Bullous pemphigoid (BP) is an autoimmune, acquired, cutaneous disease caused by the
production of autoantibodies against hemidesmosomes' components in the basement
membrane. The estimated incidence in Europe ranges from 7 to 43 cases per million
inhabitants per year. Several studies have reported an association between BP and
neurological disorders (ND). Our cohort of Bullous pemphigoid and ND is the first in
Brazil and showed a significantly high prevalence of neurological and/or psychiatric
diseases, especially cerebrovascular accident (CVA) and dementia, in agreement with
the prevalence reported in several studies published in the medical literature in
recent years.
A 32-year-old HIV negative male presented with multiple pulmonary cavitation and skin abscesses up to 15 cm in diameter mimicking tuberculosis. Sporothrix brasiliensis was isolated and patient responded well to amphotericin B followed by itraconazole, except the skin lesions that had to be surgical drained to obtain cure.
A 57-year-old woman presented with periorbital ecchymoses, laxity in skin folds,
polyneuropathy and bilateral carpal tunnel syndrome. A skin biopsy of the axillary
lesion demonstrated fragmentation of elastic fibers, but with a negative von Kossa
stain, consistent with cutis laxa. The diagnosis of primary systemic amyloidosis was
made by the presence of amyloid material in the eyelid using histopathological
techniques, besides this, the patient was also diagnosed with purpura,
polyneuropathy, bilateral carpal tunnel syndrome and monoclonal gammopathy. She was
diagnosed as suffering from multiple myeloma based on the finding of 40% plasma cells
in the bone marrow, component M in the urine and anemia. The patient developed
blisters with a clear content, confirmed as mucinosis by the histopathological exam.
The final diagnoses were: primary systemic amyloidosis, acquired cutis laxa and
mucinosis, all related to multiple myeloma.
The antagonists of tumor necrosis factor alpha (TNF-α) are increasingly being used in
the treatment of inflammatory and autoimmune diseases. Several adverse effects of
these drugs have been reported, including the paradoxical development of sarcoidosis,
especially with the use of etanercept. We present the first Brazilian case report of
systemic sarcoidosis induced by etanercept and a literature review.
Background: In Curitiba, systemic hypertension (SH) is the second leading cause of hospitalization and the leading cause of death from cardiovascular diseases. The protocols for the treatment of hypertension provide a systematic approach to patient management, aiming at improving the efficiency and quality of health services.
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