Dermatomicosis superficiales: cuando el diagnóstico lo entrega la histología / Superficial dermatomycosis: when the diagnosis is provided by histology

Superficial dermatomycosis are prevalent pathologies in the medical field and their diagnosis is fundamentally clinical. Histopathology is not considered part of his study, however, the diagnosis is exceptionally obtained by biopsy, when dermatomycosis was not suspected. Unpublished retrospective work is carried out on patients who had the histopathological diagnosis of superficial dermatomycosis between the years 2000-2019 at the HCUCH, based on selection criteria, obtaining 19 patients, in which the following were analyzed: age, gender, clinical characteristics, location, presumptive diagnosis and mycological and histological examinations. He stressed, as was our hypothesis, that dermatomycosis was not clinically suspected, since the presumptive diagnoses were various dermatoses. The most suspected dermatosis was psoriasis, as a result that 57.8% of the dermatoses studied had erythematous scaly plaques on examination. Another relevant fact is that only 21% of the cases underwent a direct mycological prior to the biopsy, which was negative ('' false negative''). It is concluded, then, that superficial dermatomycosis should be considered clinical simulators of other dermatoses, so clinical suspicion and support of mycological examination and fungal culture is essential. (AU)

Epidemiología de las dermatomicosis en 30 años de estudio en el Instituto de Medicina Tropical Daniel A. Carrión, Universidad Nacional Mayor de San Marcos, Lima, Perú / Epidemiology of dermatomycoses in 30 years of study at Daniel A. Carrion Institute of Tropical Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru

Objetivos: Determinar la evolución epidemiológica de las dermatomicosis en pacientes de consultorio externo durante el periodo 1976-2005. Diseño: Estudio descriptivo, retrospectivo y analítico. Lugar: Instituto de Medicina Tropical æDaniel Alcides CarriónÆ, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes: Pacientes positivos a dermatomicosis. Intervenciones: Se revisó las historias clínicas de 7 185 (55,3 por ciento) casos positivos a dermatomicosis. El instrumento de investigación empleado fue la ficha de levantamiento de información. Principales medidas de resultados: Agente etiológico, estación del año, sexo, edad y forma clínica. Resultados: El estudio demostró que los más afectados fueron del grupo etario de 16 a 30 años (42,7 por ciento) y sexo femenino (52,1 por ciento). La dermatomicosis más frecuente fue la onicomicosis (43,6 por ciento). Los agentes patógenos de mayor prevalencia fueron Trichophyton rubrum (33,2 por ciento), Cándida albicans (15,3 por ciento), Cándida no albicans (11,8 por ciento), Trichophyton mentagrophytes (9,4 por ciento), Malassezia spp (9,1 por ciento) y las infecciones mixtas (7,2 por ciento). Las micosis de cuero cabelludo muestran continuo aumento durante todo el estudio. El dermatofito Epidermophyton floccosum fue aislado por última vez en la década del 90. A partir de 1995 ha aumentado la prevalencia de Cándida no albicans y se encontró como especie re-emergente a la levadura Cándida tropicalis. Conclusiones: Entre los años 1976 y 2005 hubo importantes variaciones epidemiológicas en relación a las formas clínicas y a la etiología de las dermatomicosis...

Objectives: To determine dermatomycoses epidemiological evolution in outpatients during the period 1976-2005. Design: Descriptive, retrospective, and analytical study. Setting: Daniel Alcides Carrion Institute of Tropical Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Participants: Patients positive to dermatomycoses. Interventions: Medical records of 7 185 (55.3 per cent) dermatomycoses-positive patients were reviewed. Main outcome measures: Etiologic agent, season, gender, age, and clinical forms. Results: Females (52.1 per cent) and the 16 to 30 year-old group (42.7 per cent) were the most affected. Most frequent dermatomycoses was onychomycosis (43.6 per cent). Most prevalent pathogens were Trichophyton rubrum (33.2 per cent), Candida albicans (15.3 per cent), Candida non albicans (11.8 per cent), Trichophyton mentagrophytes (9.4 per cent), Malassezia spp. (9.1 per cent), and mixed infections (7.2 per cent). The fungal scalp infection showed steady increase during the period studied. Epidermophyton floccosum dermatophyte was isolated for the last time in the 1990s. Since 1995 prevalence of Candida non albicans has increased and Candida tropicalis yeast species are re-emerging. Conclusions: Epidemiological changes in dermatomycoses clinical forms and etiology were found between 1976 and 2005...

