Tinea Nigra: Clinical and Diagnostic Guidance.

Tinea nigra is a rare superficial fungal infection characterized by asymptomatic, unilateral, well-defined brown to black macules predominantly affecting the palms and soles. Diagnosis is often challenging due to its rarity and resemblance to other pigmented lesions. This report presents a clinical case, a diagnostic algorithm, and treatment recommendations, emphasizing the role of thorough examination and questioning. We describe the case of a 64-year-old woman of Amerindian (Maya) heritage from Yucatan, Mexico, who presented with a three-month history of a slowly growing dark spot on her left palm. The lesion was asymptomatic, non-scaling, and non-palpable. Palmar skin scrapings, prepared with KOH, revealed pigmented yeast and hyphae, leading to a diagnosis of tinea nigra. Following treatment with topical ketoconazole, the patient's lesions completely resolved at the one-month follow-up. The cultivation of scales confirmed the presence of Hortaea werneckii. Our findings highlight the importance of considering tinea nigra in the differential diagnosis of pigmented lesions on acral surfaces. We propose a diagnostic algorithm to aid healthcare professionals in recognizing this uncommon condition and recommend treatment protocols that effectively resolve the infection within two weeks. This case underscores the necessity for increased awareness and accurate diagnosis of tinea nigra, particularly in non-endemic regions.

Seborrheic Pemphigus: A Misunderstood Variant of Pemphigus Foliaceus.

Seborrheic pemphigus (SP) represents a localized and superficial form of pemphigus foliaceus (PF) often mistaken for other dermatological conditions such as seborrheic dermatitis (SD) due to clinical similarities. Additionally, SP may be conceptually confused with pemphigus erythematosus (PE) due to historical terminology and overlapping clinical features. We present a case study of a 38-year-old female initially diagnosed with SD but later identified as SP through detailed clinical and histopathological analysis. We discuss the challenges in accurately diagnosing SP, emphasizing the importance of distinguishing it from PE and other acantholytic dermatoses. Furthermore, we highlight the effectiveness of topical treatment in managing SP, contrary to the systemic therapy often required for PE. Our findings underscore the necessity for further research to optimize management strategies for SP and emphasize the significance of precise terminology in clinical practice and research.

Ulcerative Unilateral Tinea Manuum Caused by Nannizzia gypsea.

Dermatophytes, fungi specialized in keratin degradation, are key agents in skin infections, commonly referred to as tineas. Tinea manuum, affecting the hands, typically presents in noninflammatory or inflammatory forms, with ulcerative manifestations rarely reported. Nannizzia gypsea, a relatively uncommon cause of tineas, exhibits variable prevalence influenced by geographic factors. This study investigates a case of Ulcerative Unilateral Tinea Manuum caused by N. gypsea, aiming to explore the differential diagnosis, pathogenesis, and management. A 23-year-old female from the Yucatan Peninsula presented with an ulcerated lesion on her left hand. Initially suspected as Leishmaniasis, subsequent examination revealed tinea manuum. The study discusses differential diagnoses, highlighting the rarity of ulcerative presentations in dermatophytosis, and explores potential pathogenic mechanisms. This case underscores the importance of considering dermatophytes in ulcerative skin lesions and suggests a comprehensive diagnostic approach, particularly in endemic regions.

Tinea Capitis Kerion Type in Three Siblings Caused by Nannizzia Gypsea.

This case report describes a rare occurrence of tinea capitis kerion type caused by Nannizzia gypsea in three siblings. The clinical presentation included pseudo-alopecic plaques with a dirty appearance, erythema, and honey-like crusts. A direct examination revealed ecto-endothrix parasitization in the hair shaft. Shared use of a comb among the siblings was suspected as the mode of transmission. Treatment with oral terbinafine resulted in a complete resolution. Systematic epidemiological surveys on N. gypsea tinea infections are scarce, and preliminary data from our center indicated a higher prevalence. The literature review identified five reported cases of N. gypsea-induced tinea capitis.

Post-traumatic Bullous Pilomatrixoma Exploring the Pathogenesis.

ABSTRACT: This report demonstrates the rare variant of bullous pilomatrixoma in a 10-year-old boy who presented with a rapidly growing, red-colored, bullous nodule on his neck after trauma. The exact etiology of this subtype of pilomatrixoma is unclear, but previous studies have suggested that mechanical trauma may trigger its development.

Microsporum canis-Induced Tinea Capitis: A Rapid Screening Algorithm.

Tinea capitis is a common fungal infection of the scalp, primarily affecting children, and caused by fungi like Trichophyton and Microsporum. Its pathogenesis is influenced by both host-specific and environmental factors, resulting in various clinical presentations including hair loss and scaling of the scalp. We present the case of an eight-year-old male with tinea capitis, characterized by itching and hair loss in the occipital area. Examination revealed characteristic findings on trichoscopy, and direct examination of hair confirmed parasitization. Treatment with terbinafine was initiated, leading to the resolution of symptoms. Epidemiological variations in the etiology of tinea capitis exist globally, with Trichophyton predominating in some regions and Microsporum in others. Trichoscopy is a valuable diagnostic tool for differentiating fungal infections, guiding treatment decisions. Despite the efficiency of direct skin and hair examination, the common occurrence of tinea and the lack of mycological centers in many clinics pose challenges. To address this, we propose integrating trichoscopy and epidemiological and clinical data for a quick in-office decision tool.

Sporadic Kaposi Sarcoma Following a COVID-19 Vaccine: Mere Coincidence or Something More?

In this case report, we present a distinctive occurrence of classic Kaposi sarcoma (KS) in an individual of Latin origin, emerging seven days following the administration of the third dose of the ChAdOx1 nCoV-19 (AstraZeneca) vaccine. The progression of KS continued over two months, culminating in the development of a tumor. Given the absence of prior reports on KS development post-COVID-19 vaccination, the primary aim of this report is to explore the potential relationship between the ChAdOx1 nCoV-19 vaccine, reactivation of Kaposi sarcoma-associated herpes virus, and the subsequent onset of KS.

An Immune-Based Therapeutical Approach in an Elderly Patient With Fixed Cutaneous Sporotrichosis.

Sporotrichosis is a subcutaneous fungal infection caused by thermally dimorphic fungi from the Sporothrix genus, primarily prevalent in tropical regions of Latin America, Africa, and Asia. Mexico's Jalisco state is an endemic hotspot with a remarkable prevalence rate of 54.4%. Clinical presentation varies based on immune status and virulence. The most common form is cutaneous-lymphangitic (67%), with fixed cutaneous cases accounting for 28%. This case study explores a traditional therapeutic approach for fixed cutaneous sporotrichosis but introduces a distinct immunological perspective.

Retrospective Analysis of a Seborrheic Keratosis-Like Melanoma on the Head.

We present a clinical case of a 50-year-old female initially suspected of seborrheic keratosis but later diagnosed with melanoma through biopsy. This case highlights the challenges in distinguishing between these two conditions and emphasizes the importance of accurate diagnosis. Overdiagnosis of malignancy in seborrheic keratosis cases and the accurate identification of melanoma through dermoscopy are discussed. Further research is needed to explore potential mechanistic connections between seborrheic keratosis and melanoma.