Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 36
Filter
1.
J Oncol Pharm Pract ; 28(8): 1798-1806, 2022 Dec.
Article in English | MEDLINE | ID: mdl-34590523

ABSTRACT

INTRODUCTION: This study aimed to evaluate the frequency of nail disorders and the presence of fungi on the nails of the hands and feet of patients with hand-foot syndrome secondary to treatment with paclitaxel. METHODS: Prospective study, carried out from October 2018 to December 2019, which included 81 patients undergoing treatment for breast cancer using paclitaxel and had signs and or symptoms of hand-foot syndrome with or without nail disorders. The data were collected through interviews guided by a structured questionnaire, information from medical records and reports of mycological exams. RESULTS: The average age of women was 54.7 ± 7.4 years. Nail disorders occurred in 69 patients (85.2%), and of these, 43 (62.3%) were positive for fungi. The fungi were yeasts (n = 38; 69%), dermatophytes (n = 15; 27.2%) and non-dermatophyte filamentous fungi (n = 8; 14.5%). CONCLUSIONS: Nail disorders were the most frequent manifestations in patients with hand-foot syndrome treated with paclitaxel and occurred in 85.2% of them. It was evidenced that fungi are present on the nails of these patients and can occur in up to 65.28%. The most prevalent fungi were Candida and Trichophyton. The nail lesion was associated with the type of treatment protocol used by the patient. The results of the study point to the need to select safe management alternatives for patients, so they can prevent nail lesions and prevent the proliferation of fungi, consequently reducing negative life impact during treatment.


Subject(s)
Hand-Foot Syndrome , Nail Diseases , Onychomycosis , Humans , Female , Middle Aged , Onychomycosis/drug therapy , Onychomycosis/diagnosis , Onychomycosis/microbiology , Hand-Foot Syndrome/epidemiology , Hand-Foot Syndrome/etiology , Paclitaxel/adverse effects , Prospective Studies , Trichophyton , Nail Diseases/chemically induced , Nail Diseases/epidemiology
2.
Sci Rep ; 11(1): 22729, 2021 11 23.
Article in English | MEDLINE | ID: mdl-34815466

ABSTRACT

Cerro de Pasco, Peru, has been excessively contaminated with heavy metals due to high mining activities in the region. We investigated the presence of chronic exposure to heavy metals in children living in Cerro de Pasco and its effect on health. Heavy metal concentrations were determined in hair samples collected from 78 children living in a region exposed to an open-pit mine (Paragsha region) and from other 16 children unexposed to mine activities (Carhuamayo region). Children exposed to the mine showed statistically significant higher concentration of aluminum, antimony, arsenic, cadmium, chromium, iron, lead, tin and thallium (p < 0.05) than control children. Hair samples collected from the same children in two occasions (2016 and 2018) showed that the exposure is chronic with higher levels of heavy metals observed in 2018. The concentration of heavy metals was higher in hair tip than in hair root samples. Heavy metals are associated with substantial higher risk of nosebleed (odds ratio, OR = 15.40), chronic colic (OR = 7.30), dermatologic alterations (OR = 6.16), mood alterations (OR = 7.07), presence of white lines on nails (OR = 12.10), reduced visual camp (OR = 3.97) and other symptoms (OR = 5.12). Chronic heavy metal exposure implies various negative consequences on children's health. Preventive measures are crucial to protect children's health.


Subject(s)
Child Health/statistics & numerical data , Colic/epidemiology , Environmental Exposure/analysis , Metals, Heavy/adverse effects , Metals, Heavy/analysis , Mood Disorders/epidemiology , Nail Diseases/epidemiology , Skin Diseases/epidemiology , Adolescent , Adult , Aged , Case-Control Studies , Child , Child, Preschool , Colic/chemically induced , Colic/pathology , Environmental Exposure/adverse effects , Female , Humans , Male , Middle Aged , Mood Disorders/chemically induced , Mood Disorders/pathology , Nail Diseases/chemically induced , Nail Diseases/pathology , Peru/epidemiology , Skin Diseases/chemically induced , Skin Diseases/pathology
4.
Mycoses ; 64(9): 1092-1097, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34061419

