RESUMO
Reflectance confocal microscopy (RCM) is a noninvasive real-time imaging technique that has been widely used for the diagnosis of skin cancer. More recently, it has been reported as a useful tool for the diagnosis and management of several inflammatory and infectious skin disorders. This article provides an overview of the current available applications of RCM use in cutaneous infections and infestations. PubMed was used to search the following terms in various combinations: reflectance confocal microscopy, skin, hair, nail, infection, parasitosis, mycosis, virus, bacteria. All papers were accordingly reviewed. In most cutaneous infections or infestations, the main alterations are found in the epidermis and upper dermis, where the accuracy of confocal microscopy is nearly similar to that of histopathology. The high resolution of this technique allows the visualization of most skin parasites, fungi, and a few bacteria. Although viruses cannot be identified because of their small size, viral cytopathic effects can be observed on keratinocytes. In addition, RCM can be used to monitor the response to treatment, thereby reducing unnecessary treatments.
Assuntos
Microscopia Confocal/métodos , Dermatopatias Infecciosas/diagnóstico por imagem , Dermatopatias Parasitárias/diagnóstico por imagem , Feminino , Humanos , Masculino , Pele/diagnóstico por imagem , Pele/microbiologia , Pele/parasitologia , Pele/patologia , Dermatopatias Infecciosas/patologia , Dermatopatias Parasitárias/patologiaAssuntos
Calcinose/diagnóstico por imagem , Doenças do Tecido Conjuntivo/diagnóstico por imagem , Cisticercose/diagnóstico por imagem , Neurocisticercose/diagnóstico por imagem , Dermatopatias Parasitárias/diagnóstico por imagem , Tela Subcutânea/diagnóstico por imagem , Animais , Diagnóstico Diferencial , Humanos , Doenças Musculares/diagnóstico por imagem , Taenia saginata , Taenia solium , Tomografia Computadorizada por Raios XRESUMO
We present a rare cause for cutaneous furuncular myiasis in a 55-year-old British traveller returning from Uganda. Initially presenting with what appeared to be a cellulitic furuncle on her forehead, she returned to the emergency department 3 days later with extensive preseptal periorbital swelling and pain. Occlusive treatment with petroleum jelly was applied and one larva manually extracted and sent to London School of Tropical Medicine for examination. It was identified as Lund's Fly (Cordylobia rodhaini), a rare species from the rainforests of Africa with only one other case reported in the UK since 2015. Ultrasound imaging identified another larva, necessitating surgical exploration and cleaning. The lesion subsequently healed completely and the patient remains well.
Assuntos
Larva/parasitologia , Miíase/patologia , Celulite Orbitária/etiologia , Dermatopatias Parasitárias/patologia , Assistência ao Convalescente , Animais , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/uso terapêutico , Diagnóstico Diferencial , Dípteros/parasitologia , Emolientes/uso terapêutico , Feminino , Testa/patologia , Humanos , Larva/efeitos dos fármacos , Pessoa de Meia-Idade , Miíase/tratamento farmacológico , Miíase/parasitologia , Miíase/cirurgia , Celulite Orbitária/diagnóstico , Vaselina/administração & dosagem , Vaselina/uso terapêutico , Doenças Raras , Dermatopatias Parasitárias/diagnóstico por imagem , Dermatopatias Parasitárias/tratamento farmacológico , Dermatopatias Parasitárias/cirurgia , Resultado do Tratamento , Uganda/epidemiologia , Ultrassonografia/métodosRESUMO
Hydatid disease is still endemic in Turkey. The most common site is the liver, followed by the lungs; it is rarely observed in the other parts of the body. In this case, right lung and subclavicular subcutaneous hydatid cysts were simultaneously observed. Cystotomy and capitonnage via minithoracotomy were applied for the cyst in the lung, and the subclavicular subcutaneous hydatid cyst was completely excised. Histopathological diagnosis was confirmed. Cystic lesions localized in the body except the liver and lung hydatid disease should always assessing kept in mind. It should not be forgotten that the cyst in the lung and liver may be detected simultaneously in other parts of the body.
