RESUMO
Abstract In recent decades, an alarming increase in the number of sporotrichosis cases has been reported in southern and southeastern Brazil, especially in the state of Rio de Janeiro, has been considered a long-term hyperendemic condition associated with feline transmission. According to phenotypic classifications, the Sporothrix species recovered from cats were classified as S. brasiliensis in 96.5% of the studied cases. This finding has also been demonstrated in humans, which confirms the zoonotic transmission associated with this predominant species in Brazil. The zoonotic transmission of the fungus and its important virulence in the context of the hyperendemic situation in Rio de Janeiro have changed the approach to the disease, which in its classic form was restricted to certain professional groups and very specific regions in the Brazilian territory, into a public health challenge of scientific interest. Its atypical manifestations and hypersensitivity reactions are increasingly frequent, constituting a new sporotrichosis aspect, which deserves attention from the medical community, as well as from other health professionals.
Assuntos
Humanos , Animais , Gatos , Esporotricose/epidemiologia , Sporothrix , Doenças do Gato/epidemiologia , Hipersensibilidade , Brasil/epidemiologiaRESUMO
In recent decades, an alarming increase in the number of sporotrichosis cases has been reported in southern and southeastern Brazil, especially in the state of Rio de Janeiro, has been considered a long-term hyperendemic condition associated with feline transmission. According to phenotypic classifications, the Sporothrix species recovered from cats were classified as S. brasiliensis in 96.5% of the studied cases. This finding has also been demonstrated in humans, which confirms the zoonotic transmission associated with this predominant species in Brazil. The zoonotic transmission of the fungus and its important virulence in the context of the hyperendemic situation in Rio de Janeiro have changed the approach to the disease, which in its classic form was restricted to certain professional groups and very specific regions in the Brazilian territory, into a public health challenge of scientific interest. Its atypical manifestations and hypersensitivity reactions are increasingly frequent, constituting a new sporotrichosis aspect, which deserves attention from the medical community, as well as from other health professionals.
Assuntos
Doenças do Gato , Hipersensibilidade , Sporothrix , Esporotricose , Animais , Brasil/epidemiologia , Doenças do Gato/epidemiologia , Gatos , Humanos , Esporotricose/epidemiologiaRESUMO
The Community Dermatology Program established in the state of Guerrero, Mexico for almost 30 y provides an adaptable method of detecting and monitoring skin neglected tropical diseases such as mycetoma, which is endemic in the state. The program utilises general and thematic teaching elements combined with distance learning through teledermatology, direct patient consultations and close collaboration with community teams. Using this approach, a picture of mycetoma in Guerrero has emerged, with a focal hot spot located in the southern part of the state in the Costa Chica region. Although in much of Mexico Nocardia infections dominate, in this area there are also substantial numbers of cases of eumycetoma. This combined approach provides a means of early case detection and long-term surveillance through targeted use of a small specialist team.
Assuntos
Dermatologia , Micetoma , Medicina Tropical , Humanos , México/epidemiologia , Micetoma/diagnóstico , Micetoma/epidemiologia , Micetoma/terapia , PeleAssuntos
Antibacterianos/uso terapêutico , Doenças do Gato/microbiologia , Infecções por Chlamydophila/microbiologia , Chlamydophila/patogenicidade , Doxiciclina/uso terapêutico , Idoso , Animais , Doenças do Gato/transmissão , Gatos , Infecções por Chlamydophila/tratamento farmacológico , Infecções por Chlamydophila/transmissão , Infecções por Chlamydophila/veterinária , Feminino , Humanos , Resultado do Tratamento , ZoonosesRESUMO
BACKGROUND: Fishing is an important economic activity worldwide, but there are only a few studies on the skin health of fishermen. Daily activities in fishing communities expose fishermen to risks of traumatic, actinic, and sea dermatoses. METHODS: A semi-structured questionnaire was applied to 388 fishermen from 2014 to 2015 at their workplace (Z-8 to Z-13 fishing communities). The data collected were evaluated for descriptive analysis. In the bivariate analysis of the data, the Pearson chi-square test was used. The multinomial logistic regression was used to obtain estimates of odds ratios and adjusted confidence intervals for confounding variables. RESULTS: Three hundred and nine (79.6%) fishermen reported accidents during their fishing activity. The main fish species implicated were Genidens genidens and Scorpaena brasiliensis. Inappropriate or potentially harmful traditional treatments without scientific evidence of efficacy were recorded as main/auxiliary treatment. Other significant skin injuries were due to trauma from fishing tackle and exposure to ultraviolet radiation. Three hundred and twenty (82.5%) fishermen reported that they had never used any sun protective devices or sunscreen. CONCLUSIONS: Traumatic injuries due to fish stings were the most common accidents in this group. Despite chronic occupational sun exposure and its hazards, most fishermen did not adopt any method of photoprotection. Health educational activities as well as a specific health program for these professionals are necessary to improve the health of fishermen in Guanabara Bay area.
