Subject(s)
Acquired Immunodeficiency Syndrome/complications , Immunocompromised Host , Sarcoptes scabiei/immunology , Scabies/diagnosis , Acquired Immunodeficiency Syndrome/drug therapy , Acquired Immunodeficiency Syndrome/immunology , Adult , Animals , Anti-Retroviral Agents/adverse effects , Biopsy , Diagnosis, Differential , Drug Eruptions/diagnosis , Drug Eruptions/etiology , Humans , Male , Scabies/immunology , Skin/parasitology , Skin/pathologyABSTRACT
Crusted scabies is a less common variant of scabies that is highly contagious, difficult to treat and involves infestation by Sarcoptes scabiei var. hominis. The classical clinical presentation includes crusted, scaly and generally non-pruritic lesions usually located on the head, neck, palmar, plantar and periungual region. It was first described in Norway in 1848 in patients with leprosy who presented with crusted lesions. In this study, we report the case of a patient with crusted scabies with florid clinical manifestations and chronic liver disease due to hepatitis B and delta virus infection.
Subject(s)
End Stage Liver Disease/virology , Hepatitis B virus , Hepatitis Delta Virus , Scabies/drug therapy , Scabies/pathology , Antiparasitic Agents/therapeutic use , End Stage Liver Disease/complications , Humans , Male , Middle Aged , Scabies/immunology , Treatment OutcomeABSTRACT
Abstract: Crusted scabies is a less common variant of scabies that is highly contagious, difficult to treat and involves infestation by Sarcoptes scabiei var. hominis. The classical clinical presentation includes crusted, scaly and generally non-pruritic lesions usually located on the head, neck, palmar, plantar and periungual region. It was first described in Norway in 1848 in patients with leprosy who presented with crusted lesions. In this study, we report the case of a patient with crusted scabies with florid clinical manifestations and chronic liver disease due to hepatitis B and delta virus infection.
Subject(s)
Humans , Male , Middle Aged , Scabies/pathology , Scabies/drug therapy , Hepatitis Delta Virus , Hepatitis B virus , End Stage Liver Disease/virology , Scabies/immunology , Treatment Outcome , End Stage Liver Disease/complications , Antiparasitic Agents/therapeutic useABSTRACT
Research of human T lymphotropic virus type I (HTLV-1)-associated diseases is mostly focused on inflammatory and lymphoproliferative disorders. However, the immunosuppressive consequences of HTLV-1 infection are frequently ignored. In developing countries where exposure to parasitic and other tropical diseases is frequent, the burden of disease is significantly increased by opportunistic infections. Regulatory T cells (Tregs) are a CD4 T-cell subset capable of suppressing effector responses. During HTLV-1 infection, CD4+Foxp3+ cells are increased in HTLV-1-associated leukaemia/lymphoma (ATLL) as well as in non-leukaemic presentations. However, controversy exists regarding the actual regulatory function of these cells. In this report, we present two cases of HTLV-1 ATLL complicated by parasitic organisms and we provide a brief review of the literature regarding FoxP3+ regulatory T cells and their role as a possible mechanism for the immunosuppressive manifestations that take place during HTLV-1 infection.
Subject(s)
CD4-Positive T-Lymphocytes/immunology , Entamoeba histolytica , Entamoebiasis/immunology , Forkhead Transcription Factors/blood , HTLV-I Infections/immunology , Immune Tolerance/immunology , Leukemia-Lymphoma, Adult T-Cell/immunology , Opportunistic Infections/immunology , Scabies/immunology , Strongyloides stercoralis , Strongyloidiasis/immunology , T-Lymphocytes, Regulatory/immunology , Tinea/immunology , Aged , Animals , Biopsy , Entamoebiasis/diagnosis , Fatal Outcome , Female , HTLV-I Infections/diagnosis , Humans , Immunoenzyme Techniques , Leukemia-Lymphoma, Adult T-Cell/diagnosis , Middle Aged , Opportunistic Infections/diagnosis , Scabies/diagnosis , Shock, Septic/diagnosis , Shock, Septic/immunology , Skin/immunology , Skin/pathology , Strongyloidiasis/diagnosisABSTRACT
OBJECTIVE: To correlate the prevalence of dermatological diseases among HIV-infected patient with CD4-lymphocyte count. METHODS: A case series study was carried out in the region of Caxias do Sul, state of Rio Grande do Sul State, Brazil. Data was collected by reviewing the records of HIV-infected patients admitted to a public hospital (198 patients from March 1998 to June 2002) or seen at the university outpatient clinic (40 patients from March to June 2002). The variables analyzed were: age, sex, CD4-lymphocyte count, viral load, and dermatological diseases. Statistical analyses were performed using Student's t-test, Spearman's and Chi-Square tests. RESULTS: The frequency of dermatological disease was 67.2% among hospitalized patients and 75.0% among outpatients. Oral candidiasis was the most prevalent dermatological disease. Among the hospital population, the average CD4 count was lower among patients with dermatological disease than among those with no disease (142.34 cells/mm3 vs 512.35 cells/mm3, respectively; p=0.018). The same phenomenon was observed in outpatient population (138.88 cells/mm3 and 336.21 cells/mm3, respectively; p=0.001). In both populations, a negative correlation was found between CD4 count and the total number of dermatological diseases by a patient (p=0.000, hospital population, p=0.000, outpatient population). CONCLUSIONS: Dermatological diseases are highly prevalent among HIV-infected patients and the frequency and number of these manifestations are well correlated to the patient's immune status and disease progression.
