ABSTRACT
BACKGROUND: In the present study, Borrelia spirochetes were found in four (26.6%) out of 15 patients with Atrophoderma of Pasini and Pierini (IAPP) and lichen sclerosis et atrophicans (LSA) from the Brazilian Amazon Region. MATERIAL AND METHODS: Borreliosis was investigated by immunohistochemistry and focus floating microscopy for Borrelia burgdorferi in skin biopsy samples from 15 patients with both clinical and histopathology evidences compatible with Morphea, LSA, and IAPP. RESULTS: Spirochetes were detected by specific immunohistochemistry and focus floating microscopy for B. burgdorferi in samples from three patients. A limitation of our study was the fact that we were not able to isolate and culture these organisms. CONCLUSION: Our data confirm the presence of borreliosis cases in the Amazon.
Subject(s)
Borrelia burgdorferi Group/isolation & purification , Scleroderma, Localized/microbiology , Scleroderma, Localized/pathology , Adolescent , Adult , Antigens, CD20 , B-Lymphocytes/immunology , Brazil/epidemiology , Female , Humans , Immunohistochemistry , Lichen Sclerosus et Atrophicus/microbiology , Male , Microscopy , Middle Aged , Scleroderma, Localized/immunology , Young AdultABSTRACT
In the present study, we report the occurrence of Lyme's borreliosis in patients from the Brazilian Amazon Region. Borreliosis was investigated by immunohistochemistry and focus floating microscopy for Borrelia burgdorferi in skin biopsy samples from 22 patients with both clinical and histopathology evidences compatible with Erythema Migrans. Spirochetes were detected by specific immunohistochemistry and focus floating microscopy for B. burgdorferi in samples from five patients. Clinical cure of the cutaneous lesions was observed in all the patients after treatment with doxycycline regimen as proposed by the Center Disease Control guidelines. A limitation of our study was the fact that we were not able to isolate and culture these organisms. These are the first known Brazilian cases of borreliosis to have Focus Floating Microscopy confirmation.
Subject(s)
Borrelia burgdorferi Group/isolation & purification , Lyme Disease/diagnosis , Skin/microbiology , Adult , Anti-Bacterial Agents/therapeutic use , Biopsy , Borrelia burgdorferi Group/cytology , Brazil/epidemiology , Doxycycline/therapeutic use , Female , Humans , Immunohistochemistry , Lyme Disease/drug therapy , Lyme Disease/microbiology , Male , Microscopy , Middle Aged , Skin/pathology , Treatment OutcomeABSTRACT
Melanoma may present with a wide variety of clinicopathological presentations, among those very rarely lesions imitating atypical fibroxanthoma (AFX). While AFX usually is cured by complete excision, melanoma simulating AFX has a much more serious prognosis, and thus is important to be recognized correctly. The present series describes 4 cases of such melanomas in 3 patients whose exact diagnosis was (markedly) delayed due to unusual clinicopathological presentations including negative immunohistochemistry for melanocytic markers (S100 protein, MelanA/MART1, HMB45).