Epidemiología de las dermatomicosis en 30 años de estudio en el Instituto de Medicina Tropical Daniel A. Carrión, Universidad Nacional Mayor de San Marcos, Lima, Perú / Epidemiology of dermatomycoses in 30 years of study at Daniel A. Carrion Institute of Tropical Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru

Objetivos: Determinar la evolución epidemiológica de las dermatomicosis en pacientes de consultorio externo durante el periodo 1976-2005. Diseño: Estudio descriptivo, retrospectivo y analítico. Lugar: Instituto de Medicina Tropical æDaniel Alcides CarriónÆ, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes: Pacientes positivos a dermatomicosis. Intervenciones: Se revisó las historias clínicas de 7 185 (55,3 por ciento) casos positivos a dermatomicosis. El instrumento de investigación empleado fue la ficha de levantamiento de información. Principales medidas de resultados: Agente etiológico, estación del año, sexo, edad y forma clínica. Resultados: El estudio demostró que los más afectados fueron del grupo etario de 16 a 30 años (42,7 por ciento) y sexo femenino (52,1 por ciento). La dermatomicosis más frecuente fue la onicomicosis (43,6 por ciento). Los agentes patógenos de mayor prevalencia fueron Trichophyton rubrum (33,2 por ciento), Cándida albicans (15,3 por ciento), Cándida no albicans (11,8 por ciento), Trichophyton mentagrophytes (9,4 por ciento), Malassezia spp (9,1 por ciento) y las infecciones mixtas (7,2 por ciento). Las micosis de cuero cabelludo muestran continuo aumento durante todo el estudio. El dermatofito Epidermophyton floccosum fue aislado por última vez en la década del 90. A partir de 1995 ha aumentado la prevalencia de Cándida no albicans y se encontró como especie re-emergente a la levadura Cándida tropicalis. Conclusiones: Entre los años 1976 y 2005 hubo importantes variaciones epidemiológicas en relación a las formas clínicas y a la etiología de las dermatomicosis...

Objectives: To determine dermatomycoses epidemiological evolution in outpatients during the period 1976-2005. Design: Descriptive, retrospective, and analytical study. Setting: Daniel Alcides Carrion Institute of Tropical Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Participants: Patients positive to dermatomycoses. Interventions: Medical records of 7 185 (55.3 per cent) dermatomycoses-positive patients were reviewed. Main outcome measures: Etiologic agent, season, gender, age, and clinical forms. Results: Females (52.1 per cent) and the 16 to 30 year-old group (42.7 per cent) were the most affected. Most frequent dermatomycoses was onychomycosis (43.6 per cent). Most prevalent pathogens were Trichophyton rubrum (33.2 per cent), Candida albicans (15.3 per cent), Candida non albicans (11.8 per cent), Trichophyton mentagrophytes (9.4 per cent), Malassezia spp. (9.1 per cent), and mixed infections (7.2 per cent). The fungal scalp infection showed steady increase during the period studied. Epidermophyton floccosum dermatophyte was isolated for the last time in the 1990s. Since 1995 prevalence of Candida non albicans has increased and Candida tropicalis yeast species are re-emerging. Conclusions: Epidemiological changes in dermatomycoses clinical forms and etiology were found between 1976 and 2005...

Identificación de especies de Malassezia aisladas de piel sana en pobladores de Lima, Perú / Identification of Malassezia species isolated from healthy skin in residents of Lima, Peru

Objetivo: Identificar las especies de Malassezia en zonas seborreicas de piel sana en población limeña. Diseño: Estudio descriptivo transversal. Lugar: Instituto de Medicina Tropical æDaniel Alcides CarriónÆ, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes: Pobladores asintomáticos. Intervenciones: Empleando la técnica de Mariat y Adan-Campos, se recolectó muestras de piel de 129 pobladores asintomáticos de diversos distritos de la ciudad de Lima. El aislamiento de Malassezia se realizó en medio Dixon modificado e incubado a 32 grados centígrados por 7 días, la identificación de las colonias por sus características macro y micromorfológicas, y la tipificación mediante el estudio de las propiedades bioquímicas y fisiológicas según la técnica de Guillot y col. Principales medidas de resultados: Especie de Malassezia, sexo, edad y región anatómica. Resultados: Se aisló Malassezia spp en 43,4 por ciento de los pobladores, obteniéndose 49,2 por ciento en varones y 37,5 por ciento en mujeres. De las diferentes regiones corporales, 68 cultivos fueron positivos: cuero cabelludo 31 (45,6 por ciento), espalda 36 (52,9 por ciento) y región frontal 1 (1,5 por ciento). El grupo etario con mayor frecuencia de aislamientos (47,2 por ciento) fue el de 14 a 25 años (adolescentes jóvenes). M. slooffiae fue encontrado en 83,8 por ciento y M. obtusa en 16,2 por ciento de los casos. Conclusiones: Se encontró Malassezia spp. en la piel humana sana. M. slooffiae fue la especie predominante de los casos positivos (83,8 por ciento) seguido de M. obtusa (16,2 por ciento)...

