Case for diagnosis. Erythematous and pruritic papules on forearms.

Gamasoidosis is a poorly known and underdiagnosed mite infestation. It is characterized by the presence of erythematous and flattened papules that are quite pruritic, and can affect any region of the body, with preference for areas of folds. This article reports a case of the disease caused by mites of the species Dermanyssus gallinae. Increasingly, the agents that cause this disease are found in urban environments, increasing the incidence of people affected by the disease. This dermatosis has a self-limiting clinical picture and the treatment is done with the use of topical corticosteroids and oral antihistamines.

Case for diagnosis. Erythematous and pruritic papules on forearms

Abstract Gamasoidosis is a poorly known and underdiagnosed mite infestation. It is characterized by the presence of erythematous and flattened papules that are quite pruritic, and can affect any region of the body, with preference for areas of folds. This article reports a case of the disease caused by mites of the species Dermanyssus gallinae. Increasingly, the agents that cause this disease are found in urban environments, increasing the incidence of people affected by the disease. This dermatosis has a self-limiting clinical picture and the treatment is done with the use of topical corticosteroids and oral antihistamines.

Tick Bite Alopecia: A Report and Review.

Tick bites can cause a number of local inflammatory reactions, which are often difficult to differentiate from those induced by other arthropod bites or stings. These include erythematous nodular or pustular lesions, erosive plaques, annular lesions of erythema chronicum migrans, and both scarring and nonscarring inflammatory alopecia. We report a case of nonscarring alopecia in a 21-year-old male who reported a recent history of tick bite to the scalp. The biopsy demonstrated a dense pseudolymphomatous inflammatory infiltrate with numerous eosinophils associated with hair follicle miniaturization and an elevated catagen-telogen count. Signs of external rubbing, including lichen simplex chronicus and the "hamburger sign", were also visualized and are indicative of the associated pruritus. To the authors' knowledge, this is the fifth report of nonscarring tick bite alopecia in the literature and the first in an adult patient. This text will review the classic clinical presentation, histologic findings, and proposed mechanism of tick bite alopecia.

Chronic hookworm-related cutaneous larva migrans.

OBJECTIVES: The purpose of this study is to present the 'chronic' or 'persistent' form of hookworm-related cutaneous larva migrans. METHODS: From 1998 to 2011, 13 patients were seen in our department with clinically typical hookworm-related cutaneous larva migrans that had been present for more than 5 months and that, because of the absence of pruritus, had never been treated. RESULTS: The duration of hookworm-related cutaneous larva migrans ranged from 5 to 14 months (mean 7.8 months) in these 13 patients (10 males and three females, aged 23-55 years). The infestation was acquired in Brazil (three patients), Jamaica (three patients), Mexico (two patients), Tanzania (two patients), Thailand (two patients), and Martinique (one patient). The infestation was located on the feet in 10 patients; one of these patients also presented tracks on the back and another presented tracks on a knee. The chest (two patients) and thigh (two patients) were also involved. All patients presented with clinically typical hookworm-related cutaneous larva migrans: seven patients had one track and six patients had two tracks. Laboratory and instrumental examinations were within the normal range or negative. Histopathological examination revealed edema in the papillary and upper dermis, and a perivascular and perifollicular infiltrate in the upper dermis, consisting mainly of lymphocytes and eosinophils. No larvae were detected. CONCLUSIONS: This can be considered the 'chronic' or 'persistent' form of hookworm-related cutaneous larva migrans. Some pathogenetic hypotheses are suggested.

Efficacy of the Mentha crispa in the treatment of women with Trichomonas vaginalis infection.

PURPOSE: The aim of this study was to evaluate the efficacy of Mentha crispa in the treatment of women with Trichomonas vaginalis infection (TVI). METHODS: This was a randomized, double-blind, and controlled clinical trial consisting of three phases, pre-treatment, treatment, and post-treatment. Sixty female patients were randomized to a treatment group, M. crispa (24 mg) or secnidazole (2,000 mg), both consisting of single dose. RESULTS: After treatment the proportion of patients without TVI in secnidazole group was 96.6% and in the M. crispa group was 90%, no difference was found between groups (P = 0.6120). We observed improvement in vaginal discharge, malodorous vaginal secretion, dyspareunia, dysuria, pelvic pain, and burning and itching in the genital area in patients of both groups of treatment, with no statistically significant differences between them (P > 0.05). Adverse effects were significantly higher (P = 0.0006) in the secnidazole group (66.6%) than in the M. crispa group (20%), that being mostly nausea and metallic taste with statistically significant differences between treatment groups (P < 0.001). CONCLUSION: This study is the first to show that M. crispa is effective and safe, representing an alternative for the treatment of TVI in women.

Tick toxicosis in a dog bitten by Ornithodoros brasiliensis.

