Cutaneous protothecosis in kidney transplant recipient

Abstract Protothecosis is a rare condition caused by the aclorophylated algae of the genus Prototheca. In humans, protothecosis, caused mainly by P. wickerhamii, manifests itself in three forms: cutaneous, articular and systemic. It can occur in both immunocompetent and immunosuppressed individuals, being much more common in the latter. We present a new case of protothecosis in Brazil in a kidney transplant recipient.

Prototecosis cutánea: presentación de un caso con énfasis en la histopatología / Cutaneous protothecosis: report of a case with emphasis on histopathology

La prototecosis es una infección infrecuente causada por algas del género Prototheca. Su diagnóstico se hace mediante estudios microbiológicos o por la identificación del alga en biopsias por su morfología característica. Se presenta el hallazgo histopatológico de prototecosis en una mujer de 72 años con diagnóstico presuntivo de dermatitis actínica crónica; en el estudio anatomatopatológico de una biopsia de piel se observaron estructuras con septos internos típicos de Prototheca. Se hace una revisión de todos los registros de esta enfermedad en Colombia.

Protothecosis is a rare infection caused by algae of the Prototheca genus. Its diagnosis is based on microbiological studies and on the identification in biopsies of the characteristic structures of the algae. We present the histopathological findings of protothecosis in a 72 year-old woman with the presumptive diagnosis of chronic actinic dermatitis. The pathological study of a skin biopsy revealed structures with internal septa typical of Prototheca. A review of all reports of this disease in Colombia is also presented.

Compensation for Occupational Skin Diseases

The Korean list of occupational skin diseases was amended in July 2013. The past list was constructed according to the causative agent and the target organ, and the items of that list had not been reviewed for a long period. The revised list was reconstructed to include diseases classified by the International Classification of Diseases (10th version). Therefore, the items of compensable occupational skin diseases in the amended list in Korea comprise contact dermatitis; chemical burns; Stevens-Johnson syndrome; tar-related skin diseases; infectious skin diseases; skin injury-induced cellulitis; and skin conditions resulting from physical factors such as heat, cold, sun exposure, and ionized radiation. This list will be more practical and convenient for physicians and workers because it follows a disease-based approach. The revised list is in accordance with the International Labor Organization list and is refined according to Korean worker's compensation and the actual occurrence of occupational skin diseases. However, this revised list does not perfectly reflect the actual status of skin diseases because of the few cases of occupational skin diseases, incomplete statistics of skin diseases, and insufficient scientific evidence. Thus, the list of occupational diseases should be modified periodically on the basis of recent evidence and statistics.

Cutaneous protothecosis - case report / Prototecose cutanea - relato de caso

Cutaneous protothecosis is a rare infection caused by achlorophyllic algae of the genus Prototheca. The lesions usually occur on exposed areas, related with trauma, in immunocompromised patients. The most common clinical presentation is a vesicobullous and ulcerative lesion with pustules and scabs, simulating bacterial, fungal or herpetic infections or eczema. The diagnosis is determined by agent identification through histopathology, culture and the carbohydrates assimilation test. The finding of morula-like spherules is characteristic of Prototheca sp. Its rarity and non-specific clinical aspect may difficult the disease diagnosis. We report a case of a diabetic patient, in chronic use of systemic corticosteroids, that developed a skin lesion after trauma to the right leg.

A prototecose cutânea é uma infecção rara causada por algas aclorofílicas do gênero Prototheca. Geralmente as lesões ocorrem em áreas expostas, relacionadas à trauma, em indivíduos imunocomprometidos. A apresentação clínica mais comum é uma lesão vesico-bolhosa e ulcerativa com pústulas e crostas, simulando piodermites, infecções fúngicas, infecções herpéticas ou eczemas. O diagnóstico é realizado pela identificação do agente através do exame histopatológico, da cultura e do teste de assimilação dos carboidratos. O achado de esférulas com aspecto de mórula são características da Prototheca sp. A raridade da doença e o aspecto clínico inespecífico dificultam o diagnóstico da doença. Relatamos um caso em paciente diabética, em uso crônico de corticoide sistêmico, que desenvolveu lesão cutânea após trauma na perna direita.

Amiloidosis cutánea / Cutaneous amyloidosis

Paciente masculino de 54 años de edad, quien refiere inicio de enfermedad actual en junio de 2010 cuando evidencia aumento de volumen y dolor en ambos tobillos, astenia y pérdida de peso de 20 kilogramos y fiebre. Ingresó con epistaxis profusa, lesiones descamativas, dolorosas en miembros superiores, a predominio de regiones antebraquiales y manos. Inmunoelectroforesis de Ig en suero: hipergammaglobulinemia 2494mg/100ml. Biopsia de grasa periumbilical: positiva para depósitos amiloides a tinción con rojo Cong...