ABSTRACT

BACKGROUND: Epidemiological studies indicate that onychomycosis may affect up to 79% of psoriatic patients. Onychomycosis in psoriatic patients is more commonly caused by yeasts comparing with non-psoriatic. OBJECTIVES: Evaluate the prevalence of fungi in nail psoriasis. Evaluate the association between direct mycological examination (DME) and mycological culture, Nail Psoriasis Severity Index (NAPSI) and systemic treatment for psoriasis. METHODS: Of 133 nails from 20 patients with nail psoriasis were evaluated as follows: 9 patients were using topical treatment and 11 were on systemic treatment. The assessment of psoriasis severity using NAPSI was performed in all psoriatic nails. The presence of fungi was confirmed in DME and culture. RESULTS: DME showed the presence of fungal elements in 45 nails (33.83%) with a predominance of blastoconidia (95.5%) No septate hyphae were seen. Mycological culture was positive in 36 (27.06%) samples. Among them, Candida grew in 31 (86.1%): Candida parapsilosis in 15 (48.38%), Candida spp in 14 (45.16%). No growth of dermatophytes was observed. Patients with systemic treatment showed a higher frequency of positive test (DME and culture) for fungi when compared to topic treatment (p:.006). There was a positive correlation between NAPSI, mycological culture and systemic treatment (p:.0063); the risk was four times higher (OR:4.0). LIMITATION OF THE STUDY: Sample size. CONCLUSION: These results are consistent with some previous reports, Candida was the fungus with higher frequency on the psoriatic nails, however, the role of these fungi is controversial (contamination x colonisation x infection). The fact that the immunosuppressive treatment increases the chance of fungal infection leads us to a greater attention to this patient profile, to prevent the intensification of nail psoriasis (Köbner phenomenon).


Subject(s)
Nail Diseases , Onychomycosis , Psoriasis , Candida , Humans , Nail Diseases/drug therapy , Nail Diseases/epidemiology , Nail Diseases/microbiology , Nails , Onychomycosis/drug therapy , Onychomycosis/epidemiology , Psoriasis/drug therapy , Psoriasis/epidemiology
6.
J Pediatr ; 197: 154-157, 2018 06.
Article in English | MEDLINE | ID: mdl-29576324

ABSTRACT

INTRODUCTION: To assess the prevalence of nail involvement in children <16 years old with a confirmed diagnosis of scabies. STUDY DESIGN: Observational, prospective study in 7 French dermatology departments between June 2015 and January 2017. Children were included if they had scabies confirmed by dermoscopy and/or microscopy and if nails could be sampled. The first toenails and thumbnails as well as clinically affected nails were systematically sampled for microscopic examination. Individual data were recorded via a standardized questionnaire. RESULTS: A total of 47 children with scabies were included (26 females [55.3%], mean age 3.6 ± 4.0 years). Pruritus was present in 42 children (89.3%); the relapse rate was 38.3% (n = 18). In 3 infants (6.4%), Sarcoptes mites were revealed by dermoscopy or microscopy of the first toenails (2 cases) and a thumbnail (1 case), but nails were normal in 2 children. Two of the 3 infants had already received treatment for scabies in the previous weeks. CONCLUSION: Prevalence of nail involvement in children with confirmed scabies was 6.4%. Nails should not be overlooked during scabies treatment.


Subject(s)
Nail Diseases/epidemiology , Nails/parasitology , Scabies/epidemiology , Adolescent , Animals , Antiparasitic Agents/therapeutic use , Child , Child, Preschool , Dermoscopy , Female , France/epidemiology , Humans , Infant , Male , Nail Diseases/drug therapy , Nail Diseases/parasitology , Prevalence , Prospective Studies , Sarcoptes scabiei , Scabies/drug therapy
7.
Acta Ortop Mex ; 31(4): 162-164, 2017.
Article in Spanish | MEDLINE | ID: mdl-29216690

ABSTRACT

INTRODUCTION: Subungual osteochondromas are benign tumors of the sub- or periungual region, causing lifting, ulceration and deformity at that level. OBJECTIVE: To research the incidence of subungual osteochondromas in a specific pediatric population. MATERIAL AND METHODS: Retrospective, transversal, descriptive and observational study based on the review of records with a histopathological result of osteochondroma from 2001 to 2014. RESULTS: The pathological assessment featured four osteochondromas that corresponded to the subungual presentation, with an equal gender distribution of 1:1, an average age of 9.5 years, right: left ratio of 3:1; the 4th finger was the most affected. DISCUSSION: Subungual osteochondroma has an incidence of 8.5% of all osteochondromas.


