Tricomicosis (tricobacteriosis) en un infante: aspectos microbiológicos, dermatoscópicos y ultraestructurales / Trichomycosis (trichobacteriosis) capitis in an infant: microbiological, dermoscopic and ultrastructural features

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 Wood’s 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.

Laser fracionado de CO2 e ácido fusídico na balanite de Zoon: relato de caso / Fractional CO2 laser and fusidic acid in Zoon's balanitis: a case report

A balanite de Zoon é lesão inflamatória benigna crônica, de etiologia desconhecida. Relata-se o caso de paciente do sexo masculino de 66 anos, há dois anos com placa eritematosa localizada na glande. Observou-se redução significativa do tamanho da placa e melhora do prurido com o uso de laser fracionado de CO2 associado ao ácido fusídico. O tratamento mostrou-se tolerável e de fácil execução. Concluímos que a lesão foi pouco responsiva ao tratamento tópico conservador com corticoide e muito mais responsiva ao tratamento com laser fracionado de CO2, obtendo-se boa resposta e melhora na qualidade de vida do paciente.

Zoon's balanitis is a benign chronic inflammatory lesion of unknown etiology. This article reports the case of a 66-year-old male patient who presented a 2-year history of a erythematous plaque located on the glans penis. The lesion had not been very responsive to conservative topical treatment with corticoid. A significant reduction in the plaque's size and an improvement in the pruritus was observed with the use of fractional CO2 laser combined with fusidic acid. The treatment was well tolerated and easy to carry out, and improved the patient's quality of life.