Hansen's disease and COVID-19 co-infection in Brazil.

BACKGROUND: The implications of COVID-19 co-infection in patients under treatment for Hansen's disease (HD, leprosy) remain uncertain. We aimed to describe clinical characteristics, treatments, and outcomes in patients with HD and COVID-19 in Brazil. METHODS: Cross-sectional study recruiting adult HD patients with PCR-confirmed COVID-19 from five HD treatment centers in Brazil between March 1, 2020, and March 31, 2021. At the time of this study, no patient had received COVID-19 vaccine. RESULTS: Of 1377 patients under treatment for HD, 70 (5.1%) were diagnosed with COVID-19. Of these, 41 (58.6%) had PCR-confirmed COVID-19, comprising 19 men and 22 women, aged 24-67 (median 45) years. HD was multibacillary in 39/41 patients. Eight patients ceased WHO Multi-Drug Therapy for HD, three for lack of drugs, two because of COVID-19, and three for other reasons. Of the 33 who continued treatment, 26 were on the standard regimen and seven an alternative regimen. Seventeen patients were receiving oral prednisone, including nine patients with type 1 reaction, four with type 2 reaction, three with neuritis, and one with rheumatologic disease. Twelve patients were hospitalized for COVID-19, and six patients died, of whom three had hypertension and one also had type 2 diabetes and obesity. CONCLUSIONS: COVID-19 and Hansen's disease co-infection did not appear to change the clinical picture of either disease in this cross-sectional study. The wider impact of the pandemic on persons affected by HD requires follow-up and monitoring.

Tinea Capitis: Correlation of Clinical Aspects, Findings on Direct Mycological Examination, and Agents Isolated from Fungal Culture.

BACKGROUND: Tinea capitis (TC) is a dermatophytosis of the scalp caused by the Trichophyton and Microsporum genera. The condition can be classified according to clinical symptoms or based on mycological presentations observed on direct examination. Treatment is best determined after isolation of the causative agent, with griseofulvin indicated for Microsporum and terbinafine for Trichophyton. MATERIALS AND METHODS: This was a prospective study correlating clinical and mycological classifications with agents isolated from culture of patients seen at a tertiary hospital in São Paulo (Brazil) between May 15, 2017, and January 11, 2019. RESULTS: A total of 23 patients were treated, comprising 19 (83%) with alopecic clinical aspect (14 [60%] trichophytic and five [23%] microsporic) and 4 (17%) with kerion celsi presentation. According to the parasite invasion at the hair shaft, 9 (40%) were endothrix and 14 (60%) were ectothrix cases. Trichophyton tonsurans was isolated from culture in 14 (60%) patients and Microsporum canis in 5 (40%) patients. A statistically significant association was found for mycological classification and agent isolated from culture (P = 0.003) with associations of the endothrix form with T. tonsurans and of ectothrix with M. canis. CONCLUSIONS: The mycological classification appears to be a valid method for suggesting the etiological agent of TC.