array:23 [
  "pii" => "S1578219011707673"
  "issn" => "15782190"
  "doi" => "10.1016/S1578-2190(11)70767-3"
  "estado" => "S300"
  "fechaPublicacion" => "2011-03-01"
  "aid" => "70767"
  "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L."
  "copyrightAnyo" => "2011"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Actas Dermosifiliogr. 2011;102:106-13"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2254
    "formatos" => array:3 [
      "EPUB" => 43
      "HTML" => 1486
      "PDF" => 725
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1578219011707685"
    "issn" => "15782190"
    "doi" => "10.1016/S1578-2190(11)70768-5"
    "estado" => "S300"
    "fechaPublicacion" => "2011-03-01"
    "aid" => "70768"
    "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L."
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Actas Dermosifiliogr. 2011;102:114-20"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2341
      "formatos" => array:3 [
        "EPUB" => 42
        "HTML" => 1465
        "PDF" => 834
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Prevalence and Clinical Features of Congenital Melanocytic Nevi in 1,000 Spanish Newborns"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "114"
          "paginaFinal" => "120"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Prevalencia y características clínicas de los nevos melanocíticos congénitos en 1.000 recién nacidos españoles"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "B. Monteagudo, J. Labandeira, A. Acevedo, A. Ramírez-Santos, M. Cabanillas, A. Corrales, I. Carballeira, J. Toribio"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "B."
              "apellidos" => "Monteagudo"
            ]
            1 => array:2 [
              "nombre" => "J."
              "apellidos" => "Labandeira"
            ]
            2 => array:2 [
              "nombre" => "A."
              "apellidos" => "Acevedo"
            ]
            3 => array:2 [
              "nombre" => "A."
              "apellidos" => "Ramírez-Santos"
            ]
            4 => array:2 [
              "nombre" => "M."
              "apellidos" => "Cabanillas"
            ]
            5 => array:2 [
              "nombre" => "A."
              "apellidos" => "Corrales"
            ]
            6 => array:2 [
              "nombre" => "I."
              "apellidos" => "Carballeira"
            ]
            7 => array:2 [
              "nombre" => "J."
              "apellidos" => "Toribio"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219011707685?idApp=UINPBA000044"
    "url" => "/15782190/0000010200000002/v1_201304241539/S1578219011707685/v1_201304241539/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1578219011707661"
    "issn" => "15782190"
    "doi" => "10.1016/S1578-2190(11)70766-1"
    "estado" => "S300"
    "fechaPublicacion" => "2011-03-01"
    "aid" => "70766"
    "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L."
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Actas Dermosifiliogr. 2011;102:98-105"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2461
      "formatos" => array:3 [
        "EPUB" => 41
        "HTML" => 1545
        "PDF" => 875
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Epidemiology of Contact Dermatitis in Spain. Results of the Spanish Surveillance System on Contact Allergies for the Year 2008"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "98"
          "paginaFinal" => "105"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Epidemiología del eczema de contacto en España. Resultados de la Red Española de Vigilancia en Alergia de Contacto (REVAC) durante el año 2008"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J. García-Gavín, J.C. Armario-Hita, V. Fernández-Redondo, J.M. Fernández-Vozmediano, J. Sánchez-Pérez, J.F. Silvestre, W. Uter, A.M. Giménez-Arnau"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "J."
              "apellidos" => "García-Gavín"
            ]
            1 => array:2 [
              "nombre" => "J.C."
              "apellidos" => "Armario-Hita"
            ]
            2 => array:2 [
              "nombre" => "V."
              "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&#46;"
            "apellidos" => "L&#243;pez-Navarro"
          ]
          2 => array:2 [
            "nombre" => "E&#46;"
            "apellidos" => "Herrera-Acosta"
          ]
          3 => array:2 [
            "nombre" => "R&#46;"
            "apellidos" => "Castillo"
          ]
          4 => array:2 [
            "nombre" => "G&#46;"
            "apellidos" => "Ruiz del Portal"
          ]
          5 => array:2 [
            "nombre" => "R&#46;J&#46;"
            "apellidos" => "Bosch"
          ]
          6 => array:2 [
            "nombre" => "E&#46;"
            "apellidos" => "Herrera"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Cl&#237;nico Universitario Virgen de la Victoria&#44; M&#225;laga&#44; Spain"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Lepra importada y su dificultad en el medio actual&#58; a prop&#243;sito 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&#44; isolated cases are still occasionally diagnosed&#46; Meanwhile&#44; population migration has brought about an increase in the incidence of cases corresponding to individuals from countries where leprosy is endemic&#44; leading to changes in the epidemiology of this disease&#46;</p> <span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The aim of this paper was to describe the clinical&#44; epidemiologic&#44; dermatologic&#44; microbiologic&#44; and therapeutic characteristics of cases of leprosy in our department in the last 5 years&#46;</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&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Seven patients with leprosy &#40;3 men and 4 women&#59; age range&#44; 26-80 years&#41; were diagnosed&#59; 2 were cases of tuberculoid leprosy&#44; 2 borderline tuberculoid leprosy&#44; and 3 indeterminate&#46; All patients acquired the disease in South American or South African countries&#44; but were residing in Spain at the time of diagnosis&#46; One patient was a Spaniard&#44; from Malaga&#44; who had worked as a missionary in Venezuela for 25 years&#46; The presence of the bacterium by either Ziehl-Neelsen stain or bacilloscopy could not be demonstrated in any of the patients&#46;</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&#44; the