The Current Challenge of Imported Leprosy in Spain: A Study of 7 Cases
Lepra importada y su dificultad en el medio actual: a propósito de 7 casos
M. Contreras-Steyls
, N. López-Navarro, E. Herrera-Acosta, R. Castillo, G. Ruiz del Portal, R.J. Bosch, E. Herrera
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Servicio de Dermatología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
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"apellidos" => "Fernández-Redondo" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Fernández-Vozmediano" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Sánchez-Pérez" ] 5 => array:2 [ "nombre" => "J.F." "apellidos" => "Silvestre" ] 6 => array:2 [ "nombre" => "W." "apellidos" => "Uter" ] 7 => array:2 [ "nombre" => "A.M." "apellidos" => "Giménez-Arnau" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219011707661?idApp=UINPBA000044" "url" => "/15782190/0000010200000002/v1_201304241539/S1578219011707661/v1_201304241539/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "titulo" => "The Current Challenge of Imported Leprosy in Spain: A Study of 7 Cases" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "106" "paginaFinal" => "113" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Contreras-Steyls, N. López-Navarro, E. Herrera-Acosta, R. Castillo, G. Ruiz del Portal, R.J. Bosch" "autores" => array:7 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Contreras-Steyls" "email" => array:1 [ 0 => "torosmar1@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "N." "apellidos" => "López-Navarro" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Herrera-Acosta" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Castillo" ] 4 => array:2 [ "nombre" => "G." "apellidos" => "Ruiz del Portal" ] 5 => array:2 [ "nombre" => "R.J." "apellidos" => "Bosch" ] 6 => array:2 [ "nombre" => "E." "apellidos" => "Herrera" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Dermatología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lepra importada y su dificultad en el medio actual: a propósito de 7 casos" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-01-28" "fechaAceptado" => "2010-09-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec84853" "palabras" => array:3 [ 0 => "Leprosy" 1 => "Hansen disease" 2 => "Epidemiologic update" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras Clave" "identificador" => "xpalclavsec84852" "palabras" => array:3 [ 0 => "Lepra" 1 => "Enfermedad de Hansen" 2 => "Actualidad" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Although the foci of leprosy once present in Spain are now under control and almost inactive, isolated cases are still occasionally diagnosed. Meanwhile, population migration has brought about an increase in the incidence of cases corresponding to individuals from countries where leprosy is endemic, leading to changes in the epidemiology of this disease.</p> <span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The aim of this paper was to describe the clinical, epidemiologic, dermatologic, microbiologic, and therapeutic characteristics of cases of leprosy in our department in the last 5 years.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We report the cases of imported leprosy seen in our department between 2004 and 2009.