INTRODUCCIÓN: Los osteocondromas subungueales son tumoraciones benignas de la región sub- o periungueal que ocasionan elevación, ulceración y deformidad a dicho nivel. OBJETIVOS: Investigar la incidencia de osteocondroma subungueal en un segmento de población pediátrica. MATERIAL Y MÉTODOS: Estudio retrospectivo, transversal, descriptivo y observacional, basado en la revisión de expedientes con resultado histopatológico de osteocondroma de 2001 a 2014. RESULTADOS: Cuatro de los osteocondromas correspondieron a la presentación subungueal, con una distribución por sexos de 1:1 y un promedio de edad de 9.5 años, relación 3:1, derecho:izquierdo; el cuarto dedo fue el más afectado. DISCUSIÓN: El osteocondroma sunbungueal presenta una incidencia de 8.5% de todos los osteocondromas.


Subject(s)
Bone Neoplasms , Exostoses , Nail Diseases , Osteochondroma , Bone Neoplasms/diagnosis , Bone Neoplasms/epidemiology , Child , Female , Humans , Male , Nail Diseases/diagnosis , Nail Diseases/epidemiology , Osteochondroma/diagnosis , Osteochondroma/epidemiology , Retrospective Studies
8.
Acta ortop. mex ; 31(4): 162-164, jul.-ago. 2017. graf
Article in Spanish | LILACS | ID: biblio-886559

ABSTRACT

Resumen: Introducción: Los osteocondromas subungueales son tumoraciones benignas de la región sub- o periungueal que ocasionan elevación, ulceración y deformidad a dicho nivel. Objetivos: Investigar la incidencia de osteocondroma subungueal en un segmento de población pediátrica. Material y métodos: Estudio retrospectivo, transversal, descriptivo y observacional, basado en la revisión de expedientes con resultado histopatológico de osteocondroma de 2001 a 2014. Resultados: Cuatro de los osteocondromas correspondieron a la presentación subungueal, con una distribución por sexos de 1:1 y un promedio de edad de 9.5 años, relación 3:1, derecho:izquierdo; el cuarto dedo fue el más afectado. Discusión: El osteocondroma sunbungueal presenta una incidencia de 8.5% de todos los osteocondromas.


Abstract: Introduction: Subungual osteochondromas are benign tumors of the sub- or periungual region, causing lifting, ulceration and deformity at that level. Objective: To research the incidence of subungual osteochondromas in a specific pediatric population. Material and methods: Retrospective, transversal, descriptive and observational study based on the review of records with a histopathological result of osteochondroma from 2001 to 2014. Results: The pathological assessment featured four osteochondromas that corresponded to the subungual presentation, with an equal gender distribution of 1:1, an average age of 9.5 years, right: left ratio of 3:1; the 4th finger was the most affected. Discussion: Subungual osteochondroma has an incidence of 8.5% of all osteochondromas.


Subject(s)
Humans , Male , Female , Child , Bone Neoplasms/diagnosis , Bone Neoplasms/epidemiology , Osteochondroma/diagnosis , Osteochondroma/epidemiology , Exostoses , Nail Diseases/diagnosis , Nail Diseases/epidemiology , Retrospective Studies
9.
Rev Invest Clin ; 69(1): 47-50, 2017.
Article in English | MEDLINE | ID: mdl-28239182

ABSTRACT

BACKGROUND: Psoriasis in children and adolescents has not been well studied in Mexico. OBJECTIVE: To study the epidemiological characteristics of psoriasis in this age group. METHODS: This is a retrospective study in an academic, tertiary care dermatology center from January 1999 to December 2014. We included patients ≤ 18 years of age, with clinical and histopathological diagnosis of psoriasis. We recorded the following information: gender, age, disease duration, clinical variant, nail involvement, treatment, and family history. Descriptive and inferential statistics were used for analysis. RESULTS: Of 2,491 patients with psoriasis, 280 were ≤ 18 years of age, resulting in a prevalence of 11%. There was female predominance and the mean age was 11.5 years. Disease duration was 18 ± 34 months. Plaque psoriasis was the most common form, comprising 191 cases (68%). Nail involvement occurred in only 15 patients (5%). Topical treatment was given to 177 patients (63%). Only 14 cases (5%) had a family history of psoriasis. These variables did not differ when children were compared with adolescents, except in those with a shorter disease duration (13 ± 19 vs. 24 ± 29 months; p = 0.0004). CONCLUSIONS: We found a higher prevalence of psoriasis than previously published studies in this age group and a lower frequency of nail involvement and family history of psoriasis.


