Search

OBJECTIVES: To establish the epidemiological, clinical and mycological characteristics of tinea corporis at the Mycology Service of the Centro Dermatológico Pascua, Mexico City, from January 1956 to December 2019. MATERIALS AND METHODS: A retrospective, cross-sectional and descriptive study of patients with clinical mycosis diagnosis. RESULTS: 56,729 patients were included; 30,235 were confirmed by direct microscopy KOH examination and/or mycological culture; 3590 were tinea of the body. Tinea corporis accounted for the third place among dermatophytoses (11.8%); more frequent in adults (64.3%). The most common evolution was from 1 to 3 months (30.8%). It mainly involved the trunk (49.1%), face and neck (31.1%). The direct microscopy KOH examination was positive in 91% of cases, compared to the 75.4% positive cultures. There were 52.3% Trichophyton rubrum, 22.3% Microsporum canis, 16.8% Trichophyton tonsurans, 4.2% Trichophyton mentagrophytes, 1.7% Trichophyton concentricum, 1.1% Nannizzia gypsea (previously known as Microsporum gypseum), 1% Epidermophyton floccosum, 0.2% Trichophyton violaceum and 0.1% Microsporum audouinii. CONCLUSIONS: Tinea corporis takes third place among dermatophytoses, with a prevalence of 6.3%. Trichophytic ringworm had a clear preponderance over microsporic one. Direct microscopic KOH examination is more sensitive for confirming diagnosis than culture. Due to these results were obtained in a referral center, they reflect the behavior of these dermatophytoses in Mexico. [ABSTRACT FROM AUTHOR]

Moniletrhix is an uncommon hair shaft disease with autosomal dominant inheritance, incomplete penetrance and variable expressivity. The term monilethrix derives from monile (Latin) and thrix (Greek) meaning "hair necklace". This entity takes its name because the clinical resemblance of the hair to a string of beads, changes that can be seen with trichoscopy. It is characterized by periodic thinning of the hair shaft resulting in brittle, short and dry hair. We present the case of a 4-year-old girl, with family history of monilethrix in her father, a grandmother and a great grandfather. [ABSTRACT FROM AUTHOR]

Angioid pilomatrixoma was confirmed as a tumor in 1942 and since 1961 it is denominated pilomatrixoma; although it is also known as calcifying epithelioma of Malherbe and tricomatrixoma. It is a benign tumor derived from the cells of the hair follicle matrix. Its usual topography is the face and neck; morphologically measures 0.5 to 5 cm of diameter, it has spheric form, is of the color of the skin, pink or violet red and of stony consistence, mobile and painless. This paper reports the case of a 4-year-old female patient with angioid pilomatrixoma, who initially was considered with fixed plaque sporotrichosis because she lived at Xochimilco, an endemic zone of sporotrichosis, and due to the clinical aspect, with white flakes and hematic scabs at surface. [ABSTRACT FROM AUTHOR]

We communicate the case of a scholar child with a minimycetoma on the right shoulder of six months evolution. Minimycetomas affect children, adolescents or young adults. Their etiological agent is Nocardia brasiliensis, and affect mainly the face, trunk and upper extremities. They are of small size, with a few fistulas; they do not increase volume nor deform the region involved, neither reach deep structures. They can be single or multiple and have a good prognosis, since they respond adequately to sulfones or sulfonamides. They are not incipient mycetoma since they do not evolve to the classical type despite of time. [ABSTRACT FROM AUTHOR]

The tinea capitis in childhood is very common. We report a 7 year old boy with tinea capitis due a Trichophyton mentagrophytes. A brief review is made of the literature. [ABSTRACT FROM AUTHOR]