Prevalence of dermatophytosis among primary school children in Oke-Oyi community of Kwara state

Background: Dermatophytic infections have been known to impact negatively on health and well-being of children. This study was undertaken to determine the prevalence; clinical types as well as the etiologic organisms of dermatophyte infection among primary school children aged 5-16 years in Oke-Oyi community in Kwara state. Materials and Methods: A 4-months descriptive cross-sectional survey was carried out among 602 children aged 5-16 years in Oke-Oyi community; in Kwara state. Results: The prevalence of clinically suspected dermatophytoses lesion was 29.9(180/602). Dermatophyte accounted for 5.0(30/602) on Sabouraud dextrose agar culture; while non-dermatophyte molds represent majority of isolate i.e.; 15.4(93/602). Tinea capitis is the commonest clinical type; followed by Tinea coporis and then Tinea pedis. Multiple infections are noted in nine respondents. Three species of dermatophytes belonging to only two of the three genera of dermatophytes were responsible for human infection in the area studied; of which Trichophyton mentagrophyte is the commonest; followed by Microsporum audouinii and Trichophyton verucossum. Among the non-dermatophytes; Aspergillus fumigatus and Candida albicans predominate. Conclusion: This study demonstrates that the prevalence of dermatophytoses in the school studied was significant. Control efforts should target this vulnerable group to reduce its prevalence

Dermatofitose por Tricophyton rubrum como infecção oportunista em pacientes com doença de Cushing / Dermatophytosis caused by Tricophyton rubrum as an opportunistic infection in patients with Cushing disease

O dermatófito Trichophyton rubrum é um agente comum nas micoses superficiais, podendo apresentar lesões extensas pauci-inflamatórias de evolução crônica, especialmente em imunocomprometidos. O hipercortisolismo, na síndrome de Cushing, aumenta o risco de infecções, resultado do efeito imunossupressor dos glicocorticóides. Os casos relatados apresentam duas formas distintas de dermatofitose, em pacientes com doença de Cushing, causadas por Tricophyton rubrum e posterior remissão após normalização da cortisolemia.

Trichophyton rubrum is a common agent found in superficial mycoses, which present ample nonin?ammatory lesions, with chronic evolution, especially in immunocompromised patients. The hypercortisolism in Cushing's syndrome increases the risk of infections as a result of the immunosuppressive effect of glucocorticoids. The reported cases here refer to two different types of dermatophytosis caused by Trichophyton rubrum in patients with Cushing's disease, resistant to antifungal treatment. The disease remitted after the levels of cortisol went back to normal.

Primary cutaneous zygomycosis from a tertiary care centre in north-west India.

Background & objectives: Zygomycosis is highly invasive fungal infection, with high mortality rate. In most of patients, diabetes mellitus is an underlying factor but in primary cutaneous zygomycosis, presentation may be different. Here we present the description of clinical presentation, fungi isolated and management of cases with cutaneous zygomycosis seen in a tertiary care hospital in north India during 2001-2007. Methods: All patients diagnosed with primary cutaneous zygomycosis between November 2001 and September 2007 presenting with clinical diagnosis of necrotizing fasciitis were included. Detailed history of each patient was taken, clinical presentation, site of involvement, underlying illness and risk factor, if any were noted. The diagnosis was established by direct microscopic evidence of broad, aseptate or sparsely septate ribbon-like hyphae with right angle branching in KOH wet mount and histopathological examination of stained sections. Cultures were put up for fungal isolation and species identification. Outcome of the therapy was analysed. Results: Of the nine patients reviewed, only one had diabetes mellitus. Commonest risk factor was injection abscess (33.3%). Apophysomyces elegans was isolated in four cases, Saksenaea vasiformis and Absidia corymbifera in one each. The fungal culture was sterile in three cases. Mortality rate was high with only four patients responded well to surgical and/or medical therapy. Interpretation & conclusion: Primary cutaneous zygomycosis appears to be on rise in India that calls for high index of clinical suspicion and an early biopsy of the affected area for timely diagnosis. The standard treatment is a combination of amphotericin B therapy, surgical debridement, and reversal of the underlying disease or immunosuppression.

