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1.
Med Mycol ; 54(8): 890-8, 2016 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-27250925

RESUMEN

Neoscytalidium dimidiatum is an emerging fungus that causes a skin infection similar to dermatophytosis; it affects both immunocompetent and immunosuppressed individuals, and it may invade deeper tissues and organs and cause systemic disease. Little is known about the etiopathogenesis of the infection caused by this fungus, and no standard effective treatment is available. The aim of the present experimental study was to develop an animal model of skin infection with N. dimidiatum. BALB/c mice were inoculated with two fungal strains, and different routes of infection were tested. When challenged intradermally, N. dimidiatum strain HUPE164165 caused skin infection in 67% of the animals whereas strain HUPE115669 did it in 49%. Neoscytalidium dimidiatum was isolated from the skin of 25% of the animals inoculated via epidermal scarification and from 100% of the animals challenged via subcutaneous injection. Mice inoculated intradermally were followed-up during four weeks, and clinical samples were collected on days 3, 8, 15, and 29 after inoculation, corresponding to different stages of infection. The cutaneous infection rate, as measured by the recovery of N. dimidiatum strain HUPE164165 from skin biopsies of animals inoculated intradermally, revealed the presence of infection in 90% of the animals sacrificed at 3 days post-inoculation, 71% at 8, 85% at 15, and 33% at 29. Conidia and hyphae were observed in PAS-stained sections as well as a mild to moderate inflammatory infiltrate in haematoxylin-eosin, although it did not differ from animals inoculated either with T. quinckeanum or PBS. The intradermal route of inoculation was considered to be suitable for the study of skin infection with N. dimidiatum The animal model developed in this preliminary study is the first to allow the study of cutaneous infection with N. dimidiatum and may contribute to further investigations of the aetiology, immunology, pathogenesis and treatment targeting this emerging mycosis.


Asunto(s)
Ascomicetos/patogenicidad , Dermatomicosis/microbiología , Dermatomicosis/patología , Modelos Animales de Enfermedad , Animales , Ascomicetos/aislamiento & purificación , Enfermedades Transmisibles Emergentes/microbiología , Histocitoquímica , Humanos , Inflamación/patología , Masculino , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Microscopía , Piel/microbiología , Piel/patología
2.
An. bras. dermatol ; 83(3): 233-236, maio-jun. 2008. ilus
Artículo en Portugués | LILACS-Express | ID: lil-487627

RESUMEN

Os autores relatam um caso de paniculite criptocócica em paciente transplantado renal inicialmente tratado como celulite bacteriana. O diagnóstico definitivo só foi possível pela impressão clínica dermatológica confirmada pelo exame micológico. O tratamento foi realizado a princípio com anfotericina B e posteriormente com fluconazol, considerando-se as interações das drogas imunossupressoras utilizadas para evitar rejeição. A regressão clínica foi alcançada no sexto mês de tratamento, que, no entanto, foi mantido por 12 meses. São feitas considerações a respeito dessa forma rara de criptococose cutânea em transplantado de órgão sólido e suas implicações diagnósticas e terapêuticas.


The authors report a case of cryptococcal panniculitis in a renal transplant recipient,which was initially mistaken for bacterial cellulitis. Dermatological evaluation and laboratory studies led to the definitive diagnosis. Treatment was started with amphotericin B, followed by oral fluconazol, taking into consideration their interactions with the immunossupressive drugs. Even though clinical improvement was attained after six months, treatment was maintained during a whole year. We discuss this rare presentation of cutaneous cryptococcosis in a solid organ transplant recipient, as well as its diagnosis and therapy.

3.
An. bras. dermatol ; 80(1): 25-34, jan.-fev. 2005. tab
Artículo en Portugués | LILACS | ID: lil-399380

RESUMEN

FUNDAMENTOS: A incidência e a mortalidade por melanoma cutâneo vêm aumentando em todo o mundo. Os registros brasileiros de bases populacionais não refletem precisamente a real dimensão do problema. OBJETIVOS: Estudo prospectivo de 65 casos de melanoma cutâneo observados no Hospital Universitário Clementino Fraga Filho no período de 1993 a 2003. MÉTODOS: Foram analisadas as variáveis idade, sexo, cor, localização, tipos clínico-histológicos e estadiamento. RESULTADOS: 64,7 por cento na faixa etária de 40 a 69 anos, distribuição etária homogênea entre o sexo masculino (49,2 por cento) e o sexo feminino (50,8 por cento), predominância de brancos (83 por cento), localização no tronco (35,3 por cento), tipo clínico-histológico expansivo superficial (63 por cento/30,7 por cento) e relação de significância entre tipo acral localizado no pé em não brancos. Segundo o American Joint Committee on Cancer, em 2002, 22 casos (33,8 por cento) no estádio IA, 14 (21,5 por cento) melanomas in situ e um caso indeterminado. CONCLUSÕES: O melanoma cutâneo primário na amostra estudada mostrou padrões semelhantes aos classicamente reconhecidos e maior freqüência do estádio IA e melanoma in situ.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Melanoma , Patología , Estudios Prospectivos , Neoplasias Cutáneas
4.
An. bras. dermatol ; 79(4): 431-439, jul.-ago. 2004. tab
Artículo en Portugués, Inglés | LILACS-Express | ID: lil-366570

