Sexually Transmitted Diseases/microbiology , Tinea Capitis/microbiology , Trichophyton/isolation & purification , Alopecia/etiology , Antifungal Agents/therapeutic use , Diagnosis, Differential , Erythema/etiology , Groin , Humans , Male , Naphthalenes/therapeutic use , Sexually Transmitted Diseases/drug therapy , Terbinafine , Tinea Capitis/diagnosis , Tinea Capitis/drug therapy , Tinea Capitis/transmission , Unsafe Sex , Young Adult
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)
Humans , Male , Female , Onychomycosis/epidemiology , Onychomycosis/microbiology , Arthrodermataceae/isolation & purification , Hair/microbiology , Hair/pathology , Hair Diseases/microbiology , Infections/microbiology , Retrospective Studies , Immune Tolerance , Immune Tolerance/physiology , Immunosuppression Therapy/methods , Spain/epidemiology
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.
Tinea Capitis/epidemiology , Adult , Aged , Aged, 80 and over , Antifungal Agents/therapeutic use , Disease Susceptibility , Female , Humans , Immunocompetence , Immunocompromised Host , Incidence , Male , Microsporum/isolation & purification , Middle Aged , Naphthalenes/therapeutic use , Postmenopause , Retrospective Studies , Spain/epidemiology , Terbinafine , Tinea Capitis/drug therapy , Tinea Capitis/microbiology , Trichophyton/isolation & purification , Young Adult
Antecedentes. La información disponible sobre el uso de ciclopirox olamina en niños es limitada. Objetivos. El objetivo de este estudio fue evaluar la seguridad y eficacia de ciclopirox olamina crema al 1% en el tratamiento de la dermatomicosis en pacientes pediátricos. Métodos. Ensayo clínico fase iii multicéntrico, no controlado y abierto en pacientes de entre 3 meses y 9 años de edad diagnosticados de dermatomicosis mediante microscopía directa y cultivo, y tratados con ciclopirox olamina crema al 1% durante 28 días. Las evaluaciones clínicas y micológicas fueron realizadas antes del inicio del tratamiento, a los 7, 14 y 28 días de su inicio, y a los 28 días tras la finalización del mismo. Resultados. Se incluyeron 21 pacientes con una media de edad de 2,7 años (rango 3 meses-9 años). La localización más frecuente de la micosis fue la ingle (62%), y el agente causal más común Candida spp. (71%). El 62% de los pacientes no presentó ningún acontecimiento adverso; se notificaron acontecimientos adversos leves o moderados y únicamente uno, una dermatitis irritativa, se relacionó con el tratamiento. La seguridad global fue excelente en el 95% de los casos, y buena en el 5%. Tras la primera semana de tratamiento, 12 de 13 (92%) pacientes mostraron mejoría clínica, y en 5 de 7 (71%) se constató una eficacia clínica y micológica favorable. Al final del tratamiento, la curación clínica se observó en 7 de 9 (78%) pacientes. Ningún caso sufrió recidivas. Conclusiones. Ciclopirox olamina crema al 1% constituye un tratamiento seguro y efectivo de las micosis cutáneas superficiales, particularmente en infecciones por levaduras del género Candida, en niños de entre 3 meses y 10 años (AU)
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 (AU)
Child , Humans , Dermatomycoses/drug therapy , Antifungal Agents/pharmacokinetics , Patient Safety , Candidiasis, Cutaneous/drug therapy , Treatment Outcome
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.
