Protein expression of MMP-2 and MT1-MMP in actinic keratosis, squamous cell carcinoma of the skin, and basal cell carcinoma.

Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are 2 skin neoplasms with distinct potentials to invasion and metastasis. Actinic keratosis (AK) is a precursor lesion of SCC. Immunohistochemistry was performed to evaluate the expression of MMP-2 and MT1-MMP in samples of BCC (n = 29), SCC (n = 12), and AK (n = 13). The ratio of positive cells to total cells was used to quantify the staining. Statistical significance was considered under the level P < .05. We found a higher expression of MMP-2 in tumor stroma and parenchyma of SCC as compared to BCC. The expression of this protein was also similar between SCC and its precursor actinic keratosis, and it was higher in the stroma of high-risk BCC when compared to low-risk BCC. MT1-MMP, which is an activator of MMP-2, was similarly expressed in all groups. Our results suggest that MMP-2 expression may contribute to the distinct invasive patterns seen in SCC and BCC.

Distal and lateral toenail onychomycosis caused by Trichophyton rubrum: treatment with photodynamic therapy based on methylene blue dye.

The study showed the effectiveness of photodynamic therapy based on methylene blue to treat severe distal and lateral subungual toenail onychomycosis. 22 patients were divided into two groups: group A consisting of 11 patients with severe toenail onychomycosis and group B consisting of 11 patients with mild-to-moderate toenail onychomycosis. All patients had onychomycosis caused by Trichophyton rubrum. The patients were treated with sessions of 2% methylene blue aqueous solution irradiated with light emission diode device with 630 nm and 36 J/cm2 biweekly for six months. The clinical response was significantly better in patients with mild-to-moderate (100%) onychomycosis compared with patients with severe onychomycosis (63.6%).

Endonyx toenail onychomycosis caused by Trichophyton rubrum: treatment with photodynamic therapy based on methylene blue dye.

This study shows the effectiveness of photodynamic therapy based on methylene blue dye for the treatment of endonyx toenail onychomycosis. Four patients with endonyx onychomycosis caused by Trichophyton rubrum were treated with 2% methylene blue aqueous solution irradiated with light emission diode at 630 nm and an energy density of 36 J/cm2 for 6 months at 2-week intervals. The preliminary study showed the effectiveness of this therapy in the treatment of endonyx onychomycosis, and also indicated that the disease can be caused by T. rubrum.

Comparative analysis of the geographic distribution of the histopathological spectrum and Leishmania species of American cutaneous leishmaniasis in Brazil.

BACKGROUND: Knowledge of the relationship between specific geographical differences and histopathology of the American cutaneous leishmaniasis is limited because host-parasite interactions in space and time are complex. OBJECTIVE: To describe the geographic analysis of the histopathological pattern of localized American cutaneous leishmaniasis and the relationship with Leishmania species. METHODS: A cross-sectional, descriptive and analytical study of a sample consisting of 55 patients of municipal districts of Montes Claros and 32 of Caratinga, Minas Gerais, by comparing with other endemic regions in Brazil, assessing historical and microregional data and developing confidence intervals. RESULTS: A preponderance of cellular exudative reactions in the cutaneous form of American cutaneous leishmaniasis was found in the municipal districts of Caratinga, east of Minas Gerais, Montes Claros, north of Minas Gerais and Uberlândia, Triangulo Mineiro, and also in the states of Mato Grosso and Ceara. Necrotic and exudative granulomatous reactions were found to be more frequent in the northern areas, mainly in the states of Amazonas and Para. Necrotic and exudative reactions were the most frequent form of presentation found throughout Brazil when the predominance of L. braziliensis was below 90% in relation to other species. CONCLUSION: There is a geographic variation of the immune inflammatory response in American cutaneous leishmaniasis. Geographical correlations between the predominant species of Leishmania and the most frequent forms of histopathological presentation of American cutaneous leishmaniasis, which until the present study had not been performed, enables new approaches to the study of Leishmania subpopulations in areas with a predominance of one species and provides evidence of variations in the biological behavior of different species.

[Leprosy reactions in discharged patients following cure by multidrug therapy]. / Reações hansênicas em pacientes em alta por cura pela poliquimioterapia.

INTRODUCTION: Reactional states are the main cause of nerve lesions and incapacities provoked by leprosy. METHODS: Retrospective study aimed at verifying the frequency of leprosy reactions in discharged patients following cure by multidrug therapy (MDT). RESULTS: Among patients who presented reactions during treatment, 35.5% continued after MDT; of those that did not present during treatment, only 12.7% presented after discharge; 63.4% multibacillary patients presented during and 31.7% after; 27.7% paucibacillary patients presented during and 8.3% after. CONCLUSIONS: A direct proportional relation exists between the presence of reactions during and after treatment. Multibacillary clinical forms present a greater frequency of reactions during and after cure.

