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1.
QJM ; 112(6): 429-435, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-30778548

RESUMO

BACKGROUND: Histoid leprosy is a subtype of leprosy with distinct clinical presentation and histologic features. It accounts for <4% of leprosy cases. The exact location of histoid leprosy along the immune spectrum and its relation to other subtypes is unclear. AIM: To evaluate the local immune phenomenon which define histoid leprosy. DESIGN: Parallel skin biopsies from histoid lesions and from unremarkable skin in patients with histoid leprosy were evaluated and the histologic findings compared. METHODS: Formalin fixed, paraffin embedded tissue sections from lesional and non-lesional biopsies were assessed for changes in epidermis and dermis; type and extent of infiltrate, presence or absence of pseudocapsule and associated reactions. Bacillary index was evaluated using Wade Fite stain for lepra bacilli. RESULTS: Amongst 208 leprosy cases, six cases of histoid leprosy were identified (2.88%). The cases showed presence of nodules, patches and plaques overlying clinically unremarkable skin. Fourteen skin biopsies were evaluated of which the lesional biopsies showed equal proportion of fusocellular, fusocellular epithelioid and fusocellular-vacuolated histology. A greater circumscription was noted in lesional biopsies; however the cellular content of the infiltrate was similar in lesional and non-lesional biopsies. A case of erythema nodosum leprosum in histoid leprosy was also seen. CONCLUSIONS: Ours is the first study comparing normal and lesional skin in histoid leprosy. Though the histoid lesions appear to have a derivation from lepromatous leprosy, the local histologic and clinical alterations may be a result of heightened local immunity or reactive local modifying factors.


Assuntos
Eritema Nodoso/diagnóstico , Eritema Nodoso/patologia , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/patologia , Adulto , Idoso , Feminino , Humanos , Imuno-Histoquímica , Índia , Masculino , Pessoa de Meia-Idade , Pele/patologia
3.
Indian J Dermatol Venereol Leprol ; 83(6): 677-682, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29035287

RESUMO

BACKGROUND: Systemic sclerosis is a multisystem disorder characterized by microangiopathy, dysregulation of the immune system and massive deposition of collagen in the connective tissue of the skin, blood vessels and various internal organs. Although the mortality from renal crises has dropped significantly due to the use of angiotensin-converting enzyme inhibitors, cardiac and pulmonary involvement accounts for significant morbidity and mortality. We studied 28 patients with systemic sclerosis at Gandhi Medical College and Hospital, Hyderabad, over a period of two years for cardiopulmonary involvement. AIM: The aim of this study was to analyze the cardiopulmonary involvement in systemic sclerosis. METHODS: All patients with systemic sclerosis attending the dermatology outpatient department were included in the study. The diagnosis of systemic sclerosis was made based on the American Rheumatology Association criteria, and was further confirmed by skin biopsy and serological investigations. X-ray chest, electrocardiogram, two-dimensional ECHO, high-resolution computed tomography chest, pulmonary function tests and bronchoalveolar lavage were done to evaluate cardiopulmonary involvement. OBSERVATIONS: Out of 28 patients, 17 had diffuse systemic sclerosis and 11 had limited systemic sclerosis. Mean duration of symptoms was 2.9 years. Abnormalities in chest X-ray were found in 16 patients. Pulmonary function tests showed a restrictive pattern in 23 patients. High-resolution computed tomography of the chest showed evidence of interstitial lung disease in 21 patients, while five patients each had pleural effusion and cardiomegaly. Bronchoalveolar lavage showed different cellular patterns such as neutrophilia, eosinophilia and lymphocytosis. Pulmonary arterial hypertension was observed in seven patients and isolated pulmonary arterial hypertension in two patients. Electrocardiogram abnormalities were found in twenty patients. Two-dimensional ECHO was abnormal in 17 patients with valvular abnormalities being the most common finding. Overall, pulmonary involvement was observed in 27 patients and cardiac involvement in 17 patients. LIMITATIONS: A small sample size was a limitation of this study. Diffusing capacity of lung for carbon monoxide, and right cardiac catheterization were not done, as these were not available at our centre. CONCLUSIONS: In our patients, pulmonary involvement was more common than cardiac involvement. Interstitial lung disease and cardiac involvement were more commonly seen in diffuse systemic sclerosis whereas pulmonary hypertension was more frequent in limited systemic sclerosis. Hence, it is important to screen the patients for cardiopulmonary involvement for early diagnosis and treatment and a better prognostic outcome.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Escleroderma Sistêmico/diagnóstico por imagem , Centros de Atenção Terciária/tendências , Adolescente , Adulto , Doenças Cardiovasculares/epidemiologia , Criança , Feminino , Humanos , Pneumopatias/epidemiologia , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Doenças Pulmonares Intersticiais/epidemiologia , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória/tendências , Escleroderma Sistêmico/epidemiologia , Adulto Jovem
4.
Soft Matter ; 10(31): 5682-94, 2014 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-24983665

