RESUMO
INTRODUCTION: Cutaneous leishmaniasis is a protozoal infection. Its prevalence is increasing, especially in immunocompromised subjects. CASE REPORTS: We report four patients with rheumatoid arthritis, treated with methotrexate and prednisone who developed cutaneous leishmaniasis. Clinical outcome was favorable after institution of antimony therapy in three cases despite the continuation of methotrexate and prednisone. One patient failed to respond to therapy. DISCUSSION: The frequency of cutaneous leishmaniasis is increasing especially in immunocompromised subjects. In our patients, rheumatoid arthritis, corticosteroid therapy and methotrexate were predisposing factors of cutaneous leishmaniasis.
Assuntos
Artrite Reumatoide/complicações , Hospedeiro Imunocomprometido , Leishmaniose Cutânea/diagnóstico , Adulto , Antiprotozoários/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Leishmaniose Cutânea/tratamento farmacológico , Meglumina/uso terapêutico , Antimoniato de Meglumina , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Compostos Organometálicos/uso terapêutico , Prednisona/uso terapêuticoRESUMO
Algodystrophy (AD) of the lower limbs during pregnancy is rare and probably underdiagnosed. The physiopathologic mechanisms remain under discussion and seem multiple and complex. This report describes a retrospective survey of 6 patients seen between 1993 and 2004 who had algodystrophy of the lower limbs during pregnancy. Comparing the clinical, radiological and evolutionary results to the literature allows for identifying the main features of AD during pregnancy: disease progression during the second or third trimester, preferential localization of the left hip associated or not with other lower limb joint involvement and decalcification as seen on radiography. Magnetic resonance imaging (MRI), which is accurate, specific and non-invasive, is currently the exam of choice in early and differential diagnosis. The evolution is favourable in a few months, with general recovery without disability.