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Valbuena M.C.,Centro Dermatologico Federico Lleras Acosta | Valbuena M.C.,CES University | Patino L.A.,CES University
Revista Argentina de Dermatologia | Year: 2013

The association of psoriasis and vitiligo is a well documented event, with an incidence of 3% according to different case series, but reports of an overlap of both diseases following Blaschko lines were not found in the reviewed literature. We present the case of a 47 years old woman with vitiligo lesions in the face and abdomen, starting since childhood, distributed over the Blaschko lines; thirty years later erythematous and squamous plaques appeared over the achromic macules of the abdominal region which were clinically and histopathologically compatible with psoriasis and improved partially with narrow band UVB phototherapy. Psoriasis and vitíligo are multifactorial and polygenic skin disorders that can show patterns of cutaneous mosaicism. Some theories have tried to explain this phenomenon, but the factors that influence this presentation are still unclear. © 2013 Asociación Argentina de Dermatología.

Rubiano L.C.,Centro Internacional Of Entrenamiento E Investigaciones Medicas Cideim | Miranda M.C.,Centro Internacional Of Entrenamiento E Investigaciones Medicas Cideim | Muvdi Arenas S.,Centro Dermatologico Federico Lleras Acosta | Montero L.M.,Hospital San Juan Bautista | And 8 more authors.
Journal of Infectious Diseases | Year: 2012

Background.Children have a lower response rate to antimonial drugs and higher elimination rate of antimony (Sb) than adults. Oral miltefosine has not been evaluated for pediatric cutaneous leishmaniasis.Methods.A randomized, noninferiority clinical trial with masked evaluation was conducted at 3 locations in Colombia where Leishmania panamensis and Leishmania guyanensis predominated. One hundred sixteen children aged 2-12 years with parasitologically confirmed cutaneous leishmaniasis were randomized to directly observed treatment with meglumine antimoniate (20 mg Sb/kg/d for 20 days; intramuscular) (n = 58) or miltefosine (1.8-2.5 mg/kg/d for 28 days; by mouth) (n = 58). Primary outcome was treatment failure at or before week 26 after initiation of treatment. Miltefosine was noninferior if the proportion of treatment failures was ≤15% higher than achieved with meglumine antimoniate (1-sided test, α =. 05).Results.Ninety-five percent of children (111/116) completed follow-up evaluation. By intention-to-treat analysis, failure rate was 17.2% (98% confidence interval [CI], 5.7%-28.7%) for miltefosine and 31% (98% CI, 16.9%-45.2%) for meglumine antimoniate. The difference between treatment groups was 13.8%, (98% CI,-4.5% to 32%) (P =. 04). Adverse events were mild for both treatments.Conclusions.Miltefosine is noninferior to meglumine antimoniate for treatment of pediatric cutaneous leishmaniasis caused by Leishmania (Viannia) species. Advantages of oral administration and low toxicity favor use of miltefosine in children.Clinical Trial Registration.NCT00487253. © 2011 The Author.

Ortega-Recalde O.,El Rosario University | Fonseca D.J.,El Rosario University | Patino L.C.,El Rosario University | Atuesta J.J.,Centro Dermatologico Federico Lleras Acosta | And 5 more authors.
Mitochondrion | Year: 2013

NDUFV1 mutations have been related to encephalopathic phenotypes due to mitochondrial energy metabolism disturbances. In this study, we report two siblings affected by a diffuse leukodystrophy, who carry the NDUFV1 c.1156C>T (p.Arg386Cys) missense mutation and a novel 42-bp deletion. Bioinformatic and molecular analysis indicated that this deletion lead to the synthesis of mRNA molecules carrying a premature stop codon, which might be degraded by the nonsense-mediated decay system. Our results add information on the molecular basis and the phenotypic features of mitochondrial disease caused by NDUFV1 mutations. © 2013 Elsevier B.V. and Mitochondria Research Society. 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.

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.

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