Lupus erythematosus-like lesions by voriconazole in an infant with chronic granulomatous disease.

We report the first case of lupus-like lesions in an infant with chronic granulomatous disease during the treatment with voriconazole for chronic invasive aspergillosis. The lesions disappeared with termination of the treatment.

[Imported tinea cruris (glutealis) caused by Trichophyton rubrum var. raubitschekii in Spain]. / Tinea cruris (glutealis) de importación por Trichophyton rubrum var. raubitschekii en España.

Although Trichophyton raubitschekii was first described by Kane et al. as a distinct species of dermatophyte, it is now classified as a variety of T. rubrum. The variety raubitschekii differs from the other varieties of T. rubrum in morphology, physiology, epidemiology and patterns of infection, but they are indistinguishable using molecular methods. T. rubrum var. raubitschekii is mostly found in Africa, Asia and South America. We present two cases of imported mycosis in two Nigerian men due to T. rubrum var. raubitschekii. The patients have Tinea cruris lesions on the buttocks. These are the first reported cases of this dermatophytosis in Spain.

Tinea capitis in adults in southern Spain. A 17-year epidemiological study.

BACKGROUND: Tinea capitis is an infection of the hair due to keratinophilic fungi, known as dermatophytes. Although the disease is common in children, several studies have also shown that it is far from unusual in adults, especially in post-menopausal women and immunocompromised persons. AIMS: To determine the incidence of tinea capitis in adults in our area, as well as the predisposing factors (gender, immunity), and causative species. MATERIALS AND METHODS: A retrospective study was conducted over a period of 17 years, from 1995 to 2011, collecting data on cases of tinea capitis diagnosed in our dermatology department. Information collected for all patients included age, gender, location of the lesions, results of direct examination and culture, immune status, cause of immunosuppression, and the prescribed treatment. RESULTS: Thirty-three cases (11.4%) out of 289 cases of tinea capitis occurred in adults. Most of these adults (72%) were immunocompetent, and the rest were immunocompromised for different reasons. Three of the patients were men and 30 women, with 70% of the latter being post-menopausal. Trichophyton species were isolated in 76% of these adult patients, with Trichophyton violaceum being the most common. Treatment with oral terbinafine was successful in all these cases. Microsporum species were responsible for the other cases, all treated successfully with oral griseofulvin. CONCLUSIONS: This series of tinea capitis in adults is one of the largest to date. It shows that tinea capitis is not uncommon among the immunocompetent adult population. In our geographical area, except for prepubescent patients, most cases affecting the adult population were caused by species of the genus Trichophyton. In these cases the treatment of choice was oral terbinafine, which considerably shortened the treatment time, and was associated with fewer side effects than the classical griseofulvin.

[Phase III study of the efficacy and safety of ciclopirox olamine cream in small children with dermatomycosis]. / Estudio fase III de la seguridad y la eficacia de ciclopirox olamina crema en niños afectados de dermatomicosis.

BACKGROUND: There is scarce information on the use of ciclopirox olamine in children. AIMS: The aim of this study was to evaluate the efficacy and safety of ciclopirox olamine cream 1% for the treatment of dermatomycosis in pediatric patients. METHODS: A multicenter, non-randomized, open-label, phase iii study was conducted on patients aged 3 months to 9 years diagnosed with dermatomycosis confirmed by direct microscopy and culture, and treated with ciclopirox olamine cream 1% for 28 days. Clinical and microbiological evaluations were performed before starting the treatment therapy, at 7, 14 and 28 days after starting the treatment, and 28 days after its completion. RESULTS: Twenty-one patients with a median age of 2.7 years (range 3 months-9 years) were included. The most frequent mycosis location was the inguinal region (72%). The most frequently isolated etiological agent was Candida spp. (71%). No adverse events were reported in 62% of the patients. Among the mild and moderate reported adverse events, only one, irritative dermatitis, was considered as possibly related to the treatment. Safety evaluation was excellent in 95% of the patients, and good in 5%. After the first week of treatment, 12 patients out of 13 (92%) showed a clinical improvement, and 5 out of 7 (71%) had both clinical and mycological improvements. At the end of the treatment, clinical cure was observed in 7 out of 9 patients (78%). No relapses occurred. CONCLUSIONS: Ciclopirox olamine cream 1% is a safe and feasible treatment for superficial cutaneous mycotic infections, especially Candida spp. infection, in children aged between 3 months and 10 years.

[Efficacy of voriconazole treatment in chronic vulvovaginal candidosis due to Candida glabrata]. / Eficacia terapéutica del voriconazol en candidiasis vulvovaginal crónica por Candida glabrata.

BACKGROUND: Vulvovaginal candidosis is a common infection in young women, and it is associated with high morbidity and high health costs. AIMS: Vulvovaginal candidosis caused by Candida glabrata is a therapeutic challenge due to the acquired resistance of many strains of this species to azole antifungals. METHODS: We present two cases of vaginal candidosis complicated by fluconazole-resistant Candida glabrata, and treated with voriconazole. RESULTS: Both patients improved after administration of voriconazole, 400 mg/12 h the first day and then 200 mg every 12 h for 14 days. Their symptoms disappeared and cultures became negative. CONCLUSIONS: These results suggest voriconazole can be used as a therapeutic alternative for this type of candidosis which, although not life threatening, is associated with a high morbidity.