Assuntos
Equinococose Pulmonar/complicações , Equinococose/complicações , Dermatopatias Parasitárias/complicações , Adulto , Animais , Equinococose/diagnóstico por imagem , Equinococose/cirurgia , Equinococose Pulmonar/diagnóstico por imagem , Equinococose Pulmonar/cirurgia , Echinococcus/isolamento & purificação , Humanos , Masculino , Dermatopatias Parasitárias/diagnóstico por imagem , Dermatopatias Parasitárias/cirurgia , Tórax , Turquia/epidemiologiaRESUMO
This article describes the use of confocal microscopy for special sites and unconventional applications. These new applications have been made possible thanks to the introduction on the market of a hand-held camera. Special sites discussed include mucosa, nails, and palms and soles. Special uses discussed include infections and infestations; tumor mapping; understanding clinical, dermoscopic, and histology features; videos and ex vivo confocal microscopy.
Assuntos
Neoplasias Oculares/diagnóstico por imagem , Melanoma/diagnóstico por imagem , Neoplasias Bucais/diagnóstico por imagem , Mucosa/diagnóstico por imagem , Doenças da Unha/diagnóstico por imagem , Dermatopatias Parasitárias/diagnóstico por imagem , Blefarite/diagnóstico por imagem , Túnica Conjuntiva/diagnóstico por imagem , Córnea/diagnóstico por imagem , Dermoscopia , Cabelo/diagnóstico por imagem , Humanos , Microscopia Intravital , Microscopia Confocal , Mucosa Bucal/diagnóstico por imagem , Unhas/diagnóstico por imagemAssuntos
Dermatopatias Parasitárias/patologia , Dermatopatias Parasitárias/parasitologia , Esparganose/patologia , Esparganose/parasitologia , Plerocercoide/isolamento & purificação , Idoso , Animais , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Dermatopatias Parasitárias/diagnóstico por imagem , Esparganose/diagnóstico por imagem , Esparganose/cirurgia , UltrassonografiaRESUMO
The parasitic nodules are part of the cutaneous manifestations of the parasitic diseases, fundamentally affect children. We report the clinic history, study by images and parasitological results of three infrequent parasitic cases in the pediatric age, which were studied with images, specially ultrasound, and this contributed somehow to the diagnosis. The final parasitological diagnoses were dirofilaria, toxocara and myiasis. The epidemiology, clinical and dermatológica! manifestations are discussed of each one.
Los nodulos parasitarios forman parte de las manifestaciones cutáneas de las enfermedades parasitarias, las cuales afectan fundamentalmente a niños. Se da a conocer la historia clínica, el estudio por imágenes y los resultados histopatológicos y parasitarios de tres casos poco frecuentes en la edad pediátrica, los cuales fueron estudiados con ultrasonido que contribuyó de alguna manera al diagnóstico. Los parásitos encontrados fueron dirofilaria, toxocara y una larva de mosca. Se discute la epidemiología, manifestaciones clínicas y dermatológicas de cada una de estas parasitosis.
Assuntos
Humanos , Masculino , Feminino , Lactente , Criança , Adolescente , Dermatopatias Parasitárias/diagnóstico por imagem , Toxocaríase/diagnóstico por imagem , Dirofilariose/diagnóstico por imagem , Miíase/diagnóstico por imagem , UltrassonografiaRESUMO
Cysticercosis is a human infestation, which is considered the most common cause of seizures worldwide. The subcutaneous lesions can help in the diagnosis of neurocysticercosis. We describe a case of a 45-year-old patient with multiple cutaneous nodules first seen 2 years ago that were increasing in number, and normal neurologic and fundoscopic examination. Neurologic symptoms started 3 months before hospital admission as a mild headache and muscular weakness. The imaging examinations showed a massive central nervous system involvement. Physicians must be aware of the importance of subcutaneous nodule examination for the diagnosis of neurocysticercosis.
Assuntos
Neurocisticercose/diagnóstico , Dermatopatias Parasitárias/diagnóstico , Telencéfalo , Animais , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Neurocisticercose/complicações , Neurocisticercose/diagnóstico por imagem , Neurocisticercose/patologia , Dermatopatias Parasitárias/diagnóstico por imagem , Dermatopatias Parasitárias/etiologia , Dermatopatias Parasitárias/patologia , Taenia solium/isolamento & purificação , Tomografia Computadorizada por Raios XRESUMO
Subcutaneous involvement is a rare manifestation of echinococcosis. We report a rare case of a 28-year-old woman with widespread hydatidosis of the lung, liver, and subcutaneous adipose tissue. The patient underwent surgical excision of multiple hepatic and pulmonary cysts with a thoraco-abdominal incision two years earlier. The subcutaneous cyst was located over the incision, and it is likely that resulted from accidental rupture of the primary cyst and spreading of scolices during surgery.