Comparative analysis of the geographic distribution of the histopathological spectrum and Leishmania species of American cutaneous leishmaniasis in Brazil / Análise comparativa da distribuição geográfica do espectro histopatológico e espécies de Leishmania da leishmaniose tegumentar americana no Brasil

BACKGROUND: Knowledge of the relationship between specific geographical differences and histopathology of the American cutaneous leishmaniasis is limited because host-parasite interactions in space and time are complex. OBJECTIVE: To describe the geographic analysis of the histopathological pattern of localized American cutaneous leishmaniasis and the relationship with Leishmania species. METHODS: A cross-sectional, descriptive and analytical study of a sample consisting of 55 patients of municipal districts of Montes Claros and 32 of Caratinga, Minas Gerais, by comparing with other endemic regions in Brazil, assessing historical and microregional data and developing confidence intervals. RESULTS: A preponderance of cellular exudative reactions in the cutaneous form of American cutaneous leishmaniasis was found in the municipal districts of Caratinga, east of Minas Gerais, Montes Claros, north of Minas Gerais and Uberlândia, Triangulo Mineiro, and also in the states of Mato Grosso and Ceara. Necrotic and exudative granulomatous reactions were found to be more frequent in the northern areas, mainly in the states of Amazonas and Para. Necrotic and exudative reactions were the most frequent form of presentation found throughout Brazil when the predominance of L. braziliensis was below 90% in relation to other species. CONCLUSION: There is a geographic variation of the immune inflammatory response in American cutaneous leishmaniasis. Geographical correlations between the predominant species of Leishmania and the most frequent forms of histopathological presentation of American cutaneous leishmaniasis, which until the present study had not been performed, enables new approaches to the study of Leishmania subpopulations in areas with a predominance of one species and provides evidence of variations in the biological behavior of different species.

FUNDAMENTOS: O conhecimento das relações entre diferenças geográficas específicas e a histopatologia da leishmaniose tegumentar americana é limitada devido à complexidade espacial e temporal da interação hospedeiro-parasito. OBJETIVOS: Descrever a distribuição geográfica do padrão histopatológico da leishmaniose tegumentar americana na forma cutânea localizada e a relação com a espécie de Leishmania. MÉTODOS: Estudo transversal, descritivo e analítico, de uma amostra de 55 pacientes de Montes Claros e 32 de Caratinga, Minas Gerais, comparando com diferentes regiões do Brasil através de avaliações históricas, microregionais e da construção de intervalos de confiança. RESULTADOS: Na forma cutânea da leishmaniose tegumentar americana, foi encontrada uma preponderância de reações exsudativas-celulares nos municípios de Caratinga, leste de Minas Gerais, Montes Claros, norte de Minas Gerais e Uberlândia, Triângulo mineiro, e também nos estados de Mato Grosso e Ceará. As reações exsudativas-necróticas-granulomatosas encontradas foram mais freqüentes em áreas do norte do Brasil, principalmente nos estados do Amazonas e Pará. As reações exsudativas-necróticas foram as formas mais freqüentes de apresentação encontradas em todas as áreas no Brasil quando a predominância de L. braziliensis foi menor que 90% em relação às outras espécies. CONCLUSÕES: Existe uma variação geográfica da resposta inflamatória imune na leishmaniose tegumentar americana. As correlações geográficas entre as espécies predominantes de Leishmania e o espectro histopatológico da leishmaniose tegumentar americana, que até que o presente estudo não tinha sido realizada, permite novas abordagens nos estudos de subpopulações de Leishmania em áreas com uma predominância de uma espécie e provê evidência das variações no comportamento biológico de diferentes espécies.

Reações hansênicas em pacientes em alta por cura pela poliquimioterapia / Leprosy reactions in discharged patients following cure by multidrug therapy

INTRODUÇÃO: Reações hansênicas são a principal causa de lesões dos nervos e incapacidades provocadas pela hanseníase. MÉTODOS: Estudo retrospectivo com objetivo de verificar a frequência de reações hansênicas em pacientes com alta por cura pela poliquimioterapia (PQT). RESULTADOS: Pacientes que apresentaram reações durante o tratamento, 35,5 por cento continuaram pós-PQT; aqueles que não apresentaram no tratamento, somente 12,7 por cento tiveram pós-PQT; 63,4 por cento multibacilares apresentaram durante e 31,7 por cento após; paucibacilares 27,7 por cento durante e 8,3 por cento após. CONCLUSÕES: Existe relação diretamente proporcional entre presença de reações durante e após o tratamento. Formas clínicas multibacilares apresentam maior frequência de reações durante e após a cura.

INTRODUCTION: Reactional states are the main cause of nerve lesions and incapacities provoked by leprosy. METHODS: Retrospective study aimed at verifying the frequency of leprosy reactions in discharged patients following cure by multidrug therapy (MDT). RESULTS: Among patients who presented reactions during treatment, 35.5 percent continued after MDT; of those that did not present during treatment, only 12.7 percent presented after discharge; 63.4 percent multibacillary patients presented during and 31.7 percent after; 27.7 percent paucibacillary patients presented during and 8.3 percent after. CONCLUSIONS: A direct proportional relation exists between the presence of reactions during and after treatment. Multibacillary clinical forms present a greater frequency of reactions during and after cure.