RESUMEN
Superficial dermatomycosis are prevalent pathologies in the medical field and their diagnosis is fundamentally clinical. Histopathology is not considered part of his study, however, the diagnosis is exceptionally obtained by biopsy, when dermatomycosis was not suspected. Unpublished retrospective work is carried out on patients who had the histopathological diagnosis of superficial dermatomycosis between the years 2000-2019 at the HCUCH, based on selection criteria, obtaining 19 patients, in which the following were analyzed: age, gender, clinical characteristics, location, presumptive diagnosis and mycological and histological examinations. He stressed, as was our hypothesis, that dermatomycosis was not clinically suspected, since the presumptive diagnoses were various dermatoses. The most suspected dermatosis was psoriasis, as a result that 57.8% of the dermatoses studied had erythematous scaly plaques on examination. Another relevant fact is that only 21% of the cases underwent a direct mycological prior to the biopsy, which was negative ('' false negative''). It is concluded, then, that superficial dermatomycosis should be considered clinical simulators of other dermatoses, so clinical suspicion and support of mycological examination and fungal culture is essential. (AU)
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Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Dermatomicosis/diagnóstico , Tiña/epidemiología , Dermatomicosis/clasificación , Dermatomicosis/etiología , Dermatomicosis/epidemiologíaRESUMEN
La tiña negra es una micosis cutánea superficial causada por un hongo levaduriforme denominado Hortaea werneckii, es frecuente en regiones cálidas y en zonas de playa. Se comunica su aislamiento de la palma de la mano de un niño sin antecedentes de contacto con fuente infecciosa ni de hiperhidrosis que fue tratado con pomada de Whitfield con azufre desapareciendo la lesión al mes sin recidivas. Se considera significativo presentar este caso dada la escasa frecuencia de su diagnóstico(AU)
Tinea nigra is a superficial cutaneous mycosis, caused by the yeasty-form fungus called Hortaea werneckii. It is frequent in warm regions and in beach zones. Its isolation in the hand palm of a boy without antecedents of infectious contact or hyperhidrosis is reported in this article. He was treated with an ointment of benzoic acid, salicylic acid and sulfur; lesions disappeared after a month without recurrence. The presentation of the case was considered significant due to the scarce frequency of this diagnose(AU)
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Humanos , Masculino , Preescolar , Tiña/diagnóstico , Tiña/tratamiento farmacológico , Tiña/etiología , Dermatomicosis/diagnóstico , Dermatomicosis/tratamiento farmacológico , Dermatomicosis/etiología , Ácido Benzoico/uso terapéutico , Informes de CasosRESUMEN
BACKGROUND: Mexican diabetic population frequently presents mycosis under foot hyperkeratosis; however, in another type of onychomycosis as the ones that is assumed Candida albicans is the causal agent, it is unknown the frequency, the prevalence and if another Candida species or other yeasts are found. OBJECTIVE: Evaluate the frequency of yeasts causing onychomycosis in diabetic patients looked after in public institutions of health of the State of Hidalgo, Mexico, and its association with clinical epidemiological variables. MATERIALS AND METHODS: An observational, descriptive and transversal study was made on 261 patients, from which one nail sample of each one was obtained, used to isolate and identify dermatophytes and yeasts; the results were statistically correlated with 24 epidemiological parameters. The clinical study was done through interrogation and by medical exploration in order to evaluate Tinea pedis and onychomycosis. RESULTS: Onychomycosis were caused by Candida guilliermondii, Candida parapsilosis, Candida glabrata, Candida krusei, Candida spp., Kodamaea ohmeri, Prototheca wickerhamii and unidentified yeasts. The prevalence for general onychomycosis, by dermatophytes, mixed onychomycosis and by yeasts were: 24.1, 19.5, 2.3 and 14.6%, respectively. Patients with significant probability to be diagnosed as having onychomycosis by yeasts are those wearing open shoes (2.59%); technicians and professionals (10.49%) and alcohol drinkers (3.72%). CONCLUSION: The fact that Candida albicans is not present in this study as causal agent of onychomycosis, and emerging and non-common yeasts were indeed isolated, creates new challenges. It is remarked the clinical criterion that when onychomycosis is suspected in diabetics, the diagnosis for culturing dermatophytes and yeasts should be included.