majority of which are imported&#46; It is important to maintain a clinical suspicion of leprosy in cases of granulomatous dermatitis&#44; particularly in patients from countries where the disease is endemic&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Aunque los focos hist&#243;ricos de infecci&#243;n leprosa en nuestro pa&#237;s est&#225;n controlados y son pr&#225;cticamente inactivos&#44; a&#250;n se siguen diagnosticando algunos casos aut&#243;ctonos aislados&#46; La elevada movilidad poblacional actual ha tra&#237;do consigo un aumento en la incidencia de casos importados de pa&#237;ses end&#233;micos&#44; lo que est&#225; motivando un cambio en las caracter&#237;sticas epidemiol&#243;gicas del paciente afecto de lepra&#46;</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El prop&#243;sito de este art&#237;culo es poner de manifiesto las caracter&#237;sticas cl&#237;nicas&#44; epidemiol&#243;gicas&#44; dermatopatol&#243;gicas&#44; microbiol&#243;gicas y terap&#233;uticas de los pacientes diagnosticados de lepra en los &#250;ltimos 5 a&#241;os en nuestro Servicio&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Presentamos los casos de lepra importada que hemos valorado en nuestro Servicio desde el a&#241;o 2004 al 2009&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se trata de 7 casos de lepra&#44; 3 varones y 4 mujeres&#44; de edades comprendidas entre los 26 y los 80 a&#241;os&#44; 2 de tipo tuberculoide&#44; 2 borderline tuberculoide y 3 de tipo indeterminada&#46; Todos proced&#237;an de pa&#237;ses sudamericanos o sudafricanos donde adquirieron la enfermedad&#44; aunque resid&#237;an en Espa&#241;a en ese momento&#46; S&#243;lo uno de los pacientes era natural de M&#225;laga&#44; pero trabaj&#243; como misionero en Venezuela durante 25 a&#241;os&#46; En ning&#250;n caso se logr&#243; demostrar la existencia de bacilos mediante la t&#233;cnica de Ziehl-Neelsen&#44; siendo la baciloscopia igualmente negativa&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Queremos destacar los cambios epidemiol&#243;gicos que hemos observado en los casos de lepra diagnosticados en nuestro Servicio&#44; la mayor&#237;a de los cuales son importados&#46; Es importante seguir manteniendo la sospecha cl&#237;nica de lepra ante dermatitis granulomatosas&#44; especialmente en pacientes de pa&#237;ses end&#233;micos&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:29 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "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&#46; Lain-Entralgo"
                            1 => "L&#46; Montiel"
                            2 => "J&#46;J&#46; Picazo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Microbiolog&#237;a m&#233;dica 2"
                        "paginaInicial" => "1"
                        "paginaFinal" => "10"
                        "serieFecha" => "1996"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leprosy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;L&#46; Walker"
                            1 => "D&#46;N&#46;J&#46; Lockwood"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2006.05.012"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol"
                        "fecha" => "2007"
                        "volumen" => "25"
                        "paginaInicial" => "165"
                        "paginaFinal" => "172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17350495"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lepra&#58; visi&#243;n nueva de una enfermedad milenaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46; Carrada-Bravo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Piel"
                        "fecha" => "2004"
                        "volumen" => "19"
                        "paginaInicial" => "67"
                        "paginaFinal" => "73"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cl&#237;nica y clasificaci&#243;n de la lepra"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Garcia Perez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "1983"
                        "volumen" => "74"
                        "paginaInicial" => "339"
                        "paginaFinal" => "340"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Historia de la lepra en Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Terencio de las Aguas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Piel"
                        "fecha" => "2005"
                        "volumen" => "20"
                        "paginaInicial" => "485"
                        "paginaFinal" => "497"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Boletin epidemiologico del Ministerio de Sanidad y Consumo&#46; Instituto de Salud Carlos III&#46; Archivo de enfermedades de declaraci&#243;n obligatoria&#46; 2002&#59;10&#58;277&#8211;84"
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Organizaci&#243;n Mundial de la Salud&#46; Comit&#233; de expertos de la OMS en lepra&#46; Informe 847&#58; Quimioterapia de la lepra&#46; Ginebra&#58; OMS&#59; 1994&#46; p&#46; 1&#8211;22&#46;"
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Organizaci&#243;n&#44; Mundial de la Salud Comit&#233; de expertos de la OMS en lepra&#46; Informe 874&#58; S&#233;ptimo informe&#46; Ginebra&#58; OMS&#59; 1998 1&#8211;47"
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leprosy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46;J&#46; Britton"
                            1 => "D&#46;N&#46;J&#46; Lockwood"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(04)15952-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2004"
                        "volumen" => "363"
                        "paginaInicial" => "1209"
                        "paginaFinal" => "1219"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15081655"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiologia de la lepra a trav&#233;s del estudio de la frecuenciaci&#243;n en el Hospital especializado de Trillo durante el periodo de 1943&#8211;1995"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;R&#46; Urbija"
                            1 => "M&#46;P&#46; Garcia"
                            2 => "M&#46;M&#46; Leton"
                            3 => "R&#46; Ruiz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Salud Publica"
                        "fecha" => "1997"
                        "volumen" => "71"