Dermatofitias en niños: revisión retrospectiva de 487 casos en Tucumán-Argentina / Dermatophytoses in children: retrospective revision of 487 cases in Tucumán-Argentina

Los hongos dermatofitos son los agentes causales más frecuentes de micosis . No obstante, la prevalencia de los agentes causales varía en las regiones geográficas, las características demográficas de la población estudiada y la metodología de laboratorio. A fin de determinar la frecuencia de dermatofitos en niños de Tucumán (R. Argentina), se presentan los resultados de una revisión retrospectiva de 9 años (2000-2008) de los protocolos médicos de 712 niños de 0 a 14 años de edad, (413 varones y 299 mujeres), con diagnóstico clínico de micosis en piel, uñas, pelos y cuero cabelludo evaluados en el Hospital del Niño Jesús. Las tineas fueron diagnosticadas en 487 pacientes (68,4 por ciento), predominando en el género masculino. La distribución de los hongos aislados fue: M. canis (78,4 por ciento), T. mentagrophytes (6,4 por ciento), T. rubrum (6,2 por ciento),T. tonsurans (4,5 por ciento), M. gypseum (3,9 por ciento), T. mentagrophytes var. interdigitale (0,4 por ciento) y E. floccosum (0,2 por ciento). Coincidentemente con trabajos previos realizados en nuestra provincia, la tinea capitis es la afección predominante y M. canis sigue siendo su principal agente patógeno más frecuente (93,8 por ciento). La alta proporción de aislamientos de M. canis, indica claramente que las especies zoofílicas son las más prevalentes en nuestra área. El grupo etario de mayor incidencia fue el de 0 a 3 años seguido del grupo de 4 a 6 años de edad.

Dermatophyte fungi are the most frequent agents causing mycosis. However prevalence of the causing agents varies with the geographic regions, demographic characteristics of the studied population and with the laboratory methodology. In order to determine the incidence of Dermatophytes in chidren of Tucumán (R. Argentina), results of a 9-year retrospective revision (2000-2008) of the medical protocols of 712 children of 0 to 14 years of age (413 men and 299 women) diagnosed with mycosis in hair, scalp, skin and nails are reported and who had been evaluated in the Hospital del Niño Jesús. Tinea were diagnosed in 487 patients (68.4 percent), prevailing in the masculine genus. The distribution of isolated fungi was: M.canis, (78.4 percent), T.mentagrophytes (6.4 percent), T.rubrum (6.2 percent), T tonsurans (4.5 percent), M.gypseum (3.9 percent), T.mentagrophytes var. interdigitale (0.4 percent) and E.floccosum (0.2 percent). Coincidently with previous studies accomplished in our province, tinea capitis is the prevailing affection while M.canis continues being its main and most frequent pathogenic agent (93.8 percent). The high number of M.canis isolations show clearly that zoophilic species are the most prevalent in our area. Children aged 0 to 3 year exhibited the highest prevalence followed by those of 4 to 6 year.

