Pattern of cutaneous disorders in the South Eastern Iran, Kerman

To identify the pattern of common cutaneous disorders in the region of South Eastern Iran, Kerman Province. In this study, 1000 patients who had been referred to the Afzalipour hospital clinic during a three months period in the autumn of 2013 were included. Excluding those who had repeat visits, 900 new cases were detected including multiple diagnoses in some patients. Dermatology residents analyzed the medical records of the patients [history, physical examination and laboratory investigations]. The diagnoses were classified according to WHO International Classification of Diseases, revision [ICD 10]. Descriptive statistics were used to analyze the data. There were 500 male [55.5%] and 400 female [44.5%] patients and the mean age of the patients was 30.7 +/- 6 years. Among the non-infective diseases, dermatitis and urticaria [31%] were the most common cutaneous disorders for attendance, followed by infectious diseases [19%], pigmentary diseases [15%], acne vulgaris [14%], papulosquamous diseases [10%], out of which psoriasis contributed to 45 [5%] cases. Hair diseases [3%], skin tumors [2.2%], nail diseases [2%], adverse drug reactions [2%], vesiculobullous diseases [1%] and cutaneous manifestations of systemic diseases [0.8%] contributed to the rest of cases. The management of the vast majority of cases [85%] consisted of advice with a prescription, while only [5%] of patients required admission. Dermatitis and skin infections were the most common cutaneous disorders in our study population. On the basis of the present data, improving the socio-economic status, environmental and personal hygiene, as well as, specific instructions to the risk group can be beneficial

Activities of different types of Thai honey on pathogenic bacteria causing skin diseases, tyrosinase enzyme and generating free radicals

BACKGROUND: Honey is a natural product obtained from the nectar that is collected from flowers by bees. It has several properties, including those of being food and supplementary diet, and it can be used in cosmetic products. Honey imparts pharmaceutical properties since it has antibacterial and antioxidant activities. The antibacterial and antioxidant activities of Thai honey were investigated in this study. RESULTS: The honey from longan flower (source No. 1) gave the highest activity on MRSA when compared to the other types of honey, with a minimum inhibitory concentration of 12.5% (v/v) and minimum bactericidal concentration of 25% (v/v). Moreover, it was found that MRSA isolate 49 and S. aureus were completely inhibited by the 50% (v/v) longan honey (source No. 1) at 8 and 20 hours of treatment, respectively. Furthermore, it was observed that the honey from coffee pollen (source No. 4) showed the highest phenolic and flavonoid compounds by 734.76 mg gallic/kg of honey and 178.31 mg quercetin/kg of honey, respectively. The antioxidant activity of the honey obtained from coffee pollen was also found to be the highest, when investigated using FRAP and DPPH assay, with 1781.77 mg FeSO4•7H2O/kg of honey and 86.20 mg gallic/kg of honey, respectively. Additionally, inhibition of tyrosinase enzyme was found that honey from coffee flower showed highest inhibition by 63.46%. CONCLUSIONS: Honey demonstrates tremendous potential as a useful source that provides anti-free radicals, anti-tyrosinase and anti-bacterial activity against pathogenic bacteria causing skin diseases.

Disseminated histoplasmosis: A comparative study of the clinical features and outcome among immunocompromised and immunocompetent patients.

Background. Disseminated histoplasmosis is a chronic granulomatous disease caused by the dimorphic fungus, Histoplasma capsulatum. Clinical presentation can vary from the acute pulmonary to the chronic disseminated form. In India, disseminated histoplasmosis often presents with pyrexia of unknown origin with a presentation similar to ‘disseminated tuberculosis’ involving the adrenal glands and bone marrow. Due to rarity of the disease, data are lacking regarding its clinical presentation and outcome among immunocompromised and immunocompetent patients. Methods. During January 2000 to December 2010, we identified 37 patients of disseminated histoplasmosis and attempted to characterize the differences between immunocompromised and immunocompetent patients. Demographic characteristics, clinical presentation, risk factors, laboratory findings, diagnostic yield, treatment received and prognosis were noted and compared between the two groups. Results. Eleven of 37 patients with disseminated histoplasmosis were immunocompromised and 26 were immunocompetent. Comparison of their clinical features showed a higher frequency of skin lesions in the immunocompromised compared to the immunocompetent group (54.5% v. 11.5%). Pancytopenia and anaemia were more common among the immunocompromised (81.8%) compared to the immunocompetent (46.2%) group. In the immunocompromised patients, the diagnosis was made most often by bone marrow aspirate and culture (72.7%) compared to the immunocompromised group where the diagnosis was most often obtained by adrenal gland biopsy and fungal cultures (57.7%). The cure rate was significantly higher in the immunocompetent group (73% v. 45%). Conclusion. The clinical presentation and outcome of patients with disseminated histoplasmosis differs among immunocompromised and immunocompetent patients.

