Onychomycosis due to fusariumsolani

Fusarium species is a representative of hyaline fungi. It is one of the most potent etiologic agent recently reported as emerging pathogen. It may infect immunocompetent and immunocompromised individuals and cause disseminated disease. Three cases of toenails onychomycosis due to Fusarium solani are reported. The same fungus was isolated from the patients in more than two repeated specimens. Compatible filaments were also seen by direct microscopy. Three immunocompetent patients were from different origins, reported to have distolateral subungual onychomycosis [DLSO] of the toenails. Patient 1 was clinically cured after three pulses of oral itraconazole treatment. Patient 2 had blackish discoloration plus [DLSO] of the toenails. It was only treated for financial reasons only by topical antifungal agents, which resulted in moderate clinical improvement. Whereas, patient 3 presented with acute paronychia and onychia, was treated by different topical and systemic antifungal therapy. Such treatments resulted with only partial improvements with recurrence. Fusarium rarely causes infection and is a highly resistant fungus to antifungal therapy. Review of literature suggests that patients respond differently to various antifungal treatments. The present cases support the view that systemic antifungal therapy is more successful in the treatment of Fusarium onychomycosis

Poikilodermatous mycosis fungoides [MF]

Mycosis fungoides[MF] is a lymphoma of low-grade malignancy with prolonged survival. The progression from the clinical stage of patches to those characterized by plaques, tumors, and extra-cutaneous spread usually takes place over many years or decades. One of the problems in describing this disease is that it doesn 't look the same for all patients. Patches, plaques and tumors are the clinical names of the different presentations. Patches are usually flat, possibly scaly. Patches are often mistaken for eczema, psoriasis or [non-specific] dermatitis until an exact diagnosis of Mycosis fungoides is made. We reported an unusual variant of two cases ofpoikilodermic MF

Total Serum IgE and SCORAD in children with atopic dermatitis in Qatar

Design: a prospective study to determine the level of IgE and SCORAD in children with AD

Setting: dermatology clinic Hamad General Hospital. Patients: A total of 140 patients with AD were re- cruited [84 male and 56 female]

Methods: patients were assigned an AD symptom score [SCORAD] and were screened for levels of serum IgE. The patients were subdivided by age into four groups: Group 1 [n=26] less than one year, Group 2 [n=43] preschool children less than four years, Group 3 [n=54] from four to seven years, Group 4 [n=17] more than seven up to twelve years

Results: the SCORAD showed proportional increase with age among different groups the highest SCORAD was noticed in Group 4, IgE level was positive in only 42.1 % of the cases. The IgE level showed a significant positive correlation with SCORAD in Groups 1 and 4

Conclusions: clinical severity of atopic dermatitis increase with age especially in the older children as the mild and moderate cases tend to resolve, IgE level is correlated with the clinical severity only in infants and children beyond the age of seven years

Telangiectasia macularis eruptiva perstans [TMEP] case report with review of the literature

The most frequently affected organ in any form of mastocytosis is the skin [1]. Cutaneous lesions tend to appear early in life and include urticaria pigmentosa, mastocytoma, diffuse and erythematous Cutaneous mastocytosis and Telangiectasia Macularis Eruptiva perstans [2, 3]. Telangiectasia Macularis Eruptiva Perstans is observed in less than 1 % of cases of mastocytosis [4]. Although cutaneous mastocytosis appears to occur sporadic, yet familial incidence was reported as four cases of telangiectasia macularis eruptiva perstans appearing in three generations of one family with an autosomal dominant mode of transmission with incomplete penetrance [5]. Telangiectasia macularis eruptiva perstans is characterized by telangiectatic reddish brown macules usually on the trunk, pruritus [6] with little tendency to urticate [7]. Telangiectasia macularis eruptiva perstans is mostly seen in adults and is occasionally seen in children or infants[8] The classic symptoms in Telangiectasia macularis eruptiva perstans include episodic flushing, gastrointestinal complaints, heart palpitation, syncope and may be confused with carcinoid [8]. We present a case of telangiectasia macularis eruptiva perstans in an adult and discuss its diagnosis and mastocytosis in general and its management