Subject(s)
Dermatologic Agents/administration & dosage , Nail Diseases/epidemiology , Psoriasis/epidemiology , Administration, Cutaneous , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Mexico/epidemiology , Nail Diseases/pathology , Prevalence , Psoriasis/drug therapy , Psoriasis/pathology , Retrospective Studies
10.
An Bras Dermatol ; 91(4): 442-5, 2016.
Article in English | MEDLINE | ID: mdl-27579738

ABSTRACT

BACKGROUND: Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. OBJECTIVE: We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. METHODS: This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. RESULTS: Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). CONCLUSIONS: Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study.


Subject(s)
Nails, Malformed/epidemiology , Vitiligo/epidemiology , Adolescent , Adult , Aged , Case-Control Studies , Child , Child, Preschool , Female , Humans , Hypopigmentation/epidemiology , Male , Middle Aged , Nail Diseases/congenital , Nail Diseases/epidemiology , Nails, Malformed/etiology , Nails, Malformed/pathology , Prevalence , Statistics, Nonparametric , Turkey/epidemiology , Vitiligo/complications , Vitiligo/pathology , Young Adult
11.
An. bras. dermatol ; An. bras. dermatol;91(4): 442-445, July-Aug. 2016. tab, graf
Article in English | LILACS | ID: lil-792432

ABSTRACT

Abstract: Background: Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective: We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. Methods: This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. Results: Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). Conclusions: Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Vitiligo/epidemiology , Nails, Malformed/epidemiology , Turkey/epidemiology , Vitiligo/complications , Vitiligo/pathology , Case-Control Studies , Prevalence , Hypopigmentation/epidemiology , Statistics, Nonparametric , Nail Diseases/congenital , Nail Diseases/epidemiology , Nails, Malformed/etiology , Nails, Malformed/pathology
12.
An Bras Dermatol ; 91(3): 300-5, 2016.
Article in English | MEDLINE | ID: mdl-27438196

ABSTRACT

BACKGROUND: Psoriasis is a chronic inflammatory skin disease that often progresses with nail alterations. It is suspected that there is a correlation between nail psoriasis and enthesitis of the distal interphalangeal joint, seeming to serve as a predictor. OBJECTIVES: To analyze the profile of patients with nail psoriasis and correlate the presence of nail alterations with psoriatic arthritis, quality of life, extent of psoriasis and the histopathology of the nail. METHODS: An observational cross-sectional study with 40 patients with a diagnosis of psoriasis and without systemic treatment. The patient profile was researched, including quality of life and evaluated for the presence of psoriatic arthritis. The severity of the skin psoriasis and the presence of nail lesions were evaluated. Nail fragments were collected and analyzed through clipping. It obtained 100% of positivity for psoriasis in the histopathology exam of the nail plate. RESULTS: Of the 40 patients, 65% were diagnosed with nail psoriasis. Suggestive findings of psoriatic arthritis in hands were present in 33%, being more frequent in those with nail alteration (p = 0.01). In 92.3% of patients diagnosed with psoriatic arthritis in the hands there was some nail injury. The most frequent injuries were pitting and onycholysis. CONCLUSIONS: Patients with nail psoriasis are usually men, with worse quality of life and higher chance of psoriatic arthritis. The correlation between the nail involvement of psoriasis and psoriatic arthritis in hands confirms the association between these two forms. The clinical diagnosis of nail psoriasis did not correlate with the histological diagnosis.


Subject(s)
Nail Diseases/epidemiology , Psoriasis/epidemiology , Adult , Arthritis, Psoriatic/complications , Arthritis, Psoriatic/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Female , Hospitals, University/statistics & numerical data , Humans , Incidence , Male , Middle Aged , Nail Diseases/pathology , Onycholysis/epidemiology , Parakeratosis/pathology , Psoriasis/pathology , Quality of Life , Severity of Illness Index , Sex Distribution
13.
An. bras. dermatol ; An. bras. dermatol;91(3): 300-305, tab, graf
Article in English | LILACS | ID: lil-787295

