Name: SUELLEN RAMOS BARBOZA
Publication date: 25/02/2021
Advisor:
Name |
Role |
|---|---|
| ALOÍSIO FALQUETO | Advisor * |
| CREUZA RACHEL VICENTE | Advisor * |
Examining board:
| Name |
Role |
|---|---|
| ALOÍSIO FALQUETO | Advisor * |
| BLIMA FUX | Internal Examiner * |
| CREUZA RACHEL VICENTE | Advisor * |
| GUSTAVO ROCHA LEITE | External Examiner * |
Summary: American cutaneous leishmaniasis is a disease caused by protozoa of the genus Leishmania that affects skin and mucous membranes. Proper treatment reduces sequelae and assists in its control. However, there are few studies on the association of demographic and clinical factors with the outcome of relapse. The Cassiano Antonio de Moraes University Hospital (HUCAM) is a reference center in the diagnosis and treatment of American cutaneous leishmaniasis (ACL) in Espírito Santo and has reliable data on the reality of the cases, grouping a high number of patients. The study aimed to assess whether relapse was associated with demographic and clinical aspects in patients with ACL, according to clinical form, treated at HUCAM from 1978 to 2005. 1,145 patients were included in the analysis, of whom 1,018 had localized cutaneous leishmaniasis (LCL), 26 cutaneomucosal leishmaniasis (CML) and 101 mucosal leishmaniasis (ML). Most of the patients were male, white, farm workers and without relatives with ACL. Skin lesions were mainly ulcerated and located on the limbs. Mucous lesions, on the other hand, occurred mainly on the nose. The frequency of recurrence was 7.8%, 15.4% and 8.9% for LCL, CML and ML, respectively. The only group of patients that showed an association of variables with recurrence was LCL. In this group, the highest prevalence of relapse was in black patients (13.75%), with disseminated lesions (28.57%) and infiltrated lesions (15.71%). The chances of recurrence of a black or brown patient were 2.3 and 1.9 times greater than in white patients, respectively, 4.9 times greater in patients with disseminated injuries compared to those with an injury, and 2, 5 times higher in patients with infiltrated lesion compared to those who did not have this type of lesion. Relapse is a rare outcome in all groups, being more frequent in forms with mucosal manifestations, such as CML and ML. Some demographic factors, such as skin color, and clinical factors, such as the number and type of lesions, can influence the occurrence of recurrence in LCL. Prospective studies with a larger number of patients are needed.
