[Axillary hidrosadenitis due to Leishmania: Case report and literature review]. / Hidrosadenitis axilar por Leishmania: presentación de un caso y revisión de la bibliografía.

BACKGROUND: Hidradenitis is a disorder where abscesses appear after the infection of the apocrine sweat glands. It is located normally in the axillae, groin, perineal region, and the scalp. CLINICAL CASE: A 37 year old male was referred by his GP to the General Surgery Department with axillary hidradenitis which had evolved over the years. The physical examination shows signs of hidradenitis in both axillae, with a noticeable suppurative hidradenitis in the right armpit. En bloc extirpation was performed to remove the whole affected area. The pathological examination revealed a cutaneous leishmaniasis. Subsequently, fucidin was administered topically, as well as local infiltrations of one millilitre of Glucantime™. DISCUSSION: Hidradenitis normally appears in intertriginous areas and its manifestation is accompanied by recurrent subcutaneous nodules. The incidence rate in females is three times higher than in males. The isolated Hidradenitis caused by Leishmania is a rare condition presented only in endemic areas or in immunocompromised patients, such as HIV-infected patients. Clinical manifestations can be different and the diagnosis can be confirmed through haematoxylin-eosin. The main pattern displays a disorganised granuloma without necrosis. Systemic or topical treatment can be applied. Immunotherapy treatment is the most common. CONCLUSIONS: Hidradenitis caused by Leishmania in HIV-negative patients is a rare condition. Therefore it is important to perform a good histological diagnosis and to administer the right treatment.

Reconstrução heminasal direita com rotação de retalho cutâneo bilobado: contribuição pessoal / Right heminasal reconstruction with bi-lobed skin flap rotation: personal approach

Deformidades adquiridas do nariz por trauma ou doença têm sido corrigidas mediante retalhos cutâneos em ilha, nasogenianos, frontais, tubulados, e ainda pelo uso de retalhos bilobados. O caso relatado, mediante modificação pessoal, ilustra este tipo de procedimento.

Acquired nasal deformity by trauma or sickness have been reconstructed by island skinflaps, nasal-labial, frontal, skin tube, and also with bi-lobed flap rotation. The present cases how a personal approach with the use of this bi-lobed flap.

Splenectomy does not interfere with immune response to Leishmania major infection in mice.

Spleen is one of the largest lymphoid organs in the body; it harbors immune cells including antigen presenting cells, B and T lymphocytes. It has an important role in humoral and cellular immune responses. Herein we investigated the role of spleen in the immune response to experimental Leishmania major infection. It is known that C57BL/6 mice are resistant to L. major infection whereas BALB/c mice are susceptible. Although splenectomy was associated with reduced serum levels of IFN-gamma, absence of the spleen did not change the profile of L. major infection in the resistant C57BL/6 and BALB/c susceptible mice. Both strains of mice maintained the same profile of cytokine production in regional lymph nodes after splenectomy and responded in the same way against the infection. Only splenectomized BALB/c mice had a reduction in IL-4 and IL-10 production by lymph node cells early in infection. Our data suggest that, in localized infections, regional lymph nodes may replace efficiently the immunological role of spleen in the cellular and humoral immune responses.