                        "paginaInicial" => "463"
                        "paginaFinal" => "477"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9546866"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leprosy&#58; diagnostic and control challenges for a worldwise disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "I&#46;M&#46; Goulart"
                            1 => "L&#46;R&#46; Goulart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00403-008-0857-y"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol Res"
                        "fecha" => "2008"
                        "volumen" => "300"
                        "paginaInicial" => "269"
                        "paginaFinal" => "290"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18461340"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Organizacion&#44; Mundial de la Salud Informe 716&#58; Epidemiologia de la lepra en relaci&#243;n con la lucha antileprosa&#46; Ginebra&#58; OMS&#59; 1985 17- 29"
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lepra en el tercer milenio A prop&#243;sito de cuatro casos en M&#225;laga&#44; dos aut&#243;ctonos y dos importados"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46; Lopez"
                            1 => "R&#46;J&#46; Bosch"
                            2 => "G&#46; Ruiz del Portal"
                            3 => "R&#46; Castillo"
                            4 => "A&#46; Tejera"
                            5 => "E&#46; Herrera"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Cutan Iber Lat Am"
                        "fecha" => "2007"
                        "volumen" => "35"
                        "paginaInicial" => "219"
                        "paginaFinal" => "224"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "How <span class="elsevierStyleItalic">Mycobacterium leprae</span> infects peripheral nerves"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46;H&#46; Freedman"
                            1 => "D&#46;E&#46; Weinstein"
                            2 => "G&#46; Kaplan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lepr Rev&#46;"
                        "fecha" => "1999"
                        "volumen" => "70"
                        "paginaInicial" => "136"
                        "paginaFinal" => "139"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10464432"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Classification of leprosy into multibacillary and paucibacillary groups&#58; an analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "O&#46; Parkash"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1574-695X.2008.00491.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "FEMS Immunol Med Microbiol&#46;"
                        "fecha" => "2009"
                        "volumen" => "55"
                        "paginaInicial" => "1"
                        "paginaFinal" => "5"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19040664"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vigilancia de la lepra en situaciones de baja prevalencia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;E&#46; Gonzalez"
                            1 => "A&#46; Abreu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Panam Salud Publica&#46;"
                        "fecha" => "2001"
                        "volumen" => "9"
                        "paginaInicial" => "94"
                        "paginaFinal" => "101"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11293834"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leprosy in Toronto&#58; an analysis of 184 imported cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;K&#46; Boggild"
                            1 => "J&#46;D&#46; Correia"
                            2 => "J&#46;S&#46; Keystone"
                            3 => "K&#46;C&#46; Kain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Can Med Assoc J&#46;"
                        "fecha" => "2004"
                        "volumen" => "170"
                        "paginaInicial" => "55"
                        "paginaFinal" => "59"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hansen&#39;s disease in a general hospital&#58; uncommon presentations and delay in diagnosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Nery"
                            1 => "P&#46;A&#46; Schreuder"
                            2 => "P&#46;C&#46; De Mattos"
                            3 => "L&#46;V&#46; De Mendon&#231;a&#184;a"
                            4 => "R&#46;T&#46; Tardi"
                            5 => "S&#46; De Mello"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1468-3083.2008.03006.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "2009"
                        "volumen" => "23"
                        "paginaInicial" => "150"
                        "paginaFinal" => "156"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18785893"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lepra&#58; aproximacion epidemiologica&#44; clinica y terapeutica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Terencio de las Aguas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Jano&#46;"
                        "fecha" => "1997"
                        "volumen" => "1231"
                        "paginaInicial" => "1613"
                        "paginaFinal" => "1621"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostico y tratamiento de la lepra"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "F&#46;J&#46; Lopez Anturiano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Salud Publica Mex&#46;"
                        "fecha" => "1998"
                        "volumen" => "40"
                        "paginaInicial" => "1"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lepromatous leprosy&#58; A review and case report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Dirmeros Kustner"
                            1 => "M&#46; Pascual Cruz"
                            2 => "Pi&#241;ol Dansis"
                            3 => "H&#46; Vi&#241;als Iglesia"
                            4 => "M&#46;E&#46; Rodriguez de Rivera Campillo"
                            5 => "J&#46; Lopez Lopez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Oral Patol Cir Bucal&#46;"
                        "fecha" => "2006"
                        "volumen" => "11"
                        "paginaInicial" => "474"
