Case series of sporotrichosis at a teaching hospital in Brazil

Abstract INTRODUCTION: Sporotrichosis is a subcutaneous fungal infection with a worldwide distribution and higher incidence in tropical and subtropical areas, such as the Brazilian territory, where it has been standing out due to its frequent epidemics. Thus, the present study aimed to evaluate the prevalence of sporotrichosis and profile the affected patients at a university teaching hospital in the central region of Rio Grande do Sul, Brazil. METHODS: This study was a case series of patients diagnosed with Sporothrix spp. from January 2006 to December 2015 by microscopic examination or fungal isolates. Medical records were reviewed for epidemiological data. RESULTS: Forty-three cases of sporotrichosis were diagnosed through the period. The sample comprised predominantly young male adults and rural workers. The most common disease type was lymphocutaneous (51%), followed by fixed cutaneous form (32.5%). The predominant location was the upper limbs (70%), followed by the lower limbs (16%). A significant association was observed between the lymphocutaneous form and upper limb location and between the fixed cutaneous form and lower limb location (p = 0.019). Potassium iodine and itraconazole were the most common treatments. CONCLUSIONS: This study will help update the epidemiological situation of sporotrichosis in the central region of the state of Rio Grande do Sul, Brazil, over the last decade.

Knowledge and habits of sun exposure in university students: a cross-sectional study in Southern Brazil

Abstract BACKGROUND: Excessive sun exposure is the major risk factor for skin cancer. Thus, sun exposure behavior is the major focus for prevention of this disease, since it is potentially modifiable. Increasing the knowledge on sun related habits and other skin cancer risk factors is fundamental in the development of preventive programs, especially when directed to young people. OBJECTIVES: To assess the photoprotection habits and the knowledge about skin cancer in college students. METHODS: We conducted a cross-sectional study from Oct. 16 to Feb. 17, including 371 students from the Federal University of Santa Maria, RS, Brazil, through a self-administered questionnaire. RESULTS: The level of knowledge about skin cancer and photoprotection was unsatisfactory in more than 10% of the students. The occurrence of sunburn was extremely high among students, and 25% reported at least one episode of second degree sunburn. Proper use of sunscreen was referred by only 34% of individuals. Students who reported having received photo education in college were associated with a more consistent use of sunscreen. STUDY LIMITATIONS: health area represented a large part of the sample; instrument validated outside Brazil. CONCLUSIONS: Young people are unaware of basic information about sun protection and exposure. Even among those with proper knowledge, the use of photoprotective measures is very low. The sun exposure has shown to be excessive in most of the students, which makes this population an important target for photo-educational measures.

Disseminated cutaneous sporotrichosis in patient with alcoholism

Abstract Sporotrichosis is the most prevalent subcutaneous mycosis and is characterized by a subacute or chronic development of a cutaneous or subcutaneous nodular lesion. It is caused by the dimorphic fungus Sporothrix spp, which may manifest in different clinical forms. The disseminated cutaneous form is uncommon and is more likely to occur in immunocompromised patients. We report a 47-year-old male patient with multiple cutaneous and subcutaneous nodules. The patient was diagnosed with disseminated cutaneous sporotrichosis based on the isolation and identification of Sporothrix spp. The patient was treated with potassium iodide, which resulted in clinical improvement of the lesions.

The recurrent nevus phenomenon

Abstract: Recurrent melanocytic nevus is a proliferation of melanocytes arising from a melanocytic nevus removed partially. Asymmetry and irregular pigmentation may lead to misdiagnosis of melanoma. We report a patient presented with a lesion on the lower abdomen, which was removed by shave excision. Anatomopathological examination revealed an intradermal melanocytic nevus. Two months later, a new irregular hyperpigmented lesion appeared in the surgical scar. Histopathology of the excisional biopsy revealed a recurrent melanocytic nevus. Recurrent melanocytic nevus manifests as a scar with hyper or hypopigmented areas, linear streaking, stippled pigmented halos, and/or diffuse pigmentation patterns. Histologically, the dermoepidermal junction and the superficial dermis show melanocytic proliferation overlying the scarred area. When a pathological report of the previous lesion is not available, complete excision is the gold standard. Otherwise, regular dermoscopic monitoring is a therapeutic option. The present report emphasizes the importance of histopathological examination of the excised material - even in cases of suspected benign lesions - and warns patients about the possibility of recurrence in case of incompletely removed lesions.

