Centro Dermatologico Federico Lleras Acosta

Bogotá, Colombia

Centro Dermatologico Federico Lleras Acosta

Bogotá, Colombia
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Gutierrez-Castaneda L.D.,Centro Dermatologico Federico Lleras Acosta | Jaimes A.O.,Centro Dermatologico Federico Lleras Acosta | Sanchez Bottomley W.,Centro Dermatologico Federico Lleras Acosta
Piel | Year: 2017

Introduction: Contact dermatitis is a frequent cause of consultation in Colombia, where there is a lack of information about its epidemiology and its origin. Objective: To describe the clinical and epidemiological characteristics and the results of epicutaneous tests performed at the Federico Lleras Acosta Dermatology Center, Bogotá, Colombia. Materials and methods: A descriptive study and analysis was performed on the demographic and epidemiological characteristics of the patients who underwent epicutaneous tests with the standard European battery of allergens. Results: More than two-thirds (68%) of the patients showeded positive results in the epicutaneous tests. The most common allergen was nickel, followed by Peruvian balm, and fragrances. The age groups between 20 to 29 and 50 to 59 years were the most affected. The most common occupation and outside work activity were household tasks. The most affected areas of the body were hands (27.4%). Erythematous desquamative plaques were observed in 52% of those affected, and current relevance was found in 80% of the patients studied. Conclusions: Women were more affected than men. Nickel, fragrances, and preservatives were the predominant allergens, which is consistent with that reported in the international literature. There were no positive results to allergens such as budesonide, which shows the need to develop multicentre studies in Colombia that would help include new allergens and discard others. © 2017 Elsevier España, S.L.U.


PubMed | Grupo Colombiano de Psoriasis CoLPsor, Liga contra el Cancer de Risaralda, Technological University of Pereira, Hospital Erasmo Meoz Of Cucuta and 6 more.
Type: | Journal: Actas dermo-sifiliograficas | Year: 2017

To date, no formal study has been published regarding how Colombian patients with skin disorders could be affected according to their perception of disease.To determine the impact in quality of life of skin diseases in a Colombian population.This multicenter study included patients with skin disease from almost the whole country. Individuals >18 years old; of any gender; with any skin disease and who signed informed consent, were included. We applied the Colombian validated version of the Skindex-29 instrument.A total of 1896 questionnaires had sufficient information for the analyses. No significant differences in sociodemographic characteristics of patients who returned the questionnaire incomplete vs. complete, were found. Participants mean age was 41.5 years. There were no statistical differences in men vs. women regarding the global (p=0.37), symptoms (p=0.71) and emotions (p=0.32) domains, whereas statistical differences were found in the function domain (p=0.04; Mann-Whitney U test). Psoriasis, contact dermatitis, atopic dermatitis, urticaria, hair disorders, Hansens disease, scars, hyperhidrosis and genital human papillomavirus disease scored the highest.Skindex-29 score variability as a result of differences in the location of the skin lesions, their inflammatory or non-inflammatory nature, and the start of therapy.Even the most localized or asymptomatic skin lesion in our population leads to a disruption at some level of patients wellness. This study adds well supported scientific data of the burden of skin diseases worldwide.


Fernandez O.,Centro Internacional Of Entrenamiento E Investigaciones Medica | Diaz-Toro Y.,Centro Dermatologico Federico Lleras Acosta | Valderrama L.,Centro Internacional Of Entrenamiento E Investigaciones Medica | Ovalle C.,Centro Dermatologico Federico Lleras Acosta | And 4 more authors.
Journal of Clinical Microbiology | Year: 2012

Resistance to antimonial drugs has been documented in Leishmania isolates transmitted in South America, Europe, and Asia. The frequency and distribution of resistance to these and other antileishmanial drugs are unknown. Technical constraints have limited the assessment of drug susceptibility of clinical strains of Leishmania. Susceptibility of experimentally selected lines and 130 clinical strains of Leishmania panamensis, L. braziliensis, and L. guyanensis to meglumine antimoniate and miltefosine was determined on the basis of parasite burden and percentage of infected U-937 human macrophages. Reductions of infection at single predefined concentrations of meglumine antimoniate and miltefosine and 50% effective doses (ED 50s) were measured and correlated. The effects of 34°C and 37°C incubation temperatures and different parasite-to-host cell ratios on drug susceptibility were evaluated at 5, 10, and 20 parasites/cell. Reduction of the intracellular burden of Leishmania amastigotes in U-937 cells exposed to the predefined concentrations of meglumine antimoniate or miltefosine discriminated sensitive and experimentally derived resistant Leishmania populations and was significantly correlated with ED 50 values of clinical strains (for meglumine antimoniate, ρ = -0.926 and P < 0.001; for miltefosine, ρ = -0.906 and P < 0.001). Incubation at 37°C significantly inhibited parasite growth compared to that at 34°C in the absence of antileishmanial drugs and resulted in a significantly lower ED 50 in the presence of drugs. Susceptibility assessment was not altered by the parasite-to-cell ratio over the range evaluated. In conclusion, measurement of the reduction of parasite burden at a single predetermined drug concentration under standardized conditions provides an efficient and reliable strategy for susceptibility evaluation and monitoring of clinical strains of Leishmania. Copyright © 2012, American Society for Microbiology. All Rights Reserved.


