Enhanced IL-6 and IL-12B Gene Expression After SARS-CoV-2 Infection in Leprosy Patients May Increase the Risk of Neural Damage.

Experts have called attention to the possible negative impact of the coronavirus disease 2019 (COVID-19)-related cytokine storm syndrome on the progression of leprosy-related disabilities. We assessed the frequency of reactional states in patients co-infected with Mycobacterium leprae and severe acute respiratory syndrome (SARS) coronavirus (CoV) 2 (SARS-CoV-2). We consecutively included patients during the first peak of the COVID-19 epidemic in Brazil and analyzed the expressions of genes encoding interleukin (IL)-1ß, IL-6, IL-8, IL-10, IL-12A, IL-12B, and tumor necrosis factor-α in peripheral blood mononuclear cells. We included 64 leprosy patients and 50 controls. Twelve of the leprosy patients and 14 of the controls had been diagnosed with COVID-19. Co-infection was associated with increased IL-6 (P = 0.043) and IL-12B (P = 0.017) expression. The median disability grades were higher for leprosy/COVID-19 patients; however, the difference was not significant (P = 0.194). Patients co-infected with M. leprae and SARS-CoV-2 may experience a higher-grade proinflammatory state.

Opportunistic tropical infections in immunosuppressed patients.

Autoimmune and autoinflammatory diseases are associated with severe morbidity, and represent an impactful health and economic burden worldwide. The treatment of these diseases can include a course with detrimental side effects. Immunosuppression increases the risk of opportunistic infections, but in some cases, the abrupt discontinuation of these medications can result in immune reconstitution inflammatory syndrome. Special attention must be directed to endemic tropical infections, such as leishmaniasis, Chagas disease, malaria, arbovirosis, yellow fever, leprosy, paracoccidioidomycosis, disseminated strongyloidiasis, and ectoparasitosis. These endemic diseases of developing countries can be considered as possible emerging diseases in developed regions partially because of environmental factors and migration. In the present article, we aim to review the evidence-based aspects of the most important opportunistic tropical infections in immunosuppressed patients. We also aim to review the important aspects of vaccination, chemical prophylaxis, and treatment for these infections in people with medication-induced immunosuppression.

Pyoderma gangrenosum leading to bilateral involvement of ears.

Pyoderma gangrenosum is a destructive inflammatory disease that commonly occurs in an idiopathic way. Its occurrence in the auricular area is very rare, although this fact does not seem to determine a different behavior of the disease with regard to ulcer aspects and response to treatment. The authors report the case of a patient with pyoderma gangrenosum affecting both earlobes. The patient responded well to treatment with oral prednisone and has not shown relapses after a six-month follow-up.

Comparison of four botulinum neurotoxin type A preparations in the treatment of hyperdynamic forehead lines in men: a pilot study.

BACKGROUND: Botulinum neurotoxin type A (BTXA) offers a minimally invasive approach for the treatment of facial rhytides and has been well accepted by male patients. However, few comparative studies about the efficacy of the different BTXA preparations in this emerging group of patients are available. OBJECTIVE: To access the efficacy of four BTXA preparations in the treatment of hyperdynamic forehead lines in men. METHODS: Twelve male patients with a mean age of 30.5±5.26 years, with moderate or severe hyperdynamic forehead lines on a facial wrinkle scale (FWS), were involved in the study. Using an intra-individual controlled study design, either 17 mouse units (m.U) of Botox, Prosigne, and Xeomin or 51 Speywood units (s.U) of Dysport were applied to each side of a patient's forehead. Subjects with absent or mild forehead lines were considered responders. Study evaluations were performed monthly up to day 150. RESULTS: All patients responded in a side-to-side evaluation and no asymmetries or differences in the degree of reduction of hyperdynamic forehead lines were noted at day 30 and day 60 (P=0.340). Analysis of all combined forehead sides treated with a given BTXA did not show statistically significant differences in terms of maintenance of improvement between different BTXA preparations at day 150 (P=0.528). CONCLUSION: The data obtained in this study revealed a similar effectiveness of the BTXA preparations evaluated in the treatment of hyperdynamic forehead lines in men, when considering a dose-ratio of 1 m.U of Botox, Xeomin or Prosigne to 3 s.U of Dysport.