RESUMEN
Abstract Background: Chromoblastomycosis is a skin infection caused by dematiaceous fungi that take the form of muriform cells in the tissue. It mainly manifests as verrucous plaques on the lower limbs of rural workers in tropical countries. Objectives: The primary objective of this review is to evaluate the accuracy of diagnostic methods for the identification of chromoblastomycosis, considering the histopathological examination as the reference test. Methods: MEDLINE, LILACS and Scielo databases were consulted using the terms ‟chromoblastomycosis" AND ‟diagnosis". The eligibility criteria were: studies that evaluated the accuracy of tests for the diagnosis of chromoblastomycosis. Eleven studies were selected. Statistical analysis included the calculation of sensitivity and specificity of the diagnostic methods. Results: Considering the histopathological examination as the reference test, the culture showed a sensitivity (S) of 37.5% - 90.9% and a specificity (Sp) of 100%; while direct mycological examination showed S = 50% - 91.6% and Sp of 100% . Considering the culture as the reference test, the serology (precipitation techniques) showed S of 36% - 99%; and Sp of 80% - 100%; while the intradermal test showed S of 83.3% - 100% and Sp of 99.4% - 100%. Study limitations: The small number of studies and very discrepant sensitivity results among them do not allow the calculation of summary measures through a meta-analysis. Conclusions: Direct mycological examination, culture, intradermal test and serology show sensitivity and specificity values for the diagnosis of chromoblastomycosis with no significant difference between the studies.
RESUMEN
Chromoblastomycosis is a skin infection caused by dematiaceous fungi, characterized by a verrucous plaque on the limbs. It mainly affects rural workers in tropical countries. The purpose of this review is to identify how the diagnostic methods used in the propaedeutic of chromoblastomycosis emerged and were developed. The MeSH terms "chromoblastomycosis" or "chromomycosis" or "verrucous dermatitis" and "diagnosis" were used to search articles indexed in MEDLINE and LILACS databases. The description of a first-time-used method in diagnosing chromoblastomycosis or modifications and innovations in an existing technique was the criteria used to deem the article eligible. The first methods described in diagnosing chromoblastomycosis were histopathological examination and culture, which characterizes and defines the disease in the early 20th century. Subsequently, they were described as direct microscopic examination, fine needle aspiration for cytology, electron microscopy, serology, molecular tests, scintigraphy, nuclear magnetic resonance and dermoscopy. Tests based on the direct identification of the fungus through biopsy, culture, or direct microscopy are the oldest and more employed methods for diagnosing chromoblastomycosis. The polymerase chain reaction was introduced in the last few decades and is a promising technique. Dermoscopy of chromoblastomycosis shows blackish red dots and white and pink areas along with scaling. Other techniques, such as serology and skin testing for delayed-type hypersensitivity, have not been incorporated into clinical practice
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Piel , Cromoblastomicosis/diagnóstico , Dermatomicosis , HongosRESUMEN
Introdução: o carcinoma basocelular é a neoplasia maligna não melanoma mais frequente no ser humano. Sua variante superficial apresenta especificidades que podem representar um desafio diagnóstico e terapêutico. Objetivo: descrever o perfil epidemiológico dos pacientes com carcinoma basocelular superficial (CBCS) atendidos em um serviço de referência e correlacionar estatisticamente características clínicas, dermatoscópicas e anatomopatológicas. Métodos: estudo observacional, analítico e transversal realizado por meio de coleta de dados dos pacientes com suspeita de CBCS entre novembro de 2019 e outubro de 2020. Resultados: no total, 25 lesões foram confirmadas como CBCS, sendo mais frequentes nas mulheres, na localização da cabeça e do pescoço e com diâmetro menor que 1cm. Foi visto, ainda, nas características clínicas, um predomínio nos maiores de 60 anos e nos fototipos II e III. No exame anatomopatológico, foi observado algum tipo de pigmentação nas lesões avaliadas, e houve uma predominância de queratinócitos intraepidérmicos naquelas que apresentavam folhas de bordo na dermatoscopia. Conclusões: o CBCS pode apresentar-se clinicamente como lesão pigmentada e acometer mais cabeça e pescoço. Os fototipos mais altos provavelmente têm maior chance de apresentar CBCS com estruturas dermatoscópicas pigmentadas. Os queratinócitos intraepidérmicos possivelmente correlacionam-se à formação de estruturas em folhas de bordo.
Introduction: Basal cell carcinoma is the most common non-melanoma malignancy in humans. Its superficial variant has specificities that can represent a diagnostic and therapeutic challenge. Objective: To describe the epidemiological profile of patients with superficial basal cell carcinoma (SBCC) treated at a reference service and to correlate, statistically, clinical, dermoscopic, and anatomopathological characteristics. Methods: Observational, analytical, cross-sectional study conducted by collecting data from patients with suspected SBCC between November 2019 and October 2020. Results: In total, we confirmed 25 lesions as SBCC. They were more frequent in women, in the head and neck, and with a diameter of less than 1 cm. We also observed, in clinical characteristics, a predominance of individuals over 60 years old and with phototypes II and III. The anatomopathological examination observed some pigmentation in the lesions evaluated and a predominance of intra-epidermal keratinocytes in lesions with maple leaf-like areas in dermoscopy. Conclusions: SBCC can present clinically as a pigmented lesion, affecting more the head and neck regions. Lighter skin phototypes are more likely to have SBCC with pigmented dermoscopic structures. Intra-epidermal keratinocytes possibly correlate with the formation of maple leaf structures.