RESUMEN

FUNDAMENTOS: A leishmaniose tegumentar americana distribui-se amplamente no Brasil, e o Estado do Rio de Janeiro (capital e interior) constitui área endêmica onde o vetor é encontrado dentro e ao redor das habitações. OBJETIVOS: Análise prospectiva de 48 casos de leishmaniose tegumentar americana atendidos no Hospital Universitário Clementino Fraga Filho/UFRJ, no período de 1990 a 2002. MÉTODOS: Todos os pacientes foram submetidos à biópsia de pele ou mucosa, teste de Montenegro e exame otorrinolaringológico; SbV (10 a 20mg/kg), no total de 10, 30 e 90 doses. foi empregado em 44 pacientes; em quatro casos, anfotericina B (0,5mg/kg/dose) até dose cumulativa de 30mg/kg. RESULTADOS: 28 homens e 20 mulheres na faixa etária de 10 a 89 anos, dos quais 38 (79,1 por cento) infectados no Rio de Janeiro, apresentaram úlcera de membro inferior e comprometimento de mucosa nasal como manifestações mais freqüentes; 41 casos (85,4 por cento) foram reatores à intradermorreação de Montenegro (5mm); 17 casos (35,4 por cento) foram positivos para o achado de amastigotas em macrófagos no infiltrado inflamatório dérmico; predominou o processo inflamatório crônico granulomatoso; cura clínica foi observada em 47 casos; um caso evoluiu para óbito no décimo dia de tratamento. CONCLUSÕES: O estudo da leishmaniose tegumentar (HUCFF/UFRJ) no período 1990/2002 evidenciou padrão conhecido nos aspectos epidemiológicos, clínicos e de resposta terapêutica ao antimonial (SbV) e anfotericina B.

5.
Int. J. Lepr ; 69(3): 177-186, Sept., 2001. ilus, tab, graf
Artículo en Inglés | Hanseníase | ID: han-26734

RESUMEN

This paper aims to describe the histomorphologic features of skin biopsies of single lesion leprosy patients recruited at outpatient clinics in four Brazilian states in the Northeast (Amazonas and Rondonia), Southeast (Rio de Janeiro) and Center-West (Goiás) between October 1997 and December 1998. Patients clinically diagnosed as single skin lesion paucibacillary (SSL-PB) leprosy had a standard 4-mm punch biopsy taken from the lesion before rifampin, ofloxacin, minocycline (ROM) therapy. The features of the cellular inflammatory infiltrates, the presence of nerve involvement and acid-fast bacilli (AFB) were used to categorize SSL-PB biopsies into different histopathological groups. Two-hundred-seventy-eight (93.0%) out of 299 patients had a skin biopsy available. Seven single lesion patients were diagnosed as BL or LL leprosy types (MB) by the histopathological exams and 12 cases were excluded due to other skin diseases. Therefore, 259 patients had skin lesions with histomorphological features compatible with PB leprosy categorized as follows: 33.6% (N = 87) of the biopsies represented well-circumscribed epithelioid cell granuloma (Group 1); 21.6% (N = 56) less-circumscribed epithelioid cell granuloma (Group 2); 12.0% (N = 31) were described as mononuclear inflammatory infiltrate permeated with epithelioid cells (Group 3), and 29.7% (N = 77) had perivascular/periadnexal mononuclear inflammatory infiltrate (Group 4). Minimal/no morphological alteration in the skin was detected in only 8 (3.1%) SSL-PB patients categorized as Group 5, who were considered to have leprosy by clinical parameters. SSL-PB leprosy patients recruited in a multicentric study presented histomorphology readings comprising the whole PB leprosy spectrum but also a few MB cases. These results indicate heterogeneity among SSL-PB patients, with a predominance of well-circumscribed and less-circumscribed epithelioid cell granulomas (Groups 1 and 2) in the sites studied and the heterogeneity of local cellular immune response. (AU)


Asunto(s)
Humanos , Lepra/etnología , Lepra/fisiopatología
6.
Rev. Inst. Med. Trop. Säo Paulo ; 43(1): 01-06, Jan.-Feb. 2001. ilus, tab
Artículo en Inglés | LILACS | ID: lil-285674

RESUMEN

The aim of this case series was to describe the clinical, laboratory and epidemiological characteristics and the presentation of bacillary angiomatosis cases (and/or parenchymal bacillary peliosis) that were identified in five public hospitals of Rio de Janeiro state between 1990 and 1997; these cases were compared with those previously described in the medical literature. Thirteen case-patients were enrolled in the study; the median age was 39 years and all patients were male. All patients were human immunodeficiency virus type 1 (HIV-1) infected and they had previous or concomitant HIV-associated opportunistic infections or malignancies diagnosed at the time bacillary angiomatosis was diagnosed. Median T4 helper lymphocyte counts of patients was 96 cells per mmÝ. Cutaneous involvement was the most common clinical manifestation of bacillary angiomatosis in this study. Clinical remission following appropriate treatment was more common in our case series than that reported in the medical literature, while the incidence of relapse was similar. The frequency of bacillary angiomatosis in HIV patients calculated from two of the hospitals included in our study was 1.42 cases per 1000 patients, similar to the frequencies reported in the medical literature. Bacillary angiomatosis is an unusual opportunistic pathogen in our setting


Asunto(s)
Humanos , Adulto , Masculino , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Angiomatosis Bacilar/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/patología , Angiomatosis Bacilar/patología , Angiomatosis Bacilar/terapia , Recurrencia , Estudios Retrospectivos
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