RESUMO

The detailed aggregation behavior of sodiumdodecyl sulfate (SDS) in tetrahydrofuran (Tf)-water (W) and formamide (Fa)-water (W) media at varied volume percent compositions has been investigated. Surface tension (ST), conductance (Cond), viscosity (Visc), isothermal titration calorimetry (ITC), nuclear magnetic resonance (NMR) and small angle neutron scattering (SANS) were used in this study. The presence of nonaqueous solvents affected the critical micelle concentration (CMC) of SDS, the counter-ion binding of the micelle, the energetics of the air/water interfacial adsorption and micellization of the amphiphiles in the bulk, the ion-association (ion-pair, triple-ion, quadruple, etc. between Na(+) and DS(-) ions) as well as the weakly soluble (aggregation less) amphiphile solution. Tf has been observed to produce a "dead zone" or "non-micelle formation zone" in the mixed Tf-W domain of 10-40 vol%. Fa influenced the SDS aggregation up to 70 vol%, at higher proportions (below the Krafft temperature (K(T))), instead of the micelle, "randomly arranged globular assembly" (RAGA) was formed. The correlation of the standard free energy of micellization (ΔG(m)(0)) with different solvent parameters (1) dielectric constant (ε), (2) viscosity (η0), (3) Reichardt parameter (E(T)(30)), (4) Gordon parameter (G), and (5) Hansen-Hildebrand hydrogen bonding parameter (δ(h)) has been attempted. It has been found that δ(h) produced a master correlation between ΔG(m)(0) and δ(h) for different binary mixtures such as Tf-W, Fa-W, Ml-W and Dn-W.

5.
Int J Syst Evol Microbiol ; 64(Pt 3): 957-962, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24425825

RESUMO

Two strains (JA746(T) and JA756(T)) having yellowish brown-to-green pigment were isolated from a solar saltern and a pink pond, respectively. While both strains were non-motile and shared the presence of bacteriochlorophyll-a, major cellular fatty acids (C18 : 1ω7c, C16 : 0, C18 : 0), quinone (Q-10), polar lipids and hopanoids, they differed from each other in their carotenoid composition. The G+C content of genomic DNA of strains JA746(T) and 756(T) was 62.4 and 63.3 mol%, respectively. The 16S rRNA gene-based EzTaxon-e blast search analysis of strains JA746(T) and 756(T) indicated highest sequence similarity with members of the genus Rhodovulum in the family Rhodobacteraceae of the class Alphaproteobacteria. Strain JA746(T) has high sequence similarities with Rhodovulum visakhapatnamense JA181(T) (97.3 %), Rhodovulum steppense A-20s(T) (97.3 %), Rhodovulum phaeolacus JA580(T) (97 %), Rhodovulum strictum MB-G2(T) (97 %) and other members of the genus Rhodovulum (<97 %). Strain JA756(T) has high sequence similarities with Rhodovulum visakhapatnamense JA181(T) (99.8 %), Rhodovulum sulfidophilum Hansen W4(T) (99.1 %), Rhodovulum kholense JA297(T) (97.9 %) and other members of the genus Rhodovulum (<97 %). The sequence similarity between strains JA746(T) and JA756(T) was 97.5 %. However, these strains are not closely related to each other or to their phylogenetic neighbours since the DNA-DNA reassociation values were less than 56 %. The genomic information was also supported by phenotypic and chemotaxonomic results, leading us to classify strains JA746(T) ( = NBRC 108898(T) = KCTC 15180(T)) and JA756(T) ( = NBRC 109122(T) = KCTC 15223(T)) as the type strains of two novel species of the genus Rhodovulum, for which the names Rhodovulum salis sp. nov. and Rhodovulum viride sp. nov. are proposed, respectively.


