RESUMO
Syphilis is a worldwide sexually transmitted infection caused by Treponema pallidum subspecies pallidum. Its association with other STIs, including HIV, demands early diagnosis and immediate treatment of patients. We herein report an unusual serpiginous form of secondary syphilis.
Assuntos
Dermatoses do Pé/etiologia , Dermatoses da Mão/etiologia , Sífilis/complicações , Adulto , Antibacterianos/administração & dosagem , Dermatoses do Pé/diagnóstico , Dermatoses do Pé/tratamento farmacológico , Dermatoses da Mão/diagnóstico , Dermatoses da Mão/tratamento farmacológico , Humanos , Injeções Intramusculares , Masculino , Penicilina G Benzatina/administração & dosagem , Sífilis/diagnóstico , Sífilis/tratamento farmacológicoRESUMO
Abstract: Syphilis is a worldwide sexually transmitted infection caused by Treponema pallidum subspecies pallidum. Its association with other STIs, including HIV, demands early diagnosis and immediate treatment of patients. We herein report an unusual serpiginous form of secondary syphilis.
Assuntos
Humanos , Masculino , Adulto , Sífilis/complicações , Dermatoses do Pé/etiologia , Dermatoses da Mão/etiologia , Penicilina G Benzatina/administração & dosagem , Sífilis/diagnóstico , Sífilis/tratamento farmacológico , Dermatoses do Pé/diagnóstico , Dermatoses do Pé/tratamento farmacológico , Dermatoses da Mão/diagnóstico , Dermatoses da Mão/tratamento farmacológico , Injeções Intramusculares , Antibacterianos/administração & dosagemRESUMO
INTRODUCTION: We evaluated the benefits of a specialized consultation created in 2014 for cutaneous penile lesions. MATERIALS AND METHODS: We performed a descriptive prospective study evaluating all patients sent for a monthly urologic-dermatologic consultation at a French university hospital from September 2014 to September 2015 for cutaneous penile lesions. All patients evaluated were included. We collected the demographic data, clinical examination findings, and the proposed diagnosis and treatment for every patient. RESULTS: A total of 27 patients were included; 4 (14.8%) had been referred by a general physician and 23 (85.2%) by a specialist. Cutaneous penile lesions had evolved within 12 months in 15 patients (55.6%). Penile cancer was diagnosed in 5 patients (18.5%), of which 3 were squamous cell carcinoma (11.1%), 1 was metastasis of melanoma (3.7%), and 1 was extramammary Paget disease (3.7%). In addition, 1 patient (3.7%) had a premalignant lesion on a condyloma, 12 (44.4%) had balanitis, 2 (7.4%) had psoriasis lesions, 3 (11.1%) had condylomas, 1 (3.7%) had genital melanosis, and 3 (11.2%) had normal findings. Four patients (16.6%) underwent biopsy, 8 (33.3%) underwent surgery, and 12 (50%) received local treatment. CONCLUSION: The use of urologic-dermatology specialized consultations resulted in encouraging findings. Patients can benefit from multidisciplinary expertise and rapid treatment of various disorders. Thus, it seems important to develop reference centers created specifically for cancerous disease.
Assuntos
Neoplasias Penianas/diagnóstico , Dermatopatias/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Gerenciamento Clínico , Diagnóstico Precoce , Humanos , Masculino , Melanoma/diagnóstico , Doença de Paget Extramamária/diagnóstico , Estudos Prospectivos , Encaminhamento e ConsultaRESUMO
Here we report a case of cutaneous alternariosis in a 74-year-old man treated by corticotherapy for myasthenia, and presenting with papular, crusted lesions on the left elbow and the right knee. Histological examination of the biopsy specimens showed fungal hyphae associated with round-shaped cells which were highly suggestive of alternariosis. Mycological culture allowed the isolation of a dematiaceous fungus which was identified as a member of the Alternaria infectoria species-group. This was confirmed by PCR amplification and sequencing of the internal transcribed spacer domain of the gene encoding nuclear ribosomal DNA and of the mitochondrial small subunit ribosomal DNA domain. The fungus was therefore referred to the Scientific Institute of Public Health where it was identified as Alternaria infectoria, on the basis of its very small 1 or 2-celled conidia often arranged in long chains and presenting with very long secondary conidiophores. Corticotherapy was stopped and a local antifungal treatment with ketoconazole was initiated, allowing the stabilisation of the cutaneous lesions within 2 months.