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Arthrodermataceae/aislamiento & purificación , Candida/aislamiento & purificación , Dermatomicosis/microbiología , Diabetes Mellitus Tipo 2/complicaciones , Dermatosis del Pie/microbiología , Onicomicosis/microbiología , Adulto , Anciano , Anciano de 80 o más Años , Arthrodermataceae/clasificación , Candida/clasificación , Candidiasis/diagnóstico , Candidiasis/epidemiología , Candidiasis/etiología , Candidiasis/microbiología , Estudios Transversales , Dermatomicosis/diagnóstico , Dermatomicosis/epidemiología , Dermatomicosis/etiología , Diabetes Mellitus Tipo 2/microbiología , Femenino , Dermatosis del Pie/diagnóstico , Dermatosis del Pie/epidemiología , Dermatosis del Pie/etiología , Humanos , Masculino , México , Persona de Mediana Edad , Onicomicosis/diagnóstico , Onicomicosis/epidemiología , Onicomicosis/etiología , PrevalenciaRESUMEN
Objetivos: Determinar la evolución epidemiológica de las dermatomicosis en pacientes de consultorio externo durante el periodo 1976-2005. Diseño: Estudio descriptivo, retrospectivo y analítico. Lugar: Instituto de Medicina Tropical æDaniel Alcides CarriónÆ, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes: Pacientes positivos a dermatomicosis. Intervenciones: Se revisó las historias clínicas de 7 185 (55,3 por ciento) casos positivos a dermatomicosis. El instrumento de investigación empleado fue la ficha de levantamiento de información. Principales medidas de resultados: Agente etiológico, estación del año, sexo, edad y forma clínica. Resultados: El estudio demostró que los más afectados fueron del grupo etario de 16 a 30 años (42,7 por ciento) y sexo femenino (52,1 por ciento). La dermatomicosis más frecuente fue la onicomicosis (43,6 por ciento). Los agentes patógenos de mayor prevalencia fueron Trichophyton rubrum (33,2 por ciento), Cándida albicans (15,3 por ciento), Cándida no albicans (11,8 por ciento), Trichophyton mentagrophytes (9,4 por ciento), Malassezia spp (9,1 por ciento) y las infecciones mixtas (7,2 por ciento). Las micosis de cuero cabelludo muestran continuo aumento durante todo el estudio. El dermatofito Epidermophyton floccosum fue aislado por última vez en la década del 90. A partir de 1995 ha aumentado la prevalencia de Cándida no albicans y se encontró como especie re-emergente a la levadura Cándida tropicalis. Conclusiones: Entre los años 1976 y 2005 hubo importantes variaciones epidemiológicas en relación a las formas clínicas y a la etiología de las dermatomicosis...
Objectives: To determine dermatomycoses epidemiological evolution in outpatients during the period 1976-2005. Design: Descriptive, retrospective, and analytical study. Setting: Daniel Alcides Carrion Institute of Tropical Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Participants: Patients positive to dermatomycoses. Interventions: Medical records of 7 185 (55.3 per cent) dermatomycoses-positive patients were reviewed. Main outcome measures: Etiologic agent, season, gender, age, and clinical forms. Results: Females (52.1 per cent) and the 16 to 30 year-old group (42.7 per cent) were the most affected. Most frequent dermatomycoses was onychomycosis (43.6 per cent). Most prevalent pathogens were Trichophyton rubrum (33.2 per cent), Candida albicans (15.3 per cent), Candida non albicans (11.8 per cent), Trichophyton mentagrophytes (9.4 per cent), Malassezia spp. (9.1 per cent), and mixed infections (7.2 per cent). The fungal scalp infection showed steady increase during the period studied. Epidermophyton floccosum dermatophyte was isolated for the last time in the 1990s. Since 1995 prevalence of Candida non albicans has increased and Candida tropicalis yeast species are re-emerging. Conclusions: Epidemiological changes in dermatomycoses clinical forms and etiology were found between 1976 and 2005...