ABSTRACT

Abstract: Background: Psoriasis is a chronic inflammatory skin disease that often progresses with nail alterations. It is suspected that there is a correlation between nail psoriasis and enthesitis of the distal interphalangeal joint, seeming to serve as a predictor. Objectives: To analyze the profile of patients with nail psoriasis and correlate the presence of nail alterations with psoriatic arthritis, quality of life, extent of psoriasis and the histopathology of the nail. Methods: An observational cross-sectional study with 40 patients with a diagnosis of psoriasis and without systemic treatment. The patient profile was researched, including quality of life and evaluated for the presence of psoriatic arthritis. The severity of the skin psoriasis and the presence of nail lesions were evaluated. Nail fragments were collected and analyzed through clipping. It obtained 100% of positivity for psoriasis in the histopathology exam of the nail plate. Results: Of the 40 patients, 65% were diagnosed with nail psoriasis. Suggestive findings of psoriatic arthritis in hands were present in 33%, being more frequent in those with nail alteration (p = 0.01). In 92.3% of patients diagnosed with psoriatic arthritis in the hands there was some nail injury. The most frequent injuries were pitting and onycholysis. Conclusions: Patients with nail psoriasis are usually men, with worse quality of life and higher chance of psoriatic arthritis. The correlation between the nail involvement of psoriasis and psoriatic arthritis in hands confirms the association between these two forms. The clinical diagnosis of nail psoriasis did not correlate with the histological diagnosis.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Psoriasis/epidemiology , Nail Diseases/epidemiology , Parakeratosis/pathology , Psoriasis/pathology , Quality of Life , Severity of Illness Index , Brazil/epidemiology , Arthritis, Psoriatic/complications , Arthritis, Psoriatic/epidemiology , Incidence , Cross-Sectional Studies , Sex Distribution , Onycholysis/epidemiology , Hospitals, University/statistics & numerical data , Nail Diseases/pathology
15.
Invest Clin ; 56(3): 276-83, 2015 Sep.
Article in Spanish | MEDLINE | ID: mdl-26710542

ABSTRACT

Candida species other than C. albicans are often described as causative agents of superficial mycosis and are more resistant to treatment with azoles. In order to determine the distribution of species and in vitro antifungal susceptibility of Candida spp., one ambispective study, which analyzed 18 yeast isolates obtained from samples from patients diagnosed with superficial mycosis, was performed. Taxonomic identification was performed by macroscopic visualization of the growth characteristics in chromogenic agar and by conventional methods. The susceptibility to fluconazole and voriconazole was evaluated by the disc diffusion method. Most of the isolates (88.8%), came from nail samples. C. parapsilosis was the most common species, followed by C. tropicalis, C. albicans and C. krusei, which confirmed the prevalence of non-albicans species as a cause of superficial mycoses. The pattern of susceptibility to fluconazole and voriconazole was similar: all isolates of C. parapsilosis and C. albicans were susceptible, while 83.3% of C. tropicalis showed sensitivity to both antifungals. C. krusei, fluconazole-resistant species showed intermediate susceptibility io voriconazole. The use of chromogenic agar allowed to detect mixed infections in nail samples, involving Candida spp. and C. tropicalis in one case, the latter with resistance to both fluconazole and voriconazole. The results demonstrate the importance of species identification and susceptibility testing to avoid therapeutic failures in superficial mycoses.


Subject(s)
Antifungal Agents/pharmacology , Candida/drug effects , Candidiasis/microbiology , Candida/isolation & purification , Candidiasis/epidemiology , Drug Resistance, Fungal , Fluconazole/pharmacology , Humans , Microbial Sensitivity Tests , Nail Diseases/epidemiology , Nail Diseases/microbiology , Venezuela , Voriconazole/pharmacology
16.
Invest. clín ; Invest. clín;56(3): 276-283, sep. 2015. ilus, tab
Article in Spanish | LILACS | ID: biblio-841085

