ABSTRACT
Abstract Superficial mycoses are fungal infections restricted to the stratum corneum and to the hair shafts, with no penetration in the epidermis; they are: white piedra, black piedra, tinea versicolor, and tinea nigra. This study presents images of mycological tests performed in the laboratory, as well as exams performed at the authors office, in order to improve the dermatologist's knowledge about the diagnosis of these dermatoses, which are common in many countries.
Subject(s)
Humans , Piedra/diagnosis , Tinea/diagnosis , Piedra/classification , Piedra/pathology , Tinea/classification , Tinea/pathologyABSTRACT
La piedra blanca es una micosis superficial crónica y asintomática poco frecuente del pelo causada por Trichosporon spp. (T. asahii, T. cutaneum o T. beigelii, T. inkin y T. mucoides), caracterizada por presentar nódulos blandos, blanquecinos, adheridos a los tallos pilosos, preferentemente del cuero cabelludo, axilas, cejas, pestañas y con menor frecuencia, en la barba, el bigote, el pubis y el perineo. Suele aparecer con mayor frecuencia en población de climas templados y tropicales. En los tres casos reportados se tomó muestra de los cabellos con los nódulos sospechosos, se le realizaron pruebas diagnósticas que permitieron confirmar la presencia de estructuras levaduriformes compatibles con Trichosporon spp. La sospecha de pediculosis es el motivo de consulta de los pacientes con piedra blanca, confundiendo los nódulos con liendres; por consiguiente es importante que el médico tenga claro las enfermedades micóticas con las cuales se debe hacer el diagnóstico diferencial para poder orientar y establecer el adecuado tratamiento para el paciente
The white stone is a rare, superficial, chronic and asymptomatic mycosis of the hair caused by Trichosporon spp. (T asahii, T. cutaneum or T. beigelli, T. inkin, and T. mucoid), which is characterized by the presence of white soft nodules, adhered to the hair shafts, preferably the scalp, armpits, eyebrows, eyelashes, and less frequently, in the beard, moustache, pubic area and perineum. It usually appears with greater frequency in areas of temperate and tropical climates. In the three reported cases, the sample of hair was taken from suspect hair, and then a series of diagnostic tests were performed to allow the confirmation of the presence of yeast shaped structures compatible with Trichosporon spp. Often, a possible pediculosis was the main reason of consultation of the patients who suffer white stone, and it can be confused with nodules of nits. Therefore, it is important that the physician has a better understanding of the fungal diseases that will be part of the differential diagnosis in order to guide and establish a proper treatment for the patients
Subject(s)
Humans , Female , Child, Preschool , Child , Adult , Pediculus , Scalp , Tropical Climate , Trichosporon , Mycoses , Lice Infestations , Volition , Yeasts , Vibrissae , HairABSTRACT
White piedra of scalp hair is considered a rare entity. We report three cases of this disorder all of whom presented with nodules on the hair. Potassium hydroxide preparations of the hair revealed clustered arthrospores and mature, easily detachable nodules. Cultures grew Trichosporon inkin in 2 patients and Trichosporon mucoides in one patient. Both these fungi are unusual causes of white piedra.
ABSTRACT
Las piedras son infecciones fúngicas superficiales y asintomáticas frecuentes en los países tropicales, que se caracterizan por la presencia de nódulos a lo largo del tallo piloso. Sin embargo, la literatura publicada durante los últimos años es limitada y la taxonomía actual de sus agentes etiológicos es poco conocida. Se presenta un caso de piedra negra y otro de piedra blanca en dos mujeres colombianas inmunocompetentes con numerosas lesiones nodulares en su cabello que consultaron a un centro de referencia nacional en Bogotá, Colombia. A pesar de que las piedras fueron descritas y clasificadas desde el punto de vista clínico y microbiológico hace más de 100 años, aún se conoce poco sobre su historia, ecología, forma de transmisión, epidemiología y presentación clínica. Sin embargo, las diferencias que existen entre las dos micosis ayudan a orientar el diagnóstico clínico y fúngico.
