Fungal Melanonychia: A Systematic Review.

Fungal melanonychia is an uncommon condition, most typically caused by opportunistic melanin-producing pigmented filamentous fungi in the nail plate. In the present study, the clinical characteristics of patients diagnosed with fungal melanonychia were analyzed through a systematic review of cases reported in the literature. The MESH terms used for the search were "melanonychia" AND "fungal" OR "fungi" through four databases: PubMed, SciELO, Google scholar and SCOPUS. After discarding inadequate articles using the exclusion criteria, 33 articles with 133 cases were analyzed, of which 44% were women, 56% were men and the age range was between 9 and 87 years. The majority of cases were reported in Turkey followed by Korea and Italy. Frequent causal agents detected were Trichophyton rubrum as non-dematiaceous in 55% and Neoscytalidium dimidiatum as dematiaceous in 8%. Predisposing factors included nail trauma, migration history, employment and/or outdoor activities. Involvement in a single nail was presented in 45% of the cases, while more than one affected nail was identified in 21%, with a range of 2 to 10 nails. Regarding the clinical classification, 41% evidenced more than one type of melanonychia, 21% corresponded to the longitudinal pattern and 13% was of total diffuse type. Likewise, the usual dermoscopic pattern was multicolor pigmentation. It is concluded that fungal melanonychia is an uncommon variant of onychomycosis and the differential diagnosis is broad, which highlights the complexity of this disease.

Bioinformatics Approaches Applied to the Discovery of Antifungal Peptides.

Antifungal peptides (AFPs) comprise a group of substances with a broad spectrum of activities and complex action mechanisms. They develop in nature via an evolutionary process resulting from the interactions between hosts and pathogens. The AFP database is experimentally verified and curated from research articles, patents, and public databases. In this review, we compile information about the primary databases and bioinformatics tools that have been used in the discovery of AFPs during the last 15 years. We focus on the classification and prediction of AFPs using different physicochemical properties, such as polarity, hydrophobicity, hydrophilicity, mass, acidic, basic, and isoelectric indices, and other structural properties. Another method for discovering AFPs is the implementation of a peptidomic approach and bioinformatics filtering, which gave rise to a new family of peptides that exhibit a broad spectrum of antimicrobial activity against Candida albicans with low hemolytic effects. The application of machine intelligence in the sphere of biological sciences has led to the development of automated tools. The progress made in this area has also paved the way for producing new drugs more quickly and effectively. However, we also identified that further advancements are still needed to complete the AFP libraries.

Atypical Mycobacteriosis Due to Mycobacterium abscessus subsp. massiliense: Our Experince.

BACKGROUND: Members of Micobacterium. abscessus complex comprises three subspecies (M. abscessus subsp. Abscessus, M. abscessus subsp. Bolletii, and M. abscessus subsp. Massiliense) and are a rapid-growing nontuberculous mycobacteria present in different aquatic habitats and soil. It often causes a wide spectrum of infections involving pulmonary infections, surgical wound infections, and infections related to mesotherapy, catheters, hemodialysis devices, endocarditis, and disseminated infections in immunocompromised individuals. METHODS: In this article we comment on the most relevant aspects of nine patients with skin lesions caused by M. abscessus subsp. massiliense infection. Clinical characteristics, histopathology, and molecular identification were performed. RESULTS: The patients in the clinical cases presented a history of trauma, tattoos, and physical therapy techniques. The most common treatments were minocycline and clindamycin, doxycycline, ceftriaxone, cephalexin, moxifloxacin, rifampicin, and trimethoprim-sulfamethoxazole. The evolution of the treated patients was acceptable, except for one patient, who showed a partial improvement. M. massiliense were identified in all clinical cases using a species-specific PCR. CONCLUSION: Our series consisted of nine cases of skin biopsies recorded in different years; for this reason, we do not have all the data necessary for a complete description, in particular in four cases, causing limitations in the manuscript, especially in the therapy used and the evolution of patients due to lack of follow-up.

