ABSTRACT
Resumen La tricomicosis o tricobacteriosis palmelina es un motivo de consulta poco frecuente en los servicios de dermatología, es importante reconocerla y diferenciarla de otras patologías ya que puede ser difícil de diagnosticar. La tricomicosis o tricobacteriosis es una condición infecciosa superficial asintomática, rara, causada en la mayoría de los casos por Corynebacterium flavescens (también llamada Corynebacterium tenuis), perteneciente a la familia corinebacteriaceae, las cuales, son bacterias gram positivas, pleomórficas, inmóviles, no encapsuladas, aerobias o anaerobias facultativas. Afecta pelos de la región axilar, zona púbica, escrotal e interglutea; se debe al aumento de la población bacteriana de la microbiota normal, adherida a la cutícula del pelo. Esta afectación es propia de climas húmedos, afectando predominantemente a adultos jóvenes, de sexo masculino, deportistas y homosexuales en un entorno de pobreza y hacinamiento. El objetivo del presente reporte es comunicar un caso de tricomicosis palmelina flava en región púbica en un adulto joven y describir las características clínicas de esta patología relativamente poco conocida.
Abstract Trichomycosis or palmelin trichobacteriosis it is an infrequent reason for consultation in dermatology services, important to recognize and differentiate it from other pathologies since it can be difficult to diagnose. Trichomycosis or trichobacteriosis is a rare, asymptomatic superficial infectious condition, caused in most cases by Corynebacterium flavescens (also called Corynebacterium tenuis), belonging to the Corynebacteriaceae family, which are gram-positive, pleomorphic, immobile, non-encapsulated bacteria, aerobic or facultative anaerobic. It affects hairs in the axillary region, pubic, scrotal and intergluteal area; It is due to the increase in the bacterial population of the normal microbiota, attached to the hair cuticle. This affectation is typical of humid climates, predominantly affecting young adults, males, athletes and homosexuals in an environment of poverty and overcrowding. The objective of this article is to report a case of trichomycosis palmellina flava in the pubic region present in a young adult and to present the clinical characteristics of this relatively unrecognized condition.
ABSTRACT
La tricomicosis es una infección superficial causada por Corynebacterium flavescens, que afecta por lo regular pelos axilares, en menor grado los púbicos, los escrotales e interglúteos y excepcionalmente los de la cabeza o tricomicosis capitis (TC). Esta infección se caracteriza por formación de nódulos pilosos. Clínicamente se confunde con infecciones como piedra blanca y pediculosis. El diagnóstico se realiza por microscopia y dermatoscopia de masas bacterianas y confirmado por cultivo. OBJETIVO: Presentar un caso de TC en un infante, y mostrar las características microscópicas, dermatoscópicas y ultraestructurales. CASO CLÍNICO: Niño sano de 6 meses de edad, con dermatosis que afectó los pelos de la cabeza en forma de múltiples nódulos-pilosos amarillentos. Se comprobó TC mediante fluorescencia amarilla a la luz de Wood; a la dermatoscopia se observaron cadenas blanco-amarillentas, como "rosarios de piedras cristalinas"; al examen directo se distinguieron masas bacterianas y al cultivo se identificó Corynebacterium flavescens. A la microscopia electrónica se observó infección superficial, sin perforación de los pelos. Se realizó tratamiento con aplicación de ácido fusídico por 3 semanas y se obtuvo curación clínica y microbiológica. CONCLUSIÓN: La TC es una entidad rara que se presenta en niños, y que suele confundirse con otros padecimientos del pelo como la pediculosis e infecciones micóticas.
Trichomycosis is a superficial infection caused by Corynebacterium flavescens, which regularly affects axillary, and to a a lesser extent, pubic, scrotal and intergluteal, and exceptionally, head hairs or trichomycosis capitis (TC). This condition is characterised by the formation of bacterial nodules. Clinically, it can be confused with white piedra or pediculosis. The diagnosis is made by microscopic and dermoscopic observation and confirmed by culture. OBJECTIVE: To present a case of TC in an infant and illustrate the microscopic, dermoscopic, and ultrastructural characteristics. CLINICAL CASE: A 6 month-old boy, otherwise healthy, with multiple yellowish concretions on the hairs of the head. TC was confirmed by yellow fluorescence with Woods light; white-yellowish beads, like "rosaries of crystalline stones" were observed on dermoscopy, direct examination showed bacterial masses, and Corynebacterium flavescens was identified by culture. A superficial infection, without perforation of the hairs, was confirmed by electron microscopy. Treatment with fusidic acid for 3 weeks achieved a clinical and microbiological cure. CONCLUSION: TC is a rare condition that affects children, and tends to be mistaken for other diseases of the hair, such as pediculosis and mycotic infections.