Assuntos
Acidentes de Trabalho/estatística & dados numéricos , Mordeduras e Picadas/epidemiologia , Peixes , Abastecimento de Alimentos , Exposição Ocupacional , Pele/lesões , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Animais , Brasil , Feminino , Abastecimento de Alimentos/instrumentação , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Saúde Ocupacional , Roupa de Proteção/estatística & dados numéricos , Protetores Solares/uso terapêutico , Inquéritos e Questionários , Fatores de Tempo , Raios Ultravioleta/efeitos adversos , Adulto JovemAssuntos
Esporotricose/complicações , Esporotricose/diagnóstico , Animais , Antifúngicos/uso terapêutico , Brasil , Gatos , Criança , Vetores de Doenças , Testa/anormalidades , Testa/fisiopatologia , Humanos , Masculino , Dermatopatias/complicações , Dermatopatias/diagnóstico , Sporothrix/patogenicidadeRESUMO
Orf is a highly contagious skin disease commonly seen in goats and sheep that can be transmitted to people who have direct contact with infected animals. Here, we report the clinical manifestation, dermoscopy, and scanning electron microscopy in two women who developed skin lesions on their hands after handling goats with wounds in the udders. Human orf is usually self-limiting and no specific treatment is needed.
RESUMO
Paracoccidioidomycosis (PCM) is the most widespread endemic mycosis in LatinAmerica. If PCM is not diagnosed and treated early and adequately, the endemic fungal infection could result in serious sequelae. We report a case of PCM with duodenal and cutaneous involvement simulating cholangitis that was initially misdiagnosed as a lymphoproliferative disease. Clinicians should consider acute paracoccidioidomycosis in the differential diagnosis of jaundice and/or signs/symptoms of cholangitis developing in young patients from paracoccidioidomycosis endemic regions.
RESUMO
Injuries to humans caused by porcupines are rare. However, they may occur due to the proximity of urban areas and the animal's habitat in areas such as the Floresta da Tijuca in Rio de Janeiro. Outdoor sports and leisure activities in areas close to forests or in the rain forest are also relevant for incidents of this kind and a better knowledge of the local forest fauna would prevent such undesirable accidents. Porcupine quills have microscopic barbs at their tips which facilitate skin penetration, but hampering their removal. Once the spines are lodged in tissue, the microscopic backward-facing deployable barbs at the tips cause trauma if anyone tries to remove them. Local haemorrhage and an inflammatory response to the contaminated foreign body occur. Depending on the time lapse in removing the spines either septic or sterile foreign body reactions may occur. There is also the risk of migration of the spines, where fatal cases have been reported in human and veterinary medicine. Herein we report two unusual cases of accidents involving humans and the South American porcupine. The Sphiggurus villosus spines removed from scalp skin were also documented through Scanning Electron Microscopy.