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Humanos , Masculino , Adolescente , Adulto , Femenino , Niño , Adulto Joven , Persona de Mediana Edad , Dermatomicosis/epidemiología , Dermatomicosis/etiología , Evolución Clínica , Infecciones Bacterianas/complicaciones , Onicomicosis , Estudios RetrospectivosRESUMEN
BACKGROUND: Human T cell lymphotropic virus type I (HTLV-I) is associated with specific manifestations such as adult T cell lymphoma/leukemia (ATLL), HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), HTLV-I-associated uveitis, and infective dermatitis associated with HTLV-I (IDH). Although ATLL and IDH are considered specific manifestations of HTLV-I infection, several dermatological manifestations have been described in HTLV-I seropositive patients. OBJECTIVES: This study was conducted to determine the prevalences of skin lesions in patients infected with HTLV-I in an area of Brazil endemic for HTLV-I infection and to compare these prevalences with those in seronegative individuals in the same region. METHODS: A prevalence study was conducted between 2008 and 2010 with two groups of individuals comprising, respectively, 179 HTLV-I seropositive (positive enzyme-linked immunosorbent assay [ELISA] and positive Western blot analysis) and 193 HTLV-I seronegative individuals (ELISA-negative). The subjects were selected on a random basis and evaluated using a questionnaire to obtain epidemiological and clinical data. A physical examination was performed to verify the presence of skin lesions. RESULTS: Superficial mycoses were found in 54 (30.2%) seropositive subjects and in 26 (13.5%) of the seronegative group (P < 0.001). Xerosis was found in 39.1% of HTLV-I infected subjects and in 9.3% of seronegative controls (P < 0.001). Ichthyosis was diagnosed in nine (5.0%) HTLV-I seropositive subjects but in none of the control group (P = 0.001). A diagnosis of seborrheic dermatitis was made in 43 (24.0%) HTLV-I infected subjects and in 24 (12.4%) seronegative controls (P = 0.004). Furthermore, dermatological manifestations were more intense in the HTLV-I seropositive group. CONCLUSIONS: Several dermatological manifestations are more common and more severe in HTLV-I seropositive subjects. The presence of these manifestations in an area endemic for HTLV-I infection may provide some clues in the investigation of this infection.
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Dermatitis Seborreica/virología , Dermatomicosis/etiología , Infecciones por HTLV-I/complicaciones , Ictiosis/virología , Adolescente , Adulto , Estudios de Casos y Controles , Femenino , Virus Linfotrópico T Tipo 1 Humano , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Infectious and noninfectious skin diseases are observed in about 90% of HIV patients, and their incidence increases and is more severe as the immune system weakens. Cutaneous manifestations are considered good clinical predictors for the immunological condition of the patient with AIDS and the introduction of highly effective antiretroviral therapy totally changed the prognosis of the mycoses, among other diseases associated with AIDS, permitting longer survival and acceptable level of quality of life for these patients. This contribution describes the systemic mycoses that are more frequent in the seropositive population, that is, patients with HIV/AIDS, which are cryptococcosis, histoplasmosis, coccidioidomycosis, blastomycosis, paracoccidioidomycosis, sporotrichosis, penicilliosis, and aspergillosis. Their causative agents, mode of transmission, clinics, laboratorial diagnosis and therapy, in the aspects related to immunodepressed patients, are reviewed.
