Successful treatment of chromoblastomycosis of 36 years duration caused by Fonsecaea monophora.

We report a case of chromoblastomycosis in a 67-year-old female farmer, which involved a large (20 x 30 cm) cicatricial erythematous plaque on the inner side of her right thigh. The lesion was initially a small nodule which gradually extended over 36 years. Direct microscopic examination revealed a granulomatous lesion with muriform cells surrounded by giant cells. The mould recovered in cultures was dark olivaceous and identified as Fonsecaea monophora by ribosomal internal transcribe spacer (ITS) sequence data. The lesion was successfully cured after 4 months treatment with itraconazole, but there was a relapse.

[Analysis of the demand for dermatological care in the immigrant population served by hospital Miguel Servet in Saragossa, Spain]. / Análisis de la demanda asistencial de Dermatología en la población inmigrante del área de salud del Hospital Miguel Servet de Zaragoza.

INTRODUCTION: In recent years there has been an increase in the size of the immigrant population consulting dermatology services in Spain. The aim of this study was to describe the epidemiological characteristics of this sector of the population in the health care area served by Miguel Servet Hospital in Saragossa, Spain. MATERIAL AND METHODS: Data were collected on immigrant patients seen in the dermatology department of our hospital during 2004. Dermatological diagnoses were classified according to the International Classification of Diseases, Ninth Revision, Clinical Modification. Statistical analysis was undertaken using the SPSS statistical package, Access database management software, and Excel spreadsheets. RESULTS: A total of 706 patients were seen, corresponding to approximately 4 % of all first appointments, and more women were seen than men, a difference that was statistically significant. The mean age of the patients was 31 years and there were no statistically significant differences in age between the sexes. In order of frequency, the most common countries of origin of the patients were Ecuador, Colombia, Romania, Morocco, Gambia, Guinea, and Senegal. The most common skin diseases in this population group were infectious diseases, in particular mycoses, followed by viral diseases and pyodermatitis, as well as sexually transmitted diseases. In all cases, the incidence of the disease was higher than in the Spanish population. CONCLUSIONS: An appropriate knowledge of dermatological diseases in this population group is necessary both to obtain correct diagnosis and to develop preventative measures for imported diseases.

Tinea capitis in infants in their first year of life.

BACKGROUND: Tinea capitis is the most common type of dermatophytosis in children, but is uncommon in the first year of life. OBJECTIVES: To review clinical, mycological and epidemiological data in a series of 10 infants aged under 1 year diagnosed as having tinea capitis in three Spanish hospitals between 1998 and 2002. METHODS: A retrospective case note study. RESULTS: There were six boys and four girls with a mean of age 7 months (range 1.5-12). All the children were born in Spain, but in five cases the parents were immigrants from Africa. In these cases the isolated dermatophytes were two Trichophyton tonsurans, one T. verrucosum and two Microsporum audouinii. Four autochthonous cases were caused by M. canis and one by M. audouinii (but this one was in contact with African immigrants). In two of the five cases produced by anthropophilic dermatophytes other family members were infected by the same fungus. Most cases were treated successfully with griseofulvin. CONCLUSIONS: Although tinea capitis is rare in infants in their first year of life, the condition should be investigated if scaling and/or alopecia are present. A thorough epidemiological study of other family members is mandatory.

Comparison of ViraPap, Southern hybridization, and polymerase chain reaction methods for human papillomavirus identification in an epidemiological investigation of cervical cancer.

In order to provide a reliable diagnosis for the presence and type of human papillomavirus (HPV) DNA in a case-control study of cervical cancer in Colombia and Spain, 926 cervical scrapes from female subjects were examined by ViraPap (VP) and Southern hybridization (SH), and 510 of these (263 cases and 247 controls) were also tested by polymerase chain reaction (PCR) using the HPV L1 consensus primers. HPV DNA prevalence was much higher in cases than in controls by each of the three tests. There was complete agreement between the results of the three tests for 64.9% of the 510 specimens; 53.5% were negative and 11.4% were positive (regardless of type) by all tests. An additional 29.0% of the specimens were positive by PCR: 19.4% by PCR alone, 6.7% by PCR and VP, and 2.9% by PCR and SH. SH and/or VP gave positive results for 6.0% of the specimens for which the PCR finding was negative: 2.7% by SH alone, 2.5% by VP alone, and 0.8% by both VP and SH. When specimens which were positive by VP alone or only by SH at low-stringency conditions were excluded, PCR confirmed all but four specimens which were positive by other tests. The concordance between type-specific diagnosis by SH and PCR was 86% when HPVs were typed in both tests. HPV-16 accounted for over 80% of the typed HPVs in each test. The presence of blood in case specimens did not appear to inhibit HPV positivity by VP or by PCR at the dilution tested. Low amounts of cellular DNA of specimens resulted in some underestimation of HPV positivity by VP and SH but not by PCR. Compared with that of PCR, the sensitivities for case specimens were 38% by SH and 50% by VP; the sensitivity for control specimens, although it could not be measured precisely because there were few positive specimens, appeared to be lower than for case specimens. It was concluded that PCR-based tests are best suited for epidemiological investigation of HPVs.