Epidemiology of Clinical Sporotrichosis in the Americas in the Last Ten Years.

BACKGROUND: Sporotrichosis is a fungal infection caused by species of the Sporothrix genus. Presently, the prevalence of sporotrichosis in the Americas is unknown, so this study aims to analyze the cases reported in the past 10 years. METHODS: An advanced search was conducted from 2012 to 2022 in English and Spanish in PUBMED, SciELO, and Cochrane, with the terms: "sporotrichosis", "lymphocutaneous sporotrichosis", "fixed sporotrichosis", "mycosis", "Sporothrix spp.", "Sporothrix complex", "S. schenckii sensu stricto", "S. schenckii sensu lato", "S. globose", "S. brasiliensis", "S. luriei". Sporotrichosis is a fungal infection caused by species of the Sporothrix genus associated with "pathogenicity" or "epidemiology". RESULTS: A total of 124 articles were found in the Americas, corresponding to 12,568 patients. Of these, 87.38% of cases were reported in South America, 11.62% in North America, and 1.00% in Central America and the Caribbean. Brazil, Peru, and Mexico had the highest number of cases. The most prevalent etiological agents were S. schenckii complex/Sporothrix spp. (52.91%), S. schenckii (42.38%), others (4.68%), and Not Determined (ND) (0.03%). The most frequent form of the disease was lymphocutaneous infection; however, the infection type was not determined in 5639 cases. Among the diagnostic methods, culture was the most used. CONCLUSIONS: There is a high occurrence of cases reported in the literature. South America is the region with the highest number of reports because of its environment (climate, inhalation of spores, etc.), zoonotic transmission (scratches and sneezes from contaminated animals), and possible traumatic inoculation due to outdoor activities (agriculture, gardening, and related occupations). Molecular diagnosis has not been sufficiently developed due to its high cost.

Onychomycosis Caused by Kloeckera apiculata: A Case Report in a Patient with Multiple Sclerosis.

We report the first case of onychomycosis caused by Kloeckera apiculata in a woman with multiple sclerosis. Video-dermoscopic examination showed a spiked pattern and distal irregular aspect. Colonies on Sabouraud agar were white, creamy, and smooth. A microscopic examination showed blastoconidia. MALDI-TOF confirmed Kloeckera apiculata as the causal agent.

Disseminated and recurrent infundibulofolliculitis in children in Mexico.

Disseminated and recurrent infundibulofolliculitis is an uncommon non-infectious skin eruption characterized by recurrent, sometimes pruritic, follicular papules commonly seen on the trunk and proximal extremities. We describe the clinical, dermoscopic, and histopathologic characteristics of disseminated and recurrent infundibulofolliculitis in three young pediatric patients from the tropical regions of Mexico, Guerrero, and Chiapas.

[Prevalence of anogenital condylomas in patients with HIV infection in a center for sexually transmitted infections in Leon, Guanajuato, Mexico]. / Prevalencia de condilomas ano-genitales en pacientes con infección por VIH en un centro para infecciones de transmisión sexual en León, Guanajuato, México.

BACKGROUND: Condylomas are the most frequent sexually transmitted infection worldwide, and thus, have a close relation to HIV infection. The site and serology vary, and some pose higher risk of malignancy. AIM: To describe the prevalence, characteristics and associated factors to the presence of anogenital condylomas in patients with HIV/AIDS. METHODS: Descriptive cross-sectional study conducted in the period from June to December 2014. Adult HIV/AIDS positive patients from "CAPASITS" in Leon, Mexico, from both sexes were included. A questionnaire was performed that included: identification data, and risk factors related to anogenital condylomas. Anogenital area was examined for condylomas. Descriptive statistics were carried out according to the type and distribution of the variables, and the CD4 lymphocyte medians of patients with and without condylomas were compared using U- Mann-Whitney test. RESULTS: A total of 213 HIV/AIDS patients were included; 181 (85%) were male. The prevalence of anogenital condylomas was 30% (IC95%: 23-36%), predominating in the anal region, observed in 21% of the cases. A significant difference was found between median CD4 cell count of patients with and without condylomas (425 vs 510 CD4/mL, p= 0.034). CONCLUSION: A high prevalence of patients with anogenital condylomas was obtained. The presence of condylomas was higher in patients with lower CD4 count. Considering the high prevalence, the application of the vaccine is recommended in this patient group.

