Asunto(s)
Histiocitosis de Células de Langerhans/patología , Perineo/patología , Enfermedades de la Vulva/patología , Fármacos Dermatológicos/uso terapéutico , Femenino , Glucocorticoides/uso terapéutico , Histiocitosis de Células de Langerhans/tratamiento farmacológico , Humanos , Metotrexato/uso terapéutico , Persona de Mediana Edad , Prednisolona/uso terapéutico , Enfermedades de la Vulva/tratamiento farmacológicoAsunto(s)
Acantólisis/diagnóstico , Perineo , Enfermedades de la Vulva/diagnóstico , Femenino , Humanos , Adulto JovenAsunto(s)
Seropositividad para VIH/diagnóstico , VIH-1 , Perineo/patología , Linfoma Plasmablástico/diagnóstico , Úlcera Cutánea/diagnóstico , Adulto , Seropositividad para VIH/complicaciones , VIH-1/inmunología , Humanos , Masculino , Linfoma Plasmablástico/complicaciones , Úlcera Cutánea/complicacionesRESUMEN
A pesar de la constante afectación de la piel en la lepra, existen zonas cutáneas que excepcionalmente o nunca son afectadas. Es raro observarla en genitales, periné, axilas, región inguinal y uñas y es más frecuente en cuero cabelludo, palmas y plantas, casi siempre en enfermos multibacilares (AU)
Asunto(s)
Humanos , Lepra/inmunología , Piel/inmunología , Genitales/inmunología , Cuero Cabelludo/inmunología , Mano , Pie , Axila , Perineo , Uñas/inmunologíaRESUMEN
UNLABELLED: The efficacy of clofazimine (Lamprene) was analysed retrospectively in twenty one patients with anoperineal lesions (APL) of Crohn's disease. Clofazimine is known for its antimycobacterial, antiinflammatory and immunomodifier properties. It is used with success in leprosy and certain dermatological disorders. A number of clinical and laboratory arguments suggest the probability of a role of mycobacteria in the etiology of Crohn's disease. METHODS: twenty one patients with ileo-colono-anal or bucco-colono-anal Crohn's disease formed the basis of this study. They had been treated in various ways for APL, without success. They had APL of varying degrees of advancement (primary lesions: seven cases; secondary lesions: ten cases; major advanced lesions: four cases). Treatment with Lamprene was given for three to 38 months (mean: 12 months), the mean cumulative dose being 40 grams (4 to 146). Other therapeutic measures were started simultaneously in twelve patients: medical in six cases, medico-surgical in four cases and surgical only in two cases. The aim of treatment in fourteen cases was to obtain the healing of ulcerated lesions and/or fistulas, in three patients to delay dilatation sessions and in four patients to avoid proctectomy in the short-term. RESULTS: ten patients showed no improvement while eleven were improved (with regression of primary lesions in ten cases). Taking combined treatment into consideration, the link between the result obtained and Lamprene was considered probable in five cases, possible in four cases and uncertain in one case. Lamprene was well tolerated in general. It was not possible to evaluate the efficacy of treatment regarding intestinal disease. CONCLUSION: the efficacy of Lamprene in ano-perineal lesions of Crohn's disease is possible and is worthy of evaluation in a controlled trial.