Nocardiosis cutánea y sus formas clínicas / Cutaneous nocardiosis and its various presentations

La nocardiosis cutánea es una dermatosis infecciosa poco frecuente, que puede presentarse tanto en individuos inmunocompetentes como en inmunocomprometidos. A continuación se describen tres pacientes de sexo masculino inmunosuprimidos, en tratamiento con corticoesteroides, que presentaron diferentes formas clínicas de nocardiosis cutánea.

Cutaneous nocardiosis is a rare opportunistic infection found in bothimmunocompromised and immunocompetent patients. We describe three male immunocompromised patients who exhibited diff erent clinical forms of cutaneous nocardiosis. All of them were under corticosteroid regimen.

Dermatophytes and other skin mycoses found in featherless broiler toe webs

Feartherless broilers which are produced by a complex breeding programme from feathered parents carrying the Sc-gene, dissipates excessive body heat under hot and humid conditions. It has high body weight, and grows very rapidly when compared with standard commercial broilers. Their toe webs are bigger than standard commercial broilers, and could harbor fungi which can cause infections where there is the opportunity. To isolate and identify the presence of fungi in toe webs of featherless broilers. A total of 50 featherless broilers' toe webs samples were examined microscopically for the presence of fungi. The samples were examined microscopically and culturally using standard microbiological techniques. The fungi recovered were as follows. Microsporum gypseum 9 [22%], Trichophyton mentagrophytes var. mentagrophytes 5 [12%], Microsporum gallinae 3 [7%], Aspergilus flavus 10 [24%], Fusarium sp 6 [15%], Alternaria alternata 3 [7%] Scopulariopsis brevicaulis 2 [5%] and Candida albicans 3 [7%], The featherless broilers' toe webs habour fungi which cause mycotic skin disease and cannot be regarded as ordinary normal flora of toe webs

Superficial fungal infection of the skin in patients with rheumatoid arthritis after methotrexate therapy

Fungal infection of the skin is common disorder characterized by recurrent candidal skin infection, tinea cruris, tinea [pityriasis] versicolor and candidal infection of the nails in patients suffered of rheumatoid arthritis [R.A.] and treated by methotrexate. To discover the fungal skin complications after usage of methotrexate in the treatment of patients with Rheumatoid arthritis. Thirty two patients with R.A. were enrolled in the study who received 7.5 mg methotrexate and daily 100 mg diclofenac for six months in comparison to 32 patients with R.A. who received only daily 100 mg diclofenac as treatment. Ten patients [31.2%] developed fungal infection of the skin and nails, 5 [16%] patients with tinea versicolor of the body, 3 [9%] patients with tinea cruris and [6%] two patients had paronychia. The control group did not develop any skin or nails fungal disorders. Superficial fungal infection was a common problem among RA patients treated with methorexate

Entendiendo la relación entre la infección por Helicobacter pylori y enfermedades alérgicas en niños y adultos / Understanding the relationship between Helicobacter pylori infection and allergies in children and adults

La infección por Helicobacter pylori afecta a más del 50 por ciento de la población mundial, asociándose a gastritis histológica, úlcera duodenal y gástrica, así como también a cáncer gástrico. Abundante literatura reciente sugiere una relación entre H. pylori y las enfermedades alérgicas, las cuales han presentado un sostenido aumento en su incidencia en los últimos años. Considerando que ambas enfermedades (H. pylori y alergias), presentan respuestas Th polarizadas y opuestas, se revisan los aspectos claves de esta infección y su respuesta inmune polarizada a Th1, la cual, siendo inefectiva para erradicar H. pylori, es el elemento característico subyacente de la gastritis crónica histológica. Junto con ésto se analiza la respuesta inmune de tipo Th2 sistémica asociada a alergias cutáneas, respiratorias y alimentarias, para así comprender mejor su posible interacción. Algunos estudios plantean que la erradicación de H. pylori beneficiaría la remisión de enfermedades tales como urticaria crónica,asma y alergias alimentarias entre otras. Por el contrario, una fuerte línea de investigación se apoyanen la teoría de higiene y plantean que la erradicaciónde microrganismos como H. pylori, Toxoplasma gondii y virus de hepatitis A aumentaría la incidencia de alergias por un desbalance hacia Th2. En la mayoría de los estudios, la falta de grupo control o protocolos ciegos dificultan la posibilidad de llegar a una conclusión.