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Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Dermatomicosis/etiología , Micosis/etiología , Antifúngicos/uso terapéutico , Dermatomicosis/diagnóstico , Dermatomicosis/tratamiento farmacológico , Diagnóstico Diferencial , Humanos , Huésped Inmunocomprometido , Micosis/diagnóstico , Micosis/tratamiento farmacológicoAsunto(s)
Humanos , Femenino , Niño , Aspergilosis/patología , Aspergilosis/tratamiento farmacológico , Dermatomicosis/etiología , Dermatomicosis/tratamiento farmacológico , Antifúngicos/uso terapéutico , Diagnóstico Diferencial , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Pirimidinas/uso terapéutico , Triazoles/uso terapéuticoAsunto(s)
Adenocarcinoma/secundario , Síndrome de Behçet/complicaciones , Neoplasias del Colon/complicaciones , Criptococosis/diagnóstico , Dermatomicosis/diagnóstico , Errores Diagnósticos , Neoplasias Hepáticas/secundario , Infecciones Oportunistas/diagnóstico , Adenocarcinoma/complicaciones , Adenocarcinoma/diagnóstico , Adenocarcinoma/diagnóstico por imagen , Anciano , Antifúngicos/uso terapéutico , Neoplasias del Colon/diagnóstico , Criptococosis/tratamiento farmacológico , Criptococosis/etiología , Criptococosis/cirugía , Desbridamiento , Dermatomicosis/tratamiento farmacológico , Dermatomicosis/etiología , Dermatomicosis/cirugía , Resultado Fatal , Fluconazol/uso terapéutico , Humanos , Hallazgos Incidentales , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/diagnóstico por imagen , Masculino , Infecciones Oportunistas/tratamiento farmacológico , Infecciones Oportunistas/etiología , Infecciones Oportunistas/cirugía , Radiografía , Úlcera Cutánea/diagnóstico , Úlcera Cutánea/tratamiento farmacológico , Úlcera Cutánea/etiología , Úlcera Cutánea/cirugía , Vasculitis Leucocitoclástica Cutánea/diagnósticoRESUMEN
Se presenta un caso de una de las micosis superficiales menos frecuentes en nuestro medio, la Tiña Negra Palmaris, el diagnóstico de esta enfermedad se presta a confusión con otras entidades nosológicas. Esta patología afecta fundamentalmente las palmas de las manos, es producida por dos especies de hongos, siendo el más común en nuestro medio Exophiala werneckii o Cladosporium werneckii. Resultando interesante la presentación médica de este caso, por lo poco frecuente de esta patología y el hecho de que en pocas ocasiones se puede precisar la fuente de infección (AU)
It was reported a case of one of the less common superficial mycosis in our environment, Tinea Nigra palmaris. The diagnosis of this disease could lead to confusion with other nosologic entities. This pathology primarily affects the palms of hands. It is produced by two fungal species, being the most common in our environment Exophiala werneckii o Cladosporium werneckii. Medical presentation of this case results interesting, since this rare patholgy is very uncommon and the fact that the source of the infection can rarely be defined (AU)
Asunto(s)
Dermatomicosis/diagnóstico , Dermatomicosis/etiología , Dermatomicosis/microbiologíaRESUMEN
Fundamento: a pesar de que pocas especies de hongos son patógenos para los humanos y aun cuando su importancia es menor que las de las bacterias o los virus, no son insignificantes como causa de enfermedades. Desde el punto de vista práctico se ha comprobado que las micosis que estos causan representan uno de los primeros motivos de consulta dermatológica en nuestro país y el mundo. Objetivo: determinar las principales características clínico-epidemiológicas y de laboratorio de pacientes en edad pediátrica afectados por dermatofitosis. Métodos: estudio descriptivo, de serie de casos que incluyó 102 pacientes con diagnóstico de dermatofitosis cuya información fue recogida de historias clínicas y en el laboratorio al realizarse raspado y cultivo de las lesiones. Resultados: se obtuvo mayor positividad en el examen por cultivo (70,59 por ciento), frente a 66, 7 por ciento en el examen por raspado; el Trichophyton rubrum fue el agente causal más frecuente en las uñas y en el cuerpo, predominó en el grupo de 15 años y más, en los pacientes de color de piel blanca y en las féminas. La mayoría de los pacientes se infectaron a través del contacto con canes. Conclusiones: no son bajos los por cientos de pacientes pediátricos con dermatofitosis, la cual continúa siendo causa frecuente de consulta médica(AU)
Background: Although few fungal species are considered to be pathogenic to humans and even when they are commonly less relevant than bacteria or viruses, they are not insignificant as a cause of disease. From a practical point of view, it was found that the mycosis fungoides they cause is one of the first reasons for consultation in our country and the world. Objective: To determine the main clinical and epidemiological features and laboratory findings of pediatric patients affected by ringworm. Methods: A descriptive, case series study was conducted. It included 102 patients with dermatophytosis. The information about these patients was collected from medical records and laboratory results of scraping and cultures of the lesions. Results: We obtained more positives in the test by culture (70.59 percent), compared to a 66, 7 percent in the examination by scraping, being Trichophyton rubrum the most common causative agent in the nails and body. The age group from 15 years old on predominated, as well as white skinned and female patients. Most patients were infected through contact with dogs. Conclusions: The percentage of pediatric patients with dermatophytosis is not low. This remains a frequent cause of medical consultation(AU)
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Humanos , Niño , Dermatomicosis/epidemiología , Dermatomicosis/etiología , Epidemiología DescriptivaRESUMEN
O dermatófito Trichophyton rubrum é um agente comum nas micoses superficiais, podendo apresentar lesões extensas pauci-inflamatórias de evolução crônica, especialmente em imunocomprometidos. O hipercortisolismo, na síndrome de Cushing, aumenta o risco de infecções, resultado do efeito imunossupressor dos glicocorticóides. Os casos relatados apresentam duas formas distintas de dermatofitose, em pacientes com doença de Cushing, causadas por Tricophyton rubrum e posterior remissão após normalização da cortisolemia.