Guerrero-Guerrero M.I.,Centro Dermatologico Federico Lleras Acosta
Leprosy review | Year: 2012

To determine the frequency and factors associated with relapse in multibacillary leprosy. We performed a retrospective cohort study on multibacillary leprosy patients treated at Centro Dermatologico Federico Lleras Acosta between January 1994 and December 2004. By survival analysis we studied the incidence density for recurrence and bacillary index conversion. The assessment of risk factors associated with the occurrence of relapse was constructed using a Cox regression model. We included 299 cases of which 243 received WHO-MB MDT on a regular basis, and followed them up to assess the frequency of relapses. We obtained 490 person-years of follow-up and an incidence density of 6.70 relapses/100 patient-years that was higher than most of the data reported in the literature. The relapse rate was 9.80 per 100 person-years when the initial bacillary index was > or = 2.0 and 5.60 relapses/100 patient-years when it was < 2 (P = 0.03). The relapse rate increased to 7.70/100 patient-years among those treated with WHO-MB 24 month fixed-dose, and it reduced to 5.70/100 patient-years when treated until smear negative. The variables that showed association with relapse were: initial bacillary index > or = 2.0, antireactional treatment and clinical classification of lepromatous leprosy. For each variable, the risk was four to five times more likely to present relapse. We also found that 21 patients' BI became negative per 100 treated for 1 year with WHO-MB MDT. We found a high relapse rate associated with initial high bacillary index in the Colombian population. Among the patients who received MDT on a regular basis 33 out of 165 (20%) relapsed.


Sanchez G.,Centro Dermatologico Federico Lleras Acosta | Nova J.,Centro Dermatologico Federico Lleras Acosta | De La Hoz F.,National University of Colombia | Castaneda C.,National University of Colombia
Piel | Year: 2011

Objective: To establish the incidence of skin cancer in Colombia from 2003 to 2007. Methods: We performed an ecological study, using health services' records collected by the Colombian Ministry of Social Protection 2003-2007, the results of the National Demography and Health Survey of 2005, and the population predictions for Colombia of the National Department of Statistics. Results: The incidence rate of skin cancer in 2003 was 23 cases per 100 000 people, increasing to 41 cases per 100 000 people in 2007. The male:female ratio was 1.2:1. The incidence of skin cancer doubled in people over 60 years old. The departments with the highest incidence of skin cancer in the country were Bogota, Cundinamarca, Antioquia and Boyaca. The expected incidence of skin cancer in Colombia for 2020 is approximately 102 cases per 100 000 people. Conclusions: As in other countries, the incidence of skin cancer in Colombia is increasing. Preventive strategies are required to control this phenomenon in our setting. © 2010 Elsevier España, S.L. All rights reserved.


Sanchez G.,Centro Dermatologico Federico Lleras Acosta | Nova J.,Centro Dermatologico Federico Lleras Acosta
Actas Dermo-Sifiliograficas | Year: 2013

Introduction Nonmelanoma skin cancer is the most common malignancy in white individuals. The risk factors for squamous cell carcinoma, which belongs to the family of nonmelanoma skin cancers, have not been studied in Colombia. Objective To determine the risk factors for squamous cell carcinoma in patients at a national referral center for skin diseases in Colombia. Material and methods We conducted a case-control study that evaluated sociodemographic, epidemiological, and clinical factors among 332 individuals. Risk was calculated as odds ratio (ORs) using the multivariate conditional logistic regression analysis method. Results The following risk factors were identified: family history of skin cancer (OR, 6.55; 95% CI, 1.4-28.9), living in a rural area after the age of 30 years (OR, 3.13; 95% CI, 1.3-7.2), a lifetime working outdoors (OR, 2.98; 95% CI, 1.5-5.7), smoking more than 10 cigarettes a day (OR, 2.96; 95% CI, 1.3-6.5), actinic conjunctivitis (OR, 2.68; 95% CI, 1.2-5.9), poikiloderma of Civatte (OR, 3.29; 95% CI, 1.7-6.1), numerous facial actinic keratoses (OR, 9.23; 95% CI, 4.9-17.1), and numerous freckles (OR, 3.68; 95% CI, 1.3-10.1). Conclusions We have documented clinical characteristics and personal history factors that should guide the physician in making decisions on the preventive and follow-up measures to be adopted for individuals at risk of squamous cell carcinoma. These findings may help guide policy for controlling the disease using local information. © 2011 Elsevier España, S.L. and AEDV. All rights reserved.