ABSTRACT

Las especies de Candida distintas a C. albicans se describen con frecuencia como agentes causales de micosis superficial y presentan una mayor resistencia al tratamiento con los azoles. Con la finalidad de determinar la distribución de especies y la susceptibilidad antifúngica in vitro de Candida spp., se realizó un estudio ambispectivo donde se analizaron 18 aislados de levaduras obtenidas de muestras de pacientes con diagnóstico de micosis superficial. La identificación taxonómica se realizó mediante la visualización de las características macroscópicas de crecimiento en agar cromogénico y por métodos convencionales. La susceptibilidad a fluconazol y voriconazol se evaluó por el método de difusión en disco. El 88,8% de los aislados provenía de muestras de uñas. C. parapsilosis fue la especie más frecuente, seguida de C. tropicalis, C. albicans y C. krusei, lo cual confirmó el predominio de especies no albicans como causa de micosis superficial. El patrón de susceptibilidad a fluconazol y voriconazol fue similar: todos los aislados de C. parapsilosis y C. albicans resultaron sensibles, mientras que el 83,3% de C. tropicalis mostró sensibilidad a ambos antifúngicos. C. krusei, especie resistente a fluconazol, presentó sensibilidad intermedia al voriconazol. El uso de agar cromogénico permitió detectar infecciones mixtas en muestras de uñas, involucrando en uno de los casos a Candid spp. y C.tropicalis, esta última con resistencia tanto a fluconazol como a voriconazol. Los resultados obtenidos demuestran la importancia de la identificación de especies y la realización de pruebas de susceptibilidad con el fin de evitar fracasos terapéuticos en micosis superficiales. Autor de correspondencia: Leyla Humbría-García. Laboratorio de Micología


Candida species other than C. albicans are often described as causative agents of superficial mycosis and are more resistant to treatment with azoles. In order to determine the distribution of species and in vitro antifungal susceptibility of Candida spp., one ambispective study, which analyzed 18 yeast isolates obtained from samples from patients diagnosed with superficial mycosis, was performed. Taxonomic identification was performed by macroscopic visualization of the growth characteristics in chromogenic agar and by conventional methods. The susceptibility to fluconazole and voriconazole was evaluated by the disc diffusion method. Most of the isolates (88.8%), came from nail samples. C. parapsilosis was the most common species, followed by C. tropicalis, C. albicans and C. krusei, which confirmed the prevalence of non-albicans species as a cause of superficial mycoses. The pattern of susceptibility to fluconazole and voriconazole was similar: all isolates of C. parapsilosis and C. albicans were susceptible, while 83.3% of C. tropicalis showed sensitivity to both antifungals. C. krusei, fluconazole-resistant species showed intermediate susceptibility to voriconazole. The use of chromogenic agar allowed to detect mixed infections in nail samples, involving Candida spp. and C. tropicalis in one case, the latter with resistance to both fluconazole and voriconazole. The results demonstrate the importance of species identification and susceptibility testing to avoid therapeutic failures in superficial mycoses.


Subject(s)
Humans , Candida/drug effects , Candidiasis/microbiology , Antifungal Agents/pharmacology , Venezuela , Candida/isolation & purification , Candidiasis/epidemiology , Microbial Sensitivity Tests , Fluconazole/pharmacology , Drug Resistance, Fungal , Voriconazole/pharmacology , Nail Diseases/microbiology , Nail Diseases/epidemiology
17.
An Bras Dermatol ; 90(3): 314-9, 2015.
Article in English | MEDLINE | ID: mdl-26131859

ABSTRACT

BACKGROUND: Psoriasis is a disease of worldwide distribution with a prevalence of 1 to 3%. Nail psoriasis is estimated in 50% of patients with psoriasis, and in the presence of joint involvement, it can reach 80%. OBJECTIVE: To study the nail changes - and their clinical implications - presented by patients with psoriasis vulgaris under surveillance in a university hospital from the south of Brazil. METHODS: his cross-sectional study evaluated 65 adult patients from January 2012 to March 2013. Cutaneous severity was assessed according to the Psoriasis Area and Severity Index (PASI). The Nail Psoriasis Severity Index (NAPSI) was used to evaluate patient's nails. The diagnosis of psoriatic arthritis was established according to the Classification Criteria for Psoriatic Arthritis (CASPAR). RESULTS: The prevalence of NP was 46.1%. These patients had a median [interquartilic range (IQR)] NAPSI of 1 (0-15). A total of 63.3% of patients reported aesthetic discomfort or functional impairment related to their nails. Onycholysis was the most common feature (80%). When compared with patients without nail involvement, patients with NP had lower mean age at psoriasis onset [21 (18-41) vs. 43 (30-56) years, p=0,001]; longer disease duration [15.5 (10-24) vs. 6 (2-12) years, p=0.001]; higher PASI [9.2 (5-17) vs. 3.7 (2-10), p=0.044], higher frequency of psoriatic arthritis (43.3 vs. 3.7, p = 0.002) and more often reported family history of psoriasis (40% vs. 7.4%, p = 0.011). CONCLUSION: Onycholysis was the most frequent finding and most patients feel uncomfortable with the psoriatic nail changes that they experience.