Ticks are hematophagous parasites of people and animals and are a public health hazard in several countries. They are vectors of infectious diseases; in addition, the bite of some ticks, mainly from the Ornithodoros genus, may lead to local lesions and systemic illness, referred to as tick toxicosis. In this report, we describe a dog bitten by Ornithodoros brasiliensis, popularly known as the mouro tick. The main clinical findings were disseminated skin rash, pruritus, mucosal hyperemia, lethargy, and fever. Laboratory abnormalities 48 hours after the bites occurred included mild nonregenerative anemia, eosinophilia, basophilia, increased serum creatine kinase activity, increased serum C-reactive protein concentration, and prolonged coagulation times. Tick-borne pathogens were not detected by PCR analysis or serologic testing, supporting the diagnosis of a noninfectious syndrome due to tick bite, compatible with tick toxicosis.

Prurido do traje de banho: relato de seis casos no Sul do Brasil / Seabather's eruption: report of the six cases in southern Brazil

O prurido do traje de banho ou seabathers eruption é uma dermatite intensamente pruriginosa que ocorre pelo contato com larvas plânulas do cnidário cifozoário Linuche unguiculata, especialmente sob os trajes de banhistas. As larvas disparam seus nematocistos a partir de cnidócitos ou células urticantes de defesa na pele da vítima, causando uma típica erupção pápulo-eritemato-pruriginosa. Os primeiros cinco casos descritos no Brasil foram publicados em 2001, no litoral Sudeste (Ubatuba, SP), obtendo-se associação com larvas de Linuche unguiculata, uma vez que a ocorrência e o ciclo de vida do cnidário já haviam sido estudados no Canal de São Sebastião, SP. Os autores relatam os seis casos na região Sul do Brasil (Estado de Santa Catarina), enfatizando os aspectos clínicos e a pesquisa para identificação do agente na água do mar local.

Seabathers eruption is an intensely pruriginous form of dermatitis that occurs after contact with the planula larvae of the cnidarian scyphozoan Linuche unguiculata, especially under the bathers clothes. They discharge their poisonous nematocysts from the cnidocytes, causing a typical eruption presenting papules, erythema and intense itching. The first five cases described in Brazil were published in 2001 and occurred on the southeastern coast (Ubatuba, State of São Paulo). Those cases were linked to larvae of Linuche unguiculata, because the occurrence and life cycle of this cnidarian had been studied in the São Sebastião Channel, State of São Paulo. The present authors report the six cases observed in southern Brazil (State of Santa Catarina), with a description of the typical clinical aspects and an investigation linking the cases to Linuche unguiculata in the local seawater.

Enterobius vermicularis infection among population of General Mansilla, Argentina.

AIM: To evaluate the relationships between the personal, sociocultural, and environmental characteristics, and the presence or absence of symptoms with the detection of Enterobius vermicularis (E. vermicularis) in a population sample in our region (General Mansilla, Province of Buenos Aires, Argentina), by individual and familiar analyses. METHODS: E. vermicularis was diagnosed in 309 people from 70 family units residing in the urban area and the rural area of the city of General Mansilla. Each of them was surveyed so as to register personal, environmental and sociocultural data. Questions about the presence or absence of anal itch, abdominal pain and sleeping disorder were also asked. Significant associations were determined by square chi tests. Logistic regression models were adjusted by using a backward conditional stepwise method to determine the presence of this parasite in the individuals and in the families. RESULTS: The parasites were found in 29.12% (90/309) of the individuals, with a frequency of 14.28% (20/140) among the heads of the families and of 41.42% (70/169) among the children. The only variables showing a significant association were affiliation, where the risk category was "being the son/daughter of", and the symptoms were abdominal pain, sleeping disorder, and anal itch. Families with a member infected with parasite were considered Positive Families (PF) and they were 40/70 (57.14%), only 5% (2/40) of the PF had 100% of their members infected with the parasite. The logistic regression models applied showed that the risk categories were mainly affiliation (son/daughter) and housing (satisfactory) among others. CONCLUSION: The presence of E. vermicularis was proved in one third of the studied population. The frequency of families with all their members infected with the parasite was very low. Most of the studied personal, sociocultural, and environmental variables did not turn out to be significantly associated with the presence of the parasite. An association with the category of "son/daughter" and housing classified as "satisfactory" was determined. The latter may be due to the fact that the people living in that category of housing have hygienic practices at home that favour the distribution of the eggs in the environment. The presence of the analysed symptoms was associated with the presence of the parasite, thus strengthening the need of periodical control of the population showing at least one of these symptoms.

Primer caso de Microfilariasis de ocurrencia fatal en Santa Cruz-Bolivia / The first of case microfilariasis probably fatal in Santa Cruz-Bolivia

Se presenta el primer caso de Microfilariasis patogena probable Mansonella Ozzardi, diagnosticado por estudio Histopalogico, en un nino de 12 anos de edad, procedente de la ciudad de Santa Cruz, con un cuadro clinico atipico y desenlace fatal