Laser treatment of onychomycosis due to Neoscytalidium dimidiatum: An open prospective study.

Conventional systemic and topical treatments have proven ineffective for the treatment of onychomycosis caused by Neoscytalidium dimidiatum. Our aim was to evaluate the effectiveness and safety of laser monotherapy for the treatment of onychomycosis caused by this pathogen. Patients with clinical onychomycosis of the toenails and positive results both on direct mycological examination and N. dimidiatum culture underwent four 1064 nm Nd:YAG laser sessions with 6-week intervals between sessions. Participants were monitored by clinical examination supported by dermoscopy, measurement of diseased nail and the onychomycosis severity index (OSI), and by mycological examination for 12 months after completion of treatment. Treatment outcome was based on clinical and laboratory criteria and was divided in complete or partial cure, clinical improvement, treatment failure and relapse. No patient had complete or partial cure at any time during the study. Clinical improvement was observed in 40.6% of the patients at the end of the laser sessions; however, it did not persist during the follow-up. Treatment failure was observed in 64.7% of the patients at the end of 12 month follow-up period. Direct microscopy and culture results remained positive in most patients. Adverse events, in addition to treatment-related pain, were observed and considered severe in one case. The 1064 nm Nd:YAG laser was not able to cure onychomycosis caused by N. dimidiatum but temporarily improved the clinical appearance of the nail; however, adverse events may occur.

Infectious arthritis as the single manifestation of sporotrichosis: Serology from serum and synovial fluid samples as an aid to diagnosis

En la mayoría de las veces, la esporotricosis es una infección cutánea,granulomatosa, crónica y benigna. De modo más raro, la enfermedad puedeafectar las articulaciones. El comprometimiento articular en general secaracteriza por monoartrite sin síntomas sistémicos con presentación clínicahabitual de lesiones cutáneas y con frecuencia despunta en las personasinmunodeprimidas. El caso descrito es de una paciente sana que presentóartritis en la rodilla sin lesiones cutáneas, con el diagnostico de esporotricosisy que fue tratada con itraconazol oral. En este caso se concluye que lasorología es una herramienta valiosa para el diagnóstico de la artritis sinlesiones cutáneas producida por el hongo Sporothrix schenckii(AU)

Sporotrichosis is a generally cutaneous, granulomatous, chronic and benigninfection. Less frequently the disease may affect the joints. Articularinvolvement is usually characterized by monoarthritis in the absence ofsystemic symptoms, generally preceded by skin lesions, and frequently affectsimmunosuppressed individuals. We describe here the case of a healthy patientpresenting knee arthritis without skin lesions, diagnosed as sporotrichosis, andtreated with oral itraconazole. Serology used in this case was an invaluabletool for the diagnosis of sporotrichosis arthritis lacking skin lesions(AU)