Subject(s)
Nails, Malformed/congenital , Nails, Malformed/diagnostic imaging , Nails/physiopathology , Child, Preschool , Female , Humans , Syndrome , X-RaysABSTRACT
The yeasts of the genus Candida infect skin, nails, and mucous membranes of the gastrointestinal and the genitourinary tract. The aim of this study was to determine the prevalence of dermatomycoses caused by Candida spp., and their etiological aspects in the metropolitan area of Porto Alegre, Brazil. A retrospective study with data obtained from tertiary hospital patients, from 1996 to 2011, was performed. The analyzed parameters were date, age, gender, ethnicity, anatomical region of lesions, and the direct examination results. For all the statistical analyses, a = 0.05 was considered. Among positive results in the direct mycological examination, 12.5% of the total of 4,815 cases were positive for Candida spp. The angular coefficient (B) was -0.7%/ year, showing a decrease over the years. The genus Candida was more prevalent in women (15.9% of women versus 5.84% of men), and in addition, women were older than men (54 versus 47 years old, respectively). There was no difference between ethnic groups. The nails were more affected than the skin, with 80.37% of the infections in the nails (72.9% in fingernails and 7.47% in toenails). Our study corroborates the literature regarding the preference for gender, age, and place of injury. Moreover, we found a decrease in infection over the studied period.
Subject(s)
Candidiasis, Cutaneous/complications , Candidiasis, Cutaneous/epidemiology , Dermatomycoses/epidemiology , Dermatomycoses/microbiology , Adolescent , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Candida , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Nails/physiopathology , Prevalence , Retrospective Studies , Sex Factors , Skin/physiopathology , Young AdultABSTRACT
A noninvasive, quick, reliable, and relatively cheap procedure for the diagnosis of onychomycosis is put forward. It is known that a nail may show an abnormal appearance, although only 50% of all the nails having such an appearance may owe it to the presence of onychomycosis; hence, adequate diagnosis of nail disease is needed for appropriate prescription of medication and treatment of the nail. In order to contribute to the process of improvement in the diagnosis, a procedure based on the analysis of medium-range infrared images is presented in which it is possible to observe energy changes mostly due to the changes in emissivity of the nail. As a nail is more affected by onychomycosis, such changes become more intense. Also, it was found that a nail without onychomycosis has a lower temperature than toe skin, but has a higher emission of energy. Fifty percent of the ailments that may a cause a fingernail or toenail to have an abnormal appearance are not considered in the present work.
Subject(s)
Image Processing, Computer-Assisted/methods , Nails/physiopathology , Onychomycosis/diagnosis , Thermography/methods , Adult , Aged , Female , Humans , Male , Middle Aged , Onychomycosis/physiopathology , Skin Physiological Phenomena , Toes/physiopathologyABSTRACT
BACKGROUND: Anaemia is highly prevalent in children of developing countries. It is associated with impaired physical growth and mental development. Palmar pallor is recommended at primary level for diagnosing it, on the basis of few studies. The objective of the study was to systematically assess the accuracy of clinical signs in the diagnosis of anaemia in children. METHODS: A systematic review on the accuracy of clinical signs of anaemia in children. We performed an Internet search in various databases and an additional reference tracking. Studies had to be on performance of clinical signs in the diagnosis of anaemia, using haemoglobin as the gold standard. We calculated pooled diagnostic likelihood ratios (LR's) and odds ratios (DOR's) for each clinical sign at different haemoglobin thresholds. RESULTS: Eleven articles met the inclusion criteria. Most studies were performed in Africa, in children underfive. Chi-square test for proportions and Cochran Q for DOR's and for LR's showed heterogeneity. Type of observer and haemoglobin technique influenced the results. Pooling was done using the random effects model. Pooled DOR at haemoglobin <11 g/dL was 4.3 (95% CI 2.6-7.2) for palmar pallor, 3.7 (2.3-5.9) for conjunctival pallor, and 3.4 (1.8-6.3) for nailbed pallor. DOR's and LR's were slightly better for nailbed pallor at all other haemoglobin thresholds. The accuracy did not vary substantially after excluding outliers. CONCLUSION: This meta-analysis did not document a highly accurate clinical sign of anaemia. In view of poor performance of clinical signs, universal iron supplementation may be an adequate control strategy in high prevalence areas. Further well-designed studies are needed in settings other than Africa. They should assess inter-observer variation, performance of combined clinical signs, phenotypic differences, and different degrees of anaemia.