                        "paginaFinal" => "479"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio actual de la investigaci&#243;n en lepra"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Terencio de las Aguas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Leprologia"
                        "fecha" => "2000"
                        "volumen" => "3"
                        "paginaInicial" => "417"
                        "paginaFinal" => "418"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serology&#58; recent developments&#44; strengths&#44; limitations and prospects&#58; a state of the art overview"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Oskam"
                            1 => "E&#46; Slim"
                            2 => "S&#46; Buhrer-Sekule"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lepr Rev&#46;"
                        "fecha" => "2004"
                        "volumen" => "75"
                        "paginaInicial" => "192"
                        "paginaFinal" => "193"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15282973"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Detection of serum antibodies to M&#46; leprae major membrane protein-II in leprosy patients from Indonesia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Hatta"
                            1 => "M&#46; Makino"
                            2 => "R&#46;M&#46; Yadi"
                            3 => "M&#46; Sabir"
                            4 => "N&#46; Tandirogang"
                            5 => "L&#46;M&#46;M&#46; Rusyati"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lepr Rev&#46;"
                        "fecha" => "2009"
                        "volumen" => "80"
                        "paginaInicial" => "402"
                        "paginaFinal" => "409"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20306638"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of ML Flow serology and slit skin smears to assess the bacterial load in newly diagnosed leprosy patients in Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Lyon"
                            1 => "A&#46;C&#46; Lyon"
                            2 => "R&#46;C&#46; Da Silva"
                            3 => "M&#46;A&#46; De Faria Grossi"
                            4 => "S&#46;H&#46; Lyon"
                            5 => "S&#46; Buhrer-Sekula"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lepr Rev&#46;"
                        "fecha" => "2008"
                        "volumen" => "79"
                        "paginaInicial" => "162"
                        "paginaFinal" => "170"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18711938"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular determination of <span class="elsevierStyleItalic">Mycobacterium lepra</span> viability by use of real-time PCR"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;N&#46; Martinez"
                            1 => "R&#46; Lahiri"
                            2 => "T&#46;L&#46; Pittman"
                            3 => "D&#46; Scollard"
                            4 => "R&#46; Truman"
                            5 => "M&#46;O&#46; Moraes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.00512-09"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol&#46;"
                        "fecha" => "2009"
                        "volumen" => "47"
                        "paginaInicial" => "2124"
                        "paginaFinal" => "2130"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19439537"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Detection and quantification of <span class="elsevierStyleItalic">Mycobacterium leprae</span> in tissue samples by real-time PCR"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Kramme"
                            1 => "G&#46; Bretzel"
                            2 => "M&#46; Panning"
                            3 => "J&#46; Kawuma"
                            4 => "C&#46; Drosten"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00430-003-0188-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Microbiol Immunol&#46;"
                        "fecha" => "2004"
                        "volumen" => "193"
                        "paginaInicial" => "189"
                        "paginaFinal" => "193"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12884037"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Historia de la terap&#233;utica de la lepra"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Terencio de las Aguas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Leprologia"
                        "fecha" => "2001"
                        "volumen" => "4"
                        "paginaInicial" => "117"
                        "paginaFinal" => "124"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "<span class="elsevierStyleItalic">Mycobacterium leprae</span> DNA associated with type I reactions in single lesion paucibacillary leprosy treated with single dose rifampin&#44; ofloxacin and minocycline"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;L&#46; Sousa"
                            1 => "M&#46; Stefani"
                            2 => "G&#46; Pereira"
                            3 => "M&#46;B&#46; Costa"
                            4 => "P&#46; Rebello"
                            5 => "M&#46;K&#46; Gomes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Trop Med Hyg&#46;"
                        "fecha" => "2007"
                        "volumen" => "77"
                        "paginaInicial" => "829"
                        "paginaFinal" => "833"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17984336"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010200000002/v1_201304241539/S1578219011707673/v1_201304241539/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6256"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original article"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010200000002/v1_201304241539/S1578219011707673/v1_201304241539/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219011707673?idApp=UINPBA000044"
]
Share
Journal Information
Vol. 102. Issue 2.
Pages 106-113 (March 2011)
Share
Share
Download PDF
More article options
Vol. 102. Issue 2.
Pages 106-113 (March 2011)
Full text access
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
Visits
6306
M. Contreras-Steyls
Corresponding author
torosmar1@hotmail.com

