Search

Fundamento: la lepra es una enfermedad curable. Si es tratada en su primera fase, se puede evitar la discapacidad que genera. Objetivo: describir aspectos clínicos-epidemiológicos de pacientes diagnosticados con lepra.Métodos: estudio de serie de casos realizado en el municipio Cumanayagua, de Cienfuegos, que incluyó los 15 pacientes diagnosticados con lepra desde 2009 hasta 2019, según base de datos de la Unidad Municipal de Higiene y Epidemiología de dicho municipio. Las principales variables fueron: edad, sexo, consejos populares, clasificación clínica, operacional, tipo de contacto, tratamiento aplicado.Resultados: el grupo de 50-79 años representó el 53,3 %; las féminas constituyeron el 70,0 % de los casos; los consejos populares de mayores riesgos fueron Brisas con el 46,6 % y Vila con 20,0 %; el 73,3 % eran enfermos de lepra multibacilar; más del 40,0 % presentaron anestesia cutánea e infiltraciones; la detección fue espontánea en el 46,6 % de los pacientes. Al 73,3 % se les aplicó tratamiento multibacilar.Conclusiones: la lepra no constituye actualmente un problema grave de salud en el municipio Cumanayagua, pero no es una enfermedad totalmente eliminada, por lo que el conocimiento de las características clínicas y epidemiológicas de los pacientes diagnosticados es importante para su mejor tratamiento y seguimiento médico.

Background: leprosy is a curable disease. If it is treated in its first phase, the disability it generates can be avoided. Objective: to characterize clinically and epidemiologically patients diagnosed with leprosy. Methods: case series study carried out in the Cumanayagua municipality of Cienfuegos, which included the 15 patients diagnosed with leprosy from 2009 to 2019, according to the database of the Municipal Hygiene and Epidemiology Unit of said municipality. The main variables were: age, sex, popular councils, clinical and operational classification, type of contact, applied treatment. Results: the group of 50-79 years represented 53.3%; females constituted 70.0% of the cases; the popular councils with the highest risks were Brisas with 46.6% and Vila with 20.0%; 73.3% were patients with multibacillary leprosy; more than 40.0% had skin anesthesia and infiltrations; detection was spontaneous in 46.6% of the patients. 73.3% received multibacillary treatment. Conclusions: leprosy is not currently a serious health problem in the Cumanayagua municipality, but it is not a completely eliminated disease, so knowledge of the clinical and epidemiological characteristics of diagnosed patients is important for their better treatment and medical follow-up. [ABSTRACT FROM AUTHOR]

El granuloma anular es una dermatosis inflamatoria crónica, benigna, de etiología desconocida, generalmente autolimitada. En muchas ocasiones la lepra tuberculoide asemeja un granuloma anular y este siempre debe ser un diagnóstico diferencial a tener en cuenta. La relación entre el granuloma anular y la lepra aún no está muy clara, aunque pudiera estar relacionado con mecanismos inmunológicos desencadenados en el curso de ambas enfermedades. Por tales razones se presenta el caso de una paciente con manifestaciones cutáneas de ungranuloma anulargeneralizado, cuyo comienzo fue concomitante con el noveno mes de tratamiento para la enfermedad de Hansen (forma clínica tuberculoide). Las principales manifestaciones cutáneas que presentaba eran lesiones eritematosas, papulosas y anulares, de tamaños predominantemente pequeño, formando grandes placas, localizadas en cuello, región superior de la espalda y miembros. Se detectaron las alteraciones histológicas propias de la enfermedad, lo que corroboró el diagnóstico planteado. Se presenta el caso porque,en la literatura consultada, esta enfermedad no está descrita frecuentemente en asociación con la enfermedad de Hansen.

We present the case 49-year-old unmarried woman treated at the hospital of Cienfuegos. The patient complained of weakness in the lower limbs and "numbness" (paresthesia) of all four extremities, which improved slightly after treatment. A year later, the muscle weakness and paresthesia worsened, particularly in the upper limbs. She also developed hypopigmented skin lesions on the chest and abdomen. The investigation was initiated due to suspicion of hypertrophic polyneuropathy. A biopsy of the hypochromic lesions was performed, which led to the conclusion that the patient suffered from a hypertrophic polyneuropathy secondary to tuberculoid Hansen's disease. We decided to present this case since a neuropathy is usually slow, insidious and has a long course in these patients; however, leprosy reactions can lead to acute nerve damage, resulting in disabilities and deformities. Consequently, it is important to act quickly in order to avoid them.

Annular Granuloma is benign chronic inflammatory dermatoses of unknown etiology, usually self-limited. In many cases tuberculoid leprosy resembles an Annular Granuloma and this should always be a differential diagnosis to be considered. The relationship between Annular Granuloma and Leprosy is not yet clear, although it may be related to immunological mechanisms triggered in the course of both diseases. For these reasons it is presented a case of a patient with cutaneous manifestations of annular generalized granuloma, whose onset was concomitant with the ninth month of treatment for Hansen's disease (tuberculoid clinical form). The main cutaneous manifestations presented were erythematous, papular and annular lesions, predominantly small in size, forming large plaques, located in the neck, upper region of the back and limbs. Histological alterations of the disease were detected, which corroborated the diagnosis. The case is presented because, in the consulted literature, this disease is not frequently described in association with Hansen's disease. [ABSTRACT FROM AUTHOR]

Background: leprosy is a chronic and communicable disease affecting mankind since its origins and its incidence is very variable. Objective: to determine the incidence of leprosy in the province of Cienfuegos from 1980 through 2009. Methods: a clinical and epidemiological study was conducted involving patients diagnosed with leprosy in the province of Cienfuegos. Incidence was analyzed in each year. Results: incidence was very variable in all years studied; lowest rate occurred in 1993 with 0.3 per 100 000 inhabitants; in 2008 the rate increased to 4 per 100 000 inhabitants. Conclusions: leprosy showed an unstable incidence throughout the study period, with highs and lows. It is important to note that in recent years it has showed an increasing trend.