Antifungal Agents/therapeutic use , Dermatomycoses/drug therapy , Pyridones/therapeutic use , Child, Preschool , Ciclopirox , Dosage Forms , Female , Humans , Male , Treatment Outcome
Antecedentes. La vulvovaginitis candidiásica es una infección frecuente en mujeres jóvenes que se acompaña de alta morbilidad y elevados gastos sanitarios. Objetivos. Las candidiasis vaginales causadas por Candida glabrata constituyen un reto terapéutico dada la resistencia adquirida por muchas cepas de esta especie a los antifúngicos azólicos. Métodos. En este trabajo presentamos 2 casos de candidiasis vaginal complicada por Candida glabrata resistentes a fluconazol y tratadas con voriconazol. Resultados. Las 2 pacientes mejoraron tras la administración de voriconazol, 400mg/12h el primer día y posteriormente 200mg/12h durante 14 días, con desaparición de la sintomatología y la negativización de los cultivos. Conclusiones. En conclusión, los resultados obtenidos nos llevan a sugerir el uso del voriconazol como alternativa terapéutica en este tipo de candidiasis que, aunque no comprometen la vida, llevan asociada una elevada morbilidad(AU)
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, 400mg/12h the first day and then 200mg every 12h 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(AU)
Humans , Female , Adolescent , Young Adult , Vulvovaginitis/complications , Vulvovaginitis/diagnosis , Vulvovaginitis/therapy , Candida glabrata , Candida glabrata/isolation & purification , Candida glabrata/pathogenicity , Antifungal Agents/administration & dosage , Antifungal Agents/economics , Antifungal Agents/therapeutic use , Fluconazole/therapeutic use , Vulvovaginitis/microbiology , Indicators of Morbidity and Mortality , Azoles/economics , Azoles/therapeutic use
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.
Antifungal Agents/therapeutic use , Candida glabrata/drug effects , Candidiasis, Vulvovaginal/drug therapy , Pyrimidines/therapeutic use , Triazoles/therapeutic use , Adult , Antifungal Agents/pharmacology , Candida glabrata/isolation & purification , Candidiasis, Vulvovaginal/microbiology , Cesarean Section , Drug Evaluation , Drug Resistance, Multiple, Fungal , Female , Fluconazole/pharmacology , Humans , Microbial Sensitivity Tests , Pregnancy , Puerperal Disorders/drug therapy , Puerperal Disorders/microbiology , Pyrimidines/pharmacology , Recurrence , Species Specificity , Treatment Outcome , Triazoles/pharmacology , Voriconazole , Young Adult
Immunoglobulins, Intravenous/therapeutic use , Mucocutaneous Lymph Node Syndrome/complications , Skin Diseases/etiology , Amputation, Surgical , C-Reactive Protein/analysis , Fingers/pathology , Gangrene , Humans , Immunologic Factors/therapeutic use , Infant , Male , Mucocutaneous Lymph Node Syndrome/blood , Mucocutaneous Lymph Node Syndrome/pathology , Mucocutaneous Lymph Node Syndrome/therapy , Necrosis , Skin Diseases/pathology
Ascomycota/isolation & purification , Dermatomycoses/diagnosis , Leg Ulcer/etiology , Mitosporic Fungi/isolation & purification , Antifungal Agents/therapeutic use , Combined Modality Therapy , Debridement , Dermatomycoses/complications , Dermatomycoses/drug therapy , Dermatomycoses/surgery , Humans , Itraconazole/therapeutic use , Leg Ulcer/drug therapy , Leg Ulcer/microbiology , Leg Ulcer/surgery , Male , Middle Aged , Morocco/ethnology , Triazoles/therapeutic use
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.
Dermis/pathology , Fibroblasts/pathology , Histiocytoma, Benign Fibrous/diagnosis , Muscle, Smooth/pathology , Skin Neoplasms/diagnosis , Cell Division , Female , Humans , Infant , Male , Middle Aged
Inflammation/diagnosis , Mycosis Fungoides/diagnosis , Skin Neoplasms/diagnosis , Vitiligo/diagnosis , CD4-Positive T-Lymphocytes/immunology , CD4-Positive T-Lymphocytes/metabolism , CD8-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/metabolism , Diagnosis, Differential , Humans , Infant , Inflammation/immunology , Inflammation/metabolism , Male , Mycosis Fungoides/immunology , Mycosis Fungoides/metabolism , Skin Neoplasms/immunology , Skin Neoplasms/metabolism , Vitiligo/immunology , Vitiligo/metabolism
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.
Antifungal Agents/adverse effects , Aspergillosis/drug therapy , Granulomatous Disease, Chronic/complications , Lupus Erythematosus, Discoid/chemically induced , Pyrimidines/adverse effects , Triazoles/adverse effects , Aspergillosis/complications , Biopsy , Humans , Infant , Lupus Erythematosus, Discoid/pathology , Male , Voriconazole