Corresponding author.
, N. López-Navarro, E. Herrera-Acosta, R. Castillo, G. Ruiz del Portal, R.J. Bosch, E. Herrera
Servicio de Dermatología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
This item has received
Article information
Abstract
Background

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.

Objectives

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.

Material and methods

We report the cases of imported leprosy seen in our department between 2004 and 2009.

Results

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.

Conclusions

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.

Keywords:
Leprosy
Hansen disease
Epidemiologic update
Resumen
Introducción

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.

Objetivos

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.

Material y método

Presentamos los casos de lepra importada que hemos valorado en nuestro Servicio desde el año 2004 al 2009.

Resultados

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.

Conclusiones

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.

Palabras Clave:
Lepra
Enfermedad de Hansen
Actualidad
Full text is only aviable in PDF
References
[1.]
P. Lain-Entralgo, L. Montiel, J.J. Picazo.
Las enfermedades infecciosas y la historia.
Microbiología médica 2, pp. 1-10
[2.]
S.L. Walker, D.N.J. Lockwood.
Leprosy.
Clin Dermatol, 25 (2007), pp. 165-172
[3.]
T. Carrada-Bravo.
Lepra: visión nueva de una enfermedad milenaria.
Piel, 19 (2004), pp. 67-73
[4.]
A. Garcia Perez.
Clínica y clasificación de la lepra.
Actas Dermosifiliogr, 74 (1983), pp. 339-340
[5.]
J. Terencio de las Aguas.
Historia de la lepra en España.
Piel, 20 (2005), pp. 485-497
[6.]
Boletin epidemiologico del Ministerio de Sanidad y Consumo. Instituto de Salud Carlos III. Archivo de enfermedades de declaración obligatoria. 2002;10:277–84
[7.]
Organización Mundial de la Salud. Comité de expertos de la OMS en lepra. Informe 847: Quimioterapia de la lepra. Ginebra: OMS; 1994. p. 1–22.
[8.]
Organización, Mundial de la Salud Comité de expertos de la OMS en lepra. Informe 874: Séptimo informe. Ginebra: OMS; 1998 1–47
[9.]
W.J. Britton, D.N.J. Lockwood.
Leprosy.
Lancet, 363 (2004), pp. 1209-1219
[10.]
J.R. Urbija, M.P. Garcia, M.M. Leton, R. Ruiz.
Epidemiologia de la lepra a través del estudio de la frecuenciación en el Hospital especializado de Trillo durante el periodo de 1943–1995.
Rev Esp Salud Publica, 71 (1997), pp. 463-477
[11.]
I.M. Goulart, L.R. Goulart.
Leprosy: diagnostic and control challenges for a worldwise disease.
Arch Dermatol Res, 300 (2008), pp. 269-290
[12.]
Organizacion, Mundial de la Salud Informe 716: Epidemiologia de la lepra en relación con la lucha antileprosa. Ginebra: OMS; 1985 17- 29
[13.]
N. Lopez, R.J. Bosch, G. Ruiz del Portal, R. Castillo, A. Tejera, E. Herrera.
Lepra en el tercer milenio A propósito de cuatro casos en Málaga, dos autóctonos y dos importados.
Med Cutan Iber Lat Am, 35 (2007), pp. 219-224
[14.]
V.H. Freedman, D.E. Weinstein, G. Kaplan.
