RESUMO
Leprosy in a preschool child appearing at the age of four years is reported due to its rarity, particularly at a time when we are hoping for its elimination. A 5-year-old female child presented with an erythematous rash over-her right buttock for last one year. Histopathological examination from the patch revealed it to be a case of indeterminate leprosy. The child responded favourably with antileprosy treatment.
Assuntos
Hanseníase Dimorfa/tratamento farmacológico , Hanseníase Dimorfa/patologia , Hanseníase Tuberculoide/tratamento farmacológico , Hanseníase Tuberculoide/patologia , Pré-Escolar , Clofazimina/administração & dosagem , Dapsona/administração & dosagem , Esquema de Medicação , Quimioterapia Combinada , Feminino , Humanos , Hansenostáticos/administração & dosagem , Hanseníase Dimorfa/diagnóstico , Hanseníase Tuberculoide/diagnóstico , Rifampina/administração & dosagem , Resultado do TratamentoRESUMO
A rare case of fixed drug eruption due to metronidazole is reported.
RESUMO
For a definitive diagnosis of cutaneous tuberculosis the demonstration of mycobacteria is essential, but this is generally not possible in skin lesions. Routinely available techniques have poor sensitivity and are time consuming, therefore, delaying the institution of timely therapy. The high sensitivity and speed of polymerase chain reaction (PCR) for the detection of infectious agents has prompted investigators to use this technique for the detection of Mycobacterium tuberculosis in body fluids such as cerebrospinal fluid or pleural fluid. In the present study, PCR was used to examine punch biopsy specimens from the affected skin of 10 patients with clinical diagnoses of tuberculosis verrucosa cutis, lupus vulgaris, scrofuloderma, papulonecrotic tuberculide and erythema induratum. A control group of 20 patients included individuals having skin manifestations with definite clinical diagnoses other than cutaneous tuberculosis, such as leprosy, fungal mycetoma, chronic bullous disease of childhood and pemphigus vulgaris. The PCR amplified products were dot hybridized with a probe which was random prime labelled with 32P. The results were compared with routine microbiological and histological findings. Among the test group, six of 10 (60%) were positive for M. tuberculosis by PCR, although their histopathology showed non-specific chronic inflammation with no definite diagnosis. Microbiological investigations, including acid-fast bacillus smear and culture, were positive in a single case of scrofuloderma. All patients in the control group were negative by PCR for M. tuberculosis. The data indicate that the combination of dot hybridization with PCR markedly increased the sensitivity and specificity of PCR. This may be a useful tool in the diagnosis of tuberculosis when conventional methods fail.
Assuntos
Reação em Cadeia da Polimerase/métodos , Tuberculose Cutânea/patologia , Humanos , Immunoblotting/métodosAssuntos
Carcinoma de Células Escamosas/etiologia , Doenças do Pé/etiologia , Hanseníase/complicações , Neoplasias Cutâneas/etiologia , Úlcera Cutânea/complicações , Idoso , Carcinoma de Células Escamosas/patologia , Doenças do Pé/patologia , Humanos , Hanseníase/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Úlcera Cutânea/patologiaRESUMO
Out of 514 leprosy cases studied, 229(44.56%) had disability. Disability was most commonly seen in lepromatous leprosy. There was an increasing trend in disability with increasing age of patient and duration of disease. Disability rate was higher in males as compared to females. Nerve thickening and reactional states were more common in disabled cases. Dapsone treated group showed a disability rate of 63.8% as compared to 30.0% in untreated group. Hand was the most commonly affected site and mobile claw hand was the single most common disability. The overall disability index-D.I. (2) of Bachelli was 1.25 and lepromatous cases had highest D.I. (1.89). Disability index was higher in males and was found to increase with increasing age of patient and duration of disease.
Assuntos
Pessoas com Deficiência , Hanseníase/fisiopatologia , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Dapsona/efeitos adversos , Feminino , Humanos , Índia , Hanseníase Dimorfa/fisiopatologia , Hanseníase Virchowiana/fisiopatologia , Hanseníase Tuberculoide/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Fatores de TempoRESUMO
Out of 500 leprosy patients screened for palmar and/or plantar lesions, eighteen cases were detected. They were classified according to Ridley-Jopling classification. In majority of cases it was macular lesion. Cases were from TT, BT and BB group. In 50% cases, palmo-plantar involvement was associated with type I reaction. In 66.7% cases, it was extension of patch from surrounding area, 11.1% cases isolated lesions were seen and in 22.2% cases both extension as well as isolated lesions were present.