Cruz-Barrera M.L.,National University of Colombia | Ovalle-Bracho C.,Centro Dermatologico Federico Lleras Acosta | Ortegon-Vergara V.,Centro Dermatologico Federico Lleras Acosta | Perez-Franco J.E.,Hospital Militar Central | And 2 more authors.
Journal of Clinical Microbiology | Year: 2015

The discrimination of Leishmania species from patient samples has epidemiological and clinical relevance. In this study, different gene target PCR-restriction fragment length polymorphism (RFLP) protocols were evaluated for their robustness as Leishmania species discriminators in 61 patients with cutaneous leishmaniasis. We modified the hsp70-PCR-RFLP protocol and found it to be the most reliable protocol for species identification. Copyright © 2015, American Society for Microbiology. All Rights Reserved.


Ovalle-Bracho C.,Centro Dermatologico Federico Lleras Acosta | Londono-Barbosa D.A.,Centro Dermatologico Federico Lleras Acosta | Franco-Munoz C.,Centro Dermatologico Federico Lleras Acosta | Clavijo-Ramirez C.,National University of Colombia
Parasitology | Year: 2015

Leishmaniasis development is multifactorial; nonetheless, the establishment of the infection, which occurs by the survival and replication of the parasite inside its main host cell, the macrophage, is mandatory. Thus, the importance of studying the molecular mechanisms involved in the Leishmania-macrophage interaction is highlighted. The aim of this study was to characterize a cellular model of macrophages derived from U937 cells that would allow for the identification of infection phenotypes induced by genetic silencing with interference RNA in the context of macrophages infected with Leishmania (Viannia) braziliensis. The model was standardized by silencing an exogenous gene (gfp), an endogenous gene (lmna) and a differentially expressed gene between infected and non-infected macrophages (gro-β). The silencing process was successful for the three genes studied, obtaining reductions of 88·9% in the GFP levels, 87·5% in LMNA levels and 74·4% for Gro-β with respect to the corresponding control cell lines. The cell model revealed changes in the infection phenotype of the macrophages in terms of number of amastigotes per infected macrophage, number of amastigotes per sampled macrophage and percentage of infected macrophages as a result of gene silencing. Thus, this cell model constitutes a research platform for the study of parasite-host interactions and for the identification of potentially therapeutic targets.


PubMed | Centro Dermatologico Federico Lleras Acosta and National University of Colombia
Type: Journal Article | Journal: Parasitology | Year: 2015

Leishmaniasis development is multifactorial; nonetheless, the establishment of the infection, which occurs by the survival and replication of the parasite inside its main host cell, the macrophage, is mandatory. Thus, the importance of studying the molecular mechanisms involved in the Leishmania-macrophage interaction is highlighted. The aim of this study was to characterize a cellular model of macrophages derived from U937 cells that would allow for the identification of infection phenotypes induced by genetic silencing with interference RNA in the context of macrophages infected with Leishmania (Viannia) braziliensis. The model was standardized by silencing an exogenous gene (gfp), an endogenous gene (lmna) and a differentially expressed gene between infected and non-infected macrophages (gro-). The silencing process was successful for the three genes studied, obtaining reductions of 889% in the GFP levels, 875% in LMNA levels and 744% for Gro- with respect to the corresponding control cell lines. The cell model revealed changes in the infection phenotype of the macrophages in terms of number of amastigotes per infected macrophage, number of amastigotes per sampled macrophage and percentage of infected macrophages as a result of gene silencing. Thus, this cell model constitutes a research platform for the study of parasite-host interactions and for the identification of potentially therapeutic targets.


PubMed | Centro Dermatologico Federico Lleras Acosta and University of La Sabana
Type: Journal Article | Journal: International journal of dermatology | Year: 2016

Histological similarities between granulomas and granulomatous mycosis fungoides (GMF) may lead to misdiagnoses of sarcoidosis or leprosy.This report presents four patients with GMF in whom skin biopsies showed perineural and intraneural granulomas that were confused with tuberculoid leprosy granulomas.Patient 1 presented with erythematous plaques and bulky nodules. Biopsy findings suggested cutaneous sarcoidosis. Tumor resection showed granulomatous infiltrate extending to the fascia and skeletal muscle. Clinicopathological correlations permitted a diagnosis of GMF. Patient 2 presented with erythematous plaques. Skin biopsies had indicated sarcoidosis. Resection of a thigh nodule excluded leprosy, and GMF was diagnosed. Patient 3 presented with scaly, hyperpigmented plaques. Biopsy showed diffuse granulomatous inflammation with epithelioid and giant cells, abundant lymphocytes, and some eosinophils, and indicated GMF. Patient 4 presented with pruritic, erythematous plaques. Biopsy of an indurated mammary plaque initially indicated sarcoid granulomatous inflammation. Biopsy review suggested GMF.This study highlights both the diagnosis of GMF, and granulomatous cutaneous nerve injury in GMF and its possible confusion with leprosy granulomas. The histological diagnosis of GMF includes: (i) a granulomatous infiltrate rich in giant cells, emperipolesis, histiocytic cells, and scattered eosinophils, which may reach the fascia and muscle; (ii) the absence of elastic fibers or their phagocytosis by giant cells; and (iii) lymphocytes that may show atypia and epidermotropism. Deep biopsies reveal GMF diagnostic changes and, in conjunction with clinicopathological correlations, exclude a diagnosis of leprosy and support one of GMF, thus facilitating its appropriate management.

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