How Mycobacterium leprae infects peripheral nerves.
Lepr Rev., 70 (1999), pp. 136-139
[15.]
O. Parkash.
Classification of leprosy into multibacillary and paucibacillary groups: an analysis.
FEMS Immunol Med Microbiol., 55 (2009), pp. 1-5
[16.]
C.E. Gonzalez, A. Abreu.
Vigilancia de la lepra en situaciones de baja prevalencia.
Rev Panam Salud Publica., 9 (2001), pp. 94-101
[17.]
A.K. Boggild, J.D. Correia, J.S. Keystone, K.C. Kain.
Leprosy in Toronto: an analysis of 184 imported cases.
Can Med Assoc J., 170 (2004), pp. 55-59
[18.]
J.A. Nery, P.A. Schreuder, P.C. De Mattos, L.V. De Mendonça¸a, R.T. Tardi, S. De Mello, et al.
Hansen's disease in a general hospital: uncommon presentations and delay in diagnosis.
J Eur Acad Dermatol Venereol., 23 (2009), pp. 150-156
[19.]
J. Terencio de las Aguas.
Lepra: aproximacion epidemiologica, clinica y terapeutica.
Jano., 1231 (1997), pp. 1613-1621
[20.]
F.J. Lopez Anturiano.
Diagnostico y tratamiento de la lepra.
Salud Publica Mex., 40 (1998), pp. 1-10
[21.]
E. Dirmeros Kustner, M. Pascual Cruz, Piñol Dansis, H. Viñals Iglesia, M.E. Rodriguez de Rivera Campillo, J. Lopez Lopez.
Lepromatous leprosy: A review and case report.
Med Oral Patol Cir Bucal., 11 (2006), pp. 474-479
[22.]
J. Terencio de las Aguas.
Estudio actual de la investigación en lepra.
Leprologia, 3 (2000), pp. 417-418
[23.]
L. Oskam, E. Slim, S. Buhrer-Sekule.
Serology: recent developments, strengths, limitations and prospects: a state of the art overview.
Lepr Rev., 75 (2004), pp. 192-193
[24.]
M. Hatta, M. Makino, R.M. Yadi, M. Sabir, N. Tandirogang, L.M.M. Rusyati, et al.
Detection of serum antibodies to M. leprae major membrane protein-II in leprosy patients from Indonesia.
Lepr Rev., 80 (2009), pp. 402-409
[25.]
S. Lyon, A.C. Lyon, R.C. Da Silva, M.A. De Faria Grossi, S.H. Lyon, S. Buhrer-Sekula, et al.
A comparison of ML Flow serology and slit skin smears to assess the bacterial load in newly diagnosed leprosy patients in Brazil.
Lepr Rev., 79 (2008), pp. 162-170
[26.]
A.N. Martinez, R. Lahiri, T.L. Pittman, D. Scollard, R. Truman, M.O. Moraes, et al.
Molecular determination of Mycobacterium lepra viability by use of real-time PCR.
J Clin Microbiol., 47 (2009), pp. 2124-2130
[27.]
S. Kramme, G. Bretzel, M. Panning, J. Kawuma, C. Drosten.
Detection and quantification of Mycobacterium leprae in tissue samples by real-time PCR.
Med Microbiol Immunol., 193 (2004), pp. 189-193
[28.]
J. Terencio de las Aguas.
Historia de la terapéutica de la lepra.
Leprologia, 4 (2001), pp. 117-124
[29.]
A.L. Sousa, M. Stefani, G. Pereira, M.B. Costa, P. Rebello, M.K. Gomes, et al.
Mycobacterium leprae DNA associated with type I reactions in single lesion paucibacillary leprosy treated with single dose rifampin, ofloxacin and minocycline.
Am J Trop Med Hyg., 77 (2007), pp. 829-833
Copyright © 2011. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
Download PDF
Idiomas
Actas Dermo-Sifiliográficas
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?