RESUMO
BACKGROUND: Nail changes in leprotic patients are not specific to leprosy, and may be observed in other peripheral neuropathies. Diabetes is one of the diseases that present with nail dystrophy secondary to peripheral neuropathy, vasculopathy, trauma and infections. Therefore, nail changes in diabetic neuropathy are expected to be very similar to that of leprosy. OBJECTIVES: To evaluate the frequency and pattern of nail changes in Egyptian leprotic patients with the different spectrums of the disease, and to compare nail changes in leprosy with those seen in patients with diabetic neuropathy. METHODS: The study included 115 leprosy patients and 60 patients with diabetic peripheral neuropathy. Nail examination was thoroughly carried out and various nail changes were recorded including the location of the involved nails (fingers, toes). RESULTS: Our study detected similar incidence of nail changes in both multibacillary (MB) (86%) and paucibacillary (PB) patients (86%). Flag sign (alternating horizontal bands of whitish and pinkish discoloration of the nail) observed in our study was not reported before. It was more commonly seen in MB patients (21%) than in PB patients (14%). Our results also revealed that the nail changes were more commonly seen in leprosy patients (86%) than in diabetic patients (68%). CONCLUSION: Nail changes in leprosy are multifactorial, and could be related to one or more of the following: neuropathy, endarteritis, trauma, drugs or superimposed infections. Nail changes in leprosy may be used as an additional clue that helps in the diagnosis.
Assuntos
Neuropatias Diabéticas/patologia , Hanseníase/patologia , Unhas/patologia , Adolescente , Adulto , Idoso , Egito , Feminino , Humanos , Hanseníase/diagnóstico , Masculino , Pessoa de Meia-Idade , Doenças da Unha/diagnóstico , Doenças da Unha/patologia , Adulto JovemRESUMO
A case of chronic mucocutaneous candidiasis in a Malaysian child who subsequently developed disseminated tuberculosis and toxoplasmosis is described. The phenotype of her peripheral blood mononuclear cells showed discordance for her T cell markers. The presence of a subpopulation of CD2-/CD3+ mononuclear cells leading to an immunodeficiency state is consistent with failure of activation of CD2-mediated alternative pathway resulting in immunodeficiency. Such abnormal CD2-/CD3+ subpopulations have been described in lepromatous leprosy and foetal abortuses.
Assuntos
Antígenos de Diferenciação de Linfócitos T , Complexo CD3/análise , Candidíase Mucocutânea Crônica/complicações , Candidíase Bucal/complicações , Síndromes de Imunodeficiência/complicações , Infecções Oportunistas/complicações , Receptores Imunológicos , Subpopulações de Linfócitos T/imunologia , Antígenos de Diferenciação de Linfócitos T/genética , Antígenos CD2 , Candidíase Mucocutânea Crônica/imunologia , Candidíase Bucal/imunologia , Suscetibilidade a Doenças/imunologia , Feminino , Predisposição Genética para Doença , Humanos , Hospedeiro Imunocomprometido , Síndromes de Imunodeficiência/genética , Síndromes de Imunodeficiência/imunologia , Lactente , Ativação Linfocitária , Infecções Oportunistas/imunologia , Receptores Imunológicos/genética , Toxoplasmose/complicações , Toxoplasmose/imunologia , Tuberculose/complicações , Tuberculose/imunologiaRESUMO
A T-cell line of mixed phenotype (60% L3T4+, 40% Lyt-2+) was isolated from mice infected with Mycobacterium bovis (BCG). This line responded to M. lepraemurium and BCG but not to M. leprae and produced TCGF spontaneously. It also produced factors which stimulated macrophages to secrete hydrogen peroxide and superoxide anion. In vivo studies showed that only L3T4+ cells were required to transfer DTH responses and that Lyt-2+ cells suppressed this response. Both L3T4+ and Lyt-2+ cells were required to inhibit M. lepraemurium multiplication in vivo.