Black piedra and white piedra are common superficial and asymptomatic fungal infections in tropical countries, characterized by the presence of hard nodules located along the hair shaft. However, in recent years literature on this topic has been limited and the current taxonomy of their etiologic agents is poorly understood. Here we report two cases of black piedra and white piedra in two immune competent Colombian women with numerous nodular lesions in their hair who visited a national reference center in Bogota, Colombia. Despite having been described and classified from a clinical and microbiological perspective more than 100 years ago, little is still known about the history, ecology, mode of transmission, epidemiology and clinical presentation of piedras. Nevertheless, the differences between the two mycoses help to orient clinical and fungal diagnoses.
Subject(s)
Humans , Female , Adolescent , Aged , Piedra , Scalp , Trichosporon , Infections , MycosesABSTRACT
Los monumentos pétreos declarados como patrimonio histórico son deteriorados a través del tiempo por efecto de agentes físicos, químicos y medioambientales. Estos últimos dependen en gran medida de la ubicación geográfica del inmueble, dichos agentes son: el régimen de vientos que desgasta la roca erosionándola; temporadas de lluvia que al contener sales disueltas causan corrosión por reacciones químicas de estas con la matriz del material calcáreo solubilizando el carbonato de calcio el cual es su principal componente; radiación solar durante todo el año causante de decoloramiento; humedad que permite el establecimiento de formas de vida. Las actividades antropogénicas que no son amigables con el ambiente son otro factor determinante, las emisiones de gases vehiculares por ejemplo, deterioran en gran medida los monumentos de piedra antiguos por ser agentes ácidos altamente corrosivos. Se crean así las condiciones para el establecimiento y proliferación de organismos vivos en la piedra tales como bacterias, algas, hongos, líquenes y plantas que por ser invasivos y colonizadores causan biodeterioro. Dado que los metabolismos de estas especies involucran el consumo de sustratos químicos orgánicos e inorgánicos presentes en la roca, son otro factor que va en detrimento de la estabilidad, durabilidad, y apariencia estética de la misma.
Stony monuments declared as cultural world heritage are deteriorated through the years because of physical, chemical and environmental agents which depend largely on their geographic location. Among these agents are: gust of, winds that wear away the stone eroding it; rainy seasons which bring dissolved salts and cause corrosion because of their chemical reaction with the calcareous material matrix which solubilizes calcium carbonate which is their main component; because of solar radiation all through the year stones lose their color; high humidity allows plants and living forms to grow. Anthropogenic activities which are not environmentally friendly are other important factor: vehicle gas emissions, for example, deteriorate greatly old stone monuments because they are highly corrosive acids. This way, optimal conditions are created for fungi, algae, bacteria, lichens and plants which are invasive and colonizing to live on the stone surface and cause biodeterioration. Since metabolisms of these species involve consumption of inorganic substrates that are present in the stones, they become another factor affecting monument's durability, stability, and aesthetic appearance.
Subject(s)
Humans , Biodegradation, Environmental , Chemical Reactions , CorrosionABSTRACT
White Piedra is a superficial mycoses characterized by nodules on the hair shaft, caused by the basidiomycetous yeast Trichosporon species. In this study 25 essential oils were extracted and screened against two Trichosporon species i.e. Trichosporon asahii and Trichosporon cutaneum. Both these fungi procured from MTCC Chandigarh were maintained on yeast malt agar plates and tubes at 25oC. Two screening methods viz., agar well diffusion assay and minimum inhibitory concentration were adopted for the study. The results showed that the maximum anti-yeast activity against T. asahii and T. cutaneum was demonstrated by oil of Mentha piperita showing full inhibition of both the fungi, Melaleuca alternifolia with an inhibition zone of 45 and 40 mm, Cymbopogon winterians with inhibition zone of 45 and 45 mm and Cymbopogon flexuosus with 35 and 30 mm inhibition zones. The oil of Trachyspermum ammi exhibited 10 and 20 mm, Abelmoschus moschatus exhibited 30 and 20 mm, Salvia sclarea showed 20 and 18 mm and Jasminum officinale exhibited 25 and 15 mm inhibition zones showing moderate activity. The oil of Cyperus scariosus, Pogostemon patchouli and Rosa damascene showed no inhibition zone against both the fungi while Vetiveria zizanoides exhibited no inhibition in case of T. asahii and inhibition zone of 10 mm in case of T. cutaneum demonstrating comparatively low activity against both the fungi. These results support that the essential oils can be used to cure superficial mycoses and these oils may have significant role as pharmaceuticals and preservatives.