RESUMO
We report a 21-year-old farmer with a 4-year history of a nodular plaque with fistulas and induration of adjacent skin. The lesion had been treated surgically at another hospital, but recurred 2 years later. Black, charcoal-like grains were observed draining through the fistulas. A biopsy specimen showed brown grains with filaments in an abscess surrounded by macrophages, giant cells, and lymphocytes. Culture demonstrated small white colonies of Madurella mycetomatis. The patient was treated with itraconazole for 6 months, followed by surgery. TNP was initiated in the immediate post-operative period, and copious granulation tissue was observed within 1 week. Autologous skin grafting was performed, and itraconazole was continued for an additional 3 months. Although necrosis of the graft ensued, the functional result was acceptable. The patient appeared free of disease at 18 months of follow-up. Eumycotic mycetoma is an infectious and inflammatory process that occurs after traumatic inoculation of fungi through the skin. Surgery is the treatment of choice, but successful reconstruction may be challenging and recurrence is common. Topical negative pressure (TNP) promotes the formation of granulation tissue, which facilitates closure of deep wounds and chronic ulcers. This case illustrates that eumycotic mycetoma is difficult to treat. Whether TNP contributed to the successful outcome cannot be proven but, given the generally poor response of eumycetoma to therapy, we suggest that the role of TNP in the management of this disease merits attention.
Assuntos
Antifúngicos/administração & dosagem , Itraconazol/administração & dosagem , Madurella , Micetoma/tratamento farmacológico , Micetoma/cirurgia , Tratamento de Ferimentos com Pressão Negativa , Terapia Combinada , Humanos , Masculino , Micetoma/patologia , Adulto JovemRESUMO
IFN-gamma, TNF-alpha, IL-4, IL-10 and IL-12 concentrations in the supernatant of peripheral blood mononuclear cell (PBMC) cultures and the in vitro proliferation of PBMC were studied in 25 patients with actinomycetoma caused by Nocardia brasiliensis and in 10 healthy controls from endemic zones. Cell cultures were stimulated by a N. brasiliensis crude cytoplasmic antigen (NB) and five semi-purified protein fractions (NB2, NB4, NB6, NB8, and NB10) separated by isoelectric. Phytohemagglutinin (PHA) and purified protein derivative (PPD) of Mycobacterium tuberculosis were used as control antigens. Skin tests were performed by injecting 0.1 ml of candidin and PPD intradermally (ID). Patients showed a poor response to tuberculin, while their response to candidin was more than two fold greater than that observed in the controls. Cell proliferation showed no statistically significant differences in either group. IFN-gamma production was higher in the healthy controls than in the patients, whereas TNF-alpha secretion was slightly higher in the patients' cultures. IL-4 was detected in the patients' cultures but not in the controls. IL-10 and IL-12 were present at low concentrations in both groups. These results suggest that patients with actinomycetoma show normal antigen recognition, but with low IFN-gamma production, and higher concentrations of IL-4, IL-10 and TNF-alpha in the patients' PBMC cultures, indicating that they probably have a Th2 type of immune response.
Assuntos
Citocinas/biossíntese , Leucócitos Mononucleares/metabolismo , Nocardiose/imunologia , Nocardiose/prevenção & controle , Nocardia/isolamento & purificação , Adolescente , Adulto , Idoso , Feminino , Humanos , Interferon gama/biossíntese , Interleucina-10/biossíntese , Interleucina-12/farmacologia , Interleucina-2/biossíntese , Interleucina-4/biossíntese , Ativação Linfocitária , Masculino , Pessoa de Meia-IdadeRESUMO
Se ralizó un estudio transversal para determinar la prevalencia de las enfermedades piógenicas de la piel en el medio rural, su asociación a factores de riesgo y costo por atención. Se encuestaron un total de 211 casas con una población de 1,387 personas; se encontró una prevalencia del 6 por ciento de piodermias; sobre los factores de riesgo estudiados, se encontró que una persona que convive con otros pacientes con esta dermatosis tiene más de seis vece el riesgo de tener la enfermedad comparada con otra que no refirió este antecente (RR 6.6, RD 0.12 Xmh 5.6); se utilizó un modelo de regresión logística donde se incluyeron varios factores de manera simultánea
Assuntos
Humanos , Serviços de Saúde Comunitária/economia , Infecções Comunitárias Adquiridas/economia , Infecções Comunitárias Adquiridas/epidemiologia , Economia e Organizações de Saúde , Pioderma/economia , Pioderma/epidemiologia , População RuralRESUMO
18 girls from an orphanage (Orfanato Santo Antônio) in Niterói presented tinea capitis due to Trichophyton tonsurans (15 cases-83.3% ) and Microsporum canis (3 cases-26.7% ). Comments are made about clinical, mycological and therapeutic aspects of this microepidemic