Aleitamento materno e colonização mucocutânea pelo Staphylococcus aureus na criança com dermatite atópica / Breastfeeding and mucosal and cutaneous colonization by Staphylococcus aureus in atopic children

FUNDAMENTOS: Não há consenso quanto ao efeito do aleitamento materno no desenvolvimento da dermatite atópica. É necessário aprofundar conhecimentos sobre possíveis fatores envolvidos nessa relação, como a influência do aleitamento materno na colonização do paciente atópico pelo Staphylococcus aureus (S. aureus). OBJETIVO: Avaliar uma potencial associação entre aleitamento materno e colonização pelo S. aureus nas crianças atópicas. MÉTODOS: Estudo transversal envolvendo 79 crianças atópicas de 4-24 meses, de ambos os sexos, em acompanhamento no Ambulatório de Dermatologia Sanitária de Porto Alegre, e 72 mães. Registraram-se dados clinicoepidemiológicos e de alimentação das crianças. Pesquisou-se a presença do S. aureus em swab nasal e cutâneo nas crianças e swab nasal das respectivas mães. Para análise dos dados, realizaram-se os testes qui-quadrado de Pearson e exato de Fischer. RESULTADOS: Entre as crianças amamentadas, S. aureus foi encontrado nas cavidades nasais de oito (25,8 por cento) e na pele (fossas cubitais) de quatro (12,9 por cento). Entre as não amamentadas, encontrou-se S. aureus nas cavidades nasais de dez (20,8 por cento) e na pele de 11 (22,9 por cento). Entre as mães, 16 (22,2 por cento) apresentaram crescimento de S. aureus no material proveniente do swab nasal. Não se observou associação significativa entre aleitamento materno e colonização pelo S. aureus das cavidades nasais ou da pele das crianças. Entretanto, houve concordância entre a colonização pelo S. aureus nas cavidades nasais das mães e nas cavidades nasais e/ou na pele dos filhos. Das 72 duplas, houve concordância em 56 (77,8 por cento). CONCLUSÃO: O aleitamento materno parece não influenciar a colonização mucocutânea pelo S. aureus em crianças com dermatite atópica.

BACKGROUND: Studies on the effects of breastfeeding on the development of Atopic Dermatitis (AD) have shown controversial results. The importance of this condition deserves further studies; in particular, it remains unclear whether colonization of atopic patients by Staphylococcus aureus (S. aureus) through breastfeeding is relevant to the development of AD. OBJECTIVE: To examine the potential relation between breastfeeding and colonization by S. aureus in atopic patients. METHOD: Transversal study of atopic patients, aged from 4 to 24 months, both genders, receiving outpatient care and 72 mothers. Data on infant breastfeeding practices and on clinical-epidemiological profile were registered. Swabs of the infants' nares and skin (cubital fossa) and swabs of the mothers' nares were collected. For univariate analysis, X2 (chi-square) and Fischer Exact's test were used. RESULTS: Among breastfed children, S. aureus was isolated from 8 (25.8 percent) infants' nares swabs and from 4 (12.9 percent) skin swabs. Among not breastfed children, S. aureus was isolated from 10 (20.8 percent) infants' nares swabs and from 11 (22.9 percent) skin swabs. Sixteen mothers (22.2 percent) had S. aureus isolated from their nares swabs. There was no significant association between breastfeeding and S. aureus colonization (child skin and/or nares). However, there was a degree of concordance for S. aureus carriage among mothers and infants. Among 72 pairs, 56 (77.8 percent) were concordant. CONCLUSION: Breastfeeding was not associated with S. aureus muco-cutaneous colonization in atopic infants.