Oral treatment of crusted scabies with ivermectin: report of two cases.

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.

Antibody-based enzyme-linked immunosorbent assay for determination of anti-PGL-I specific circulating immune complex in leprosy patients.

A serological study was performed in 122 individuals: 75 leprosy patients and 47 healthy controls. The ELISA test was performed for IgG and IgM using the glycolipid PGL-I antigen from Mycobacterium leprae. Circulating immune complexes (CIC) were isolated by PEG 6000 precipitation method and after dissociation with an acid solution, the IgG and IgM specific against PGL-I were tested with the ELISA test. The multibacillary patients had high levels of antibodies, compared with paucibacillary patients and controls. The antibodies isolated from the CIC presented a similar spectrum spectral distribution as the serology. A positive correlation between the levels of free and CIC bound antibodies was observed. In contrast with tuberculosis patients, specific antibodies present in CIC were not responsible for false-negative results found in some multibacillary patients' serology, since no or very low levels of specific antibodies were found in PEG precipitated serum of these patients. No relation was observed with specific antibody levels detected in CIC during leprosy reactions.

Anti-phenolic glycolipid-I (PGL-I) determination using blood collection on filter paper in leprosy patients.

The authors studied 70 leprosy patients and 20 normal individuals, comparing the traditional sera collection method and the finger prick blood with the conservation on filter paper for specific antibodies against the native phenolic glycolipid-I (PGL-I) from Mycobacterium leprae. The finger prick blood dried on filter paper was eluated in phosphate buffer saline (PBS) containing 0.5% gelatin. The classical method for native PGL-I was performed for these eluates, and compared with the antibody determination for sera. It was observed that there is a straight correlation comparing these two methods; although the titles found for the eluates were lower than those obtained for serology. This blood collection method could be useful for investigation of new leprosy cases in field, specially in contacts individuals.

Atopic dermatitis in children

The authors studied 36 children with atopic dermatitis, from newborns to 12-year-olds whose diagnosis was established based on Hanifin's criteria. These children were attended at the outpatient clinic of the Department of Dermatology of the Escola Paulista de Medicina (UNIFESP/EPM) from September, 1993 to September, 1994. Predominance of pruritus, personal and/or family history of atopy were observed in addition to a preferential topography regarding age range, that would be the basic characteristics for the identification of an atopic individual in our environment. Other manifestations have been found such as intolerance to food and clothing, palmar hyperlinearity, Dennie Morgan fold, pityriasis alba, keratosis pilaris, etc. that can be classified as "minor" features

Circulating immune complexes in leprosy sera: demonstration of antibodies against mycobacterial glycolipidic antigens in isolated immune complexes.

Circulating immune complexes (CIC) were assayed in sera of leprosy patients. Using an immunoassay for two mycobacterial antigens--phenolic glycolipid-I (PGL-I) and glycolipid IV (SL-IV)--sera from 65 patients with leprosy (38 lepromatous, 18 borderline, and 9 tuberculoid) were studied. The CIC were isolated by polyethylene glycol (PEG) precipitation, washed, treated with an acid buffer, neutralized, and tested using an enzyme-linked immunosorbent assay (ELISA). We demonstrated that CIC could contain IgG and IgM antibodies reacting against PGL-I and SL-IV. The high levels of antibodies in the precipitable CIC showed concordance with high levels in the original sera, although some patients presented high levels of precipitable CIC in the absence of high titers of antibodies in their sera. It was concluded that some of the CIC observed in patients with leprosy were composed of IgG and IgM immunoglobulins against specific mycobacterial antigens.

[Idiopathic skin calcinosis with transepithelial elimination]. / Calcinose cutánea idiopática com eliminação transepitelial.

A case of universal cutaneous calcinosis developed without apparent cause is reported. It had an evolution towards epidermic perforation and was treated with aluminium hydroxide. A discussion was made on the rarity of the idiopathic calcinosis as well as on the interesting phenomenon of transepidermal elimination.

Reactive perforating collagenosis. Report of 3 cases.

3 cases of reactive perforating collagenosis in siblings are reported which were characterized clinically by typical umbilicated papules at sites exposed to traumatism. The histopathological feature is characterized by a cup-shaped depression of the epidermis together with extrusion of collagen fibers at its base.

Colagenose reativa perfurante. / Reactive perforating collagenosis

Os autores apresentam um caso de colagenose reativa perfurante, doenca de heranca recessiva, caracterizada por papulas queratosicas, com umbilicacao central, em sitios sujeitos a traumatismos. Sob o ponto de vista histopatologico ha solucao de continuidade epidermica por meio da qual sao eliminadas fibras colagenas de permeio a restos de celulas inflamatorias. Ha neste caso associacao, ainda nao relatada, com lesoes sugestivas de pioderma gangrenoso