Kerion Celsi with erythematous tumefaction on the groin due to Trichophyton mentagrophytes / Querion de Celso con tumefacción dolorosa en la ingle por Trichophyton mentagrophytes

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Tinea capitis in adults in southern Spain. A 17-year epidemiological study / Tinea capitis en pacientes adultos del sur de España. Un estudio epidemiológico de 17 años

Background. Tinea capitis is an infection of the hair due to keratinophilic fungi, known as dermatophytes. Although the disease is common in children, several studies have also shown that it is far from unusual in adults, especially in post-menopausal women and immunocompromised persons. Aims. To determine the incidence of tinea capitis in adults in our area, as well as the predisposing factors (gender, immunity), and causative species. Materials and methods. A retrospective study was conducted over a period of 17 years, from 1995 to 2011, collecting data on cases of tinea capitis diagnosed in our dermatology department. Information collected for all patients included age, gender, location of the lesions, results of direct examination and culture, immune status, cause of immunosuppression, and the prescribed treatment. Results. Thirty-three cases (11.4%) out of 289 cases of tinea capitis occurred in adults. Most of these adults (72%) were immunocompetent, and the rest were immunocompromised for different reasons. Three of the patients were men and 30 women, with 70% of the latter being post-menopausal. Trichophyton species were isolated in 76% of these adult patients, with Trichophyton violaceum being the most common. Treatment with oral terbinafine was successful in all these cases. Microsporum species were responsible for the other cases, all treated successfully with oral griseofulvin. Conclusions. This series of tinea capitis in adults is one of the largest to date. It shows that tinea capitis is not uncommon among the immunocompetent adult population. In our geographical area, except for prepubescent patients, most cases affecting the adult population were caused by species of the genus Trichophyton. In these cases the treatment of choice was oral terbinafine, which considerably shortened the treatment time, and was associated with fewer side effects than the classical griseofulvin (AU)

Antecedentes. Tinea capitis es una infección del pelo producida por hongos queratinofílicos llamados dermatofitos. Aunque la enfermedad es más común en niños, varios estudios han demostrado que no es infrecuente en adultos, especialmente en mujeres posmenopáusicas y personas inmunodeprimidas. Objetivo. Determinar la incidencia de tinea capitis en adultos de nuestra área, así como los factores predisponentes (inmunidad, género) y agentes causales. Métodos. Llevamos a cabo un estudio retrospectivo de un periodo de 17 años, desde 1995 a 2012, seleccionando casos de tinea capitis diagnosticados en nuestro departamento de Dermatología. Se recogió información clínico-demográfica de los pacientes que incluyó edad, sexo, localización de las lesiones, resultados de examen directo y cultivos, inmunidad, causa de la inmunosupresión y tratamiento. Resultados. De los 289 casos de tinea capitis, 33 (11,4%) eran de pacientes adultos. La mayoría (72%) fueron inmunocompetentes; la inmunodepresión en el resto de los casos era por diferentes causas. Tres de los pacientes eran hombres y 30 mujeres, la mayoría de las cuales eran posmenopáusicas (70%). Las especies de Trichophyton fueron aisladas en el 76% de los casos, con Trichophyton violaceum como el dermatofito más común; el tratamiento con terbinafina oral fue exitoso en todos los casos. Las especies microspóricas fueron responsables de los casos restantes y tuvieron una buena evolución con griseofulvina. Conclusiones. Esta serie de tinea capitis del adulto es una de las más largas hasta la fecha. Se demuestra que tinea capitis no es infrecuente entre la población adulta inmunocompetente. En nuestra área geográfica, salvo en prepúberes, la mayoría de los casos de tinea capitis de adultos son debidos a especies del género Trichophyton. En estos casos el tratamiento de elección fue la terbinafina oral, que acorta considerablemente la duración de tratamiento y se asocia a menos efectos secundarios que la clásica griseofulvina (AU)

Two cases of dermatomyofibroma (plaque-like dermal fibromatosis).

BACKGROUND: Dermatomyofibroma is a rare but distinct benign cutaneous mesenchymal neoplasm of fibroblastic/myofibroblastic differentiation. It is more common in adolescents and young adults, with a female preponderance. In most cases, the lesions are asymptomatic and small, measuring from 10 to 20 mm. Early and active lesions tend to be actin positive. CASE REPORT: We present a) a new case of dermatomyofibroma in an 11-month-old male infant, the youngest case reported to date, and b) the second reported case of a giant annular dermatomyofibroma, measuring 10 cm × 6 cm, in a 52-year-old woman. In both cases, histological examination showed a spindle-cell proliferation embedded among the collagen fibers of the dermis, arranged predominantly parallel to the skin surface. In both cases the spindle cells stained positive for smooth muscle actin and the elastic fibers were increased and fragmented. CONCLUSION: Dermatologists and pediatricians should be aware of this benign entity in order to avoid unnecessary treatment.

¿Cuál es el valor real de los cultivos como herramienta diagnóstica en las onicomicosis? / Which is the role of cultures in the diagnosis of onychomycosis?

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