Assuntos
Filogenia , Lagoas/microbiologia , Rhodovulum/classificação , Microbiologia da Água , Bacterioclorofila A/química , Composição de Bases , DNA Bacteriano/genética , Ácidos Graxos/química , Índia , Dados de Sequência Molecular , Hibridização de Ácido Nucleico , Fosfolipídeos/química , Pigmentação , RNA Ribossômico 16S/genética , Rhodovulum/genética , Rhodovulum/isolamento & purificação , Água do Mar , Análise de Sequência de DNA , Cloreto de Sódio , Ubiquinona/química
6.
Indian J Dermatol Venereol Leprol ; 77(4): 498-502, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21727699

RESUMO

Generalized eruptive histiocytosis (GEH) is a rare cutaneous histiocytosis that mainly affects adults and presents with multiple symmetric papules on face, trunk, and proximal extremities. GEH is included in type IIa (histiocytes involving cells of dermal dendrocyte lineage) of histiocytic disorders. Clinical and pathological correlations are required for differentiating GEH from other histiocytic disorders and from lepromatous leprosy which clinically mimic GEH and is prevalent in India. We report a case of a middle-aged woman who presented with generalized asymptomatic papules and nodules and was treated for leprosy but was finally diagnosed to have GEH after clinical, histopathological, and immunohistochemical correlation. Furthermore, the newer lesions also showed features of progressive nodular histiocytosis.


Assuntos
Histiocitose de Células de Langerhans/diagnóstico , Hanseníase/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Histiocitose de Células de Langerhans/terapia , Humanos , Hanseníase/terapia , Fototerapia/métodos
7.
Clin Exp Dermatol ; 28(3): 245-50, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12780703

RESUMO

Chronic macrocheilia has a multifactorial aetiology and is often a diagnostic and therapeutic challenge. Epidemiological information on this condition is scarce, most of the data reported relating only to granulomatous cheilitis. We have performed a detailed clinico-pathological analysis of all patients with chronic macrocheilia presenting to us during the last 6.5 years. Of the 28 patients identified, 13 (46.4%) had granulomatous cheilitis (GC), six (21.4%) had tuberculosis of the lip, three (10.7%) had leprous macrocheilia, two (7.1%) had multiple endocrine neoplasia type IIb, and one each had Ascher's syndrome and non-Hodgkin's lymphoma. Two patients were diagnosed as 'nonspecific cheilitis'. Histopathological differentiation between tuberculosis and GC was often not possible; but PCR for Mycobacterium tuberculosis was positive in all patients with tuberculosis and negative in four patients with GC in whom M. tuberculosis was sought. In spite of detailed clinical examination and investigations, a therapeutic trial was required to confirm the diagnosis in five (17.9%) patients. We have reviewed the available literature on this subject, and to our knowledge this study is the first of its kind. More such studies from other centres will help physicians to make an accurate aetiological diagnosis and treat this uncommon but disfiguring condition with confidence.


Assuntos
Doenças Labiais/patologia , Adolescente , Adulto , Queilite/patologia , Criança , Doença Crônica , Feminino , Granuloma/patologia , Humanos , Hanseníase/patologia , Neoplasias Labiais/patologia , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Neoplasia Endócrina Múltipla Tipo 2b/patologia , Estudos Retrospectivos , Tuberculose/patologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-17642854

RESUMO

A total of one hundred patients (75 males and 25 females) age ranged from 17-65 years with genital lesions attending the STD clinic of Bowring and LC Hospitals Bangalore constituted the study group. Based on clinical features, the study groups were classified as syphilis (39), chancroid (30), herpes genitalis (13), condylomato lato (9), LGV (7t condylomata acuminata (5), genital scabies (3), granuloma inguinole (2) and genital candidiasis (1). In 68% microbiological findings confirmed the clinical diagnosis. Of the 100 cases 13% and 2% were positive for HIV antibodies and HbsAg respectively.

11.
Lepr Rev ; 72(1): 70-7, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11355521

RESUMO

Four hundred and sixty-seven male patients with leprosy were screened for genital involvement. Genital lesions were observed in 6.6% of all male cases of leprosy. They were seen most frequently in lepromatous leprosy (25.8%), followed by borderline lepromatous (13.3%) and borderline tuberculoid (1.4%) leprosy.