Cryptococcosis is an opportunistic mycoses caused by theyeastlike fungus Cryptococcus neoformans. C. neoformans occasionally causes infections in humans, mainly in those with altered cellular immunity. Patients with HIV disease have defective immunity because of depletion of CD4 lymphocytes. We report the case of a 55 year-old woman with an initial clinical diagnosis of ulcerated basal-cell carcinoma (ulcus rodens) which was later diagnosed by biopsy as cryptococcosis and ultimately mycological demonstration of the causal agent was obtained. HIV infection was confirmed showing Stage 3 AIDS with a CD4 count of 25 cells and a viral load for HIV of 272,409 copies log 5.44. In AIDS patients meningoencephalitis presents in 60% and progresses rapidly, 10% have pulmonary infection and 10 to 20% present the cutaneous form which has beendescribed as centinel to meningeal and systemic signs of the disease, especially when CD4 lymphocytes fall bellow 100. The diagnosis in this case was disseminated cryptococcosis with cutaneous and meningeal involvement. The patient was hospitalized and treated with amphotericin B deoxicolate, adding other drugs later includingfluconazole, posaconazole and antiretroviral treatment with abacavir, lamivudine and efavirenz obtaining a favorable outcome. [ABSTRACT FROM AUTHOR]

Background: The patients with psoriasis and ungueal alterations ocurres between 10 to 67% according to the world literature and the results have not been concluyents because the authors reports different percentages. Objetive: To determine the frequency of in psoriatic patients with ungueals changes. Material and methods: prospective, transversal, descriptive trial, with 50 psoriatic patients who had ungueal alterations. We did clinical, micological examination and cutaneous biopsy. Results: We studied 32 women (64%) and 18 men (36%) with a media of age: 54 años. The predominant psoriasis was in plaques in 84%, palm and plantar 10% and scalp psoriasis 6%. The frequency of onychomycosis in psoriatic patients with ungueal alterations was the 34%. The ungueal alterations associates with onychomycosis was more frequent in the feet than the hands: 30% vs. 4% respectively. The subungueal distal and lateral onychomycosis was the predominant clinical variety. The subungueal hiperqueratosis associates with onychomycosis was the most frequent and significant with a p-valiu of 0.0006 and OR of 4.12. Between the 34% of the psoriatic patients with ungueal alterations and onychomycosis, the cultive was positive in the 59% and 80% was dermatophytes vs 20% Candida albicans. Between the dermatophytes, trichophyton rubrum was insolated in the 70% and trichophyton mentagrophytes in the 10%. Conclusions: the frequency of onychomycosis in psoriatic patients with ungueal alterations was the 34%. The dermatophytes dominated over the yeasts. [ABSTRACT FROM AUTHOR]

Background: Mycetoma is a chronic, infectious and granulomatous process that affects skin, subcutaneous tissue and bone. It is produced by bacteria (actinomycetoma) or fungus (eumycetoma). In Mexico, the most common agent causing actinomycetoma is Nocardia brasiliensis followed by Actinomadura madurae. For diagnosis it is necessary to identify the etiologic agent (grain) by direct exam, culture, and histopathological study. The gold standard treatment is diaminodifenilsulfona (DDS) plus trimethoprim/sulfamethoxazol (TMP/SMX); in patients with bad-prognosis topography and bone and/or visceral affection, amikacin in added to this treatment; thus, the use of kanamycin in the treatment of actinomycetomas arises from the need of an efficacious and low-cost drug. Objective: To show the efficacy of kanamycin, added to trimethoprim-sulfamethoxazole and DDS, in patients with diagnosis of actinomycetomas due to Nocardia brasiliensis and Actinomadura madurae with topography of bad prognosis and bone and/or visceral damage. Patients and method: At the Mycology Service of the Dermatological Center Dr. Ladislao de la Pascua, 20 patients with Nocardia brasiliensis and Actinomadura madurae actinomycetomas resistant to conventional treatment were studied. To the conventional treatment of TMP-SMX (160-800 mg/12 h) and DDS (100 mg/day) kanamycin sulphate (15 mg/kg/day) was added in cycles of 14 days with interval of one month; depending on the clinical features 2-4 cycles of kanamycin sulfate were administered. Results: The clinical improvement was achieved in all patients in a mean time of three months. Cure, corroborated by a microbiological study, was obtained in 18 patiens (90%) in a mean time of seven months. Radiological improvement was observed in 50%-70% of cases. Conclusions: Considering the good clinical and radiological response in our group of study, we propose this therapeutic scheme as an efficient and safe alternative in the treatment of actinomycetomas, with topography of bad prognosis and bone and/or visceral damage. [ABSTRACT FROM AUTHOR]