Prevalencia de condilomas ano-genitales en pacientes con infección por VIH en un centro para infecciones de transmisión sexual en León, Guanajuato, México / Prevalence of anogenital condylomas in patients with HIV infection in a center for sexually transmitted infections in Leon, Guanajuato, Mexico

INTRODUCCIÓN: Los condilomas son la infección de transmisión sexual más frecuente en el mundo y tiene estrecha relación con la infección por VIH. La topografía y la serología son variables, y algunos presentan mayor riesgo de malignización. OBJETIVO: Describir la prevalencia, características clínicas, topográficas y factores asociados a la presencia de condilomas ano-genitales en pacientes con infección por VIH/SIDA en Guanajuato. MATERIAL Y MÉTODOS: Estudio descriptivo y transversal realizado entre junio y diciembre de 2014. Se incluyeron pacientes adultos con infección por VIH/SIDA, de ambos sexos, del CAPASITS León, México. Se aplicó un cuestionario que incluyó: datos de identificación, y factores de riesgo relacionados a los condilomas ano-genitales, y se les revisó dicha región corporal en busca de condilomas. Se realizó estadística descriptiva de acuerdo al tipo y distribución de las variables y se compararon las medianas de linfocitos T CD4 (LTCD4+) de los pacientes, con y sin condilomas, con la prueba U- Mann-Whitney. RESULTADOS: Se incluyeron 213 pacientes con infección por VIH/SIDA, 181 (85%) hombres. La prevalencia de condilomas ano-genitales fue de 30% (IC95%:23-36%), con mayor frecuencia en la región anal, con 21% de los casos. Encontramos una diferencia significativa entre las medianas en el recuento de linfocitos LTCD4+ en los pacientes, con y sin condilomas, (425 vs 510 LTCD4+/mL, p = 0,034). CONCLUSIONES: Se obtuvo una prevalencia alta de pacientes con condilomas ano-genitales. La presencia de condilomas fue mayor en pacientes con menor recuento de linfocitos LTCD4+. Considerando la elevada prevalencia, se recomienda la aplicación de la vacuna en este grupo de pacientes.

BACKGROUND: Condylomas are the most frequent sexually transmitted infection worldwide, and thus, have a close relation to HIV infection. The site and serology vary, and some pose higher risk of malignancy. AIM: To describe the prevalence, characteristics and associated factors to the presence of anogenital condylomas in patients with HIV/AIDS. METHODS: Descriptive cross-sectional study conducted in the period from June to December 2014. Adult HIV/AIDS positive patients from "CAPASITS" in Leon, Mexico, from both sexes were included. A questionnaire was performed that included: identification data, and risk factors related to anogenital condylomas. Anogenital area was examined for condylomas. Descriptive statistics were carried out according to the type and distribution of the variables, and the CD4 lymphocyte medians of patients with and without condylomas were compared using U- Mann-Whitney test. RESULTS: A total of 213 HIV/AIDS patients were included; 181 (85%) were male. The prevalence of anogenital condylomas was 30% (IC95%: 23-36%), predominating in the anal region, observed in 21% of the cases. A significant difference was found between median CD4 cell count of patients with and without condylomas (425 vs 510 CD4/mL, p= 0.034). CONCLUSION: A high prevalence of patients with anogenital condylomas was obtained. The presence of condylomas was higher in patients with lower CD4 count. Considering the high prevalence, the application of the vaccine is recommended in this patient group.