Subject(s)
Humans , Male , Infant , Corynebacterium Infections/diagnosis , Dermoscopy/methods , Fusidic Acid/therapeutic use , Lice Infestations/diagnosis , Treatment Outcome , Corynebacterium/isolation & purification , Corynebacterium Infections/microbiology , Corynebacterium Infections/drug therapy , Hair/microbiology , Hair Diseases/diagnosis , Hair Diseases/microbiology , Hair Diseases/drug therapy , Microscopy , Anti-Bacterial Agents/therapeutic useABSTRACT
BACKGROUND: Pitted keratolysis (PK) is an acquired, chronic, usually asymptomatic, non-inflammatory, superficial bacterial infection of the stratum corneum of the soles. Corynebacterium species are thought to be the causative organisms of PK. This condition is common in feet of active people wearing sweaty shoes, namely, athletes and soldiers. OBJECTIVE: To analyze the clinical manifestations of pitted keratolysis. METHODS: A total of 133 Korean male soldiers diagnosed with PK (aged between 19 and 33, mean 21.9 years) were included in this study. All patients were investigated between April 2004 and May 2005. Factors investigated included age, location, duration, date of visit, physical examination, subjective symptoms, associated medical conditions, and treatment modalities. All patients were examined carefully to verify accompanying erythrasma or trichomycosis axillaris (TMA). RESULTS: About half of the patients visited our department in spring (March, April, and May). However, PK was found in all the seasons. The ball of the foot was the most frequently involved site (92.5%). The big toe (72.2%) was also a frequent site of involvement. Forty-five patients (41.7%) had coexistent erythrasma, 22 (20.4%) had TMA, and 14 (13.0%) had a simultaneous presence of both erythrasma and TMA. Hyperhidrosis (98.5%) and foul odor (95.5%) were the main complaints in most of the patients. Other symptoms associated with PK were sliminess (38.3%), burning (23.3%), itching (18.8%), and prickling (13.5%) sensations. Various treatment modalities such as topical antibiotics, topical antifungal agents, and oral erythromycin have been used. All lesions subsided within 1 month after treatment. Although recurrence rate was high (64.3%), parameters such as period of prevalence, size and shape of the lesion, and treatment modality were not associated with the recurrence rate. CONCLUSION: The present study provides basic clinical information on PK, which is a common condition of the feet of Korean male soldiers.
Subject(s)
Humans , Male , Anti-Bacterial Agents , Antifungal Agents , Athletes , Bacterial Infections , Burns , Corynebacterium , Erythrasma , Erythromycin , Foot , Hyperhidrosis , Military Personnel , Odorants , Physical Examination , Prevalence , Pruritus , Recurrence , Seasons , Sensation , Shoes , ToesABSTRACT
BACKGROUND: Trichomycosis axillaris and pubis is a bacterial infection of the hair shaft. It is characterized by nodular thickening on the hair shaft, composed of colonies of aerobic Corynebacterium. Benzoyl peroxide and erythromycin topical application can be used successfully. OBJECTIVE: We performed this study to compare treatment efficacy of benzoyl peroxide and erythromycin in trichomycosis axillaris and pubis METHOD: The clinical study was made with 12 patients of trichomycosis axillaris and pubis. RESULT: Among 12 patients, 6 patients were treated by benzoyl peroxide topical application and the other by erythromycin. 1) All the affected patients were male, and mean age of onset was 31 years old. 2) Simultaneous involvement of axillae and pubis was found in 9 cases, and involvement of axillae only in 3 cases. 3) There was no statistically significant difference in the treatment efficacy between benzoyl peroxide and erythromycin (p> 0.05). 4) Infected hair shafts were removed by shaving in 7 cases. But shaving itself did not shorten the period for complete cure (p> 0.05). 5) Mean disease duration was 6.7 months and mean period for complete cure was 3.1 weeks. And there was no significant relation between disease duration and mean period for complete cure. 6) Only 1 case (8.3%) showed recurrence within 6 month-follow up, in which erythromycin topical application without shaving was used. 7) Among 12 cases, irritation and contact dermatitis were observed in 5 cases (41.7%). And these were all related with benzoyl peroxide application. CONCLUSION: Benzoyl peroxide is as effective as erythromycin in the treatment of trichomycosis axillaris and pubis. But, benzoyl peroxide have more side effect. Shaving itself is not necessag to treat trichomycosis.