RESUMEN
Aims: To determine the type of superficial fungi infections of the skin affecting different ages and gender at a dermatology clinic in a developing country. Study Design: A descriptive cross-sectional study. Place and Duration of Study: Dermatology Clinics of Obafemi Awolowo University Teaching Hospitals’ Complex, (OAUTHC), Ile-Ife, Osun State, Nigeria between October 2009 and September 2012. Methodology: Demographic information, history and clinical examination of consecutive patients with fungi infections of the skin were documented. The diagnoses were mainly clinical, and necessary laboratory procedures were performed for confirmation. Statistical analysis was done using SPSS 16 and odds ratio with 95% confidence interval obtained using WINPEPI version 11. Results: The total number of new cases of dermatoses presenting during the study period were 1454, from few weeks to 90 years of age, and 55% were females. Patients affected constituted 39.5%. Superficial fungi infections found were Dermatophytes (13.1%), Pityriasis versicolor (4.3%), and Candidiasis (2.1%). Children had more infections than adults (P = 0.000; OR = 9.31; 95% C.I. = 6.93; 12.50). The most common type was tinea capitis (children), pityriasis versicolor (adults), tinea unguium (females), and tinea cruris (males). Dermatophytic infections and candidiasis were significantly associated with childhood and female gender respectively. Conclusion: Superficial fungi diseases are the most common dermatoses presenting to dermatologists in Nigeria and affect different ages and both gender invariably. Tinea capitis occurred predominantly in children, and pityriasis versicolor, tinea unguium and tinea cruris in adults, females and males respectively. Adequate control will lead to drastic fall in the number of skin problems confronting the general populace.
RESUMEN
Acute leukemia is the most frequent cancer in children. Recently, a new hypothesis was proposed for the pathogenesis of childhood acute lymphoblastic leukemia (ALL). The so-called "adrenal hypothesis" emphasized the role of endogenous cortisol in the etiology of B-cell precursor ALL. The incidence peak of ALL in children between 3 to 5 years of age has been well documented and is consistent with this view. The adrenal hypothesis proposes that the risk of childhood B-cell precursor ALL is reduced when early childhood infections induce qualitative and quantitative changes in the hypothalamus-pituitary-adrenal axis. It suggests that the increased plasma cortisol levels would be sufficient to eliminate all clonal leukemic cells originating during fetal life. Because Brazil is a continental and tropical country, the exposure to infections is diversified with endemic viral and regionally non-viral infections, with some characteristics that support the recent adrenal hypothesis. Here we discuss this new hypothesis in terms of data from epidemiological studies and the possible implications of the diversity of infections occurring in Brazilian children.