5-aminolevulinic acid-based photodynamic therapy in combination with antifungal agents for adult kerion and facial ulcer caused by Trichophyton rubrum.

Dermatophytosis is the most common fungal infectious disease in the world, which is commonly caused by Trichophyton rubrum in China. The traditional therapies for treating dermatophytosis include topical and oral antifungal agents like terbinafine, griseofulvin, and azole antifungal drugs. However, 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) as a new alternative therapy avoids the side effects and drug resistance of traditional antifungal agents. We report two cases diagnosed as kerion and tinea faciei secondary to ulcers with CARD 9 deficiency, both of whom were infected by T.rubrum. They were both successfully treated by ALA-PDT combined with antifungal drugs, providing a feasible strategy for therapeutic choice for adult kerion and ulcer treatment.

Advances in research on echinococcoses epidemiology in China.

Echinococcoses are serious zoonotic diseases in China's vast, western and north-western pastoral areas that has one of the highest prevalence in the world. The two most common forms, cystic echinococcosis (CE) and alveolar echinococcosis (AE), are co-epidemic in some areas causing a grave threat to people's health and economic development. Echinococcus spp. are transmitted through domestic, sylvatic and mixed cycles involving many kinds of host. Successful transmission requires a favourable environment for the growth of the parasites and survival of their eggs, while the unique customs and religious beliefs in the endemic areas pose a challenge to the prevention and control of these parasites. Based on previous epidemiological studies, this paper reviews the particular factors affecting the transmission of Echinococcus parasites in China, with a focus on biological (parasite genotype and the species, age, sex and density of hosts), environmental (landscape and climate) and social (age, gender, ethnicity, education, occupation, life style, cultural customs, living conditions and hygiene practices of humans in the endemic areas). These three factors interact with each other and jointly determine the parasites' transmission intensity, the study of which supports the formulation of the strategies and measures that are significant for control of these infections.

Successful Treatment of Eczema-Like Mucormycosis in a Child by Combination of Intravenous Drip and Percutaneous Injection Amphotericin B.

We report a case of eczema-like cutaneous mucormycosis caused by Rhizopus arrhizus. A 4-year-old child was presented to our hospital with a history of gradually enlarging papule and plaque in the periumbilical area for nearly 4 years since 2 weeks after his birth, and it has been misdiagnosed as eczema for nearly 3 years. Based on histopathology examination, the fungus culture test and DNA sequencing, it was revealed that R. arrhizus should be the responsible fungus for skin infection. The patient was successfully cured by combination of intravenous drip and percutaneous injection amphotericin B for nearly 3 months, and no recrudescence was seen during a follow-up of 6-month observation.

Primary cutaneous zygomycosis caused by rhizomucor variabilis: a new endemic zygomycosis? A case report and review of 6 cases reported from China.

We report a case of primary cutaneous zygomycosis caused by Rhizomucor variabilis and review 6 cases reported from China that share similar features and are different from those cases caused by other species of Mucorales. It is noteworthy that all 6 of the cases were observed in 3 adjacent provinces of eastern China.

Genotype comparisons of strains of Candida albicans from patients with cutaneous candidiasis and vaginal candidiasis.

BACKGROUND: It is uncertain whether genotypes of Candida albicans (C. albicans) are associated with colonizing body locations or variant conditions of infection. The aim of this study was to investigate whether there are significant associations between strain genotypes and body sites of infection and to determine the potential pathogenesis of cutaneous candidiasis at multiple locations. METHODS: A total of 151 strains of C. albicans were isolated from 74 infant patients with cutaneous candidiasis and 61 female patients with vaginal candidiasis. Patients were grouped according to the body sites and underlying conditions of infection. Genotypes were identified by polymerase chain reaction (PCR) of the 25S rDNA and PCR-restriction fragment length polymorphism (RFLP) of ALT repeats digested with EcoRI and Clal. RESULTS: Ten genotypes were detected. There were significant differences in genotype frequencies between the two groups. However, we found no clear association between genotypes and the sites of cutaneous infection or the underlying conditions of vaginal candidiasis (VVC). In addition, strains of C. albicans from multiple cutaneous locations of the same patient had identical genotypes. CONCLUSIONS: Populations of C. albicans from patients with cutaneous and vaginal candidiasis were genetically different. However, the lack of genetic difference between strains from different body sites with cutaneous infections or from different underlying conditions for VVC suggests no evidence of genotype selection for different skin surfaces or patients with different underlying conditions for VVC.

Pyoderma gangrenosum with pulmonary involvement?

Pyoderma gangrenosum is a rare, painful, noninfectious, ulcerative, reactive neutrophilic skin condition. It is characterized by ulcers that can spread quickly showing undermined violaceous borders. Since there is no single diagnostic test, early diagnosis is always challenging. The aggressive nature of classical pyoderma gangrenosum may become apparent only with time. Pulmonary involvement of pyoderma gangrenosum maybe underreported. We describe a case of classical pyoderma gangrenosum in a 65-year-old man with pulmonary involvement, who presented with a painful fluctuate nodule and ulcer with mucopurulent and hemorrhagic exudates, and with a monoclonal gammopathy, IgA type. One month later the ulcer and hemoptysis all disappeared after treatment with glucocorticosteroids. The pulmonary manifestations of pyoderma gangrenosum were also reviewed.

[Association between environmental risk factor exposure in the first trimester and nonsyndromic cleft lip with or without cleft palate: a case-control study].

OBJECTIVE: To identify the environmental risk factors during the first trimester responsible for nonsyndromic cleft lip with or without cleft palate to collect data for prevention of this congenital defect. METHODS: A hospital-based case-control study was conducted to identify the risk factors by means of field investigation with standardized questionnaires. Single factor analysis and logistic regression of the data are performed using SPSS 13.0 software. RESULTS: Multifactorial analysis revealed that folic acid was significantly associated with lowered incidence of nonsyndromic cleft lip with or without cleft palate (OR=0.100, 95%CI: 0.032-0.312), whereas maternal infection (OR=4.155, 95%CI: 2.166-7.970), poisonous chemical exposure (OR=6.816, 95%CI: 2.528-18.381) and emotional stress (OR=3.250, 95%CI: 1.477-7.154) were risk factors for this defect. CONCLUSIONS: Sufficient follic acid intake and prevention of infection and poisonous chemical exposure during the first trimester are measures to reduce the risks of nonsyndromic cleft lip with or without cleft palate.

[Clinical observation on the efficacy of ivermectin in the treatment of intestinal nematode infections].

OBJECTIVE: To observe the efficacy and side effects of ivermectin in the treatment of intestinal nematode infections. METHODS: A single dose of ivermectin 0.1, 0.2, 0.2 and 0.2 mg/kg was orally administered to cases with infection of Ascaris, hookworm, Trichuris and Enterobius respectively. A single dose of albendazole 400 mg was used as control. RESULTS: The egg negative conversion rates of ivermectin and albendazole were both 100% (34/34) for Ascaris infection, 17.6% (6/34) and 76.5% (26/34) respectively for hookworm infection, 67.6% (23/34) and 47.1% (16/34) respectively for Trichuris infection, 58.8% (20/34) and 100% (34/34) respectively for Enterobius infection. The worm discharge reached a peak in 1-2 days after treatment. The side effect of ivermectin was mild and transient showing no adverse effect on blood picture, liver function, renal function or ECG. CONCLUSION: Ivermectin shows similar effect on Ascaris with albendazole, better effect on Trichuris and poorer effect on hookworm and Enterobius than albendazole.