Langerhans Cells Express IL-17A in the Epidermis of Chromoblastomycosis Lesions.

Chromoblastomycosis (CBM) is a chronic fungal infection that affects skin and subcutaneous tissue, and little is known about the immunological aspects of such lesions. We have previously described the high expression of IL-17 in this group. Understanding the innate immune response of patients with CBM would improve the knowledge of its immunopathogenesis and contribute to the most appropriate therapies. Nineteen biopsies of verrucous form were obtained from patients with clinical and histopathological diagnosis of CBM, without treatment. This was done with a double immunostaining with conventional immunohistochemistry and immunofluorescence technique as well as confocal microscopy to detect Langerin and IL-17 expression. All of the specimens that were analyzed showed expression of Langerin in the epidermis - the same as the control group. However, only the CBM group presented cells expressing CD207 in the dermis. Interestingly, the coexpression of IL-17 and Langerin was visualized along the epidermis and dermis in 100% of the lesion group. We demonstrated for the first time in situ coexpression of IL-17 and Langerin (CD207) in epidermal cells of patients with CBM and speculated on their role as IL-17-producing cells or whether they could be a new subpopulation of dendritic cells distinct from Langerhans cells.

Phaeohyphomycosis in renal transplantation: report of two cases.

Phaeohyphomycosis is an infection caused by a filamentous fungus that contains pigment melanin in its cell wall. We report two cases caused by Exophiala sp. emphasizing the clinical variability of the disease, as well as diagnostic and therapeutic difficulties of this opportunistic infection in immunosuppressed patients (kidney transplant).

Phaeohyphomycosis in renal transplantation: report of two cases

Abstract Phaeohyphomycosis is an infection caused by a filamentous fungus that contains pigment melanin in its cell wall. We report two cases caused by Exophiala sp. emphasizing the clinical variability of the disease, as well as diagnostic and therapeutic difficulties of this opportunistic infection in immunosuppressed patients (kidney transplant).

In situ immune response in human chromoblastomycosis--a possible role for regulatory and Th17 T cells.

BACKGROUND: Chromoblastomycosis is a chronic fungal infection that affects skin and subcutaneous tissue. Lesions can be classified in tumorous, verrucous, cicatricial and plaque type. The cellular immune response in the severe form of the disease seems to correlate with a Th2 pattern of cytokines. The humoral immune response also seems to play a role. We intended to explore the populations of regulatory T cells and the Th17 pattern. METHODOLOGY: Twenty-three biopsies of verrucous form were obtained from patients with clinical, culture and histopathological diagnostic of chromoblastomycosis, without treatment. It was performed an immunohistochemistry method to detect Foxp3, CD25, TGF-ß, IL-6, IL-17 and IL-23. PRINCIPAL FINDINGS: IL-17 was the only cytokine with high expression in CBM when compared to normal skin. The expression of Treg cells, TGF- ß, IL-6 and IL-23 were similar to normal skin. CONCLUSIONS/SIGNIFICANCE: The constitution of a local immune response with high expression of IL-17 and low expression of other cytokines could be at least in part, an attempt to help the immune system against fungal infection. On the other hand, high levels of local immune response mediated by Th17 profile could overcome the role of Treg cells. The inefficient immunomodulation as a consequence of the unbalance by Treg/Th17 cells seems to corroborate with the less effective immune response against fungi.

Study on lymphocyte proliferation in nickel sensitive patients / Estudo da proliferação linfocitária em pacientes sensibilizados ao niquel

Fundamento: O diagnóstico da alergia ao níquel é estabelecido com a realização do teste de contato. Objetivo: Desenvolver um método diagnóstico mais sensível e específico.Casuísticas e Métodos: Dezenove pacientes com teste de contato positivo para o níquel e 25 controles foram submetidos ao teste da proliferação linfocitária. As células mononucleadas foram isoladas do sangue venoso periférico e cultivadas em triplicatas, em placas de cultura (2×105 células/orifício) com: meio de cultura apenas; sulfato de níquel (156,25; 78,13; 19,53; 9,77 e 2,44µM) e concentrações ideais do antígeno Candida albicans e dos mitógenos pokeweed, fito-hemaglutinina A e anticorpo anti-CD3 (OKT3). Timidina tritiada foi adicionada às placas, a radioatividade incorporada pelas células medida e os resultados expressos pelo índice de estimulação (IE).Resultados: A resposta proliferativa dos linfócitos dos casos foi superior à dos controles em todas as concentrações de níquel testadas. Considerando teste positivo para níquel quando IE ≥ 3, nenhum dos controles e 16 (84,21por cento) dos casos apresentaram teste positivo em pelo menos uma das cinco concentrações usadas. As respostas à Candida albicans e aos mitógenos foram semelhantes nos casos e controles, demonstrando a integridade da imunidade celular em ambos os grupos.Conclusão: O teste da proliferação linfocitária mostra-se útil no diagnóstico da alergia ao níquel

