Isolation of Malassezia spp. in HIV-positive patients with and without seborrheic dermatitis.

BACKGROUND: Malassezia, a skin saprophyte, is frequently isolated from patients with seborrheic dermatitis, which is one of the most common dermatoses in HIV-infected patients. Its role in pathophysiology has not been defined. OBJECTIVE: To determine whether patients living with HIV and seborrheic dermatitis have more Malassezia than those without seborrheic dermatitis. METHOD: This is an descriptive, observational, prospective cross-sectional study to which all adult patients living with HIV that attend the infectious disease outpatient clinic at the Dr. Manuel Gea González General Hospital were invited. Patients presenting with scale and erythema were included in Group 1, while patients without erythema were included in Group 2. Samples were taken from all patients for smear and culture. RESULTS: Thirty patients were included in each group. All patients with seborrheic dermatitis had a positive smear, with varying amounts of yeasts. In the control group, 36.7% of patients had a negative smear. The results are statistically significant, as well as the number of colonies in the cultures. Study limitations The study used a small sample size and the subspecies were not identified. CONCLUSIONS: Patients with clinical manifestations of seborrheic dermatitis have larger amounts of Malassezia. Further studies need to be performed to analyze if the greater amount is related to imbalances in the microbiota of the skin.

Isolation of Malassezia spp. in HIV-positive patients with and without seborrheic dermatitis

Abstract Background Malassezia, a skin saprophyte, is frequently isolated from patients with seborrheic dermatitis, which is one of the most common dermatoses in HIV-infected patients. Its role in pathophysiology has not been defined. Objective To determine whether patients living with HIV and seborrheic dermatitis have more Malassezia than those without seborrheic dermatitis. Method This is an descriptive, observational, prospective cross-sectional study to which all adult patients living with HIV that attend the infectious disease outpatient clinic at the Dr. Manuel Gea González General Hospital were invited. Patients presenting with scale and erythema were included in Group 1, while patients without erythema were included in Group 2. Samples were taken from all patients for smear and culture. Results Thirty patients were included in each group. All patients with seborrheic dermatitis had a positive smear, with varying amounts of yeasts. In the control group, 36.7% of patients had a negative smear. The results are statistically significant, as well as the number of colonies in the cultures.Study limitations The study used a small sample size and the subspecies were not identified. Conclusions Patients with clinical manifestations of seborrheic dermatitis have larger amounts of Malassezia. Further studies need to be performed to analyze if the greater amount is related to imbalances in the microbiota of the skin.

Cutaneous Leishmaniasis: A Case Involving the Scalp - Clinical and Videodermoscopic Findings.

Cutaneous leishmaniasis (CL) is a worldwide infectious disease caused by flagellate protozoa of the genus Leishmania. In America, the species most commonly responsible for CL are L. mexicana and L. brasiliensis. Usually, in America, it is transmitted by sand flies mainly of the genus Lutzomyia and Psychodopygus. CL most commonly affects exposed areas and is characterized by an erythematous infiltrated and ulcerated papular or nodular lesion. We report a 28-year-old male, with a 6-month history and a previous trip to the forest in the south of Mexico. He presented with an asymptomatic erythematous plaque on his scalp, with slow and progressive nodular lesions with central crusted ulceration, with a raised and well-defined border. On videodermoscopy, we observed erythematous gummy lesions, yellowish scabs, and white star, dotted, hairpin, and glomerular patterns of vessels.

Acneiform Rash Caused by an Unlikely Drug: Topiramate.

Topiramate is an antiepileptic drug that can also be used for migraine prophylaxis, weight control, and even for methamphetamine dependence; the dosage margin is wide, and the list of side effects is shorter than with other anticonvulsants. We present the case of a 35-year-old man with a disseminated rash of the trunk and extremities after treatment with 25 mg of topiramate daily as a prophylactic migraine treatment. This case report is useful, as this patient was not polymedicated and had a score of 7 on the Naranjo Adverse Drug Reaction Probability Scale. The patient was diagnosed as atypical DRESS syndrome and resolved satisfactorily with symptomatic treatment and topiramate withdrawal; slowly, the lesions regressed. He required no further drugs for the dermatologic condition.