Plantar keratoderma-like crusted scabies in an immunocompetent infant after topical steroids.

A healthy 6-month-old girl presented with plantar keratoderma-like lesions unresponsive to topical corticosteroids. Nocturnal pruritus in 13 relatives, presence of burrows on clinical exam, and the positive scabies preparation led to the diagnosis of crusted scabies. She was successfully treated with topical and oral scabicides. Crusted scabies is a severe form of Sarcoptes scabiei infection uncommon in immunocompetent subjects, in whom previous corticosteroid use may favor its occurrence.

New Skin Flaps for Triangular Surgical Defects: Design, Assessment on Experimental Model, and Clinical Outcomes.

BACKGROUND: Most skin flaps are designed to repair circular surgical defects after skin tumor excisions, but few flaps have been described to reconstruct triangular defects. OBJECTIVE: The aim of this study was to describe new skin flaps for triangular surgical defects using an innovative experimental model. METHODS: We tested new flap designs in an experimental pig skin model using a tension sensor to measure maximum tension and tension augmentation when the flap is performed in an area of increased basal tension. The results were compared with those from classic flaps. Finally, the new flaps were performed on a series of patients with triangular surgical defects. RESULTS: Six new flaps with adequate levels of tension were obtained and named after their morphology: spider crab, mantis, toy windmill, nautilus, origami bird, and clover. These new flaps were successfully performed on a series of 40 patients; among them, spider crab and mantis flaps showed a better response to basal tension augmentation. CONCLUSIONS: Six new flaps for triangular surgical defects were proposed and successfully performed in a series of 40 patients, using an experimental pig skin model and a tensiometer.

Transient neonatal zinc deficiency due to a new autosomal dominant mutation in gene SLC30A2 (ZnT-2).

Transient neonatal zinc deficiency (TNZD) has a clinical presentation similar to that of acrodermatitis enteropathica but is caused by a low zinc concentration in maternal breast milk. TNZD becomes clinically evident during breastfeeding and is resolved by weaning and the introduction of complementary nutrition. We present a 4-month-old girl with TNZD due to a new autosomal dominant mutation (663delC) in the maternal SLC30A2 gene not previously described in the literature.

Caliber-persistent labial artery: report of 3 cases.

The caliber-persistent labial artery is a vascular anomaly in which a primary arterial branch penetrates into the submucosal tissue without reduction in diameter. Most lesions are benign and do not require treatment, except for complications and/or on patient demands. In this way, noninvasive diagnostic tools are preferred such as high-resolution and color Doppler ultrasonography which allow direct observation of the lesion, assessing its exact location and diameter at every axis, as well as the blood flow velocity. An excisional biopsy of these lesions or even their surgical extirpation could have a fatal outcome with profuse bleeding.

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.

[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.