Immunodepressed patients in the intermediate phase of Chagas' disease may undergo reactivation of the disease together with atypical symptoms. The case of an immunodepressed kidney transplant patient with reactivation of Chagas' disease with skin symptoms is reported. A 65-year-old man presented with infiltrated erythematous lesions on the anterior aspect of the right thigh of 2 weeks' duration. The lesions later extended to the abdomen, thorax, and lower limbs. In the histologic skin examination, amastigotes and Trypanosoma cruzi trypoamastigotes were observed. A fresh smear showed positive parasitemia. Using the Strout hemoconcentration method, multiple Trypanosoma cruzi trypoamastigotes with motility could be seen. Polymerase chain reaction was positive for Trypanosoma cruzi. An immunofluorescence test was positive (1 : 64) and there was hemoagglutination (1 : 32). Treatment was started with benznidazole, 7 mg/kg/day. The patient did not evolve favorably and died 20 days after hospitalization. Skin lesions may be a manifestation of the reactivation of Chagas' disease in immunosuppressed patients. All patients with positive Chagas' serology who require immunosuppressant drugs should receive specific treatment for Chagas' disease.

Background Leishmaniasis is a disease produced by several species of protozoa of the Leishmania genus. These protozoa are injected into the human bloodstream by sandflies. The symptomathology, either cutaneous, mucocutaneous or visceral, depends on the infective species and the immune status of the patient. Antimonial drugs are the mainstay treatment for all the clinical forms of the disease. Amphotericin B is the second-choice drug. MethodsWe report two clinical cases of cutaneous leishmaniasis treated with itraconazole.One case was a relapsing form unresponsive to conventional therapy.Results Both patients achieved fast resolution of their lesions with no secondary effects.Conclusions Itraconazole may be a valid option for the treatment of cutaneous leishmaniasis, mainly in those cases unresponsive to conventional drugs.

Se presentan dos casos diagnosticados de dermatosis perforante adquirida (DPA) en el contexto de pacientes con neoplasias malignas, en los que se confirmó la resolución de la clínica cutánea luego de la mejoría oncológica. Se identificaron pocos informes de casos que relacionaran la DPA con ampulomas o linfomas de Hodgkin, como estos pacientes; se plantea que es posible esta relación como anomalía paraneoplásica, pero se necesitan estudios adicionales para confirmarlo.

El síndrome poliglandular autoinmunitario es un trastorno inmunológico que afecta a diferentes glándulas endocrinas y se relaciona con enfermedades cutáneas de origen autoinmunitario como el vitiligo. Se clasifica en cuatro grupos de acuerdo con las glándulas comprometidas. El síndrome poliglandular autoinmunitario de tipo IIIB es el más notificado y se caracteriza por enfermedad tiroidea autoinmunitaria con gastritis autoinmunitaria. El vitiligo es la enfermedad cutánea que más se vincula con este síndrome. Se comunica un caso de síndrome poliglandular autoinmunitario de tipo IIIB en un paciente de 58 años, en relación con psoriasis.