Leishmaniose Tegumentar na Região Amazônica e Região Centro Oeste: estudo clínico-patológico comparativo

Abstract

Cutaneous leishmaniasis represents one of the main public health problems in our country, along with other endemic diseases such as Chagas disease, schistosomiasis and malaria. Much has been done to assess the extent of the problem, seek solutions to limit it, understand its pathogenesis and establish safe therapeutic approaches. This is the constant concern of the Ministry of Health, through SUCAM. The National Council for Scientific and Technological Development (CNPq) has also been encouraging the study of these problems by financing several projects, and this thesis is precisely the result of this realistic policy that aims to create conditions for a greater understanding of the various facets of the problems and for establishing the best strategies for resolution. The World Health Organization, in turn, has promoted meetings in various parts of the world with the same objective, such as the one recently held in Brasilia from July 10 to 13, 1979, with the aim of critically evaluating the various therapeutic alternatives in use in Cutaneous Leishmaniasis and discussing new perspectives in this field. The histopathological study of cutaneous leishmaniasis emerged at the same time as the identification of the disease in Brazil. Since then, several authors have contributed significantly to the clarification of histopathological changes in skin and mucous lesions, establishing a morphological pattern of the disease that is still used today. This pattern has not been modified even with new immunological knowledge, nor has it been confirmed with a greater number of cases and in different regions of the country, in addition to the Northeast and Southeast regions, where most of the studies were carried out. In view of this situation, we decided to study Cutaneous Leishmaniasis using a large number of cases from two distinct regions - the Amazon Region and the Central-West Region - and to seek a correlation between the clinical and histopathological findings and to establish comparisons between the cases studied from the two regions. With this study, we intend to provide some support for the histopathological interpretation of leishmaniasis lesions. We intend to raise controversial points that cannot be answered by analyzing the slides using routine staining methods, so that in a later study, with the help of more sophisticated techniques, we can confirm the propositions raised here.