Atención hospitalaria de la leishmaniosis tegumentaria americana en los miembros inferiores / Hospital care of American tegumentary leishmaniasis in the lower limbs

La leishmaniosis tegumentaria americana (LTA) como enfermedad endémica crónica continúa afectando a la población del medio rural venezolano, ocasionándole morbilidad y limitaciones laborales. Mediantes la descripción de casos clínicos se evaluaron 38 pacientes con LTA que recibieron atención hospitalaria por úlceras leishmánica en miembros inferiores. De los pacientes descriptos 63% eran niños, 84% procedía del Estado Miranda, 66% tenía una lesión ulcerosa única, 45% recibió cefadroxilo previo al tratamiento antiparasitario específico y el 24% había recibio inmunoterapia previa para la enfermedad. Treinta y siete pacientes (97%) recibieron antimoniato de meglumina en series terapéuticas de aiez días y uno anfoterecina B, por contraindicación cardiovascular para el uso del antimonial. Todos presentaron re-epitelización adecuada de sus lesiones, por lo que el antimoniato de meglumina demuestra una vez más su utilidad en la terapéutica de esta zoonosis parasitaria.

American tequmentary leishmaniasis (ATL) endemic chronic disease continues to affect the population of rural Venezuela, causing morbidity and labor constraints. By the description of clinical were evaluated 38 patients with ATL who received hospital care for leishmanial ulcers in lower limbs. Sixty-three percent of the patients were children, 84% came from Miranda state, 66% had a unique ulcerated lesion, 45% received cefadroxil prior to parasite specific treatment and 24% had received immunotherapy for the diseaes. Thirtyseven patients (97%) received meglumine antimoniate in series of ten days and one patient received anfotericine B, due to cardiovascular contraindication for the use of the antimonial. All ulcers healed. The antimoniate of meglumine demonstrates once again its usefulness in the treatment of this parasitic zoonosis.

Prototecose cutânea: relato de caso / Cutaneous protothecosis: case report

Descreve-se um caso de prototecose cutânea em paciente de 78 anos, submetido a tratamento para pênfigo foliáceo e feohifomicose. Ele apresentava lesões eritematosas infiltradas na perna direita e o diagnóstico foi feito através de estudo histológico e através de cultura da pele lesada. A cura foi obtida com o uso oral de itraconazol.

A case of cutaneous protothecosis was reported in a 78-year-old man that was in treatment for pemphigus foliaceus and phaeohyphomycosis. He presented erythematous lesions which were infiltrated into his right leg. The diagnosis was made histopathologically and confirmed by culture, and the patient was successfully treated with itraconazole.

Incapacidades físicas em pacientes de hanseníase na faixa de zero a 14 anos, no Distrito Federal, no período de 1979 a 1989 / Physical disabilites in leprosy patients in the ) to 14 age group, in the Federal District, between the years 1979 and 1989

Um estudo retrospectivo foi realizado em relaçäo à ocorrência de incapacidades físicas em 148 pacientes portadores de hanseníase, na faixa etária de zero a 14 anos, no Distrito Federal, no período compreendido entre 1979 e 1989. Procurou-se correlacionar as incapacidades com a idade, sexo, localizaçäo e formas clínicas da doença. A taxa de incapacidades foi de 11,49%. A faixa etária mais acometida por incapacidades foi a de 11 a 14 anos, com percentual de 82,35%. Houve predomínio em crianças do sexo masculino (58,82%). As mäos foram os locais mais acometidos pelas incapacidades, com 71,42%. Houve correlaçäo entre as formas clínicas da doença e a taxa de incapacidades físicas, indicando as formas multibacilares com destaque para a forma dimorfa como as que mais incapacitam

Cutaneous anthrax--a report of ten cases.

The clinical features of ten cases of cutaneous anthrax are reported. Six males and four females were affected. Their ages ranged from one and a half year to sixty years. The average incubation period was 8 days. Fever and headache were common systemic manifestations. Pruritus and ulcer with formation of black eschar were typical features. The patients were treated with penicillins and chloramphenicol. There was no mortality. Possible human-to-human spread in a patient is discussed.

Actinomicosis de pared abdominal presentacion de un caso / Actinomycosis of the abdominal wall. Report of a case

La actinomicosis es una enfermedad infecciosa crónica producida por un microorganismo gram positivo anaerobio, el actinomycoses israelii. Crece por continuidad hacia órganos adyacentes con la formación de masas densas de tejido leñoso, produciendo abscesos y fístulas que drenan hacia el exterior. Los síntomas generales de la enfermedad son fiebre, escalofríos, asociados con los síntomas propios de cada localización. El diagnóstico se realiza cuando hay secreción de pus y se pueden encontrar "gránulos de azufre" característicos del pus de la actinomicosis. El tratamiento debe ser quirúrgico, a través de la extirpación quirúrgica y la quimioterapia. El antibiótico de elección es la penicilina en altas dosis. La baja frecuencia y la afectación secundaria de la pared abdominal, con escasos antecedentes en la literatura, motivó la presentación de este caso

Acantolisis / Acantholysis

La acantalosis es un hallazgo histopatológico observado en numerosas y diversas dermatosis, con expresiones clínicas variadas. Se describen los caracteres clínicos e histopatológicos más importantes de estas afecciones y se resumen los mecanismos etiopatogénicos de la acantolisis propuestos en cada una de ellas

A contribution to the study of acute schistosomiasis: an experimental trial

Os autores descrevem o macho e a fêmea de uma nova espécie de flebótomo, Lutzomyia brisolai n.sp., antropofílica, encontrada em várias estaçöes do piemonte andino. Esta espécie, difícil de classificar, apresenta características que a assemelham à L. oliveirai e à L. minasensis, mas também às espécies do sub-gênero Nyssomyia