| We report herein a case of 61-year-old man with Unna-Thost disease (nonepidermolytic hereditary palmoplantar keratoderma) who had been suffering from refractory dermatophyte infection. Diffuse palmoplantar hyperkeratosis developed in his infancy. Coarse scaling, fissures, marked erythema, and nail deformities appeared in his early adult life. Microscopic examination revealed fungal elements in scales and nail particles. Cultures of those scales isolated epidermophyton floccosum. Genealogical study demonstrated that his mother, sister, brother, daughter, and niece had had similar tylosis, and all of the affected individuals except his daughter had been proved to have E. floccosum or trichophyton rubrum infection. Oral itraconazole (100mg/day) was highly effective in treating his dermatophytosis without any adverse effects. Scaling, fissures and underlying erythema disappeared within four months. ( info) |
2/196. Photolocalized tinea facialis. The case of a 34-year-old white woman with tinea facialis that persisted for nine months prior to diagnosis is presented. The confluent plaquelike erythematous eruption of the face with eyelid lichenification that flared outdoors was thought to represent polymorphic light eruption and was refractory to antibiotics, corticosteroids (topical and systemic), and antimalarials. A KOH preparation was positive when the dermatosis spilled onto the mandibular region, and restaining of the initial skin biopsy revealed fungal hyphae. Complete resolution was accomplished with griseofulvin and MicTin. Tinea cab be added to the list of infectious agents that have a photosensitivity component. The fungus possibly "photolocalizes" to sun-damaged areas, ie, areas of increased capillary permeability. This case illustrates the importance of including tinea in considering diagnoses of sun-exposed lesions of the face. ( info) |
3/196. Superficial and deep granulomatous lesions caused by trichophyton violaceum. A patient with cutaneous and reticulo-endothelial lesions, lymphadenopathy and osteitis caused by trichophyton violaceum is presented. Two types of skin lesions were found: 1. Erythematous, scaly plaques on the arms, chest and abdomen; 2. areas of diffuse infiltration, granulomatous ulceration, fistulation and destruction of the sternal bone. Long-term treatment with penicillin, streptomycin, sulfonamides, and griseofulvin, gave temporary improvement. ( info) |
| trichophyton rubrum has been implicated as a potential trigger in flares of atopic dermatitis. We describe a patient with atopic dermatitis who presented with a history of multiple flares and concurrent acute tinea pedis and onychomycosis. Symptoms of atopic dermatitis and culture-positive acute infection with T. rubrum resolved during each flare using systemic antifungals. Flares of atopic dermatitis may be triggered by acute T. rubrum infections. Antifungal therapy should be considered in these patients. ( info) |
5/196. Microbiological and molecular diagnosis of deep localized cutaneous infection with trichophyton mentagrophytes. We describe a healthy young woman with a localized deep dermal infection on the right side of the chest wall. It was caused by the dermatophyte trichophyton mentagrophytes, and resolved after two pulses of oral itraconazole 200 mg twice daily for 1 week. As cultural and microscopic features did not enable a precise identification of the fungus, molecular investigation was undertaken. Patterns of HaeIII restriction digests of genomic dna from the culture matched those from Arthroderma incurvata and A. benhamiae, which is the teleomorph of T. mentagrophytes var. mentagrophytes. ( info) |
6/196. Case report. Tinea corporis purpurea. We report a case of tinea corporis purpurea localized to a calf in a 36-year-old woman. The patient, who was also affected by mild superficial venous insufficiency of lower limbs, complained of intense pruritus. microsporum canis was the aetiological agent. Clinically atypical varieties of tinea corporis were sometimes reported in the literature, particularly in HIV-positive patients, although they are uncommon in immunocompetent patients; in particular, tinea corporis purpurea is very rare. ( info) |
7/196. Dermatophytosis caused by trichophyton raubitschekii. Report of the first case in Sao Paulo, brazil. The authors report the first case of dermatophytosis caused by trichophyton raubitschekii in a patient from the State of Sao Paulo with Tinea corporis lesions localized on the buttocks. culture on Sabouraud-agar with cycloheximide permitted the isolation and identification of the fungus, and the diagnosis was confirmed by Dr. Lynne Sigler, University of alberta, canada. Systemic treatment with fluconazole, 150 mg/week for 4 weeks, in combination with topical treatment with isoconazole initially yielded favorable results, with recurrence of the lesions after the medication was discontinued. This is the fifth case of this dermatophytosis published in the Brazilian medical literature. ( info) |
8/196. Tinea incognito due to microsporum gypseum in three children. Tinea incognito is a dermatophytosis of atypical clinical character due to the absence of classic features of ringworm. It is caused by prolonged use of topical steroids, sometimes prescribed as a result of incorrect diagnosis. The cases reported in the literature have different clinical presentations and have generally been in adults. We report three children with tinea incognito in whom the lesions were psoriasis-like, eczema-like, and lichenoid, respectively. diagnosis was confirmed by mycologic examination, which led to the identification of microsporum gypseum, a geophilic dermatophyte which is an infrequent agent of mycotic infection in humans. ( info) |
9/196. Extensive and deep dermatophytosis caused by trichophyton mentagrophytes var. interdigitalis in an hiv-1 positive patient. BACKGROUND: Cutaneous infections are common in hiv-1 positive patients and are usually severe, recurrent, and caused by microorganisms that are unusual in immunocompetent patients. OBJECTIVE: We report a case of an hiv-1-positive 23-year-old male, with a history of intravenous drug use, in stage C-II (CDC '86), with a cd4 lymphocyte count of 335 cells/mm3. He had multiple, large erythematous, circinate and pustular plaques on his abdomen, back, arms and legs. RESULTS: We isolated trichophyton mentagrophytes var. interdigitalis from the lesions. The biopsy showed suppurative deep dermatophytosis and folliculitis. The patient satisfactorily responded to itraconazole (100 mg/d for 14 days). CONCLUSION: This is the first reported case of deep dermatophytosis caused by T. mentagrophytes in an HIV-positive patient. ( info) |
10/196. Hazardous hedgehogs. The African pygmy hedgehog has recently become a fashionable exotic pet in the united states, particularly in the South. As illustrated by the three cases reported, this mammalian insectivore can be a carrier of fungi that cause human dermatomycoses. The African pygmy hedgehog has also been associated with contact urticaria and human salmonellosis. ( info) |