RESUMEN
BACKGROUND: Xeroderma pigmentosum (XP) is a very rare and severe genetic disorder with a DNA repair defect of ultraviolet (UV)-induced damage. Photodynamic therapy (PDT) has been successfully used in XP patients to treat actinic keratosis (AK) and daylight PDT (DL-PDT) has demonstrated similar efficacy to conventional PDT (C-PDT) for AK. OBJECTIVES: To assess DL-PDT for the treatment of AK in patients with XP. METHODS: Patients with XP were evaluated by a group of Spanish and African dermatologists. Clinical characteristics of the patients were assessed and divided in mild, severe or moderate affectation of AK in the face. A topical photosensitizer was extended on the patients' faces and after two hours of indoor light exposure, fluorescence was assessed and the cream was removed. Patients were examined two and seven days later to assess the reaction to PDT and followed up three months later. RESULTS: A total of 13 patients were treated on the whole face. Three were classified as severe AK, six as moderate AK and four as mild AK. Fluorescence assessment showed a soft yellow-green colour and a pink-color delineating the AK. Two days after treatment patients presented a scaly reaction. After one week the reaction healed, there was improvement and after three months no adverse events were noticed. CONCLUSIONS: PDT is an option for treatment of AK in patients with XP.
Asunto(s)
Ácido Aminolevulínico/uso terapéutico , Queratosis Actínica/tratamiento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Xerodermia Pigmentosa/tratamiento farmacológico , Adolescente , Adulto , África , Niño , Preescolar , Femenino , Humanos , Lactante , MasculinoRESUMEN
Actinomycetoma is a chronic disease that affects subcutaneous tissue. We present a case of a patient with abdominal actinomycetoma caused by Nocardia brasiliensis resistant to different treatments over several years, who also presented phagocyte immunodeficiency. He received two cycles (23 day cycles) of cefotaxime, 1 g every 8-h, and amikacin, 500 mg every 12 hours. Immunomodulation was carried out with levamisole 300 mg per week, during 4 weeks and bacterial antigen (at a concentration of 600,000,000 bacteria per mL), twice for a week during 20 months. The importance of susceptibility testing and immunological function investigation in this type of patients is discussed.
Asunto(s)
Adyuvantes Inmunológicos/uso terapéutico , Amicacina/uso terapéutico , Antibacterianos/uso terapéutico , Cefotaxima/uso terapéutico , Cefalosporinas/uso terapéutico , Quimioterapia Combinada/uso terapéutico , Nocardiosis/tratamiento farmacológico , Músculos Abdominales , Adulto , Enfermedad Crónica , Farmacorresistencia Microbiana , Resistencia a Múltiples Medicamentos , Humanos , Masculino , Micetoma/tratamiento farmacológicoRESUMEN
We show the records about diagnosed mycoses in a hospital in Mexico City in two periods of time: from 1967 to 1977 and from 1993 to 1997. In the former 15,429 patients were studied and in the latter, 5,998. Striking differences among frequency, etiological agents and clinical outcome, were observed. The most frequent infections in both lapses were the superficial ones, however the most recent scores showed a notorious increase in opportunistic infections. We diagnosed only one histoplasmosis case during the period from 1993 to 1997. Etiological agents have also changed, dermatophytes frequency like Trichophyton mentagrophytes and T. tonsurans have diminished while T. rubrum increased from 60% to 80% of the whole dermatophytoses cases. Even though Criptococcus neoformans used to be the only agent causing criptococosis, in the most recent report we found that C. laurentii, C. terreus and C. unigutulatus were also isolated. Another important difference was mortality in rhinocerebral mucormicosis: twenty years ago it was fairly 80%, nowadays it has decreased to 20%.
Asunto(s)
Micosis/epidemiología , Cryptococcus/aislamiento & purificación , Humanos , México/epidemiología , Micosis/microbiología , Estudios Retrospectivos , Trichophyton/aislamiento & purificaciónRESUMEN
We show the records about diagnosed mycoses in a hospital in Mexico City in two periods of time: from 1967 to 1977 and from 1993 to 1997. In the former 15,429 patients were studied and in the latter, 5,998. Striking differences among frequency, etiological agents and clinical outcome, were observed. The most frequent infections in both lapses were the superficial ones, however the most recent scores showed a notorious increase in opportunistic infections. We diagnosed only one histoplasmosis case during the period from 1993 to 1997. Etiological agents have also changed, dermatophytes frequency like Trichophyton mentagrophytes and T. tonsurans have diminished while T. rubrum increased from 60 to 80 of the whole dermatophytoses cases. Even though Criptococcus neoformans used to be the only agent causing criptococosis, in the most recent report we found that C. laurentii, C. terreus and C. unigutulatus were also isolated. Another important difference was mortality in rhinocerebral mucormicosis: twenty years ago it was fairly 80, nowadays it has decreased to 20.(AU)
Asunto(s)
Humanos , Micosis/epidemiología , Cryptococcus/aislamiento & purificación , México/epidemiología , Micosis/microbiología , Estudios Retrospectivos , Trichophyton/aislamiento & purificaciónRESUMEN
We show the records about diagnosed mycoses in a hospital in Mexico City in two periods of time: from 1967 to 1977 and from 1993 to 1997. In the former 15,429 patients were studied and in the latter, 5,998. Striking differences among frequency, etiological agents and clinical outcome, were observed. The most frequent infections in both lapses were the superficial ones, however the most recent scores showed a notorious increase in opportunistic infections. We diagnosed only one histoplasmosis case during the period from 1993 to 1997. Etiological agents have also changed, dermatophytes frequency like Trichophyton mentagrophytes and T. tonsurans have diminished while T. rubrum increased from 60 to 80 of the whole dermatophytoses cases. Even though Criptococcus neoformans used to be the only agent causing criptococosis, in the most recent report we found that C. laurentii, C. terreus and C. unigutulatus were also isolated. Another important difference was mortality in rhinocerebral mucormicosis: twenty years ago it was fairly 80, nowadays it has decreased to 20.
Asunto(s)
Humanos , Micosis , Cryptococcus , México , Micosis , Estudios Retrospectivos , TrichophytonRESUMEN
We show the records about diagnosed mycoses in a hospital in Mexico City in two periods of time: from 1967 to 1977 and from 1993 to 1997. In the former 15,429 patients were studied and in the latter, 5,998. Striking differences among frequency, etiological agents and clinical outcome, were observed. The most frequent infections in both lapses were the superficial ones, however the most recent scores showed a notorious increase in opportunistic infections. We diagnosed only one histoplasmosis case during the period from 1993 to 1997. Etiological agents have also changed, dermatophytes frequency like Trichophyton mentagrophytes and T. tonsurans have diminished while T. rubrum increased from 60
to 80
of the whole dermatophytoses cases. Even though Criptococcus neoformans used to be the only agent causing criptococosis, in the most recent report we found that C. laurentii, C. terreus and C. unigutulatus were also isolated. Another important difference was mortality in rhinocerebral mucormicosis: twenty years ago it was fairly 80
, nowadays it has decreased to 20
.