Helicobacter pylori’s infection affects more than 50% of the world’s population, inducing a histologic chronic gastritis, which can develop to a duodenal and gastric ulceration, as well as gastric cancer. Recent literature suggests a possible relationship between H. pylori and allergic diseases, which have also shown an increase in their incidence these last years. Considering that both diseases, H. pylori and allergies, have polarized and opposite immune responses, we wanted to examine the important aspects of this infection and it’s immune response (Th1), which is ineffective in eradicating H. pylori, and is a characteristic element in the histologic chronic gastritis. We also wanted to review the immune response linked to skin, food and respiratory allergies (Th2) so we can understand the interaction between allergic diseases and H. pylori. Many of the studies conclude that the eradication of H. pylori would benefit the remission of chronic urticaria, asthma and food allergies among others. However, other studies mention the hygiene hypothesis where the eradication of microrganisms such as H. pylori, Toxoplasma gondii and hepatitis A virus could increase the incidence of allergic diseases due to a polarized response towards Th2. The lack of control groups and blind studies make difficult to establish a final conclusion

Fusariosis diseminada por Fusarium oxysporum en un paciente adulto con leucemia mieloide aguda y neutropenia severa febril / Disseminated fusariosis by Fusarium oxysporum in an adult patient with acute myeloid leukemia and severe febrile neutropenia

Reportamos el primer caso de fusariosis diseminada en un paciente adulto en Chile, con una neoplasia hematológica y tratamiento quimioterápico, quien evolucionó con neutropenia febril prolongada, refractaria, fuera tratado con un amplio esquema antibacteriano y desarrollara una infección multisistémica, con compromiso cutáneo, sinusal y pulmonar por Fusarium oxysporum. Cursó con refractariedad al tratamiento antifúngico con anfotericina B deoxicolato y caspofungina, utilizados en forma secuencial. El desenlace fatal de este paciente se asoció a la persistencia de la neutropenia y a la infección por un hongo filamentoso habitualmente resistente a terapia antifúngica.

Vasculitis leucocitoclástica cutánea debida a infección por Micoplasma pneumoniae / Cutaneous leukocytoclastic vasculitis due to Mycoplasma pneumoniae infection

El Micoplasma pneumoniae (MP) es un germen frecuentemente implicado en cuadros de infecciones respiratorias en niños y adultos jóvenes. Se han descrito múltiples afectaciones extrapulmonares asociadas con la enfermedad, fundamentalmente a nivel del sistema nervioso central, como mielitis trasversa, meningoencefalitis y meningitis aséptica. Sin embargo, sólo hemos encontrado, en la literatura, tres casos descritos previamente en los que coexisten infección por MP (confirmada serológicamente) y vasculitis leucocitoclástica (confirmada por biopsia). Creemos que esto se debería a la realización de tratamiento empírico sin confirmación histológica y serológica, lo que conllevaría un infradiagnóstico de esta patología. Presentamos un caso de infección aguda por MP con lesiones cutáneas de vasculitis leucocitoclástica.

Criptococosis cutánea, reporte de un caso y revisión de la literatura / Cutaneous cryptococcosis: a case report and literature review

La criptococosis es una micosis cosmopolita, originada por una levadura encapsulada denominada Cryptococcus neoformans. El compromiso cutáneo es a menudo un fenómeno secundario a una criptococosis diseminada, presentándose la mayoría de los casos en un contexto de inmunosupresión. Las lesiones dermatológicas se pueden hallar con un frecuencia de 10 por ciento, a menudo bajo formas papulares y/o nodulares. Presentamos a un paciente portador de VIH/SIDA con cuadro de criptococosis, realizándose una revisión de la literatura.

Actual taxonomía del género Malassezia / Current taxonomy of Malassezia genus

Desde 1853 a la fecha, las levaduras del género Malassezia han recibido diferentes denominaciones debido a su gran polimorfismo y dificultad para cultivarlas. Se revisa la evolución histórica del género, concluyendo en la taxonomía actual propuesta por Guého, Midgley y Guillot, que agrupa siete especies dentro del género Malassezia.

From 1853 to date, yeasts of the Malassezia genus have received different denominations due to their great polymorphism and cultivation difficulties. We review the historic evolution of the genus, giving way to the current taxonomy proposed by Guého, Midgley and Guillot, which groups them into seven species.

