Nail clipping in onychomycosis and comparison with normal nails and ungual psoriasis

Abstract: Background: Of all nail disorders seen in dermatology offices, half of them are due to onychomycosis. The main differential diagnosis is nail psoriasis. The objective of this study was to compare the microscopic findings, other than the presence of fungi, in the clipping of onychomycosis versus normal nails and nail psoriasis. Methods: Cross-sectional study of onychomycosis cases, analyzed by clipping and compared with data on normal nails and those with nail psoriasis. Results: Sixty-two onychomycosis samples were compared with 30 normal nails and 50 nails with psoriasis. In onychomycosis, measurement of subungual region, serous lakes, neutrophils and number of layers of parakeratosis are more intense than in psoriasis. Onychocariosis is less common in psoriasis, while bacteria are more frequent. The nail transition zone is more commonly blurred and irregular in onychomycosis. Conclusion: Clipping helps in the differential diagnosis of onychomycosis and nail psoriasis and may be useful even when fungi are not found.

Susceptibility and molecular characterization of Candida species from patients with vulvovaginitis

Abstract Vulvovaginal candidiasis affects women of reproductive age, which represents approximately 15–25% of vaginitis cases. The present study aimed to isolate and characterize yeast from the patients irrespective of the presentation of clinical symptoms. The isolates were subjected to in vitro susceptibility profile and characterization by molecular markers, which intended to assess the distribution of species. A total of 40 isolates were obtained and identified through the CHROMagar, API20aux and by ITS and D1/D2 regions sequencing of DNAr gene. Candida albicans strains were genotyped by the ABC system and the isolates were divided into two genotypic groups. The identity of the C. albicans, C. glabrata, C. guilliermondii, C. kefyr and Saccharomyces cerevisiae isolates was confirmed by the multilocus analysis. The strains of Candida, isolated from patients with complications, were found to be resistant to nystatin but sensitive to fluconazole, amphotericin B and ketoconazole, as observed by in vitro sensitivity profile. The isolates from asymptomatic patients, i.e., the colonized group, showed a dose-dependent sensitivity to the anti-fungal agents, fluconazole and amphotericin B. However, the isolates of C. albicans that belong to distinct genotypic groups showed the same in vitro susceptibility profile.

Mucormycosis and chromoblastomycosis occurring in a patient with leprosy type 2 reaction under prolonged corticosteroid and thalidomide therapy / Mucormicose e cromoblastomicose em um paciente com reação hansênica tipo II sob terapia prolongada com corticosteróide e talidomida

Mucormycosis is an uncommon fungal infection caused by Mucorales. It frequently occurs in patients with neutropenia, diabetes, malignancy and on corticoid therapy. However, it is rare in patients with AIDS. Clinical disease can be manifested in several forms. The case reported illustrates the rare occurrence of chromoblastomycosis and mucormycosis in an immunosuppressed patient with multibacillary leprosy, under prolonged corticosteroid and thalidomide therapy to control leprosy type 2 reaction. Neutrophil dysfunction, thalidomide therapy and work activities are some of the risk factors in this case. Chromoblastomycosis was treated by surgical excision and mucormycosis with amphotericin B. Although the prognosis of mucormycosis is generally poor, in the reported case the patient recovered successfully. This case should alert dermatologists to possible opportunistic infections in immunosuppressed patients.

Mucormicose é uma infecção fúngica incomum causada por Mucorales. Ocorre frequentemente em pacientes com neutropenia, diabetes, corticoterapia e condições malignas. Porém, é rara em pacientes com AIDS. A doença pode apresentar-se em diferentes formas. Este caso ilustra a rara ocorrência de mucormicose e cromoblastomicose em um paciente com hanseníase multibacilar, que estava sendo tratado com prednisona e talidomida devido a eritema nodoso (reação hansênica tipo II). Disfunção de neutrófilos, uso de talidomida e atividades profissionais são alguns fatores de risco neste caso. A cromoblastomicose foi tratada por excisão cirúrgica e a mucormicose com anfotericina B. Embora o prognóstico da mucormicose seja ruim, neste caso o tratamento foi bem sucedido. Este caso alerta dermatologistas para a possibilidade de infecções oportunistas em pacientes imunossuprimidos.