ABSTRACT
Piedra, is an asymptomatic fungal infection of the hair shaft, resulting in the formation of nodules of different hardness on the infected hair. The infection also known as Trichomycosis nodularis is a superficial fungal infection arising from the pathogen being restricted to the stratum corneum with little or no tissue reaction. The nodules are a concretion of hyphae and fruiting bodies of the fungus. Two varieties of Piedra may be seen, Black Piedra and White Piedra. The fungus Trichosporon ovoides is involved in the occurrence of both types of Piedras. The purpose of this study was to examine the effectiveness of selected essential oils for the control of growth of the fungus and to determine whether the antifungal effect was due to the major compounds of the oils. Two screening methods viz. Agar well diffusion assay and Minimum Inhibitory Concentration were adopted for the study. MIC and MFC were determined by tube dilution method. Essential oils from Eucalyptus, Ocimum basilicum, Mentha piperita, Cymbopogon flexuosus, Cymbopogon winterians, Trachyspermum ammi, Zingiber officinalis, Citrus limon, Cinnamomon zeylanicum, Salvia sclarea, Citrus aurantifolia, Melaleuca alternifolia, Citrus aurantium, Citrus bergamia, Pogostemon pathchouli, Cedrus atlantica, Jasminum officinale, Juniperus communis, Abelmoschus moschatus, Cyperus scariosus, Palargonium graveolens, Boswellia carterii, Rosa damascene, Veteveria zizanoides and Commiphora myrrha were evaluated. The essential oils of Cymbopogon winterians, Mentha piperita, Cinnamomum zeylanicum, Melaleuca alternifolia and Eucalyptus globulus were proved to be most effective against the fungus Trichosporon ovoides.
Subject(s)
Humans , Anti-Infective Agents , Mycoses , Oils, Volatile/analysis , Piedra , Trichosporon/growth & development , Methods , VirulenceABSTRACT
Piedra, is an asymptomatic fungal infection of the hair shaft, resulting in the formation of nodules of different hardness on the infected hair. The infection also known as Trichomycosis nodularis is a superficial fungal infection arising from the pathogen being restricted to the stratum corneum with little or no tissue reaction. The nodules are a concretion of hyphae and fruiting bodies of the fungus. Two varieties of Piedra may be seen, Black Piedra and White Piedra. The fungus Trichosporon ovoides is involved in the occurrence of both types of Piedras. The purpose of this study was to examine the effectiveness of selected essential oils for the control of growth of the fungus and to determine whether the antifungal effect was due to the major compounds of the oils. Two screening methods viz. Agar well diffusion assay and Minimum Inhibitory Concentration were adopted for the study. MIC and MFC were determined by tube dilution method. Essential oils from Eucalyptus, Ocimum basilicum, Mentha piperita, Cymbopogon flexuosus, Cymbopogon winterians, Trachyspermum ammi, Zingiber officinalis, Citrus limon, Cinnamomon zeylanicum, Salvia sclarea, Citrus aurantifolia, Melaleuca alternifolia, Citrus aurantium, Citrus bergamia, Pogostemon pathchouli, Cedrus atlantica, Jasminum officinale, Juniperus communis, Abelmoschus moschatus, Cyperus scariosus, Palargonium graveolens, Boswellia carterii, Rosa damascene, Veteveria zizanoides and Commiphora myrrha were evaluated. The essential oils of Cymbopogon winterians, Mentha piperita, Cinnamomum zeylanicum, Melaleuca alternifolia and Eucalyptus globulus were proved to be most effective against the fungus Trichosporon ovoides.
