The frequency of superficial mycoses according to agents isolated during a ten-year period (1999-2008) in Zagreb area, Croatia.

Fungal infections involving the skin, hair and nails represent one of the most common mucocutaneous infections. Significant changes in the epidemiology, etiology and clinical pattern of mycotic infections have been observed during the last years. The aim of this retrospective study was to determine the incidence and the etiologic factors of superficial fungal infections in Zagreb area, Croatia, over a 10-year period (1999-2008). A total of 75828 samples obtained from 67 983 patients were analyzed. Dermatomycosis was verified by culture in 17410 (23%) samples obtained from 16086 patients. Female patients were more commonly affected than male (59% vs. 41%). Dermatophytes were responsible for 63% of all superficial fungal infections, followed by yeasts (36%) and molds (1%). Trichophyton (T.) mentagrophytes (both var. interdigitalis and var. granulosa) was the most frequent dermatophyte isolated in 58% of all samples, followed by Microsporum (M). canis (29%) and T. rubrum (10%). The most common clinical forms of dermatomycosis were onychomycosis (41%), tinea corporis (17%) and tinea pedis (12%). Candida spp. was mainly isolated from fingernail debris.

Unrecognized dermatophyte infection in ichthyosis vulgaris.

A case of unrecognized widespread dermatophyte infection associated with ichthyosis vulgaris and atopy is described. Our patient was a young woman in which the diagnosis of ichthyosis vulgaris and atopic dermatitis blocked the recognition of widespread dermatophyte infection for more than six months. The case showed some clinical peculiarities in terms of both extent of lesions and their clinical appearance.

Macular amyloidosis: a case report.

Macular amyloidosis is a major cause of skin pigmentation and a rare form of localized primary cutaneous amyloidosis in western countries, with a higher prevalence in Asia and South America. The etiopathogenesis of macular amyloidosis has not yet been fully clarified; a number of risk factors are involved, among them chronic friction in particular. A 54-year-old patient with macular amyloidosis is presented. The diagnosis of macular amyloidosis was based on history data on long-term persistence of the disorder, localized pruritus and constant scratching urge, grayish-brown pigmentation over the scapula, and detection of amyloid in histologic slides. Three-month tretinoin therapy resulted in pruritus alleviation, with no change in the appearance of hyperpigmentation. The exact incidence of macular amyloidosis in Croatia is not known, however, the issue appears to be underestimated or neglected in dermatology routine.

An unusual case of superficial lymphangioma of the right foot.

Superficial lymphangioma is a microcytic lymphatic malformation that is usually present already at birth. Women are more commonly affected than men are. It occurs because of the deep lymphatic circulation obstruction. Superficial lymphangioma is most commonly found in the mouth, especially the tongue, on the shoulders, neck, limbs, armpits and groin. It appears as a cluster of small firm blisters filled with clear or hemorrhagic lymph fluid, resembling frogspawn. We are presenting an unusual case of superficial lymphangioma of the right foot in an adult female patient.

Milker's nodule--case report.

Milker's nodule (noduli mulgentium) is a benign viral skin disease caused by parapoxvirus, a poxvirus that is endemic in cattle. The virus is usually transmitted to cattle handlers from infected cows. We present a case of a 25-year-old housewife who milked cows on her family farm and developed itchy, purplish red nodules on her fingers and hands, and lymphangiitis of the right arm. Two weeks before, several cows on her family farm were treated by a veterinarian under the diagnosis of pseudocowpox. She was treated with orally administered amoxicillin with clavulanic acid 2 g for 10 days, with complete resolution of lymphangiitis. The nodules resolved in several weeks.

Neurofibromatosis--review of the literature and case report.

Neurofibromatoses are genetic disorders of the nervous system that primarily affect the development and growth of neural (nerve) cell tissues. These disorders cause tumors to grow on nerves, and produce other abnormalities such as skin changes and bone deformities. Although many affected persons inherit the disorder, between 30 and 50 percent of new cases arise spontaneously through mutation in the individual's genes. We report on seven cases of type 1 neurofibromatosis (NF1) diagnosed from 2001 to 2006 at our Department. There were four female and three male patients, mean age 46.1 and 49 years, respectively. All patients showed neurofibromas accompanied by fibromas, café au lait spots, cases showed five axillary freckling (lentigines) and one case showed five plexiform neurofibromas and pruritus belonging to NF1 category. All patients had affected first degree relatives. Systemic findings were rare and included optic glioma in one case and Lisch hamartoma nodules in three cases. In all cases, the diagnosis was established according to the National Institutes of Health criteria, including at least two of the diagnostic criteria for NF1 diagnosis. None of our cases had malignancies or gastrointestinal tract involvement.

Erysipeloid--case report.

Erysipeloid is an acute, bacterial infection of traumatized skin in an individual who was in direct contact with meat or other animal products contaminated with a gram-positive bacillus Erysipelothrix rhusiopathiae. We present a case of a 50-year-old housewife whose hobby was fishing, with a reddish, tender patch on the fifth finger and dorsum of the left hand, which developed a week after she had sustained an injury while boning the fish. The patient was treated with orally administered penicillin V 1,500,000 IU t.i.d. for 7 days, with complete resolution.