Temporal triangular alopecia, also referred as congenital triangular alopecia, is
an uncommon dermatosis of unknown etiology. It is characterized by a
non-scarring, circumscribed alopecia often located unilaterally in the
frontotemporal region. It usually emerges at ages 2-9 years. Alopecia areata is
the main differential diagnosis, especially in atypical cases. Dermoscopy is a
noninvasive procedure that helps distinguish temporal triangular alopecia from
aloepecia areata. Such procedure prevents invasive diagnostic methods as well as
ineffective treatments.
The pretibial myxedema is a manifestation of Graves' disease characterized by
accumulation of glycosaminoglycans in the reticular dermis. The dermopathy is
self-limiting but in some cases may cause cosmetic and functional damage.
Conventional treatment is use of topical steroids under occlusive dressing, however
the intralesional application has shown good results. We present a case of pretibial
myxedema treated with single injection of intralesional corticosteroid.
Coinfections with human immunodeficiency virus (HIV) and infectious agents have been recognized since the early 90s. In the central nervous system (CNS) of HIV+ patients, parasitic protozoans like Toxoplasma gondii have been described as responsible for the space occupying lesions (SOL) developed. However, the involvement of Trypanosoma cruzi is also described but appears to be less frequent in acquired immunodeficiency syndrome (AIDS) and transplant recipients, associated with necrotizing myocarditis and neurological symptoms related to the occurrence of necrotizing pseudotumoral encephalitis (NPE) and meningoencephalitis (NME). The present work aims to present a Venezuelan case of NME associated with the coinfection of HIV and a T. cruzi-like trypanosomatid as well as its evolution and diagnosis by histopathological techniques, electron microscopy, and PCR methods using formalin-fixed- (FF-) and paraffin-embedded- (PE-) tissues. Postmortem cytological studies of leptomeninges imprints reveal the presence of trypomastigotes of Trypanosoma sp. Histopathological and electron microscopy studies allowed us to identify an amastigote stage and to reject the involvement of other opportunistic microorganisms as the etiological agent of the SOL. The definitive confirmation of T. cruzi as the etiological agent was achieved by PCR suggesting that the NME by T. cruzi was due to a reactivation of Chagas' disease.
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