Background: Paracoccidioidomycosis is a chronic or subacute granulomatous mycosis. It is caused by the dimorphic fungus Paracoccidioides brasiliensis and although it can affect any organ, the most commonly affected are: lung, oral mucosa, nasal mucosa, skin, lymph nodes, suprarenal glands and central nervous system. Objective: To report epidemiological and clinical characteristics of cases assisted at the Centro Dermatologico Pascua. Material and methods: We made a retrospective transversal study at the Centro Dermatologico Pascua, from 1956 to 2006. Results: During 50 years (1956 to 2006), we studied a total of 43,251 first time patients, of whom 12 (0.03%), all men, had clinical diagnosis of paracoccidioidomycosis. Conclusions: In most cases, the diagnosis of paracoccidioidomycosis was delayed largely due to low awareness that first contact physician have of this condition, leading to misdiagnosis. It is necessary to deepen the knowledge of clinical and epidemiological characteristics of this fungal infection, to better study and treat our patients. [ABSTRACT FROM AUTHOR]

The sporotrichosis is a subacute or chronic infection caused by dimorphic fungus Sporothrix schenckii that is introduced to the skin through trauma and, in rare occasions, by inhalation to the lungs. We report a case of a male 13 year-old patient with lymphangitic sprotrichosis that developed spontaneous involution. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about small eumycetic mycetoma due to black grain.

The skin damage due to injury or trauma induces a healing process, however, with exposure of subcutaneous tissue that usually is sterile, it can be colonized and infected by normal skin flora or environmental, which complicates the whole process of wound healing and may occasionally promote widespread dissemination. It has been recently shown that biofilms are the main barrier to delay wound healing, for this reason it is important to establish strategies to prevent and control the formation of such microbial associations. Key words: biofilms, wounds, wound healing. [ABSTRACT FROM AUTHOR]

Antibiotic resistance by microorganisms, increased recurrent and intrahospital infections by medical devices contamination, and difficulty to healing wounds are some of regular problems in medical practice. Nowadays it is known that the origin of these facts is consequence of biofilm formation that these microorganisms develop as survival mechanism. Therefore it is important to know the conditions that allow its development and the possible mechanisms to prevent and control its origin. [ABSTRACT FROM AUTHOR]

Background: Sporotrichosis is a chronic fungal infection caused by the Sporothrix schenckii complex, is characterized by the presence of granulomas of epithelioid, tuberculoid or foreign body composed of histiocytes surrounding a central area of neutrophils that contribute to the non-specific immune system. Neutrophils are in lactoferrin which exerts a protective action against fungi and yeasts, attributing the antifungal effect to its ability to sequester an atom of Fe+2 or Fe+3, and they can also join to Cu+2, Zn+2 and Mn+ ions. There is evidence that lactoferrin activity increases blood neutrophil phagocytic activity of NK cells, the number of cells progenitors of neutrophils in the blood and the production of gamma interferon; it is able to display antimicrobial activity on a broad spectrum of pathogens among including: bacteria, yeasts, fungi, protozoa and viruses. Objective: To demonstrate the presence of lactoferrin in Sporothrix sp yeasts present on the histological sections of patients with cutaneous sporotrichosis. Material and method: A retrospective study in which 11 biopsies of patients with diagnosis of cutaneous sporotrichosis attended at Dermatological Center Ladislao de la Pascua and General Hospital Dr. Manuel Gea González, both in Mexico City, were included. Two cuts were made by biopsy, one for the realization of the technique of PAS and the other for the marking of the lactoferrin. We used the commercial kit Cell and Tissue Staining Kit, Goat Kit HRP-AEC System (catalog no. CTS009) R&D Systems, and the primary antibody that was used was the IgG polyclonal anti-human lactoferrin made in goat by Santa Cruz Biotechnology laboratories. Results: We found the presence of lactoferrin on yeasts of Sporothrix sp, previously observed by the reaction of PAS in the studied sections of the 11 patients, already diagnosed with sporotrichosis. Conclusion: It was found lactoferrin present in the specific granules of polymorphonuclear neutrophils attached to the yeasts of the Sporothrix schenckii complex, engaged in kidnapping of ions Fe+2 and Fe+3 function, trying to prevent the development and proliferation of this fungus in the cutaneous sporotrichosis. [ABSTRACT FROM AUTHOR]