Trichophyton rubrum is a common agent found in superficial mycoses, which present ample nonin?ammatory lesions, with chronic evolution, especially in immunocompromised patients. The hypercortisolism in Cushing's syndrome increases the risk of infections as a result of the immunosuppressive effect of glucocorticoids. The reported cases here refer to two different types of dermatophytosis caused by Trichophyton rubrum in patients with Cushing's disease, resistant to antifungal treatment. The disease remitted after the levels of cortisol went back to normal.
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Adulto , Femenino , Humanos , Masculino , Adulto Joven , Síndrome de Cushing/microbiología , Dermatomicosis/etiología , Hidrocortisona/sangre , Trichophyton/aislamiento & purificación , Síndrome de Cushing/sangre , Dermatomicosis/diagnósticoRESUMEN
This study was designed to compare cutaneous mycoflora isolation and CD4+:CD8+ ratio in feline immunodeficiency virus (FIV)-infected cats with that in FIV-uninfected cats. Sixty cats were examined. Twenty-five were FIV-infected cats and 35 were FIV-uninfected cats. All 60 cats were FeLV-negative. Fungi were speciated and immunophenotyping of peripheral CD4+ and CD8+ T lymphocytes was performed. At least one fungal colony was isolated from 22/25 (88%) FIV-infected cats. Among the FIV-uninfected cats fungal colonies were recovered from 13/35 (37%) specimens. Dermatophytes were recovered from 2/25 (8%) FIV-infected cats (one Microsporum gypseum, one Microsporum canis) and 3/35 (8.5%) FIV-uninfected cats (M gypseum). Malassezia species was the most commonly isolated organism from both groups of cats (51.6%). Malassezia species was more commonly isolated from FIV-infected cats than FIV-uninfected cats (84% vs 28.6%). The CD4+ to CD8+ lymphocyte ratio for FIV-infected cats was significantly lower than the CD4+ to CD8+ ratio in the FIV-uninfected cats. The CD4+ to CD8+ lymphocyte ratio for FIV-infected cats with cutaneous overall fungal isolation was significantly lower than the CD4:CD8 lymphocyte ratio in the FIV-infected cats but without cutaneous fungal isolation. We can conclude that immunologic depletion due to retroviral infection might represent a risk factor to cutaneous fungal colonization in cats.
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Relación CD4-CD8/veterinaria , Enfermedades de los Gatos/inmunología , Dermatomicosis/veterinaria , Síndrome de Inmunodeficiencia Adquirida del Felino/inmunología , Virus de la Inmunodeficiencia Felina/inmunología , Animales , Estudios de Casos y Controles , Enfermedades de los Gatos/etiología , Enfermedades de los Gatos/microbiología , Gatos , Dermatomicosis/etiología , Dermatomicosis/inmunología , Dermatomicosis/microbiología , Síndrome de Inmunodeficiencia Adquirida del Felino/complicaciones , Síndrome de Inmunodeficiencia Adquirida del Felino/microbiología , Femenino , Masculino , Factores de RiesgoRESUMEN
Trichophyton rubrum is a common agent found in superficial mycoses, which present ample non-inflammatory lesions, with chronic evolution, especially in immunocompromised patients. The hypercortisolism in Cushing's syndrome increases the risk of infections as a result of the immunosuppressive effect of glucocorticoids. The reported cases here refer to two different types of dermatophytosis caused by Trichophyton rubrum in patients with Cushing's disease, resistant to antifungal treatment. The disease remitted after the levels of cortisol went back to normal.