ABSTRACT
White piedra is a superficial mycosis caused by the genus Trichosporon. It is characterized by nodules on the hair shaft. Pediculosis capitis is caused by Pediculus humanus var. capitis of the suborder Anoplura. Whereas pediculosis is a common infestation, clinical reports of white piedra are rare. Molecular biology procedures identified T. inkin as the agent of white piedra in this case report. The authors present associations between the two diseases in the same patient in order to highlight their clinical differences.
Piedra branca é micose superficial causada pelo gênero Trichosporon e caracterizada por nódulos aderidos à haste do pelo. Pediculose capitis é causada pelo Pediculus humanus var. capitis pertencente à subordem Anoplura. Enquanto que a pediculose é enfermidade comum, relatos clínicos de piedra branca são raros. Técnicas de biologia molecular identificaram o agente de piedra branca do presente relato como T.inkin. Os autores apresentam associação de ambas as infestações no mesmo paciente para salientar seus aspectos clínicos distintos.
Subject(s)
Female , Humans , Young Adult , Lice Infestations/complications , Piedra/complicationsABSTRACT
INTRODUCTION: White piedra is a superficial mycosis caused by the genus Trichosporon and characterized by nodules on hair shaft. METHODS: The authors report a family referred to as pediculosis. Mycological culture on Mycosel® plus molecular identification was performed to precisely identify the etiology. RESULTS: A Trichosporon spp. infection was revealed. The molecular procedure identified the agent as Trichosporon inkin. CONCLUSIONS: White piedra and infection caused by T. inkin are rarely reported in Southern Brazil. The molecular tools are essentials on identifying the Trichosporon species.
INTRODUÇÃO: Piedra branca é micose superficial causada por fungos do gênero Trichosporon e caracterizado por nódulos firmemente aderidos à haste do pêlo. MÉTODOS: Os autores relatam casos familiares encaminhados como pediculose. Foram utilizados cultura em ágar Mycosel® e identificação molecular. RESULTADOS: Exame micológico revelou a infecção por Trichosporon spp. A identificação molecular demonstrou se tratar do Trichosporon inkin. CONCLUSÕES: Piedra branca e infecção pelo T. inkin são raramente relatados na região sudeste do Brasil. A identificação molecular é essencial para correta determinação de espécies no gênero Trichosporon.
Subject(s)
Adult , Child , Child, Preschool , Female , Humans , Male , Piedra/diagnosis , Scalp Dermatoses/diagnosis , Scalp Dermatoses/microbiology , Trichosporon/genetics , Piedra/microbiology , Trichosporon/isolation & purification , Trichosporon/classificationABSTRACT
Se estudiaron los hábitos alimentarios del barbul de piedra en el río Sinú. El contenido estomacal se evaluó con el coeficiente de vacuidad, grado de digestión, frecuencia de ocurrencia, frecuencia numérica, gravimetría, índice de importancia relativa y relación longitud intestinal-longitud total. Solo 18,8% de los estómagos se encontró vacío, la mayoría de las presas estaban medio digeridas y se identificaron cinco grupos alimentarios: crustáceos, peces, material vegetal, moluscos y otros. Crustáceos fue el grupo más frecuente, abundante y con mayor composición en peso. El índice de importancia relativa indicó que crustáceos y peces son grupos de importancia relativa secundaria, mientras que restos vegetales, moluscos y otros fueron ocasionales o circunstanciales. Los resultados alcanzados en este trabajo muestran que el barbul de piedra es un pez que mantiene sus hábitos alimentarios a medida que va creciendo y a lo largo del ciclo hidrológico, aunque muestra preferencia carnívora, especialmente por los Crustáceos.