Assuntos
Genitália Masculina , Hanseníase/epidemiologia , Dermatopatias Bacterianas/epidemiologia , Humanos , Incidência , Índia/epidemiologia , Hanseníase/patologia , Masculino , Dermatopatias Bacterianas/patologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-17664757

RESUMO

This study was undertaken with the aim of evaluating the effect of associated atopy on severity and age at onset of alopecia areata in north Indians. Presence of atopy was elicited by detailed history, examination and intracutaneous tests. Chisquare test was carried out to evaluate statistical significance. One hundred patients (76 males and 24 females) with alopecia areata were evaluated. Historical evidence of atopy was present in 50 including patients alone (23), Patients and first degree relatives (11) and first degree relatives alone (16). Intracutaneous tests were positive in 23 out of 50 patients tested randomly. There was a trend towards increasing frequency of severe alopecia as evidence of atopy became stronger e.g. both patient and first degree relative with atopy or positive intracutaneous test but results did not attain statistical significance. Similarly the onset and duration of alopecia areata was not significantly related to the presence of atopy. It is concluded that in north Indians with alopecia areata, the presence of atopy is not significantly associated with severe alopecia or onset at younger age.

14.
Artigo em Inglês | MEDLINE | ID: mdl-17664796
15.
Int J Lepr Other Mycobact Dis ; 69(3): 187-94, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11875762

RESUMO

A total of 20 bacteriologically positive multibacillary (MB) leprosy patients older than 18 years of age with a bacterial index (BI) of 2+ or greater were given standard World Health Organization multiple drug therapy (MDT-MB) for 12 consecutive months plus four intradermal doses of Mycobacterium w vaccine at 3 monthly intervals (Study group). Twenty age-matched MB patients were given WHO/MDT alone (Control group). The patients of both groups were followed up for 1 year. Improvements in the patients were periodically monitored by clinical (Ramu's score), bacteriological (SSS), histopathological (skin biopsy) and immunological (lepromin conversion) parameters. Study group patients showed more significant improvements in all parameters except for lepromin conversion compared to patients in the Control group. The incidence of type 1 reaction was more in the Study group (30% vs 10%), while the incidence of type 2 reaction was more in the Control group (25% vs 15%). Neuritis associated with reactions was seen more often in the Control group compared to the Study group (20% vs 10%). The addition of Mycobacterium w vaccine as an adjunct to the 1-year WHO/MDT regimen appears to be significantly more beneficial in MB leprosy patients with a high initial BI compared to WHO/MDT given alone. Studies on larger numbers of patients with extended follow up will be in order.


Assuntos
Vacinas Bacterianas/uso terapêutico , Hanseníase/terapia , Mycobacterium leprae/imunologia , Adulto , Vacinas Bacterianas/imunologia , Biópsia , Combinação de Medicamentos , Feminino , Histocitoquímica , Humanos , Antígeno de Mitsuda/imunologia , Hanseníase/imunologia , Masculino , Organização Mundial da Saúde
17.
Indian J Lepr ; 72(3): 305-16, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11105273

RESUMO

A simulation model for leprosy transmission and control has been developed with specific objectives. Several sensitivity experiments have been carried out by altering the various inputs based on empirical data combined with intelligent guessing. The outputs generated through these exercises were on the expected lines. While incremental exercises would improve the model, it can be used even at the existing stage as a tool for programme managers.


Assuntos
Hanseníase/epidemiologia , Modelos Teóricos , Previsões , Humanos , Incidência , Hansenostáticos/uso terapêutico , Hanseníase/tratamento farmacológico , Hanseníase/transmissão
20.
J Infect Dis ; 181(3): 1189-93, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10720553

RESUMO

Adherence of Mycobacterium avium complex (MAC) to human respiratory epithelial cells (HEp-2) induced 2 distinct modes of internalization. In the first, MAC induced ruffling of HEp-2 cell membrane and formation of surface projections securing the bacilli on the surface, and concurrent membrane depressions, beneath the sites of attachment of bacilli, resulted in internalization of the organisms. The second mode involved formation of membrane folds wrapping around the bacilli, followed by internalization. Two MAC proteins of approximately 31 kD and approximately 25 kD, respectively, were identified that mediated these interactions specific for HEp-2 cells. The N-terminal amino acid sequence of the 31-kD MAC protein displayed homology with the 21-kD hypothetical protein of Mycobacterium tuberculosis, and the 25-kD MAC protein showed homology with Mn-superoxide dismutase of MAC and Mycobacterium leprae. These 2 HEp-2 cell-specific MAC proteins may be involved in the interaction of MAC with epithelial cells.


Assuntos
Complexo Mycobacterium avium/fisiologia , Sequência de Aminoácidos , Proteínas de Bactérias/análise , Células Epiteliais/microbiologia , Humanos , Laringe/microbiologia , Microscopia Eletrônica de Varredura , Dados de Sequência Molecular , Células Tumorais Cultivadas
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