BackgroundLeprosy is a chronic infectious disease endemic in some undeveloped areas, and still represents a public health problem in Brazil. Therefore, the control of this endemic disease depends necessarily on the institution of correct treatment and containment of treatment dropout. This study aims to conduct a systematic review of published studies on treatment dropout of leprosy.MethodsWe conducted a systematic review of articles on treatment dropout of leprosy, published between january 2005 and april 2013, on MEDLINE and SciELO databases. The search was performed using the MeSH terms: “leprosy”; “patients dropouts” and the keywords: “leprosy, treatment” and “noncompliance, leprosy” in association, beside the equivalents in Portuguese.ResultsThere were originally 196 references. After analyzing the titles and abstracts of articles, 20 articles were obtained and included in the final sample.DiscussionLeprosy is a notifiable disease known as its disfiguring capability and the high rate of non-compliance to treatment. The low adhesion is responsible for the remaining potential sources of infection, irreversible complications, incomplete cure and, additionally, may lead to resistance to multiple drugs. Many factors are responsible for the interruption or dropout treatment: socioeconomic factors, education level, knowledge about the disease, lack of efficiency of health services, demographics, side effects of drugs, alcoholism, among others.ConclusionThe recent scientific literature about the subject diverge regarding the factors that most affect the dropout problem in treating leprosy patients. However, better integration between professionals and users, and greater commitment of the patient, are common points among the authors of the studies.

Agenesis of the internal carotid artery (ICA) is defined as a congenital absence of the carotid canal and occurs in less than 0.01% of the population. This anomaly is usually diagnosed as an incidental finding or after a cerebrovascular event. We present the case of a 36-year-old woman, with bilateral agenesis of the ICA who had suffered a subarachnoid hemorrhage due to ruptured aneurysm of the basilar artery. Therefore, agenesis of the ICA is a condition that, although rare, should be considered since there is a risk of coexistence with other life-threatening conditions such as aneurysms.Keywords: internal carotid artery; carotid artery diseases; intracranial aneurysm. ResumoAgenesia da artéria carótida interna (ACI) é definida como uma ausência congênita do canal carotídeo e ocorre em menos de 0,01% da população. O diagnóstico dessa anomalia ocorre geralmente como um achado incidental ou depois de um evento cerebrovascular. Apresentamos o caso de uma mulher de 36 anos, hipertensa e tabagista, com agenesia bilateral de ACI, que abriu quadro com hemorragia subaracnoide decorrente de rotura de aneurisma de artéria de basilar. A agenesia da ACI é, portanto, uma condição que, embora rara, deve ser lembrada por estar associada a outras más formações potencialmente fatais, como os aneurismas cerebrais.Palavras-chave: artéria carótida interna; doenças das artérias carótidas; aneurisma intracraniano.

An 18-year-old man presented with neuropsychomotor development delay since birth associated with multiple nevi and basal cell carcinomas (BCCs), which appeared in the third year of life (figure 1). Family history was unremarkable. Brain CT showed tentorium and falx cerebri calcification, associated with sphenoid hypoplasia (figure 2). Brain MRI disclosed a jaw odontogenic cyst (figure 2). Gorlin-Goltz syndrome (GGS) was diagnosed based on clinical and neuroimaging features. GGS (OMIM:109400) is an unusual autosomal dominant disorder caused by mutations in one of the 3 following genes: PTCH1, PTCH2, or SUFU.1 Around 5%-10% of patients with GGS develop medulloblastoma or meningiomas.2 GGS is characterized by multiple BCC, jaw cyst, palmar and plantar pits, cerebral sickle calcification, and skeletal malformation.

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