The feeding habits of Barbul de piedra in the Sinu river were studied. The stomach content was analyzed using the proportion of empty stomachs, grade of digestion, frequency of occurrence, numerical frequency, gravimetry, relative importance index and the gut length-total length relationship. Only 18.8% of stomachs were empty, most of preys were half-digested and five food groups were identified: Crustaceans, fishes, vegetable rests, molluscs and others. Crustaceans were the most frequent, abundant and greater weight composition group. The relative importance index indicated that crustaceans and fishes were secondary relative importance groups and vegetable rests, molluscs and others were occasional or circumstantial groups. The results achieved in this work indicate that Barbul de piedra is a fish that keeps your feeding habits as they grow and along the hydrological cycle, although shows carnivorous preference, especially by Crustaceans.
ABSTRACT
La piedra blanca es una micosis superficial causada por levaduras del género Trichosporon. Se manifiesta como una infección crónica y asintomática que afecta a los tallos pilosos y forma concreciones fúngicas en forma de nódulos, preferentemente en los pelos de axilas y pubis, aunque puede afectar también a la cabeza. Presentamos el caso de una niña de 9 años con afectación de los pelos de la cabeza.
The white stone is a superficial fungal infection caused by the yest Trichosporon sp. It clinically manifests as a chronic and asymptomatic infection that affects the hair shaft and forms nodules shaped fungal concretions, preferably in the axillae and pubis, but scalp hairs can also be affected. We presented the case of a 9-year- girl with affectation of the scalp hairs.
Subject(s)
Humans , Female , Child , Dermatomycoses , Piedra/diagnosis , Trichosporon , Diagnosis, DifferentialABSTRACT
Objective To report a case of cutaneous infection due to Trichosporon dermatis. Methods Lesional discharge and tissue were obtained and subjected to microscopic examination, fungal culture and histopathology, respectively. The fungal isolate was then identified with DNA sequence analysis, API 20C AUX system, gelatin liquefaction test, thermal tolerance test. Antifungal susceptibility test was also performed for the fungus. Results A 70-year-old male presented with a 9-month history of ulcerated swelling of the right medial malleolus after plant puncture. Direct microscopic examination of lesional discharge showed no fungal elements, but histopathological biopsy revealed hyphae and spores in the dermis. Yellowish white yeast-like colony grew on Sabouraud dextrose agar (SDA). Slide culture showed pseudohyphae, true hyphae, arthroconidia and blastoconidia. The isolate was identified as Candida humicola by API 20C AUX system, but as T. dermatis by DNA sequence analysis. The strain was unable to liquefy gelatin, could grow at 25 ℃ to 40 ℃, and was sensitive to amphotericin B, itraconazole, voriconazole and nystatin. The skin lesion completely subsided after 4-month treatment with oral itraconazole. Conclusions The isolate is identified as T. dermatis according to morphological features and DNA sequence, which is sensitive to itraconazole.
ABSTRACT
ANTECEDENTES: la piedra blanca es una micosis caracterizada por la presencia de nódulos de color blanco a pardo claro, adheridos a los pelos de la región genital, axilas, cejas, pestañas y cuero cabelludo, es causada principalmente por Trichosporon inkin y Trichosporon ovoides. PRESENTACIÓN DEL CASO: paciente del sexo femenino de 35 años, originaria de San Pedro Sula, Honduras, de buena presencia física y buenos hábitos higiénicos, acude a consulta por presentar nódulos en los pelos púbicos, asintomáticos, de 2 meses de evolución. Al examen físico se pudo observar la presencia de nódulos de color blanquecino a pardo claro, blandos, de 1 a 2 mm, que rodeaban los pelos. No se detectó fluorescencia de los pelos a la luz de Wood. Al examen microscópico se observaron blastoconidios y artroconidios; en el cultivo se obtuvo el crecimiento de colonias levaduriformes, elevadas, de aspecto cerebriforme; en el microcultivo en agar extracto de malta se observaron hifas hialinas, tabicadas que formaban apresorios, pseudohifas fragmentadas, artroconidios rectangulares y blastoconidios. Mediante el sistema API ID32C fue identificado como Trichosporon inkin. Se instauró tratamiento con crema de isoconazol, previo rasurado del vello púbico. Los exámenes realizados al final del tratamiento fueron negativos. CONCLUSIONES: se presenta un caso de piedra blanca genital en el sexo femenino y se hace una actualización sobre la taxonomía del género Trichosporon sobre la base de los estudios moleculares, se discute el papel de T. inkin en esta micosis y su relevancia creciente como agente de infecciones invasivas en pacientes inmunocomprometidos, así como la importancia del diagnóstico de laboratorio para la confirmación de los casos.