Analysis of the in vitro adherence of Streptococcus mutans and Candida albicans

The objective of the present study was to investigate the in vitro adherence capacity of Streptococcus mutans and Candida albicans. Adherence assays were conducted on dental surfaces and analyzed by scanning electron microscopy (SEM). Extracted human teeth were inoculated with Streptococcus mutans or Candida albicans and with both species simultaneously, and incubated at 37ºC for 21 days. Bacterial inocula had been obtained from saliva samples of children that had been colonized by both organisms. ATCC reference strains were used as controls. SEM analyses showed that the biofilm that covered the entire analyzed dental surface was more homogeneous inoculated with the two microorganisms simultaneously than with each species separately. In a second experiment, carried out with isolates that had shown the highest adherence the isolates were tested for adherence to high-density polyethylene substrates. The potentialization of the adherence capacity of Streptococcus mutans and Candida albicans when in association was confirmed.

O objetivo deste trabalho foi investigar a capacidade de aderência in vitro de Streptococcus mutans e Candida albicans. Ensaios de aderência foram realizados in vitro na superfície dentária, com posterior análise por Microscopia Eletrônica de Varredura (M.E.V.). Dentes humanos extraídos foram inoculados com Streptococcus mutans e Candida albicans, além de ambas espécies em conjunto, e foram incubados a 37ºC por 21 dias. Os inóculos eram provenientes de amostras salivares de crianças colonizadas por ambos microrganismos. Como controles foram utilizadas linhagens de referência ATCC dos dois microrganismos. A análise por M.E.V. mostrou a formação de um biofilme que cobriu toda a superfície dentária analisada de forma mais homogênea quando incubados juntos do que separadamente. Um segundo experimento foi desenvolvido utilizando isolados mostrando maior aderência dos experimentos anteriores e cortes de polietileno de alta densidade como substrato. A potencialização da capacidade de aderência de Streptococcus mutans e Candida albicans em associação foi confirmada.

Diagnóstico laboratorial de micoses superficiais e cutâneas: comparaçäo dos métodos do hidróxido de potássio e do calcofluor white / Laboratory diagnosis of superficial and cutaneous mycosis: a comparison of the potassium hydroxide and calcofluor white methods

FUNDAMENTOS: As micoses superficiais e cutâneas têm surgido com grande prevalência no Hospital de Clínicas da Universidade Federal do Paraná. OBJETIVOS: Avaliar o método do calcofluor white (CFW) mediante comparaçäo com o método do hidróxido de potássio (KOH). MÉTODOS: Foram analisadas 74 amostras de raspados de pele, unha, couro cabeludo e cabelo de 62 pacientes de ambos os sexos em diferentes idades. O material foi coletado nos Ambulatórios de Dermatologia, Dermatopediatria e Pronto Atendimento do Hospital de Clínicas da Universidade Federal do Paraná, entre outubro de 1995 e março de 1996. Os espécimes foram analisados por ambos os métodos e comparados no presente trabalho. Os resultados obtidos foram submetidos à análise estatística do Qui-quadrado. RESULTADOS: Os resultados obtidos indicaram o CFW täo efetivo quanto o KOH. O hidróxido de potássio apresentou 38 (51 por cento) resultados positivos e 36 (49 por cento) negativos. O calcofluor white foi positivo em 35 (47 por cento) amostras e negativo em 39 (53 por cento). CONCLUSÄO: Os dados revelaram igual eficácia entre os métodos avaliados; no entanto, o método do calcofluor white necessita de um laboratório equipado com microscópio de imunofluorescência.