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Seven patients with leprosy (3 men and 4 women; age range, 26-80 years) were diagnosed; 2 were cases of tuberculoid leprosy, 2 borderline tuberculoid leprosy, and 3 indeterminate. All patients acquired the disease in South American or South African countries, but were residing in Spain at the time of diagnosis. One patient was a Spaniard, from Malaga, who had worked as a missionary in Venezuela for 25 years. The presence of the bacterium by either Ziehl-Neelsen stain or bacilloscopy could not be demonstrated in any of the patients.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We would like to draw attention to the changes we have observed in the characteristics of cases of leprosy seen in our department, the majority of which are imported. It is important to maintain a clinical suspicion of leprosy in cases of granulomatous dermatitis, particularly in patients from countries where the disease is endemic.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Aunque los focos históricos de infección leprosa en nuestro país están controlados y son prácticamente inactivos, aún se siguen diagnosticando algunos casos autóctonos aislados. La elevada movilidad poblacional actual ha traído consigo un aumento en la incidencia de casos importados de países endémicos, lo que está motivando un cambio en las características epidemiológicas del paciente afecto de lepra.</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El propósito de este artículo es poner de manifiesto las características clínicas, epidemiológicas, dermatopatológicas, microbiológicas y terapéuticas de los pacientes diagnosticados de lepra en los últimos 5 años en nuestro Servicio.</p> <span class="elsevierStyleSectionTitle">Material y método</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Presentamos los casos de lepra importada que hemos valorado en nuestro Servicio desde el año 2004 al 2009.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se trata de 7 casos de lepra, 3 varones y 4 mujeres, de edades comprendidas entre los 26 y los 80 años, 2 de tipo tuberculoide, 2 borderline tuberculoide y 3 de tipo indeterminada. Todos procedían de países sudamericanos o sudafricanos donde adquirieron la enfermedad, aunque residían en España en ese momento. Sólo uno de los pacientes era natural de Málaga, pero trabajó como misionero en Venezuela durante 25 años. En ningún caso se logró demostrar la existencia de bacilos mediante la técnica de Ziehl-Neelsen, siendo la baciloscopia igualmente negativa.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Queremos destacar los cambios epidemiológicos que hemos observado en los casos de lepra diagnosticados en nuestro Servicio, la mayoría de los cuales son importados. Es importante seguir manteniendo la sospecha clínica de lepra ante dermatitis granulomatosas, especialmente en pacientes de países endémicos.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Las enfermedades infecciosas y la historia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Lain-Entralgo" 1 => "L. Montiel" 2 => "J.J. Picazo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Microbiología médica 2" "paginaInicial" => "1" "paginaFinal" => "10" "serieFecha" => "1996" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 11 | 9 | 20 |
| 2024 October | 68 | 58 | 126 |
| 2024 September | 77 | 27 | 104 |
| 2024 August | 110 | 48 | 158 |
| 2024 July | 77 | 36 | 113 |
| 2024 June | 77 | 44 | 121 |
| 2024 May | 75 | 37 | 112 |
| 2024 April | 55 | 33 | 88 |
| 2024 March | 58 | 38 | 96 |
| 2024 February | 50 | 42 | 92 |
| 2024 January | 58 | 41 | 99 |
| 2023 December | 51 | 41 | 92 |
| 2023 November | 60 | 68 | 128 |
| 2023 October | 56 | 43 | 99 |
| 2023 September | 46 | 24 | 70 |
| 2023 August | 31 | 11 | 42 |
| 2023 July | 40 | 43 | 83 |