INTRODUCTION: white piedra is a type of mycosis characterized by white to light brown nodules attached the hair shafts of genitals, axilla, eyelashes, eyebrowns, and scalp and is mainly caused by Trichosporon inkin and Trichosporon ovoides. CASE PRESENTATION: a 35 years-old female with good physical condition and good hygienic habits, who came from San Pedro Sula in Honduras, went to the doctor because of some nodules in their genital hair, asymptomatic, two months of evolution. On physical examination, it was observed that there were white-to-light brown coloured nodules measuring 1-2mm and surrounding the hair shafts. No fluorescence was detected in the hair on Wood´s light. On microscopic examination, blastoconidia and arthroconidia were observed; the culture yielded the growth of elevated yeastlike colonies; the microculture in malt extract agar showed disarticulating hyaline hyphae, partitioned appressoria, fragmented pseudohyphae, rectangular arthroconidia and blastoconidia. Through the API ID32C system, it was identified as Trichosporon inkin. The patient was treated with Isoconazole cream after her genital hair had been shaved. At the end of treatment, the exam results were negative. CONCLUSIONS: the case of a female with genital white piedra was presented and an updating on Trichosporon genus taxonomy on the basis of molecular studies. The role of T. inkin in this mycosis, and its growing importance as an agent of invasive infections in immunocompromised patients, as well as the relevance of lab diagnosis to confirm cases, were discussed.
ABSTRACT
White piedra is a superficial fungal infection of the hair shaft, caused by Trichosporon beigelii . We report two cases of white piedra presenting as brown palpable nodules along the hair shaft with a fragility of scalp hairs. T. beigelii was demonstrated in hair culture of both the patients and T. ovoides as a species was confirmed on carbohydrate assimilation test. The first patient responded to oral itraconazole and topical ketoconazole, with a decrease in the palpability of nodules and fragility of scalp hairs at the end of two months.
ABSTRACT
The Trichosporon genus is constituted by many species, of which Trichosporon ovoides and Trichosporon inkin are the causative agents of white piedra. They can cause nodules in genital hair or on the scalp. At present, Brazilian laboratory routines generally do not include the identification of the species of Trichosporon genus, which, although morphologically and physiologically distinct, present many similarities, making the identification difficult. The aim of this study was to identify the aetiological agents at the species level of white piedra from clinical specimens. Therefore, both the macro and micro morphology were studied, and physiological tests were performed. Trichosporon spp. was isolated from 10 clinical samples; T. ovoides was predominant, as it was found in seven samples, while T. inkin was identified just in two samples. One isolate could not be identified at the species level. T. inkin was identified for the first time as a white piedra agent in the hair shaft on child under the age of 10.