Subject(s)
AIDS-Related Opportunistic Infections/immunology , CD4 Lymphocyte Count , Skin Diseases/epidemiology , AIDS-Related Opportunistic Infections/epidemiology , Adult , Brazil/epidemiology , Candidiasis, Oral/epidemiology , Candidiasis, Oral/immunology , Epidemiologic Methods , Female , Herpes Simplex/epidemiology , Herpes Simplex/immunology , Humans , Male , Scabies/epidemiology , Scabies/immunology , Sex Factors , Skin Diseases/immunology , Viral LoadABSTRACT
Oral treatment with ivermectin of crusted (Norwegian) scabies in two immunosuppressed patients is reported. There was resolution of symptoms and signs of the cutaneous parasitosis on administration of 18-36 mg ivermectin (total doses) in 2- and 3-week periods of treatment, with remission periods of 3 and 4 months, respectively.
Subject(s)
AIDS-Related Opportunistic Infections/drug therapy , Antiparasitic Agents/administration & dosage , Ivermectin/administration & dosage , Scabies/drug therapy , AIDS-Related Opportunistic Infections/parasitology , Administration, Oral , Adolescent , Animals , Child , Dose-Response Relationship, Drug , Down Syndrome/complications , Female , Hepatitis, Autoimmune/complications , Humans , Recurrence , Scabies/diagnosis , Scabies/immunology , Treatment OutcomeABSTRACT
Se revisan los principales aspectos epidemiológicos, clínicos, inmunológicos, de diagnóstico y terapéuticos; se insiste en las manifestaciones clínicas que caracterizan al padecimiento y en las medidas terapéuticas necesarias para adecuado manejo y control de la escabiasis
Subject(s)
Humans , Sarcoptes scabiei/parasitology , Scabies , Scabies/immunology , Scabies/parasitology , Scabies/transmissionABSTRACT
Two children with acute lymphoblastic leukemia undergoing chemotherapy had a special form of scabies characterized by fine scaling of the scalp simulating seborrheic dermatitis. Pruritus was mild or absent. Immunocompromised children and adults should receive whole-body and scalp antiscabietic treatment.
Subject(s)
Dermatitis, Seborrheic/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Scabies/diagnosis , Scalp Dermatoses/diagnosis , Child , Child, Preschool , Dermatitis, Seborrheic/immunology , Diagnosis, Differential , Humans , Immunocompromised Host , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Scabies/immunology , Scalp Dermatoses/immunologyABSTRACT
Se presenta un paciente de 24 años de edad con lesiones exulceradas e induradas de pene, de 7 meses de evolución, con características totalmente inusuales por su número y expresión clínica, exudado abundante y resistencia a toda terapéutica. Se descartan múltiples patologías chancriformes. Al diagnóstico histopatológico, la lesión es compatible con chancro escabiótico atípico
Subject(s)
Chancre/pathology , Hexachlorocyclohexane/therapeutic use , Penile Diseases/etiology , Scabies/complications , Chancre/complications , Chancre/therapy , Penile Diseases/diagnosis , Penile Diseases/pathology , Scabies/immunology , Scabies/therapy , Acquired Immunodeficiency Syndrome/complications , Substance-Related Disorders , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/immunologyABSTRACT
Se presenta un paciente de 24 años de edad con lesiones exulceradas e induradas de pene, de 7 meses de evolución, con características totalmente inusuales por su número y expresión clínica, exudado abundante y resistencia a toda terapéutica. Se descartan múltiples patologías chancriformes. Al diagnóstico histopatológico, la lesión es compatible con chancro escabiótico atípico