the schoolchildren examined was 0.08%. Population movement (urbanization), socioeconomic situation, living conditions, promiscuity, and lack of hygiene may be the cause of such high prevalence and of association of two or more skin conditions. Climatic conditions might have enhanced the prevalence of certain dermatoses (pityriasis versicolor, dermatophytosis, piedra nigra, candidiasis, miliaria rubra).

[Ultrastructural aspects of the epidermis from a sun exposed and from a covered area in two cases of xeroderma pigmentosum (x. p.) and in two controls (author's transl)]. / Etude ultrastructurale de l'épiderme des parties découvertes et couvertes de deux malades noirs atteints de xeroderma pigmentosum (x. p.) et de deux sujets témoins.

Xeroderma pigmentosum is rare among Caucasoids and seems to be rarer among Negroes. Advantage was taken of the observation of two cases in the latters to study the ultrastructure of the epidermis and to verify whether the findings were similar to those observed in the formers. The skin exposed to sunlight (forearm) and that from an covered area (buttock) were studied in the two cases and also in two controls, obviously from the same race. The tissue material was coded after each biopsy and identified only when the ultrastructural study was completed. The authors have noted vacuolization and rarely necrosis of melanocytes, great increase and polymorphism of melanosomes, abnormal melanization sometimes large masses of melanosomes and pre-melanosomes, some other aspects already described in x.p. They have also observed melanosomes disposed as cluster or grapes, and large and strange shaped keratohyaline granules in the squamous cell layer. Even in the unexposed skin there were polymorphism and increased amount of melanosomes. The macroscopic and ultrastructural changes of x. p. in the two Negroes were apparently similar to those observed in Caucasoids.