Subject(s)
Anemia/diagnosis , Conjunctiva/physiopathology , Hand/physiopathology , Nails/physiopathology , Pallor/etiology , Africa , Anemia/blood , Anemia/complications , Chi-Square Distribution , Child , Child, Preschool , Hemoglobins/analysis , Humans , Infant , Physical Examination , Predictive Value of TestsSubject(s)
Humans , Psoriasis , Nails , Adrenal Cortex Hormones , Anthralin , Methotrexate , Ointments , Nails/physiopathologyABSTRACT
Os autores apresentam três casos de pacientes com faixas longitudinais acastanhadas acometendo as lâminas ungueais, caracterizadas como melanoníquia estriada. A investigaçäo etiológica identificou um caso de onicomicose, um nevo da matriz ungueal e uma hiperplasia melanocítica benigna. Esses achados säo comparados com os da literatura, e säo discutidos aspectos relativos à freqüência de lesöes pigmentares ungueais de comportamento benigno
Subject(s)
Humans , Female , Male , Middle Aged , Hyperplasia/diagnosis , Melanosis/diagnosis , Nails/physiopathology , Onychomycosis/etiology , Pigmentation/physiology , Melanocytes/ultrastructureABSTRACT
FUNDAMENTOS - As infecçöes por Trichosporon beigelii (tricosporonose) que näo correspondem à pedra branca säo reconhecidas com cada vez mais freqüência e produzem desde lesöes localizadas na pele e unhas até o comprometimento de múltiplos órgäos ou sistemas, especialmente em pacientes com imunodepressäo. OBJETIVOS - Conhecer a freqüência da tricosporonose em pacientes imunocompetentes no Departamento de Dermatologia num período de três anos (janeiro de 1994 - fevereiro de 1977). MATERIAL E MÉTODOS - Realizou-se estudo retrospectivo consultando os arquivos da Seçäo de Micologia, que incluem os estudos micológicos (exame direto e cultivo), de janeiro de 1994 a fevereiro de 1997. RESULTADOS - No total de 2.285 indivíduos, encontrou-se a T. beigelii em 13 casos (0,56) porcento, sete afetando pés, e, seis prosseguindo com onicomicose. CONCLUSÖES - O T. beigelii é capaz de ocasionar lesöes, localizadas na pele e nas unhas, que simulam as dermatofitoses ou a infecçäo por outras leveduras, como Candida albicans
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Immunocompetence , Mycoses/epidemiology , Onychomycosis/microbiology , Retrospective Studies , Trichosporon/isolation & purification , Dermatomycoses/diagnosis , Nails/physiopathology , Trichosporon/classificationABSTRACT
A doença de Darier é genodermatose autossômica dominante, porém, casos sem história familiar säo comuns. Caracteriza-se por pápulas ceratósicas, principalmente na parte superior do tronco e no couro cabeludo, ceratoses punctatas palmares e distrofia ungeal. Os autores relatam um caso de doença de Darier com extensas lesöes cutâneas, alteraçöes ungeais e lesöoes na mucosa oral, que säo raras. Realizou-se exame histopatológico em duas lesöes, uma na regiäo dorsal e outra na mucosa oral. O paciente foi tratado com etretinato na dose de 1mg/kg/dia (50mg/dia) durante um mês, com excelente resultado. Inclui-se revisäo da literatura.
Subject(s)
Humans , Male , Middle Aged , Back , Back Injuries , Darier Disease/drug therapy , Darier Disease/pathology , Etretinate/therapeutic use , Mouth Mucosa/injuries , Nails/physiopathology , Darier Disease/diagnosis , Darier Disease/etiology , Darier Disease/genetics , Darier Disease/psychology , Dermatitis, Seborrheic/diagnosis , Diagnosis, Differential , Physician-Patient Relations , Retinoids/therapeutic useABSTRACT
A sin drome de jadassohn lewandowsky ou paquioniquia conjenita (PC) hereditaria autossomica dominante de ocorrencia rara com expressividade fenotipica altamente variavel. Caracteriza-se pela formação de quantidades excessivas de queratina nas unhas pele e mucosas, manifestada por hiperceratose ungueal simetrica hiperceratose palmoplantar e leucoceratose folicular. Apresenta-se o caso de um jovem portador dessa anomaliacom onicodistrofa generalizada de mâos e pes, hiperceratose palmoplantar dentes natis maculas no dorso comedões e cistos multiplos pelo corpo paquitriquia e placas alopecias ocipitais. Neste artigo citam-se aspectos geneticos compilam-se manifestações clinicas revisam-se propostas de classificação descreve-se o quadro histologico e aventam-se as possibilidades terapeiticas da PC.
Subject(s)
Humans , Darier Disease/diagnosis , Darier Disease/physiopathology , Darier Disease/rehabilitation , Darier Disease/therapy , Nails/abnormalities , Nails/physiopathology , Nails/injuries , Nails/microbiologyABSTRACT
As unhas podem ser acometidas em algumas doenças sistêmicas. Os autores examinaram 50 pacientes portadores de insuficiência renal crônica e constataram que unha "meio a meio" foi a mais freqüente alteraçäo e ocorrem em 32 por cento dos casos.