[Surveillance of dermatophytosis and the causative agents among children referred to pasteur institute of Iran from 2005 to 2006]

Superficial fungal infections of the skin, including the dermatophytosis, are a public health problem. The aim of this study is to determine the prevalence of fungal infections and identify the causative agents of dermatophytosis and other related factors in children in Tehran, Iran. In this descriptive study a total of 984 children aged 2 months to 14 years, who were referred to the Medical Mycology Department, Pasteur Institute of Iran, in Tehran, in 2005 and 2006, were surveyed for the presence of dermatophytosis infections. All children were referred with a dermatological disorder, for direct examination, fungal culture and identification, and the incidence of each species was calculated. In this study 264 cases were positive for fungal infections. The patients comprised of 182 male and 82 female. This study found a high prevalence of tinea corporis [51.7%] and tinea capitis [36.8%] in the population studied, with high proportions of Trichophyton tonsurans. The most frequently isolated etiological agent was Trichophyton tonsurans [44%], followed by Trichophyton verrucosum [19.6%]. Epidermophyton floccosum [10.5%], Microsporum canis [6.75%] and Trichophyton violaceum [6.75%], Trichophyton rubrum [4.8%], and Trichophyton mentagrophytes [4.8%], and Trichophyton schoenIeinii [2.8%] infections occurred sporadically among patients. A male preponderance [69%] was observed. In the present study 19.7% of our patients participated in wrestling. Our experience has confirmed previous observations that during recent years there has been an increase in incidence of dermatophytosis due to Trichophyton tonsurans, in children. Consequently, development of infection control programs can be a challenging task. These findings suggest that further measures regarding public health and personal hygiene have to be taken to reduce the risk of dermatophytosis in Iran

Primary cutaneous mucormycosis (zygomycosis) caused by Apophysomyces elegans.

A 53 year-old male diabetic presented with a month-old, painful ulcer with necrotic margins over the right thigh. Wound debridement was done twice and the ulcer showed recurrent growth of a white, cottony filamentous structure. Cutaneous mucormycosis was suspected and confirmed by histopathology and a culture isolate of Apophysomyces elegans . The patient was treated with liposomal amphotericin-B and itraconazole followed by partial thickness skin grafting, and then discharged after being prescribed posaconazole syrup for three weeks. Regular follow-up was done and during the last visit after six months following discharge, the ulcer was found to have healed well with no recurrence of the fungus.

Agentes etiológicos de dermatomicosis aislados en pacientes de la ciudad de Concepción y comunas circunvecinas: año 2006 / Ethiologic agents of dermatomicosis isolated from patients at Concepcion and arounded locations: Chile 2006

Las dermatomicosis son infecciones causadas por hongos queratinofilicoss que infectan la piel, pelo y uñas y constituyen un motivo frecuente de consulta dermatológica. Con el propósito de determinar la prevalencia de agentes fúngicos causantes de dermatomicosis, se analizaron en forma retrospectiva los resultados obtenidos en muestras de pelo, piel y uñas de 664 pacientes con sospecha clínica de dermatomicosis, procedentes de consultas de la especialidad en la ciudad de Concepción, en el periodo comprendido entre enero y diciembre de 2006. La edad de los pacientes fluctuó entre uno y 80 años. Se estudiaron 164 muestras de piel lampiña, sin considerar manos ni pies; 16 muestras palmares e interdigitales de mano; 51 muestras plantares e interdigitales de pie; 339 muestras de uñas de pies; 83 muestras de uñas de manos, y 11 muestras de cuero cabelludo. A todas las muestras se les realizaron examen microscópico directo con KOH tinta y cultivo en dos tipos de medios: agar Saboraud cloramfenicol y agar Saboraud cloramfenicol más cicloheximida. De las 664 muestras analizadas, resultaron 443 positivas para hongos (66,7%), de las cuales 412 (93%) fueron diagnosticadas por el examen directo; y 368 (83%) fueron positivas en el cultivo; en 31 muestras el diagnóstico sólo fue posible en el examen de cultivo, y en 44 el diagnóstico fue hecho a través del examen microscópico directo, no recuperándose el hongo en el cultivo. Las especies fúngicas aisladas en orden de frecuencia fueron: Trichophyton rubrum (73,4%); Trichophyton mentagrophytes (9,0%), Candida spp. (3,5%); Microsporum canis (2,4%); Epidermophyton floccosum (0,5%), Fusarium spp. (0,3%). Podemos concluir que la especie predominante en la población estidiada fue Trichophyton rubrum, que se presenta a todos los sitios topográficos estudiados. La frecuencia de aislamiento de cada especie fúngica varía según la localización...