Ascitis por carcinoma lobulillar infiltrante bilateral de mama / Ascites due to bilateral invasive lobular carcinoma of the breast

Resumen El cáncer de mama representa sólo 3% de la proporción de cánceres que causan ascitis maligna. Suele relacionarse con el carcinoma lobulillar infiltrante, pues se manifiesta como enfermedad multicéntrica y es propenso a metastatizar a las regiones del peritoneo (en 10% de las admisiones), meninges, serosas, retroperitoneo y órganos ginecológicos; además, es el que con mayor frecuencia metastatiza al tubo gastrointestinal (64%). Por tanto, debe considerarse el diagnóstico de cáncer lobulillar infiltrante en mujeres con ascitis, hidronefrosis o masas pélvicas.

Abstract Breast cancer occupies accounts for 3% of the proportion of cancers that develop malignant ascites. It is usually associated with infiltrating lobular carcinoma. It pre-sents as a multicentric disease. It metastasizes to peritoneal (in 10% of admissions), meninges, serous, retroperitoneum and gynecological organs. In addition, frequently metastasizes to the gastrointestinal tract (64%). Therefore, in women with ascites, hydronephrosis or pelvic masses, the diagnosis of infiltrating lobular cancer should be considered.

Cutaneous Leishmaniasis: A Case Involving the Scalp - Clinical and Videodermoscopic Findings.

Cutaneous leishmaniasis (CL) is a worldwide infectious disease caused by flagellate protozoa of the genus Leishmania. In America, the species most commonly responsible for CL are L. mexicana and L. brasiliensis. Usually, in America, it is transmitted by sand flies mainly of the genus Lutzomyia and Psychodopygus. CL most commonly affects exposed areas and is characterized by an erythematous infiltrated and ulcerated papular or nodular lesion. We report a 28-year-old male, with a 6-month history and a previous trip to the forest in the south of Mexico. He presented with an asymptomatic erythematous plaque on his scalp, with slow and progressive nodular lesions with central crusted ulceration, with a raised and well-defined border. On videodermoscopy, we observed erythematous gummy lesions, yellowish scabs, and white star, dotted, hairpin, and glomerular patterns of vessels.

Tuberculosis cutánea verrugosa / Tuberculosis verrucosa cutis

Resumen La tuberculosis es una infección global, con formas pulmonares y extrapulmonares. La tuberculosis cutánea corresponde a 0.5-2% de todas las formas extrapulmonares; la forma verrugosa abarca 8% de todas las formas cutáneas. Es una lesión localizada, de reinfección exógena o por inoculación externa. Por lo general se manifiesta después de un traumatismo sobre la piel; la mayor parte ocurre sobre los dedos y el dorso de las manos. El diagnóstico definitivo requiere el aislamiento del microorganismo por cultivo o secuenciación por PCR, pero hay alta frecuencia de cultivos negativos, por lo que el diagnóstico se establece con base en la correlación clínico-patológica y la respuesta al tratamiento antifímico. El objetivo de este artículo es comunicar un caso de tuberculosis cutánea verrugosa y diferenciar esta afección dermatológica de la provocada por M. marinum por su gran parecido en la manifestación clínica.

Abstract Tuberculosis is a global infection with pulmonary and extrapulmonary forms. Cutaneous tuberculosis corresponds to 0.5-2% of all extrapulmonary forms. The warty form comprises 8% of all cutaneous forms. It is a localized lesion, of exogenous reinfection or external inoculation. Usually, it occurs after a trauma to the skin; most occurring on the fingers and the back of the hands. The definitive diagnosis requires the isolation of the microorganism by culture or sequencing by PCR, but there is a high frequency of negative cultures, so the diagnosis is made based on clinical-pathological correlation and response to antituberculosis treatment. The aim of this article is to report a case of verrucous cutaneous tuberculosis and differentiate this dermatological entity from that caused by M. marinum because of its similarity in clinical presentation.