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2.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-917902

RESUMO

Typically, sporotrichosis follows an environmental transmission route via traumatic inoculation of contaminated plant or soil matter. Although familial occurrences of sporotrichosis are rare, human-to-human transmission is even rarer. Herein, we report two cases, a father and son, with sporotrichosis caused by Sporothrix (S.) globosa. A 33-year-old male who otherwise appeared healthy presented with a tender, erythematous, ulcerative crusted plaque on the left ala nasi and upper lip. A skin biopsy and mycological study revealed fixed cutaneous sporotrichosis. The patient irregularly received oral itraconazole with a relapsing course. Approximately a year later, his 3-year-old son developed a single plaque on the left leg. When the father carried his son on his shoulder, there was direct contact between the two lesions. Fungal culture results from the father and son's lesions confirmed S. globosa with ribosomal DNA ITS sequencing. In both patients, oral terbinafine exhibited better results than oral itraconazole. These cases are an excellent example of human-to-human transmission of sporotrichosis.

3.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-213571

RESUMO

BACKGROUND: PCR-based reverse blot hybridization assay (PCR-REBA) has high sensitivity and specificity, can be performed directly on nail samples, is relatively cheaper than other molecular biologic methods, and is useful for diagnosing onychomycosis. OBJECTIVE: This study aims to compare the diagnostic efficacy of fungal culture and REBA Fungus-ID® which is a commercial PCR-REBA-based kit used for onychomycosis diagnosis. METHODS: Fifty nail samples were collected from 50 patients diagnosed with onychomycosis via direct microscopic examination using KOH preparation, and subjected to fungal culture and REBA Fungus-ID® test. RESULTS: The sensitivity of conventional fungal culture and REBA Fungus-ID® was 56% and 100%, respectively. In REBA Fungus-ID®, 43 of 50 samples were found to be infected with Trichophyton rubrum. Four of the remaining 7 samples were identified as infected with Trichophyton spp., one with Trichophyton mentagrophytes, and two revealed a panfungal DNA sequence. In fungal culture, 28 of 50 samples showed growth, of which 18 samples were identified as T. rubrum, 3 as Rhodotorula mucilaginosa, 3 as Cladosporium spp., 1 as Cyphellophora europaea, 1 as Penicillium cvjetkovicii, 1 as Lachnum soppittii, and 1 as non-dermatophytic mold. REBA Fungus-ID® and fungal culture were identical in 20 cases (40%). The non-dermatophytic fungi identified in fungal culture were considered contaminants. CONCLUSION: Nail specimens can be used directly for REBA Fungus-ID®, which has a high sensitivity for onychomycosis diagnosis. Therefore, it can be considered useful for diagnosis and identification of the causative organism in mixed infections like onychomycosis.


Assuntos
Humanos , Sequência de Bases , Cladosporium , Coinfecção , Diagnóstico , Fungos , Onicomicose , Penicillium , Reação em Cadeia da Polimerase , Rhodotorula , Sensibilidade e Especificidade , Trichophyton
4.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-112169

RESUMO

Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare primary cutaneous lymphoma that is predominantly composed of large lymphoid cells that express the CD30 antigen. The skin lesion of PCALCL is usually single, ulcerative, and located on the trunk or extremities and rarely the palm. A 25-year-old woman presented with a plaque on the left palm for 20 days. The plaque was walnut-sized and purple to gray colored with erosion in the center. Histopathologic examination showed infiltration of large atypical cells in the dermis. The large tumor cells showed positivity for CD3, CD4, and CD30 and negativity for CD8, CD20, epithelial membrane antigen, and anaplastic lymphoma kinase. PET-CT showed no other hypermetabolic lesion except that on the left palm, and we finally arrived at a diagnosis of PCALCL. The patient was treated with an intralesional injection of methotrexate (25 mg/mL, 0.45 cc). After 3 months of treatment, the walnut-sized plaque had disappeared and a peripheral hyperpigmented patch remained.


Assuntos
Adulto , Feminino , Humanos , Antígeno Ki-1 , Derme , Diagnóstico , Extremidades , Injeções Intralesionais , Linfócitos , Linfoma , Linfoma Anaplásico de Células Grandes , Linfoma Anaplásico Cutâneo Primário de Células Grandes , Metotrexato , Mucina-1 , Fosfotransferases , Pele , Úlcera
5.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-86669

RESUMO

BACKGROUND: Trichophyton mentagrophytes complex is a heterogeneous group. A new classification, based on molecular biology, has replaced the one based on morphology, physiology, and mating behavior. OBJECTIVE: T. mentagrophytes isolates from Korean patients were classified using the new method and compared with the classic classification. METHODS: During 2010-2011, fungal isolates were collected at the Catholic skin clinic from 562 patients infected with T. mentagrophytes; clinical characteristics were reviewed. Patients were divided into four groups based on the morphological characteristics of the isolates. Thirty-four strains of T. mentagrophytes were randomly selected from the four groups for mycological and molecular biology analyses, including analyses of morphological characteristics, ribosomal DNA (rDNA) internal transcribed spacer (ITS) sequence, and rDNA nontranscribed spacer (NTS) typing. RESULTS: Among the 562 isolates, persicolor (41.6%) was the most common strain type, followed by the powdery (38.4%), downy (11.2%), and granular (8.7%) types. The granular type differed from the other three with respect to the isolation site, patient's age, seasonal variation, and microscopic characteristics. Among the selected 34 strains, the microscopic characteristics varied for each strain. The powdery, persicolor, and downy types had ITS sequences identical to those of the anthropophilic T. interdigitale/A. vanbreuseghemii. The ITS sequence of granular type was similar to that of zoophilic T. interdigitale/A. vanbreuseghemii. The granular type had different NTS types than the other types did. CONCLUSION: The T. mentagrophytes strains isolated were classified as T. interdigitale/A. vanbreuseghemii; the majority (91.7%) was anthropophilic and 8.3% were zoophilic and granular type.


