RESUMO
BACKGROUND: In the present study, Borrelia spirochetes were found in four (26.6%) out of 15 patients with Atrophoderma of Pasini and Pierini (IAPP) and lichen sclerosis et atrophicans (LSA) from the Brazilian Amazon Region. MATERIAL AND METHODS: Borreliosis was investigated by immunohistochemistry and focus floating microscopy for Borrelia burgdorferi in skin biopsy samples from 15 patients with both clinical and histopathology evidences compatible with Morphea, LSA, and IAPP. RESULTS: Spirochetes were detected by specific immunohistochemistry and focus floating microscopy for B. burgdorferi in samples from three patients. A limitation of our study was the fact that we were not able to isolate and culture these organisms. CONCLUSION: Our data confirm the presence of borreliosis cases in the Amazon.
Assuntos
Grupo Borrelia Burgdorferi/isolamento & purificação , Esclerodermia Localizada/microbiologia , Esclerodermia Localizada/patologia , Adolescente , Adulto , Antígenos CD20 , Linfócitos B/imunologia , Brasil/epidemiologia , Feminino , Humanos , Imuno-Histoquímica , Líquen Escleroso e Atrófico/microbiologia , Masculino , Microscopia , Pessoa de Meia-Idade , Esclerodermia Localizada/imunologia , Adulto JovemRESUMO
BACKGROUND: Morphea and lichen sclerosus et atrophicus (LSA) are sclerotic skin lesions of unknown etiology involving connective tissue. The hypothesis of a borrelial origin of morphea and LSA is currently controversial. METHODS: Immunoglobulin G (IgG) immunoblot serologies against Borrelia burgdorferi in patients with morphea and LSA were analyzed and compared with those from healthy donors and patients with syphilis to determine the association with a probable borrelial agent in Colombia. RESULTS: No significant differences in the number of reactive antigenic bands were found between morphea/LSA patients and syphilis patients or healthy donors. The presence of at least one of the following bands, p28, p39, or p45, was the criterion most able to distinguish morphea/LSA, yielding a specificity of 95% and a sensitivity of 28.6%. Using this criterion as evidence of putative exposure to a causative borrelial agent, sclerotic skin lesions had an odds ratio of 7.60 (95% confidence interval, 1.47-39.23). CONCLUSIONS: These results could be explained by cross-reactivity; however, the partial shared reactivity of sera from patients with syphilis and morphea/LSA does not rule out the possibility that a new spirochetal agent, unrelated to B. burgdorferi or Treponemas, may be the causative agent of morphea/LSA in Colombia.