Dermatomycoses are infections caused by fungus that affect skin, hair and nails, and represent a common cause of dermatologic consultations. In order to establish the type of fungi that cause these infections we analyzed 664 outpatients with a clinical diagnosis of dermatomycoses during the year 2006. Age ranged from 1 to 80 years. We studied 164 samples of skin lesions, 16 palms and interdigital area; 51 soles and interdigital toenails, 339 to enails, 83 fingernails, and 11 from scalps AII samples were analyzed microscopically using KOH and were cultured in agar Sabouraud with chloramphenicol, and agar Sabouraud with chloramphenicol plus cycloheximide. Results: of a total 664 samples, 443 (66.7%) were positive for fungi, 412 (93%) through microscopic exam, 368 (83%) had a positive culture for fungi. In 33 samples the diagnosis was made only through culture and in 44 samples only through microscopic exam. The fungal species isolated and related to the area were. Trichophyton rubrum (73.4%), Trichophyton mentagrophytes (9.0%), Candida spp. (3.5%), Microsporum canis (2.4%), Epidermophyton floccosum (0.5%), Fusarium spp (0.26%). We concluded that the frequency of each specie of fungi iso-lated varied with anatomical location, but the predominant species was Trichophyton rubrum and it was present in all anatomical sites studied. In general, these lab results agreed with clinical diagnosis.

Cutaneous manifestations in renal failure patients: a case series.

Cutaneous involvement in renal disease is due to a host of factors ranging from metabolic disturbances to immunosuppressive drugs. Herein we report a series of six cases of renal failure with varied cutaneous manifestations ranging from infections to neoplasms due to prolonged immunosuppression. Our first case had cutaneous cryptococcosis where skin lesions gave a clue to the diagnosis of altered sensorium and underlying meningitis. The second case initially presented with florid warts and was treated successfully but later presented with an explosive recurrence of skin lesions due to malignant transformation. Our third case had basal cell carcinoma over the presternal region that was successfully treated with liquid nitrogen cryotherapy. Our fourth case had diabetic nephropathy that presented with septicemia and purpura fulminans. The last case had cutaneous manifestations of drug therapy because of heparin infusion. To conclude, cutaneous manifestations in patients with renal failure are varied and a high degree of suspicion is needed for early diagnosis and aggressive treatment to effectively combat mortality and morbidity.

Estudio clínico doble ciego controlado para evaluar la respuesta terapéutica con terbinafina HCL 1 por ciento Panacap crema sin aceite comparado a crema placebo en el tratamiento de onicomicosis subungueal distal causada por T. rubrum en el lecho de la uña del primer dedo / Study clinical blind double controlled to evaluate the therapeutic answer with terbinafina HCL 1 percent Panacap it cremates without oil compared to cream placebo in the treatment of onicomicosis subungueal distal caused by T. rubrum in the channel o

Este es un estudio clínico piloto (experimental), doble ciego controlado para evaluar la respuesta terapeutica de terbinafina HCI 1 por ciento Panacap crema sin aceite en comparación con crema de placebo en el tratamiento de Onimicosis (OSD) por Tricophyton rubrum en el lecho de la uña del primer dedo. Este estudio se llevó a cabo en el Centro Nacional de Dermatología "Francisco José Gómez Urcuyo" con 11 pacientes.

Malassezia yeast species isolated from patients with dermatologic lesions / Especies de Malassezia aisladas de pacientes con lesiones dermatológicas