We report the case of a female patient with cutaneous manifestations of leprosy, whose clinical presentation was atypical and of torpid evolution. From disease onset, the patient developed polymorphic skin lesions accompanied by sensory disturbances. The initial diagnosis was indeterminate leprosy. Multibacillary treatment was indicated. After two years of evolution, given the exacerbation of lesions and general symptoms worsening, biopsy was performed again, providing the following histological result: Hansen dimorphic, the result of the sputum smear being negative. In 2001, a nerve conduction study showed axomielynic damage in the sensory fibers of the right crural nerve. In 2004 the patient presented hives without stinging that left white stains when they disappeared. From that date until 2008 she continued to refer the disease. Multidisciplinary interconsultation was performed in coordination with the national team leader and she was assessed at the meeting of specialists in Havana City, where they initiated therapy with rifampicin, ofloxacin and minocycline, under which she remained for a year, with a satisfactory outcome.

Se presenta el caso de una paciente con manifestaciones cutáneas de lepra, cuyo cuadro clínico fue atípico y de evolución tórpida. Desde su inicio la paciente presentó lesiones cutáneas polimorfas acompañadas de trastornos de la sensibilidad; el diagnóstico inicial fue de lepra indeterminada. Se indicó tratamiento multibacilar. A los dos años de evolución, dada la exacerbación de las lesiones y empeoramiento de la sintomatología general se realizó nuevamente biopsia, cuyo resultado histológico fue: Hansen dimorfo; el resultado de la baciloscopia fue negativo. En el año 2001, un estudio de la conducción nerviosa mostró un daño axomielínico de fibras sensitivas del nervio crural derecho. En el año 2004 presentó ronchas en la piel, sin escozor, que al desaparecer dejaban manchas blanquecinas. Desde esa fecha hasta el año 2008 continuó sin que remitiera la enfermedad. Se realizó interconsulta multidisciplinaria en coordinación con el jefe del grupo nacional y fue valorada en reunión de especialistas en la Ciudad de La Habana, donde se impuso terapia con rifampicina, ofloxacina y minociclina, con la que permaneció durante un año, con una evolución satisfactoria.

Background: Leprosy is a chronic and communicable disease that has appeared in human beings since their very emergence as species. It can produce, along its evolution, great deformities that patients very much fear. Objective: To describe diagnostic forms and leprosy-related disabilities in the province of Cienfuegos from 1980 to 2005. Methods: A descriptive case series study was conducted with patients diagnosed with leprosy in the province of Cienfuegos. The variables analyzed were diagnostic form (early or late) and presence of disabilities. Data processing was performed using the SPSS program. In this sense, we created a database with the previously mentioned variables. Results: The proportion and trend of diagnostic form (early or late) was not stable. In general, patients with early diagnosis and without disabilities predominated. Conclusions: through the case series study, the importance of early diagnosis to prevent the disabilities became evident: as the number of early diagnosis increases, thus proportionally decreased the number of disabilities in patients.

Fundamento: la lepra es una enfermedad crónica y transmisible que acompaña al hombre desde sus inicios. Es capaz, en su evolución, de producir grandes deformidades muy temidas por los pacientes. Objetivo: describir la forma de diagnóstico y las discapacidades por lepra en la provincia de Cienfuegos de 1980 a 2005. Métodos: estudio descriptivo de serie de casos sobre pacientes con diagnóstico de lepra en la provincia de Cienfuegos. Se analizaron las variables: forma de diagnóstico (precoz o tardío), la existencia de discapacidades. El procesamiento de la información se realizó empleando el programa SPSS, para lo cual se creó una base de datos con las variables antes referidas. Resultados: la proporción y tendencia de la forma de detección, precoz o tardío fue variable, en general predominaron los casos con diagnóstico precoz y sin incapacidad. Conclusiones: se evidenció, mediante la serie estudiada, la importancia de un diagnóstico precoz para evitar la aparición de discapacidades, pues a medida que aumenta el número de diagnóstico precoz disminuye proporcionalmente el número de discapacidades en los enfermos.

We present the case 49-year-old unmarried woman treated at the hospital of Cienfuegos. The patient complained of weakness in the lower limbs and "numbness" (paresthesia) of all four extremities, which improved slightly after treatment. A year later, the muscle weakness and paresthesia worsened, particularly in the upper limbs. She also developed hypopigmented skin lesions on the chest and abdomen. The investigation was initiated due to suspicion of hypertrophic polyneuropathy. A biopsy of the hypochromic lesions was performed, which led to the conclusion that the patient suffered from a hypertrophic polyneuropathy secondary to tuberculoid Hansen's disease. We decided to present this case since a neuropathy is usually slow, insidious and has a long course in these patients; however, leprosy reactions can lead to acute nerve damage, resulting in disabilities and deformities. Consequently, it is important to act quickly in order to avoid them. [ABSTRACT FROM AUTHOR]