Outbreak of Trichophyton soudanense causing tinea capitis in an orphanage in Myanmar.

We report an outbreak of Trichophyton soudanense causing tinea capitis and corporis in an orphanage in Myanmar. The thirty orphan children were suspected to have anthropophilic tinea but zoonotic tinea could not be excluded as all children were playing with stray dogs. Direct mycological examinations of hair and scalp samples showed filaments but culture assays remained sterile. We revealed T. soudanense as the infectious agent by PCR amplification of extracted fungal DNA and further sequencing of the PCR products. Children were successfully treated by terbinafine and reinfection was prevented by hygiene measures. This case report shed the light on T. soudanense infection on another continent than Africa and on the significant help of PCR identification.

[A pill to replace physical activity?]. / Une pilule pour remplacer l'activité--physique?

A recent study has identified two molecules able to transform white adipose tissue ("bad fat", responsible for excess weight) in brown adipose tissue ("good fat", consuming energy), bringing new hope for the treatment of obesity and diabetes. But the authors' announcement (more humorous than scientific) declaring that the study is thefirst step toward a pill that can replace the treadmill is inappropriate. It underscores the importance of employing preventive methods such as physical activity, whose benefits on health are well documented and which represents the best medicine available. Different means and tools are described in this article in order to improve the amount and quality of physical activity prescription in primary care.

Imaging of basal cell carcinoma by high-definition optical coherence tomography: histomorphological correlation. A pilot study.

BACKGROUND: With the continued development of noninvasive therapies for basal cell carcinoma (BCC) such as photodynamic therapy and immune therapies, noninvasive diagnosis and monitoring become increasingly relevant. High-definition optical coherence tomography (HD-OCT) is a high-resolution imaging tool, with micrometre resolution in both transversal and axial directions, enabling visualization of individual cells up to a depth of around 570 µm, and filling the imaging gap between conventional optical coherence tomography (OCT) and reflectance confocal microscopy (RCM). OBJECTIVES: We sought to determine the feasibility of detecting BCC by this technique using criteria defined for RCM and conventional OCT and compared with histology. METHODS: In this pilot study skin lesions of 21 patients with a histologically proven BCC were imaged by HD-OCT just before excision and images analysed qualitatively. RESULTS: Features for four different BCC subtypes were described in both transverse and axial directions. In general, these features were subepidermal or intradermal aggregations of cells. These islands or trabeculae were surrounded by a less refractile border corresponding with palisading and peritumoral mucin production. There was a pronounced architectural disarray of the epidermis. A variably refractile stroma together with abundant dilated peritumoral blood vessels was present. These features were comparable with histological features for each patient. CONCLUSIONS: Using features already suggested by RCM and conventional OCT, the study implies that HD-OCT facilitates in vivo diagnosis of BCC and allows the distinction between different BCC subtypes for increased clinical utility.