Assuntos
Equinococose/diagnóstico , Dermatopatias Parasitárias/diagnóstico , Abdome , Adulto , Cicatriz , Diagnóstico Diferencial , Equinococose/diagnóstico por imagem , Equinococose/patologia , Equinococose/cirurgia , Equinococose Hepática/cirurgia , Feminino , Humanos , Doença Iatrogênica , Dermatopatias Parasitárias/diagnóstico por imagem , Dermatopatias Parasitárias/patologia , Dermatopatias Parasitárias/cirurgia , Tomografia Computadorizada por Raios XRESUMO
A 25-year-old man and a 14-year-old boy presented with neurocutaneous cysticercosis involving the eyelid. Both patients had hundreds of scattered subcutaneous cysticerci. They were arranged in clusters over the sternocleidomastoid muscle in the neck. Such clustering of cysticerci is highly suggestive of central nervous system (CNS) involvement, as both the sternocleidomastoid muscle and the CNS are supplied by the carotid artery and cysticerci travel via the hematogenous route. We used ultrasonography to diagnose subcutaneous cysticercosis, which showed characteristic low reflective cysts and high reflective scolices inside. Although subcutaneous cysticerci are inconsequential, their verification is important in the diagnosis of more severe CNS involvement. They may be confused with other painless swellings such as lymphadenopathies, neurofibromas, and epidermoid cysts.
Assuntos
Cisticercose/diagnóstico por imagem , Infecções Oculares Parasitárias/diagnóstico por imagem , Doenças Palpebrais/diagnóstico por imagem , Dermatopatias Parasitárias/diagnóstico por imagem , Adolescente , Adulto , Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Antiparasitários , Cisticercose/tratamento farmacológico , Cisticercose/patologia , Infecções Oculares Parasitárias/tratamento farmacológico , Infecções Oculares Parasitárias/patologia , Doenças Palpebrais/tratamento farmacológico , Doenças Palpebrais/patologia , Glucocorticoides/uso terapêutico , Humanos , Masculino , Neurocisticercose/diagnóstico por imagem , Neurocisticercose/tratamento farmacológico , Neurocisticercose/patologia , Prednisolona/uso terapêutico , Dermatopatias Parasitárias/patologia , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Two cases, one of subcutaneous cysticercosis and one of neurocysticercosis, are described--both in young women, who had been in Mexico and ex-Yugoslavia, respectively. Neurocysticercosis is the most common neuroparasitosis in the world (and probably the reason for 2/3 of the cases of epilepsy) and as travels to endemic areas and immigration are on the increase, general practitioners should have cysticercosis in mind when treating a patient with subcutaneous noduli or cerebral symptoms.
Assuntos
Cisticercose , Neurocisticercose , Dermatopatias Parasitárias , Adulto , Cisticercose/diagnóstico , Cisticercose/diagnóstico por imagem , Cisticercose/patologia , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Neurocisticercose/diagnóstico , Neurocisticercose/diagnóstico por imagem , Neurocisticercose/patologia , Dermatopatias Parasitárias/diagnóstico , Dermatopatias Parasitárias/diagnóstico por imagem , Dermatopatias Parasitárias/patologia , Tomografia Computadorizada por Raios X , ViagemRESUMO
Subcutaneous involvement by the larval stages of the pork tapeworm Taenia solium in patients suffering from neurocysticercosis (neurocysticercosis) is well-described. It has been a clinical but undocumented impression that subcutaneous nodules are less common in cases of neurocysticercosis in Latin American than in Africa or Asia. We report on the absence of subcutaneous nodules found in a screened population of 2,891 residents of an Andean village in Ecuador with a prevalence rate for neurocysticercosis of 144 per thousand. Thirty-four patients with multiple intracranial calcifications and or cystic or encephalitic parenchymal lesions of neurocysticercosis were examined and questioned about subcutaneous nodules. Only one patient described nodules and this computed tomography plain films are presented. Several hypotheses are presented as to why nodules may be less common in this Andean community with a high prevalence of neurocysticercosis.