Objective: To identify Malassezia species in healthy skin seborrhea areas in Lima inhabitants. Design: Cross-sectional study. Setting: Daniel Alcides Carrion Tropical Medicine Institute, Universidad Nacional Mayor de San Marcos, Lima, Peru. Participants: Asymptomatic persons. Interventions: Skin samples were collected from 129 asymptomatic residents of several districts of Lima city using Mariat and Adan-CamposÆ technique. Malassezia isolation was performed in modified Dixon medium and incubated at 32 grades centigrades for 7 days. Colonies were identified by macro and micro morphological characteristics and typing was determined by biochemical and physiological properties using GuillotÆs technique. Main outcome measures: Malassezia species, participantsÆ gender, age and anatomical region. Results: Malassezia spp was isolated in 43.4 per cent of the residents, 49.2 per cent in men and 37.5 per cent in women. From various body regions 68 cultures were positive: scalp 31 (45.6 per cent), back 36 (52.9 per cent) and frontal region 1 (1.5 per cent). Isolates most common age group (47.2 per cent) was that of adolescents-young (14-25 year-old). M. slooffiae was found in 83.8 per cent and M. obtusa in 16.2 per cent of cases. Conclusions: Malassezia spp. was present in healthy human skin. M. slooffiae was the predominant species in positive cases (83.8 per cent) followed by M. obtusa (16.2 per cent)...

Seroprevalence of human toxocariasis in Andean communities from the Northeast of Lima, Peru / Soroprevalência da toxocaríase humana em três comunidades andinas do Nordeste de Lima, Peru

The aim of this study was to assess the seroprevalence of human toxocariasis in three Andean communities from the Northeast of Lima, Peru. A total of 303 subjects including children and adults were studied and blood samples were collected to detect anti-Toxocara antibodies by ELISA-IgG test and by hematological examination; stool samples were collected also for parasitological examination. The overall seroprevalence of toxocariasis observed in the total population was 20.46 percent, with a significant high proportion in children from one to 10 years old (p = 0.034). Among the subjects with positive serology, 32.26 percent of them had respiratory disturbances, 22.58 percent hepatomegaly, 17.74 percent ocular signs or symptoms, 14.51 percent abdominal pain, 9.68 percent neurological involvement, and 4.84 percent cutaneous signs, but none of these clinical features were associated to a positive serology by multivariate analysis. Furthermore, 79.03 percent of seropositive subjects also harbored at least one intestinal parasite, which was associated to a positive serology (p < 0.05). The presence of pets within the houses, a previous history of pica or geophagia and the use of public places were also present in this population, but only the latter was associated to the serology (p < 0.05). In conclusion, clinical, serological, and epidemiological evidences for larval Toxocara infection were found in the studied population.

O propósito do presente trabalho foi estimar a soroprevalência da toxocaríase humana em três comunidades andinas do Nordeste de Lima, Peru. Foi estudado um total de 303 pessoas, entre crianças e adultos. Foram coletadas amostras de sangue para a detecção de anticorpos anti-Toxocara e para a análise hematológica, além de amostras fecais para o exame parasitológico. A soroprevalência geral da população foi de 20,46 por cento com proporção significativamente maior de positividade em crianças de um a 10 anos (p = 0,034). Das pessoas com sorologia positiva, 32,26 por cento apresentavam sintomas respiratórios, 22,58 por cento moléstias hepáticas, 17,74 por cento manifestações oculares, 14,51 por cento dor abdominal, e 4,84 por cento sinais cutâneos. Além disso, 79,03 por cento das pessoas com sorologia positiva tinham pelo menos algum parasito intestinal com associação significativa (p < 0.05). A presença de cachorros dentro das casas, história de pica ou geofagia e o uso dos lugares públicos também estiveram presentes nesta população, mas o ultimo deles só esteve associado com a sorologia positiva (p < 0.05). Conclui-se que existem evidências clínicas, sorológicas e epidemiológicas de infecção por larvas de Toxocara na população estudada.