Dermatophyte agents in the city of São Paulo, from 1992 to 2002

Dermatofitoses são infecções fúngicas superficiais causadas por agentes capazes de produzir lesões em tecidos queratinizados. Com o intuito de avaliar a epidemiologia e etiologia das infecções causadas por dermatófitos, em pacientes de Ambulatório do Departamento de Dermatologia do Hospital das Clínicas de São Paulo, SP, Brasil, foram analisados os resultados de culturas realizadas pelo Laboratório de Micologia deste Departamento da Faculdade de Medicina da Universidade de São Paulo, no período de janeiro de 1992 a junho de 2002. O dermatófito isolado com maior freqüência foi o Trichophyton rubrum (48,7 por cento), seguido por Microsporum canis (20,9 por cento), Trichophyton tonsurans (13,8 por cento), Trichophyton mentagrophytes (9,7 por cento), Epidermophyton floccosum (4,1 por cento) e Microsporum gypseum (2,5 por cento). Esses agentes foram responsáveis por diferentes formas clínicas: tinea corporis (31,9 por cento), tinea capitis (27,5 por cento), tinea unguium (14,8 por cento), tinea cruris (13,9 por cento), tinea pedis (9,9 por cento) e tinea manuum (1,9 por cento). Foi analisada a relação, entre as formas clínicas da dermatofitose e os seus respectivos agentes etiológicos, comparando-se os nossos dados com os de estudos semelhantes, em diversas regiões do país e do mundo.

Dermatophyte agents in the city of São Paulo, from 1992 to 2002.

Dermatophytosis are superficial mycoses caused by fungi that can invade stratum corneum and keratinized tissues. In order to study the frequency of dermatophytes species and the clinical manifestations caused by these fungi, in São Paulo, SP, Brazil, the authors analyzed cultures isolated at the Mycology Laboratory from a selected population (15,300 out-patients of the Hospital das Clínicas, Department of Dermatology, Faculty of Medicine of University of São Paulo) from January 1992 to June 2002. The most prevalent dermatophyte was Trichophyton rubrum (48.7%), followed by Microsporum canis (20.9%), Trichophyton tonsurans (13.8%), Trichophyton mentagrophytes (9.7%), Epidermophyton floccosum (4.1%), and Microsporum gypseum (2.5%). These agents determined more than one clinical manifestation, i.e., tinea corporis (31.5%), tinea capitis (27.5%), tinea unguium (14.8%), tinea cruris (13.9%), tinea pedis (9.9%), and tinea manuum (1.9%). Clinical variants of dermatophytosis and their relationship to the etiologic agents were studied and the results were compared to those obtained in previous studies in other regions of Brazil and in other countries.

Eumicetoma podal por Acremonium kiliense: registro de um caso / Podalic eumycotic mycetoma caused by Acremonium kiliense: report of one case

Os autores registram um caso de eumicetoma de gräos branco-amarelados, em paciente do sexo masculino, procedente da Bahia, com lesöes no pé esquerdo, provocadas por Acremonium kiliense (Grütz, 1925). O exame histopatológico näo demonstrou a presença de gräos, revelados, todavia, ao exame "a fresco", todos eles com estrutura de eumicetos. Discreta regressäo do quadro inflamatório com o uso de itraconazol, após tratamento prolongado

Onychomycosis caused by Scytalidium dimidiatum. Report of two cases. Review of the taxonomy of the synanamorph and anamorph forms of this coelomycete

The authors report two cases of onychomycosis in the dystrophic form, one of them involving an HIV-positive patient, provoked by Scytalidium dimidiatum, previously called Scytalidium lignicola. The subject is reviewed from the taxonomic viewpoint, considering the anamorph Hendersonula toruloidea as a synonym of Nattrassia mangiferae, and having Scytalidium dimidiatum as the major synanamorph. According to many mycologists, Scytalidium hyalinum may be a separate species or a hyaline mutant of Scytalidium dimidiatum. Scytalidium lignicola Pesante 1957 was considered to be the type-species of the genus by ELLIS (1971)13 and later to be a "conidial state" of Hendersonula toruloidea by the same author, today known as Nattrassia mangiferae. The microorganism lives only on the roots of certain plants (mainly Platanus and Pinus). It produces pycnidia and is not considered to be a pathogen, although it is considered as a possible emerging agent capable of provoking opportunistic fungal lesions. The importance of this topic as one of the most outstanding in fungal taxonomy, so likely to be modified over time, as well as its interest in the field of dermatologic mycology, are emphasized