O Trypanosoma cruzi foi reconhecido como agente etiológico da Doença de Chagas há mais de um século. Contudo, essa afecção ainda é considerada uma doença tropical negligenciada pela Organização Mundial da Saúde (OMS), sendo um grande problema social e de saúde pública na América Latina, que tem impacto considerável na morbimortalidade, sobretudo, nos países subdesenvolvidos. Atualmente, o tratamento para a DC é insatisfatório em virtude de sua efetividade reduzida e elevada toxicidade, destacando-se a necessidade do desenvolvimento de novas alternativas farmacológicas. Foi realizada revisão da literatura nas bases de dados PubMed Central, SciELO e LILACS, nos idiomas inglês, espanhol e português, nos últimos 5 anos. Foram selecionadas 24 publicações sobre os principais aspectos relacionados ao tratamento da doença de Chagas. Os estudos mostram que a terapia atual consiste basicamente no uso do Benzonidazol - embora seu perfil de segurança e eficácia esteja longe do ideal -, além de manejo específico para o acometimento cardíaco e digestivo da doença. Em um contexto mais atual, tem-se testado novas estratégias terapêuticas antiparasitárias, como o reposicionamento de drogas; a associação de duas ou mais drogas utilizadas concomitantemente ou de forma sequencial; o desenvolvimento de novos fármacos e a terapia celular, tendo sido alcançado resultados promissores em muitos desses estudos. Vários trabalhos ainda estão em andamento para avaliar a eficácia e segurança de novas abordagens terapêuticas, mas, por se tratar de doença negligenciada, ainda existem desafios que dificultam esse progresso, como o alto custo e baixo retorno para as indústrias farmacêuticas.
Cutaneous metastases of visceral neoplasms are rare conditions, and urothelial or transitional cell carcinomas are responsible for less than 1% of cases. We report the case of a 50-year-old male patient who progressively developed multiple cutaneous nodules on his head, abdomen, axilla, and groin, some with ulceration. Skin biopsy and immunohistochemistry were consistent with cutaneous metastasis of urothelial carcinoma. Computed tomography scan revealed generalized metastasis in internal organs. In this rare case, cutaneous metastases were the presenting sign of the disease and, as reported, a sign of bad prognosis.
: The relationship between atopic and allergic contact dermatitis is often discussed, especially in children. The damaged skin barrier in atopic patients can make the skin more permeable to exogenous agents and increase the risk of triggering contact dermatitis. Topical treatment of atopic dermatitis is associated with skin sensitization to several drugs, including antiseptics, emollients, and topical corticosteroids. The early onset of atopic dermatitis, as in the case reported here, the severity of the disease, and IgE-mediated sensitization are identified as the main risk factors associated with sensitization to topical treatments for atopic dermatitis. We report a two-year-old child with a previous diagnosis of atopic dermatitis, whose condition was aggravated by inadequate medical treatment.
The number of leprosy cases in those aged under 15 years is an important indicator for determining the level of transmission of the disease, and it indicates the need to intensify specific prevention and control measures. A 14-year-old female patient, resident in Pernambuco, Northeast Brazil, was admitted to a leprosy referral clinic, complaining of small skin lesions, initially on the eyebrow, progressing to the malar, ears, knees, feet, and hands, associated with arthralgia in the extremities. Histopathological examination of the skin biopsy was compatible with leprosy. Herein, we reported a patient with dermatological lesions that are atypical for leprosy. It draws attention to the fact that leprosy can clinically mimic several other dermatological or systemic pathologies.
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