Assuntos
Pé/patologia , Mãos/patologia , Hanseníase/patologia , Adolescente , Adulto , Biópsia , Criança , Feminino , Humanos , Hanseníase/classificação , Masculino , Pessoa de Meia-IdadeRESUMO
The cutaneous lesions of leprosy on male genitalia were studied. They were found in 2.9% of cases examined in this series. They were seen most commonly in borderline group. It is emphasised that it is not uncommon to find lesions on male genitalia in leprosy.
Assuntos
Genitália Masculina/patologia , Hanseníase/patologia , Adolescente , Adulto , Idoso , Biópsia , Humanos , Hanseníase/classificação , Hanseníase/diagnóstico , Masculino , Pessoa de Meia-IdadeRESUMO
A case of Tuberculoid leprosy who had taken irregular treatment for five years and had thickened ulnar nerve which on radiological examination showed calcification, is reported.
Assuntos
Calcinose/patologia , Hanseníase Tuberculoide/patologia , Nervo Ulnar/patologia , Adolescente , Calcinose/diagnóstico por imagem , Humanos , Hansenostáticos/uso terapêutico , Hanseníase Tuberculoide/tratamento farmacológico , Masculino , Doenças do Sistema Nervoso Periférico/diagnóstico por imagem , Doenças do Sistema Nervoso Periférico/patologia , Radiografia , Nervo Ulnar/diagnóstico por imagemRESUMO
Six cases of histoid variety of lepromatous leprosy among children below 12 years of age were detected in over 3 years period. Bacteriological index was high (3 to 5+). None of the patients had received any anti-leprosy treatment. It is a public health problem because of infectious nature of the disease, therefore early detection and management of this entity among children is important.
Assuntos
Histiócitos/patologia , Hanseníase Virchowiana/patologia , Criança , Feminino , Humanos , MasculinoRESUMO
Sera from 3500 individuals including patients of non-Hodgkin's lymphoma, patients with sexually transmitted diseases, leprosy, jail inmates, healthy laboratory workers and patients on hemodialysis were screened for antibodies against human immunodeficiency virus (HIV) as a sero surveillance exercise of one of the centers set up by the India Council of Medical Research at the Postgraduate Institute of Medical Education & Research, Candigarh. Three individuals were found to be strongly positive by ELISA using the Wellcozyme kit, with no background noise in the population studies. These three patients were also evaluated by the Western blot technique and showed strong antibody reaction to all the major gene products. It was also possible to ascertain the approximate incubation period of infection in a case who rapidly developed full blown AIDS and died of wasting syndrome. Comprehensive data of 14 cases was also collected from all the centers in India and in every case one could trace the contact outside India. None of the 3 cases studied at our center had Kaposi's sarcoma. These observations could be important landmarks in the epidemiology of AIDS in India.
Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/diagnóstico , Adulto , Feminino , Anticorpos Anti-HIV/análise , Humanos , Índia , MasculinoRESUMO
A 55-year-old male Nepali patient developed rhinaphyma. he had rosacea aAd history of intake of alcohol for a long duration.The cosmetic defect was removed by surgical repair.
RESUMO
One case having trophic ulcer over the heel which on histological examination showed malignant melanoma is reported because of malignant melanoma occurring over the trophic ulcer.
Assuntos
Doenças do Pé/etiologia , Hanseníase/complicações , Melanoma/etiologia , Úlcera Cutânea/complicações , Idoso , Traumatismos do Pé , Humanos , MasculinoRESUMO
Pure neural leprosy developing in a 3 1/2 years old female child is reported.
Assuntos
Hanseníase , Doenças do Sistema Nervoso Periférico , Pré-Escolar , Feminino , HumanosRESUMO
Two cases having trophic ulcer over the heel, for long time, later developed squamous cell carcinoma are reported, because of its paucity in literature. Various factors blamed for carcinomatous change are enumerated.