Introducción. Las levaduras del género Malassezia forman parte de la flora normal de la piel y se asocian con varios tipos de lesiones dermatológicas. Desde 1996, la descripción de nuevas especies dentro de este género planteó numerosos interrogantes sobre su epidemiología y patogenicidad. Objetivo. El fin de este trabajo fue encontrar la frecuencia de las diferentes especies de Malassezia en individuos con pitiriasis versicolor, dermatitis atópica, dermatitis seborreica, dermatitis seborreica en pacientes positivos para VIH, y en individuos sin lesiones a partir de tres zonas corporales (cabeza, tórax, extremidades inferiores y superiores). Materiales y métodos. Se identificaron 154 aislamientos de especies de Malassezia de 112 individuos: 39 con dermatitis seborreica de los cuales 20 eran positivos para VIH, 18 con pitiriasis versicolor, 18 con dermatitis atópica y 37 individuos sin lesión dermatológica (controles). Las escamas de piel de los pacientes se observaron microscópicamente y las muestras de pacientes y controles se cultivaron en agar Dixon modificado. Posteriormente, se observaron las colonias y se identificaron según sus características macroscópicas, microscópicas y fisiológicas. Resultados. Las especies más frecuentemente aisladas en el total de los grupos estudiados fueron: Malassezia globosa (37,5 por ciento), M. sympodialis (31,3 por ciento) y M. furfur (31,3 por ciento). M. globosa predominó en los aislamientos de pacientes con pitiriasis versicolor (67 por ciento) y en pacientes positivos para VIH con dermatitis seborreica (85 por ciento). En pacientes con dermatitis atópica y dermatitis seborreica sin diagnóstico de VIH, se aislaron M. furfur y M. restricta en el 72 por ciento y el 26 por ciento de los casos, respectivamente. Conclusiones. Las diferentes especies de Malassezia pueden aislarse de pacientes con lesiones dermatológicas o sin ellas. Además, la frecuencia de especies en la población muestreada difiere de lo reportado en otras zonas geográficas. Se destaca la alta frecuencia de M. globosa en pacientes con lesiones lo que podría indicar la mayor patogenicidad de esta especie. No obstante, se requieren estudios adicionales para determinar el papel de las diferentes especies del género Malassezia, asociadas con estas patologías

Micosis cutáneas y manifestaciones cutáneas de las micosis sistémicas en pacientes con SIDA / Cutaneous mycoses and cutaneous manifestations of systemic mycoses in AIDS

Las micosis cutáneas adquieren en los individuos con SIDA características particulares. Las diferencias observadas son debidas al déficit inmunológico presente en estos pacientes, sobre todo en la inmunidad celular, de vital importancia en el control de éstas y otras infecciones micóticas. Las lesiones suelen ser poco inflamatorias y extendidas a regiones donde no se ubican en individuos inmunocompetentes, además de ser recidivantes y notablemente resistentes a la terapéutica antifúngica específica. El agente causal más frecuente de las dermatoficias (tineas pedis, cruris y unguium) es Trichophyton rubrum, en las pitirosporosis (dermatitis seborreica, foliculitis y pitiriasis versicolor) Pityrosporum ovale y en las candidiasis Candida albicans. Otras micosis cutáneas, formas clínicas y agentes etiológicos, si bien probables, no son frecuentes en estos pacientes. El tratamiento de todas ellas es difícil, más aún teniendo en cuenta las numerosas interacciones medicamentosas con los diferentes esquemas terapéuticos que reciben los pacientes con SIDA. También las micosis sistémicas (en nuestro medios criptococosis e histoplasmosis) se manifiestan en la piel con lesiones papulosas o moluscoides, únicas o múltiples. Su reconocimiento permite el diagnóstico temprano de estas micosis. El propósito de este trabajo es describir algunas de las características clínicas, inmunológicas, diagnósticas y terapéuticas de las micosis cutáneas en los pacientes con SIDA

Etiologia e epidemiologia das dermatofitoses em Goiânia, GO, Brasil / Etiology and epidemiology in dermatophytosis in Goiânia, State of Goiás, Brazil