Nocardiosis localizada / Cutaneous nocardia infections

La Nocardiosis cutánea primaria es de rara observación, se presenta en pacientes que han sufrido un traumatismo y se pusieron en contacto con la tierra, ya que este agente es un actinomiceto aeróbico cuyo hábitat es el suelo. Presentamos un caso de Nocardiosis localizada en tabaquera anatómica de la mano izquierda, en un paciente de sexo masculino de 52 años de edad y de profesión agricultor. Las lesiones, de tres años de evolución, presentaban al momento de la consulta, aspecto de placas cubiertas por costras, con numerosas bocas de superación, acompañadas de elementos, no dolorosos, y sin adenopatía regional. Se extrae material para estudio micológico directo y cultivo, y toma biopsia para el estudio histopatológico. Como antecedentes de la enfermedad actual el paciente relata haber sufrido un traumatismo en mano izquierda por manipuleo de herramientas en el momento de la cosecha.

Superantígenos em dermatologia / Superantigens in dermatology

Os superantígenos säo moléculas de origem microbiana, bacteriana (toxinas) ou viral, que, por meio do complexo maior de histocompatibilidade, estimulam as células T por ligaçäo direta aos receptores de células T (porçäo v-beta). Diferem dos demais antígenos por sua intensa seletividade e capacidade de estimular linfócitos T mediante mecanismos independentes do processamento antigênico intracelular por células apresentadoras de antígenos. Têm sido apontados como fatores de importância na etiopatogenia de enfermidades dematológicas, principalmente as toxinas bacterianas (Staphylococcus e Streptococcus). Os superantígenos podem levar à liberaçäo massiva de linfocinas e chegam a ativar até cerca de 30 porcento dos linfócitos periféricos. Acredita-se que os superantígenos possam exercer papel importante na induçäo e exacerbaçäo das doenças inflamatórias.

Terapéutica dermatológica / Dermatologic therapy

En el presente artículo se revisan reportes de la literatura referentes a avances recientes en la terapéutica dermatológica, enfatizando los relativos a procedimientos quirúrgicos, enfermedades infecciosas y parasitarias observadas en nuestro medio

Mucormicosis cutánea: reporte de 3 pacientes con diabetes mellitus / Cutaneous mucormycosis. A report of three cases in diabetes mellitus patients

Se describen tres mujeres diabéticas que desarrollaron mucormicosis cutánea en la espalda, pierna derecha y pierna izquierda, respectivamente. Las lesiones fueron únicas, entre 12 a 18 cm de diámetro, sin secreciones, con edema, eritema, calor, induración, necrosis importante y zonas isquémicas a su alrededor. Los exámenes histológicos mostraron extensa necrosis y numerosas hifas no septadas; en los cultivos creció Mucor spp. Todas las pacientes recibieron tratamiento con anfotericina B. En la primer paciente la enfermedad no se reconoció tempranamente y la paciente falleció; la segunda paciente requirió amputación de su pierna y la tercer paciente tuvo una buena respuesta. El diagnóstico temprano es primordial para evitar morbilidad y mortalidad por esta rara infección oportunista

Las tetraciclinas en dermatología / Tetracyclins in dermatology

La amplitud de las indicaciones dermatológicas hacen a las tetraciclinas un grupo básico en esta especialidad. Comparte propiedades antimicrobianas, antiinflamatorias e inmunosupresoras entre otras, por lo que han sido usadas en el tratamiento de varios estados patológicos no infecciosos. Se hace una revisión de las enfermedades cutáneas que han sido tratadas con tetraciclinas y algunas propiedades que justifican su uso

Clinical and bacteriological study of impetigo contagiosa

This work included clinical and bacteriological examination of 102 patients with active impetigo lesions in both forms of ordinary vesicular impetigo contagiosa [89 patients] and bullous impetigo [13 patients] of both sexes. The possible predisposing factors were hot and humid climate, sweat rash, septic foci and 50% of cases with scalp affection were infested with pediculosis capitis. In the present study, out of 89 patients, it was found that the mixed infection of Staphylococcus aureus and group A beta-hemolytic streptococci constitute the majority of cases [43.8%], followed by pure Staphylococcus aureus form [34.9% of cases] and A beta-hemolytic streptococci were cultured from 20.2% of cases. In cases of bullous impetigo, out of 13 cases Staphylococcus aureus in pure culture was recovered from 61% of cases. Mixed culture of group A beta-hemolytic streptococci and Staphylococcus aureus were isolated from 23% of cases and group G beta-hemolytic streptococci with Staphylococcus aureus were isolated from 7.7% of cases

Chromoblastomycosis in Pakistan

Chromoblastomycosis is a fungal infection of chronic nature, ubiquitous in distribution, with no definite treatment and with tendency to malignant transformation. It is caused by a number of different dematicaeous fungi. First case of Chromoblastomycosis was diagnosed and confirmed in Pakistan, showing that the disease is present in Pakistan, but must have been undiagnosed or misdiagnosed previously