Subject(s)
Adult , Child , Child, Preschool , Female , Humans , Male , Piedra/microbiology , Scalp Dermatoses/microbiology , Trichosporon/classification , Mycological Typing Techniques , Retrospective Studies , Trichosporon/chemistry , Trichosporon/cytologyABSTRACT
White piedra is a superficial mycosis caused by Trichosporon spp. that affects the hair shaft of any part of the body. It is presented an outbreak of scalp white piedra seen in 5.8 percent of the children frequenting a day care in Northeastern of São Paulo State, Brazil. Mycological exam and culture identified T. cutaneum in all five cases, and scanning electron microscopy of nodules around hair shaft infected by Trichosporon spp. is demonstrated comparing them with those of black piedra and with nits of Pediculous capitis.
Piedra branca caracteriza-se por ser micose superficial, causada por Trichosporon spp., que compromete a haste dos pelos de qualquer região do corpo. Um surto de piedra branca, afetando os cabelos do couro cabeludo, foi registrado em 5,8 por cento das crianças que freqüentavam uma creche na região nordeste do estado de São Paulo. Exame micológico direto e cultura identificaram T. cutaneum nas cinco crianças afetadas. Enfatiza-se a utilização da microscopia eletrônica de varredura, que mostrou nódulos circundando a haste dos cabelos infectada por Trichosporon spp., comparando-os com nódulos de Piedra nigra e com lêndeas de Pediculus capitis.
Subject(s)
Child, Preschool , Female , Humans , Child Day Care Centers , Piedra/epidemiology , Scalp Dermatoses/epidemiology , Trichosporon/isolation & purification , Brazil/epidemiology , Disease Outbreaks , Microscopy, Electron, Scanning , Piedra/diagnosis , Piedra/microbiology , Scalp Dermatoses/diagnosis , Scalp Dermatoses/microbiology , Trichosporon/ultrastructureABSTRACT
El autor emplea la historia de la Piedra Rosseta y la moderna comprensión de los jeroglíficos egipcios como una metáfora referida a una clave crítica en el proceso de desciframiento de una enfermedad encubierta y su traslación en términos clínicos reconocibles. Jean-François Champollion quien la descifró, nunca será olvidado y los estudiosos de la cultura egipcia siempre recordarán que gracias a él, la historia de un lenguaje que había muerto para el mundo, revivió dejándonos lecciones que han aumentado el conocimiento acerca del Egipto de los faraones. El síndrome del seno silencioso, condición visible pero poco conocida, está tipificada por asimetría facial indolora, enoftalmía e hipoglobo causados por sinusopatía crónica maxilar atelectásica, reabsorción ósea y consecuente remodelación del piso orbitario. Para el conocedor de la entidad el diagnóstico es sospechado clínicamente y confirmado por signos radiológicos característicos que incluyen obstrucción del meato medio, opacificación y disminución del volumen del seno maxilar causado por la retracción del piso orbitario hacia la órbita. El síndrome es paucisintomático o totalmente asintomático. Puede ser tratado efectivamente creando una salida para la secreción mucosa acumulada en el seno. Permanece como una condición poco conocida y reconocida para los oftalmólogos y otorrinolaringólogos. Se presentan los primeros casos descritos en el país.
The author uses the story of the Rosetta Stone and the modern understanding of Egyptian hieroglyphs as a metaphor to refer to a critical key in the process of decription and identification of a covered disease and its translation to clinical terms. Jean-François Champollion its decipherer has never been forgotten and the students of the Egyptian culture always will have in mind that thanks to him the history of a language, that was dead for the world, revived and he has left lessons to us that day to day increases the knowledge of pharaonic Egypt. The silent sinus syndrome which is relatively unknown consists of painless facial visible asymmetry and enophthalmos with hypoglobus caused by bone resorption and remodeling of the orbital floor due to chronic maxillary sinus atelectasis. Although the diagnosis is usually suspected clinically, it is confirmed radiologically by characteristic imaging features that include maxillary sinus outlet obstruction, sinus opacification, and sinus volume loss caused by inward retraction of the sinus walls. The silent sinus syndrome can be definitively treated by creating an outlet for mucous drainage from obstructed sinus. It remains an under-recognised condition in both ophthalmologic and otolaryngologic community. We present the first cases ever described in Venezuela