As dermatofitoses säo infecçöes superficiais capazes de produzir lesöes em tecidos queratinizados, como pele, pêlo e unhas. Foram examinados 6068 indivíduos procedentes de Goiânia, com suspeita clínica de infecçöes fúngicas, durante 5 anos (1993-1997), verificandose a incidência e a etiologia das dermatofitoses nos referidos pacientes. Material coletado de várias regiöes corpóreas permitiu caracterizar 1595 dermatófitos em 1345 indivíduos. A identificaçäo dos dermatófitos realizada através de cultivo em ágar Sabouraud e microcultivo em lâmina, permitiu verificar uma maior frequência de Trichophyton rubrum (37,4 por cento), T. mentagrophytes (36,4 por cento)e Microsporum canis (16 por cento). Os dermatófitos foram mais frequentemente encontrados produzindo lesöes nos pés (30,5 por cento), regiäo inguino crural (l 7, 8 por cento) e regiäo glabra do corpo (15,5 por cento). Foi analisada a distribuiçäo corporal das lesöes de dermatofitoses com os respectivos agentes etiológicos encontrados. Melhores condiçöes higiênicas e diagnóstico precoce da doença säo necessários para controlar e diminuir a incidência de dermatofitoses na nossa regiäo

Freqüência de dermatofitoses em Joäo Pessoa - Paraíba - Brasil / Dermatophytosis frequency in Joäo Pessoa - Paraíba - Brazil

FUNDAMENTOS - Os gêneros Epidermophyton, Microsporum e Trichophyton têm grande afinidade por tecidos queratinizados (pele, pêlo e unhas), causando as dermatofitoses. OBJETIVOS - Estudar a frequência de dermatofitoses e de seus agentes etiológicos, em Joäo Pessoa-PB. MÉTODO - No período de 02/05/1989 a 22/12/1996, sobre 1708 pacientes com suspeita clínica de micose superficial, foram diagnosticados 398 casos de dermatofitoses. Em 158 casos o diagnóstico foi baseado em exame clínico e micológico direto, e, nos outros 240, foi realizado, além do exame clínico e microscopia, o cultivo. RESULTADOS - Entre as espécies de dermatófitos antropofílicos foram isolados: T. rubrum (50,8 porcento), T. tonsurans (2,5 porcento) e E. floccosum (0,8 porcento). As espécies zoofílicas foram representadas por M. canis (22,9 porcento), T. mentagrophytes (22,1 porcento) e T. verrucosum (0,4 porcento). A única espécie geofílica isolada foi M. gypseum (0,4 porcento). Esses agentes foram responsáveis por diferentes formas clínicas: tinha do corpo (35,8 porcento), tinha do couro cabeludo (29,6 porcento), tinha dos pés (13,3 por cento), tinha crural (8,8 porcento), tinha das unhas (8,8 porcento) e tinha das mäos (3,8 porcento). CONCLUSÄO - Em Joäo Pessoa-PB, as dermatofitoses compreenderam 398 (23,3 porcento) casos, do total de 1708 pacientes estudados. Em 240 casos, T. rubrum (50,8 porcento) foi a espécie mais encontrada nas diferentes formas clínicas com maior frequência em tinha do corpo (38,5 porcento) e tinha do couro cabeludo (25,4 porcento)

Manifestaciones cutáneas de histoplasmosis diseminada en pacientes infectados con el virus de inmunodeficiencia humana / Cutaneous manifestations of disseminated histoplasmosis in VIH infected patients

El objetivo de este trabajo es dar a conocer la frecuencia de lesiones cutáneas de histoplasmosis diseminada (HD) en pacientes con SIDA en nuestro medio, las características clínicas, métodos diagnósticos empleados y resultados terapéuticos de los casos clínicos considerados. De los 24 casos de histoplasmosis diagnosticada, 13 pacientes (54,16 por ciento), presentaron lesiones cutáneas, donde se demostró la presencia de Histoplasma capsulatum, observándose pápulas eritematoescamosas y úlceras. La correcta escarificación de dichas lesiones permitió realizar coloraciones y cultivos, que tuvieron una gran sensibilidad para detectar esta micosis. Así, del total de 13 pacientes con lesiones cutáneas, a 11 se les realizó el diagnóstico de histoplasmosis diseminada por ese método, cuando los otros materiales analizados en esos pacientes fueron negativos. Tratamiento: los 3 pacientes tratados con anfotericina B y el paciente tratado con fluconazol (F), tuvieron buena respuesta, los 7 pacientes que recibieron itraconazol: 6 presentaron buena respuesta, con un fracaso terapéutico que responde favorablemente al utilizar anfotericina B