Assuntos
Humanos , Classificação , DNA Ribossômico , Métodos , Biologia Molecular , Fisiologia , Estações do Ano , Pele , Trichophyton
8.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-32292

RESUMO

Sporotrichosis is a chronic cutaneous fungal infection caused by Sporothrix (S.) schenckii complex. Fixed cutaneous sporotrichosis is one of the three subtype of sprotrichosis and accounts for 20% of total sporotrichosis cases. However, the incidence of total sporotrichosis cases is decreasing recently due to improvement of personal hygiene and industrialization. A 60-year-old woman presented to the hospital with multiple erythematous papules and ulcers on left cheek for 5 months. Histopathologic examination revealed chronic granulomatous inflammation and immunohistochemical staining was positive for GMS and PAS stain. The fungal culture on Sabouraud dextrose agar showed grayish dark brown colonies and the sequences of ribosomal DNA internal transcribed spacer region of clinical sample was 100% similarity with S. globosa. The patient was treated with oral itraconazole 200 mg daily and topical ketoconazole cream for 3 months. At that time after this treatment, skin lesion was almost cured and recurrence is not observed to date.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Ágar , Bochecha , DNA Ribossômico , Glucose , Higiene , Incidência , Inflamação , Itraconazol , Cetoconazol , Recidiva , Pele , Sporothrix , Esporotricose , Úlcera
11.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-12172

RESUMO

BACKGROUND: Dermatofibrosarcoma protuberance (DFSP) must be differentiated from dermatofibroma (DF). However, especially in cases of superficial biopsy and cellular dermatofibroma, this is difficult by using histopathology alone since both are composed of neoplastic spindle cells. Although a panel of immunostains is useful, the expressions of conventional markers often overlap. A previous study showed that novel D2-40 immunostain may be useful for differentiating between DF and DFSP. OBJECTIVE: To evaluate the usefulness of D2-40 immunohistochemical staining for differentiating DFSP from DF and compare the results with other commonly used immunostains (CD34 and factor XIIIa). METHODS: Twenty-eight cases of DF and 15 cases of DFSP were selected from clinicopathologically proven cases reviewed by the Department of Dermatology at our medical center and Daegu Catholic University Medical Center. D2-40, CD34, and factor XIIIa immunohistochemical staining was performed. The immunopositivity was measured throughout the entire lesion. RESULTS: Seventeen cases (60.7%) of DF and no cases of DFSP showed immunoreactivity to D2-40 in the spindle cells. Three (10.7%) cases of DF and 13 (86.7%) cases of DFSP showed immunoreactivity to CD34 in the spindle cells. Twenty-five (89.3%) cases of DF and four (26.7%) cases of DFSP showed immunoreactivity to factor XIIIa in the spindle cells. A total of 60.7% of cases of DF were positive on D2-40 staining, 89.3% were negative on CD34 staining, and 89.3% were positive on factor XIIIa staining. All cases (100%) of DFSP were negative by D2-40 staining, 86.7% were positive by CD34 staining, and 73.3% were negative by factor XIIIa staining. CONCLUSION: D2-40 immunostaining may be useful for distinguishing between DF and DFSP since the immunoreactivity of DF was significantly higher than that of DFSP (p=0.001). However, the results of our study were not as useful as those of a previous study. Therefore, further studies are needed to address this issue.


Assuntos
Centros Médicos Acadêmicos , Biópsia , Dermatofibrossarcoma , Dermatologia , Fator XIIIa , Histiocitoma Fibroso Benigno
12.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-18919

RESUMO

Primary myelofibrosis (PMF) is a chronic myeloproliferative disorder that is characterized by clonal proliferation of myeloid cells in the bone marrow. PMF should be distinguished from other chronic myeloproliferative neoplasms. Leukemia cutis is defined as cutaneous infiltration of malignant hematopoietic cells. The clinical features of leukemia cutis are variable, and the lesions may be localized or disseminated. A 53-year-old male individual presented with a month's history of several erythematous papules on the trunk. The number of lesions had increased, but he had no subjective symptom. He was diagnosed with PMF 3 years ago. For the last 5 months, he has suffered from inguinal lymph node enlargement, myalgia, and abdominal discomfort. Laboratory test showed leukocytosis in the peripheral blood (blast cells: 18%). Histopathologic examination of skin lesions showed perivascular infiltration of immature myeloid cells in the dermis. The infiltrative cells showed positivity for myeloperoxidase. We diagnosed the condition as leukemia cutis from primary myelofibrosis.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Medula Óssea , Derme , Leucemia , Leucocitose , Linfonodos , Mialgia , Células Mieloides , Transtornos Mieloproliferativos , Peroxidase , Mielofibrose Primária , Pele
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