Chromoblastomycosis: clinical experience and review of literature.

BACKGROUND: Chromoblastomycosis is a tropical chronic infectious dermatosis characterized by the moriform bodies. To review all cases of chromoblastomycosis attended in the reference service of dermatology. METHODS: Series of cases of chromoblastomycosis attended in a dermatology reference service. Through an integrated system search of assistance, based on CID-10 B43, we reviewed epidemiological and comorbidities data, clinical presentations, treatments, and outcomes of each clinical case. RESULTS: From 2011 to 2017, we had five new cases of chromoblastomycosis. The average age was 65.6 years. All of them were men. One patient was HIV-positive, and another patient was immunosuppressed by the use of mycophenolate mofetil and prednisone due to renal transplant. Two patients had no history of evident trauma. The time between onset of symptoms and diagnosis ranged from 7 to 600 months. Fonsecaea pedrosoi was the isolated fungi. All cases were formally confirmed. Itraconazole with or without other therapies was effective in all cases. CONCLUSIONS: We report five never reported cases of chromoblastomycosis, and we review the clinical experience in diagnosis and treatment of chromoblastomycosis, an infrequent and neglected subcutaneous mycosis.

Role of nicotine on cognitive and behavioral deficits in sepsis-surviving rats.

Sepsis and its complications are important causes of mortality in intensive care units and sepsis survivors may present long-term cognitive and emotional impairments, including memory deficits and anxiety symptoms. In the present study, we investigated whether repeated nicotine administration can affect the behavioral changes in sepsis-surviving rats. Male Wistar rats were divided in two groups: sham-operated and experimental sepsis induced by cecal ligation and puncture (CLP). The animals were injected subcutaneously with nicotine (0.1 mg/kg) or vehicle once a day during 1 week before and/or 1 week after sepsis induction. Thirty minutes after the last administration (i.e., 7 days after surgery), the animals were tested in the open field, elevated plus-maze and step-down inhibitory avoidance tasks. The repeated nicotine treatment did not affect the survival rate in the sepsis group (50%). Moreover, no significant changes on locomotor activity were observed in the sepsis group while the treatment with nicotine during 1 week after surgery reduced the locomotion of sepsis-surviving rats in the open field. It is important to note that both schedules of nicotine treatment (prior and/or after CLP) improved the sepsis-induced anxiogenic-like responses. Interestingly, nicotine was able to improve short- and long-term inhibitory avoidance memory impairments, observed in sepsis survivors, only when administered during 2 consecutive weeks (i.e., prior and after CLP). Taken together, these results indicate that repeated nicotine administration does not alter the survival rate in rats submitted to CLP and provide new evidence that nicotine can improve long-lasting memory impairments and anxiogenic-like responses in sepsis-surviving animals.

Expression of laminin-5 γ2 chain in cutaneous pseudocarcinomatous hyperplasia.

BACKGROUND: Since the use of laminin-5 as a marker of invasiveness has been proposed by several authors, our objective was to compare the expression of this protein in pseudocarcinomatous hyperplasia and squamous cell carcinoma (SCC). METHODS: Sixty-four paraffin-embedded skin biopsy samples with diagnosis of epidermal hyperplasia (non-pseudocarcinomatous), pseudocarcinomatous hyperplasia, actinic keratosis/carcinoma in situ, microinvasive and frankly invasive SCC were obtained for immunohistochemical study. RESULTS: Adjacent normal epithelium and epidermal hyperplasia (non-pseudocarcinomatous) showed no staining. In pseudocarcinomatous hyperplasia, laminin-5 was positive, at least focally, in 14 of 16 (87.5%) samples and was concentrated in peripheral cells of elongated rete pegs and in migrating cells in dermis. In samples of microinvasive carcinoma (n = 7), the expression was observed in all cases and was concentrated in the leading edge of the tumor. All cases (n = 21) of frankly invasive SCC showed cells expressing laminin-5, at least focally. Well-differentiated areas of the tumor presented a pattern of expression in peripheral cells of tumor nests while a diffuse pattern of expression was observed in less differentiated areas. CONCLUSION: We showed that cytoplasmic laminin-5 expression should not be used as a criterion of malignancy and is not useful in distinguishing pseudocarcinomatous hyperplasia from microinvasive and well-differentiated SCC.