Background: The mycetoma is a clinical inlammatory syndrome with sinus tracts draining a seropurulent exudates and affecting skin and subcutaneous tissue and bones. In Mexico, actinomycetomas are the most common in 97.9% and eumycetomas only in 2.1%. Nocardia has a high incidence with 86.5% of these etiological agents N. brasiliensis is the most important one, followed by Actinomadura madurae with 10%. Grains in actinomycetoma are composed of bacteria amalgamated by a polysaccharide and surrounded by polymorphonuclear which are producing enzymes in their pellets specific such as collagenase, alkaline phosphatase, lysozyme, and lactoferrin, the latter is important for its bacteriostatic, bactericide and immunomodulatory action. Objective: To demonstrate the presence of the enzyme lactoferrin in grains of patients with actinomycetomas in humans. Material and method: Eight biopsies of patients with diagnosis of actinomycetoma from Dermatological Center Dr. Ladislao de la Pascua and General Hospital Dr. Manuel Gea González were done. Two cuts were made by biopsy, one for H-E and the other for the marking of the lactoferrin enzyme. We used the commercial kit Cell and tissue staining kit goat kit HRP-AEC system (catalog no. CTS009) R&D systems, and the primary antibody that was used was the IgG polyclonal anti-human lactoferrin made in goat by Santa Cruz Biotechnology laboratories. Results: In general the actinomycetomas showed the presence of lactoferrin from activated neutrophil polymorphonuclear. In actinomycetomas by A. madurae, we found a 66.6% of high concentration of lactoferrin in the grain, and 33.3% of low concentration. To analyze the actinomicetomas produced by N. brasiliensis 60% of high concentration of lactoferrin in the grains, 20% of moderate concentration and 20% of low concentration. Lactoferrin is released within the actinomycetoma grain, on the way the cell inside them during the inlammatory process, releasing the contents of their granules side (or specific) directly to the environment, to try to eliminate and control the infection. Conclusion: Lactoferrin is present and attached in the grains of the actinomycetomas, with a high or signiicant concentration according to our assessment, suggesting that it exerts its bactericidal or bacterio-static action participating as one of the mechanisms of innate immune resistance in this pathology. [ABSTRACT FROM AUTHOR]

Background: Leprosy (Hansen disease) is described as chronically contagious disease produced by Mycobacterium leprae that attacks mainly nerves and skin, with neurological damage that causes sensitivity lost and paralysis. Its classification is based in two fundamental polar types: lepromatous and tuberculoid and unstable cases: indeterminate and borderline. This classification is based in clinical, immunological, histopathological and bacteriological features. In lepromatous leprosy, patients have higher specific antibodies titles against M. leprae antigens, but their cellular responses are weak. In contrast, the tuberculoid leprosy patients show potent cellular immunity but their humoral response is low. Objective: To determine cross reactivity between Candida albicans antigens and antibodies against lepromatous leprosy and tuberculoid leprosy. Material and method: Peptides from total extract of Candida albicans between 9 and 96 kDa were purified and were exposed to four sera from lepromatous leprosy patients and three sera of tuberculoid leprosy patients, using anti-IgM or anti IgG peroxidase conjugates. The cross reactivity was evaluated by Western blot and enzyme immunoassay (ELISA) techniques. Conclusion: The 65 kDa antigen from C. albicans was well recognized by IgM from patients with leprosy, mainly lepromatous leprosy which demonstrated have high antibodies titles by ELISA and intense recognition by Western blot. With these results we can propose the use of this antigen as an auxiliary diagnostic tool in lepromatous nodular leprosy and possibly in future to use it in therapy because this protein has properties as immune cellular response stimulator. [ABSTRACT FROM AUTHOR]