| 2023 June | 51 | 33 | 84 |
| 2023 May | 54 | 50 | 104 |
| 2023 April | 44 | 40 | 84 |
| 2023 March | 28 | 49 | 77 |
| 2023 February | 33 | 51 | 84 |
| 2023 January | 40 | 44 | 84 |
| 2022 December | 31 | 64 | 95 |
| 2022 November | 17 | 48 | 65 |
| 2022 October | 13 | 33 | 46 |
| 2022 September | 26 | 85 | 111 |
| 2022 August | 28 | 50 | 78 |
| 2022 July | 26 | 33 | 59 |
| 2022 June | 21 | 23 | 44 |
| 2022 May | 16 | 40 | 56 |
| 2022 April | 34 | 41 | 75 |
| 2022 March | 33 | 48 | 81 |
| 2022 February | 13 | 35 | 48 |
| 2022 January | 23 | 38 | 61 |
| 2021 December | 24 | 44 | 68 |
| 2021 November | 23 | 58 | 81 |
| 2021 October | 29 | 62 | 91 |
| 2021 September | 26 | 59 | 85 |
| 2021 August | 12 | 26 | 38 |
| 2021 July | 18 | 27 | 45 |
| 2021 June | 17 | 24 | 41 |
| 2021 May | 20 | 23 | 43 |
| 2021 April | 61 | 42 | 103 |
| 2021 March | 36 | 17 | 53 |
| 2021 February | 38 | 30 | 68 |
| 2021 January | 24 | 9 | 33 |
| 2020 December | 22 | 11 | 33 |
| 2020 November | 15 | 18 | 33 |
| 2020 October | 23 | 10 | 33 |
| 2020 September | 20 | 11 | 31 |
| 2020 August | 17 | 8 | 25 |
| 2020 July | 10 | 11 | 21 |
| 2020 June | 37 | 25 | 62 |
| 2020 May | 19 | 13 | 32 |
| 2020 April | 19 | 11 | 30 |
| 2020 March | 35 | 24 | 59 |
| 2020 February | 4 | 6 | 10 |
| 2020 January | 0 | 6 | 6 |
| 2019 December | 0 | 8 | 8 |
| 2019 November | 0 | 4 | 4 |
| 2019 October | 0 | 6 | 6 |
| 2019 September | 0 | 6 | 6 |
| 2019 August | 0 | 2 | 2 |
| 2019 July | 0 | 2 | 2 |
| 2019 June | 0 | 3 | 3 |
| 2019 May | 2 | 36 | 38 |
| 2019 April | 0 | 1 | 1 |
| 2019 March | 0 | 7 | 7 |
| 2018 April | 0 | 1 | 1 |
| 2018 March | 1 | 1 | 2 |
| 2018 February | 9 | 1 | 10 |
| 2018 January | 17 | 6 | 23 |
| 2017 December | 22 | 9 | 31 |
| 2017 November | 17 | 1 | 18 |
| 2017 October | 17 | 5 | 22 |
| 2017 September | 21 | 4 | 25 |
| 2017 August | 33 | 10 | 43 |
| 2017 July | 20 | 2 | 22 |
| 2017 June | 15 | 9 | 24 |
| 2017 May | 19 | 15 | 34 |
| 2017 April | 30 | 9 | 39 |
| 2017 March | 21 | 24 | 45 |
| 2017 February | 25 | 11 | 36 |
| 2017 January | 21 | 6 | 27 |
| 2016 December | 37 | 13 | 50 |
| 2016 November | 29 | 18 | 47 |
| 2016 October | 23 | 13 | 36 |
| 2016 September | 32 | 6 | 38 |
| 2016 August | 46 | 10 | 56 |
| 2016 July | 30 | 8 | 38 |
| 2016 June | 10 | 5 | 15 |
| 2016 May | 5 | 5 | 10 |
| 2016 April | 7 | 3 | 10 |
| 2016 March | 3 | 0 | 3 |
| 2016 February | 7 | 5 | 12 |
| 2016 January | 6 | 0 | 6 |
| 2015 December | 8 | 2 | 10 |
| 2015 November | 6 | 2 | 8 |
| 2015 October | 7 | 1 | 8 |
| 2015 September | 4 | 6 | 10 |
| 2015 August | 11 | 4 | 15 |
| 2015 July | 44 | 6 | 50 |
| 2015 June | 40 | 9 | 49 |
| 2015 May | 82 | 10 | 92 |
| 2015 April | 48 | 8 | 56 |
| 2015 March | 29 | 12 | 41 |
| 2015 February | 17 | 4 | 21 |
| 2015 January | 31 | 8 | 39 |
| 2014 December | 21 | 5 | 26 |
| 2014 November | 27 | 10 | 37 |
| 2014 October | 37 | 20 | 57 |
| 2014 September | 31 | 13 | 44 |
| 2014 August | 34 | 14 | 48 |
| 2014 July | 33 | 17 | 50 |
| 2014 June | 32 | 9 | 41 |
| 2014 May | 36 | 15 | 51 |
| 2014 April | 28 | 11 | 39 |
| 2014 March | 44 | 15 | 59 |
| 2014 February | 24 | 14 | 38 |
| 2014 January | 30 | 14 | 44 |
| 2013 December | 31 | 8 | 39 |
| 2013 November | 26 | 21 | 47 |
| 2013 October | 26 | 14 | 40 |
| 2013 September | 25 | 18 | 43 |
| 2013 August | 22 | 33 | 55 |
| 2013 July | 29 | 28 | 57 |
| 2013 June | 27 | 40 | 67 |
| 2013 May | 20 | 13 | 33 |
| 2013 April | 28 | 16 | 44 |
| 2013 March | 19 | 17 | 36 |
| 2013 February | 4 | 6 | 10 |
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