[Myxedema tuberosum atypicum (Jadassohn-Doesserkker, 1916) in the clinical picture of the myxodermias and in the normal course of Graves-Basedow's disease]. / O myxedema tuberosum atypicum (Jadassohn-Doesserkker, 1916) no quadro das mixodermias e no ciclo formal da moléstia de Graves-Basedow.

An extraordinary case: large cutaneous tumors, intense "endocrine" exophthalmos, macroglossia, acropachie, prétibial mucinosis, diffuse myxodermia, symptoms of systemic involvement.

Doenca de Basedow-Graves: grave comprometimento sistemico cutaneo e ocular. / Basedow-Graves' disease: severe systemic cutaneous and ocular involvement

Os autores apresentam dois casos de oftalmopatia infiltrativa de Graves-Basedow em sua forma mais grave e exuberante associada a dermopatia (mucinosis cutis: tanto na forma localizada - mixedema pre-tibial, como na forma tuberosa intensa) e a acropaquia tireotoxica. Discutem a etiopatogenia de cada uma dessas condicoes e consideram as varias medidas terapeuticas locais e sistemicas preconizadas nesses casos

[Transfer factor in diffuse cutaneous leishmaniasis. Experience with one case]. / Fato r de transferència na leishmaniose cutis difusa. Experiència de um caso.

Transfer factor was administered in one case of Diffuse Cutaneous Leishmaniasis ("DCL") with minimal therapeutical results after two courses of ten doses each. The patient was 34-year-old white man, born in the State of Pará --Amazon-- region, goldwasher, his disease started 9 years ago and consisted of disseminated papular and nodular lesions, some of them secondarily ulcerated and more closely clustered over the knees elbows and dorsa of the hands. Physical examination was normal except for the skin lesions and a perforation of the nasal septum. Some intradermal tests (Paracoccidiodin, Lepromin and PPD) were positive while the Montenegro (leishmanin) reaction was negative. Increased levels of IgG and IgM were found; IgA was normal even after the treatment. Transfer Factor was obtained from leishmanin positive and PPD strong reactors and the method of preparation is described. By the end of the first ten-doses course, lesions were reduced to dark atrophic residual macules but the histological sections displayed a surprising amount of parasites, predicting unavoidable relapse. For the second series, as the patient refused to be given Amphotericin B he was treated with hot baths and levamisole was administered in a 150 mg daily dosage and 45 days cycles. The leishmanin intradermal test did not became positive after the treatment and this fact is discussed.

Central nervous system involvement in South American blastomycosis.

The authors present a patient with South American blastomycosis with cerebral involvement in whom a ventriculography and a cerebral arteriography showed a tumour at the level of the fourth ventricle. After six months of therapy, clinical cure of some lesions was obtained while the neurological picture of right hemiparesia remained unchanged. Surgery was performed and the histopathological study revealed a tuberculoid, granuloma-forming gumma. The literature is reviewed and comments are made on the cerebro-spinal fluid changes and the types of involvement of the nervous system. The neurological examination and the analysis of the cerebro-spinal fluid indicated that the relative frequency of central nervous system localization in South American blastomycosis was not in agreement with current thought.