Asunto(s)
Síndrome de Cushing/microbiología , Dermatomicosis/etiología , Hidrocortisona/sangre , Trichophyton/aislamiento & purificación , Adulto , Síndrome de Cushing/sangre , Dermatomicosis/diagnóstico , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
Los hongos dermatofitos son los agentes causales más frecuentes de micosis . No obstante, la prevalencia de los agentes causales varía en las regiones geográficas, las características demográficas de la población estudiada y la metodología de laboratorio. A fin de determinar la frecuencia de dermatofitos en niños de Tucumán (R. Argentina), se presentan los resultados de una revisión retrospectiva de 9 años (2000-2008) de los protocolos médicos de 712 niños de 0 a 14 años de edad, (413 varones y 299 mujeres), con diagnóstico clínico de micosis en piel, uñas, pelos y cuero cabelludo evaluados en el Hospital del Niño Jesús. Las tineas fueron diagnosticadas en 487 pacientes (68,4 por ciento), predominando en el género masculino. La distribución de los hongos aislados fue: M. canis (78,4 por ciento), T. mentagrophytes (6,4 por ciento), T. rubrum (6,2 por ciento),T. tonsurans (4,5 por ciento), M. gypseum (3,9 por ciento), T. mentagrophytes var. interdigitale (0,4 por ciento) y E. floccosum (0,2 por ciento). Coincidentemente con trabajos previos realizados en nuestra provincia, la tinea capitis es la afección predominante y M. canis sigue siendo su principal agente patógeno más frecuente (93,8 por ciento). La alta proporción de aislamientos de M. canis, indica claramente que las especies zoofílicas son las más prevalentes en nuestra área. El grupo etario de mayor incidencia fue el de 0 a 3 años seguido del grupo de 4 a 6 años de edad.
Dermatophyte fungi are the most frequent agents causing mycosis. However prevalence of the causing agents varies with the geographic regions, demographic characteristics of the studied population and with the laboratory methodology. In order to determine the incidence of Dermatophytes in chidren of Tucumán (R. Argentina), results of a 9-year retrospective revision (2000-2008) of the medical protocols of 712 children of 0 to 14 years of age (413 men and 299 women) diagnosed with mycosis in hair, scalp, skin and nails are reported and who had been evaluated in the Hospital del Niño Jesús. Tinea were diagnosed in 487 patients (68.4 percent), prevailing in the masculine genus. The distribution of isolated fungi was: M.canis, (78.4 percent), T.mentagrophytes (6.4 percent), T.rubrum (6.2 percent), T tonsurans (4.5 percent), M.gypseum (3.9 percent), T.mentagrophytes var. interdigitale (0.4 percent) and E.floccosum (0.2 percent). Coincidently with previous studies accomplished in our province, tinea capitis is the prevailing affection while M.canis continues being its main and most frequent pathogenic agent (93.8 percent). The high number of M.canis isolations show clearly that zoophilic species are the most prevalent in our area. Children aged 0 to 3 year exhibited the highest prevalence followed by those of 4 to 6 year.
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Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Dermatomicosis/diagnóstico , Dermatomicosis/etiología , Dermatomicosis/historia , Prevalencia , Argentina , MicosisRESUMEN
PURPOSE OF REVIEW: Eumycetoma, phaeohyphomycosis and chromoblastomycosis are subcutaneous mycoses having in common the fact that they are acquired as a result of penetrating trauma to the skin and may be caused by a large variety of fungi. This article will review recent data regarding the epidemiology and treatment of these infections. RECENT FINDINGS: Recent epidemiologic observations in these mycoses include an increased incidence of phaeohyphomycosis in immunosuppressed patients, the association of polymorphisms in genes involved in innate immunity, the occurrence of eumycetoma caused by Madurella mycetomatis and the nosocomial acquisition of phaeohyphomycosis. The management of these infections continues to be challenging. An approach that involves early diagnosis, the use of systemic antifungal agents and local therapies, including surgical removal of lesions, is the basis of the treatment of these diseases. SUMMARY: It is crucial that the epidemiology and clinical presentation of these infections are understood if we are to improve their outcomes.