Subject(s)
Nail Diseases/epidemiology , Nail Diseases/pathology , Psoriasis/epidemiology , Psoriasis/pathology , Adult , Age Distribution , Age of Onset , Aged , Brazil/epidemiology , Epidemiologic Methods , Female , Humans , Male , Middle Aged , Nails/pathology , Severity of Illness Index , Sex Distribution
18.
An. bras. dermatol ; An. bras. dermatol;90(3): 314-319, May-Jun/2015. tab
Article in English | LILACS | ID: lil-749664

ABSTRACT

Abstract BACKGROUND: Psoriasis is a disease of worldwide distribution with a prevalence of 1 to 3%. Nail psoriasis is estimated in 50% of patients with psoriasis, and in the presence of joint involvement, it can reach 80%. OBJECTIVE: To study the nail changes - and their clinical implications - presented by patients with psoriasis vulgaris under surveillance in a university hospital from the south of Brazil. METHODS: his cross-sectional study evaluated 65 adult patients from January 2012 to March 2013. Cutaneous severity was assessed according to the Psoriasis Area and Severity Index (PASI). The Nail Psoriasis Severity Index (NAPSI) was used to evaluate patient's nails. The diagnosis of psoriatic arthritis was established according to the Classification Criteria for Psoriatic Arthritis (CASPAR). RESULTS: The prevalence of NP was 46.1%. These patients had a median [interquartilic range (IQR)] NAPSI of 1 (0-15). A total of 63.3% of patients reported aesthetic discomfort or functional impairment related to their nails. Onycholysis was the most common feature (80%). When compared with patients without nail involvement, patients with NP had lower mean age at psoriasis onset [21 (18-41) vs. 43 (30-56) years, p=0,001]; longer disease duration [15.5 (10-24) vs. 6 (2-12) years, p=0.001]; higher PASI [9.2 (5-17) vs. 3.7 (2-10), p=0.044], higher frequency of psoriatic arthritis (43.3 vs. 3.7, p = 0.002) and more often reported family history of psoriasis (40% vs. 7.4%, p = 0.011). CONCLUSION: Onycholysis was the most frequent finding and most patients feel uncomfortable with the psoriatic nail changes that they experience. .


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Nail Diseases/epidemiology , Nail Diseases/pathology , Psoriasis/epidemiology , Psoriasis/pathology , Age Distribution , Age of Onset , Brazil/epidemiology , Epidemiologic Methods , Nails/pathology , Severity of Illness Index , Sex Distribution
20.
Int J Dermatol ; 52(6): 684-7, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23432149

ABSTRACT

BACKGROUND: Nail lichen planus affects 10% of all patients with lichen planus. It is a severe disease that may lead to destruction of the nail plate. It affects fingernails more than toenails. Early diagnosis is important due to its aggressive behavior. Histopathology should be carried out, but in many occasions it is not enough to come to a conclusive diagnosis. Dermatoscopy, a complementary tool, has proven to be useful in its diagnosis, management, and prognosis. Currently, there is very little data regarding dermatoscopy of nail lichen planus. METHODS: Dermatoscopic photographic data of 11 patients having 79 nails affected with nail lichen planus, seen in a specialized nail disease facility, were selected and analyzed. The data was confirmed with histopathological analysis. RESULTS: Dermatoscopy showed abnormalities of the nail matrix, with trachyonychia in 40.51% and pitting in 34.18%. As to nail bed anomalies, there was chromonychia in 55.70%, fragmentation of body of nail in 50.63%, splinter hemorrhage in 35.44%, onycholysis in 27.85%, and subungual keratosis in 7.59%. Concerning anomalies that involved nail matrix, bed, and perionychial region altogether, there were longitudinal streaks in 82.28% and anonychia in 1.27%. Paronychia was present in 31.65% of the cases. CONCLUSION: Considering that nail lichen planus is an underdiagnosed disease with severe consequences, early diagnosis is essential. This descriptive study of dermatoscopic characteristics of nail lichen planus would highlight some key changes in the course of the disease that will contribute to early diagnostic suspicion, early treatment, and could improve prognosis.


Subject(s)
Dermoscopy , Lichen Planus/diagnosis , Lichen Planus/epidemiology , Nail Diseases/diagnosis , Nail Diseases/epidemiology , Adult , Databases, Factual , Early Diagnosis , Humans , Incidence , Nails/pathology , Prevalence , Prognosis , Prospective Studies
SELECTION OF CITATIONS
SEARCH DETAIL