ABSTRACT
BACKGROUND: Chromoblastomycosis is a tropical chronic infectious dermatosis characterized by the moriform bodies. To review all cases of chromoblastomycosis attended in the reference service of dermatology. METHODS: Series of cases of chromoblastomycosis attended in a dermatology reference service. Through an integrated system search of assistance, based on CID-10 B43, we reviewed epidemiological and comorbidities data, clinical presentations, treatments, and outcomes of each clinical case. RESULTS: From 2011 to 2017, we had five new cases of chromoblastomycosis. The average age was 65.6 years. All of them were men. One patient was HIV-positive, and another patient was immunosuppressed by the use of mycophenolate mofetil and prednisone due to renal transplant. Two patients had no history of evident trauma. The time between onset of symptoms and diagnosis ranged from 7 to 600 months. Fonsecaea pedrosoi was the isolated fungi. All cases were formally confirmed. Itraconazole with or without other therapies was effective in all cases. CONCLUSIONS: We report five never reported cases of chromoblastomycosis, and we review the clinical experience in diagnosis and treatment of chromoblastomycosis, an infrequent and neglected subcutaneous mycosis.
Subject(s)
Antifungal Agents/therapeutic use , Ascomycota , Chromoblastomycosis/diagnosis , Chromoblastomycosis/drug therapy , Itraconazole/therapeutic use , Aged , Chromoblastomycosis/microbiology , Chromoblastomycosis/pathology , Delayed Diagnosis , Humans , Male , Middle AgedSubject(s)
Alopecia Areata/etiology , Penicillin G Benzathine/administration & dosage , Syphilis/complications , Treponema pallidum/isolation & purification , Alopecia Areata/diagnostic imaging , Alopecia Areata/drug therapy , Female , Hair/diagnostic imaging , Humans , Male , Rare Diseases , Sampling Studies , Syphilis/diagnosis , Syphilis/drug therapy , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Since the use of laminin-5 as a marker of invasiveness has been proposed by several authors, our objective was to compare the expression of this protein in pseudocarcinomatous hyperplasia and squamous cell carcinoma (SCC). METHODS: Sixty-four paraffin-embedded skin biopsy samples with diagnosis of epidermal hyperplasia (non-pseudocarcinomatous), pseudocarcinomatous hyperplasia, actinic keratosis/carcinoma in situ, microinvasive and frankly invasive SCC were obtained for immunohistochemical study. RESULTS: Adjacent normal epithelium and epidermal hyperplasia (non-pseudocarcinomatous) showed no staining. In pseudocarcinomatous hyperplasia, laminin-5 was positive, at least focally, in 14 of 16 (87.5%) samples and was concentrated in peripheral cells of elongated rete pegs and in migrating cells in dermis. In samples of microinvasive carcinoma (n = 7), the expression was observed in all cases and was concentrated in the leading edge of the tumor. All cases (n = 21) of frankly invasive SCC showed cells expressing laminin-5, at least focally. Well-differentiated areas of the tumor presented a pattern of expression in peripheral cells of tumor nests while a diffuse pattern of expression was observed in less differentiated areas. CONCLUSION: We showed that cytoplasmic laminin-5 expression should not be used as a criterion of malignancy and is not useful in distinguishing pseudocarcinomatous hyperplasia from microinvasive and well-differentiated SCC.
