Post-kala-azar dermal leishmaniasis (PKDL) is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area) presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.

Post-kala-azar dermal leishmaniasis (PKDL) is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area) presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.

PURPOSE:To evaluate the effects of fat embolism in organs such as lung and liver. METHODS:Twenty rabbits underwent autologous intramuscular fat grafting in the right thigh after liposuction. The groups were determined according to the postoperative day that occurred in euthanasia: 60, 90 and 120 day. Then, lung and liver were excised and sent to the histopathology laboratory for analysis in search of late injury secondary to a prior event of fat embolism in the tissues. RESULTS:The results showed a change in the macroscopic sample with discoloration of the liver tissue heterogeneously. There were no changes consistent with embolic effect under the microscope. CONCLUSION:The option of performing a technique of fat grafting with a less traumatic surgical procedure can be considered protective against embolic events, with no impact to late embolic events on the tissues.Key words: Embolism, Fat. Lipectomy. Ischemia. Rabbits. RESUMOOBJETIVO: Avaliar a repercussão da embolia gordurosa em órgãos como pulmão e fígado. MÉTODOS:Vinte coelhos foram submetidos à enxertia autóloga intramuscular de gordura em coxa direita após lipoaspiração. Os grupos foram determinados conforme os dias pós-operatórios (DPO) em que ocorreu a eutanásia: 60 DPO, 90DPO, 120 DPO. Em seguida, o pulmão e o fígado foram ressecados e encaminhados ao laboratório de histopatologia para análise em busca de lesão tardia secundária a evento de embolia gordurosa prévia nos tecidos. RESULTADOS:Foi evidenciada uma alteração na amostra a analise macroscópica com alteração da coloração do tecido hepático de forma heterogênea. Não houve alterações compatíveis com repercussão de processo embólico à microscopia. CONCLUSÃO:A opção pela realização de uma técnica de lipoenxertia menos traumática e com pequeno tempo cirúrgico pode ser considerada protetora para eventos embólicos, não havendo repercussão embólica a tardiamente.Descritores: Embolia Gordurosa. Lipectomia. Isquemia. Coelhos.Felzemburgh VA et al.

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Introduction: Simple steatosis or nonalcoholic steatohepatitis are liver diseases associated with diabetes mellitus (DM). However, a form of diabetic microangiopathy with hepatic sinusoidal fibrosis and basement membrane deposition without cirrhosis has been described and referred as diabetic hepatosclerosis (DH). Objective: To identify scientific studies and to deepen the knowledge on DH, and to evaluate the prevalence of DH in the main published studies in medical literature. Method: Integrative review of the literature conducted in the database PubMed/MEDLINE, and crossed the following descriptors from the Health Science Descriptors (DeCs) and MeSH: liver microangiopathy, hepatosclerosis and diabetes mellitus connected by the Boolean operator AND. Only studies that evaluated the prevalence of DH were selected, summarizing and identifying the limitations of research from 1965 to date. Results: The sample consisted of five studies published that met the inclusion criteria. Studies showed the following aspects: 1. Harrison SA, et al. (2006), described 12 patients identified from hepatic biopsy findings, all had a history of long-standing DM and a noncirrhotic form of hepatic sinusoidal fibrosis not associated with nonalcoholic steatohepatitis. 2. Chen G, et al (2009), reported a prevalence of 12% in 10-year of study. 3. Hudacko RM, et al. (2009) showed that in autopsies from 57 adults with DM, only 1 case (1.7%) of DH was identified. 4. Wang Z et al. (2012), in their study showed that pathological features of 14.2% cases were consistent with the diagnosis of DH. 5. Balakrishnan M, et al. (2015) showed that DH was significantly more prevalent among diabetic patients compared with controls: 45% versus 29%. Conclusion: We identified a small number of studies that addressed the topic, and represent a hepatic form of microvascular disease in DM, in the majority of the cases clinically silent, probably it is common but under-recognized. There is a paucity of literature about DH, and further studies are needed to precisely characterize the DH, to understand mechanisms of pathogenesis and your clinical significance.