Assuntos
Alopecia/diagnóstico , Cabelo/diagnóstico por imagem , Microsporum/isolamento & purificação , Pele/diagnóstico por imagem , Tinha do Couro Cabeludo/diagnóstico , Alopecia/microbiologia , Pré-Escolar , Dermoscopia , Cabelo/microbiologia , Humanos , Masculino , Microscopia Confocal , Couro Cabeludo , Pele/microbiologia , Tinha do Couro Cabeludo/microbiologiaRESUMO
Abstract Leprosy is a chronic infectious disease caused by Mycobacterium leprae. This bacillus has a high predilection for skin and peripheral nerves. The scalp’s anatomical properties do not favor the development of such mycobacterium. We report a case of leprosy with scalp involvement, a rare occurrence in our literature.
Assuntos
Humanos , Masculino , Adolescente , Dermatoses do Couro Cabeludo/microbiologia , Hanseníase Multibacilar/patologia , Couro Cabeludo/patologia , Dermatoses do Couro Cabeludo/patologia , Biópsia , Alopecia/microbiologia , Alopecia/patologia , Hanseníase Multibacilar/complicaçõesRESUMO
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. This bacillus has a high predilection for skin and peripheral nerves. The scalp's anatomical properties do not favor the development of such mycobacterium. We report a case of leprosy with scalp involvement, a rare occurrence in our literature.
Assuntos
Hanseníase Multibacilar/patologia , Dermatoses do Couro Cabeludo/microbiologia , Dermatoses do Couro Cabeludo/patologia , Adolescente , Alopecia/microbiologia , Alopecia/patologia , Biópsia , Humanos , Hanseníase Multibacilar/complicações , Masculino , Couro Cabeludo/patologiaRESUMO
An 11-year-old healthy red-haired girl presented with a 3-year history of hair loss and mild pruritus of her scalp. She had previously been diagnosed with trichotillomania. Cutaneous examination showed scant hair loss with neither crusting nor scaly lesions. The scalp hair was diffusely thin, dry, and brittle on the frontal, mid-parietal, and anterior occipital scalp (Figure 1A). A pull test was negative, and a significant number of hair shafts were not detached on repeated traction. Closer examination using a dermatoscope showed follicles with broken hair shafts. The dermatoscopic evaluation also showed frequent pinpoint black dots scattered among the terminal hair shafts at their bases. No scale, scar, or inflammatory changes were seen in the involved areas (Figure 1B). A 20% potassium hydroxide (KOH) preparation of material obtained after gentle scrapping of the black dots on the scalp provided fragments of hair fibers containing aggregates of pigmented yeast forms (Figure 2A) and brown septate hyphae (Figure 2B). Two samples were sent for fungal culture and both showed dark brown colonies on the surface and black coloration when viewed from the reverse side (Figure 3A). Lactophenol cotton blue preparation of the fungal colonies revealed long and septate hyphae with laterally branching conidiophores ending in round-shaped conidia (Figure 3B). The microorganism was identified by the reference laboratory as Cladosporium species. The conidia were usually noted to be single-celled with a distinct dark hilum. They also exhibited prominent attachment scars that caused the cells to appear "shield-shaped." These features were considered to be diagnostic for Cladosporium; however, the reference laboratory could not identify the organism to the species level. The girl's Cladosporium scalp infection was treated with itraconazole at an oral daily dose of 200 mg for 2 months. Upon re-evaluation, she showed significant improvement with not only discontinuation of her alopecia and new hair growth (Figure 4A), but also an absence of broken hair shafts and the dark pigmentation found initially at their base when her scalp was examined using a dermatoscope (Figure 4B). In addition, a new KOH preparation did not reveal the presence of conidia.
Assuntos
Cladosporium/isolamento & purificação , Dermatomicoses/patologia , Dermatoses do Couro Cabeludo/patologia , Alopecia/microbiologia , Alopecia/patologia , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Criança , Dermatomicoses/tratamento farmacológico , Dermatomicoses/microbiologia , Dermoscopia , Feminino , Seguimentos , Humanos , Itraconazol/administração & dosagem , Itraconazol/uso terapêutico , Dermatoses do Couro Cabeludo/tratamento farmacológico , Dermatoses do Couro Cabeludo/microbiologiaAssuntos
Dermatoses do Couro Cabeludo/microbiologia , Dermatoses do Couro Cabeludo/patologia , Tuberculose Cutânea/patologia , Adulto , Alopecia/microbiologia , Antituberculosos/uso terapêutico , Feminino , Humanos , Dermatoses do Couro Cabeludo/tratamento farmacológico , Teste Tuberculínico , Tuberculose Cutânea/tratamento farmacológico , Tuberculose dos Linfonodos/diagnósticoRESUMO
Leprosy, a rare chronic granulomatous communicable disease caused by Mycobacterium leprae, is classically known to have cutaneous and neurologic sequelae. As a result of immigration, the disease, endemic in Brazil, India, Nepal, Madagascar, Myanmar, and Indonesia, has been recognized to be present in North America and the Caribbean. We describe a case of a woman presenting with a long history of a recurrent rash and leg numbness, initially diagnosed with systemic lupus, who was later proven to have lepromatous leprosy. It is a reminder that this underappreciated disease should still be considered in the differential diagnosis of skin rash and neuropathy, even in nonendemic regions.
Assuntos
Hipestesia/microbiologia , Hanseníase Virchowiana/diagnóstico , Alopecia/microbiologia , Dor no Peito/microbiologia , Diagnóstico Diferencial , Emigração e Imigração , Feminino , Guiana/etnologia , Humanos , Pessoa de Meia-Idade , Úlceras Orais/microbiologia , Doenças Reumáticas/diagnósticoRESUMO
We report and eight years old boy presenting with a pyogenic granuloma of the scalp, generalized alopecia, descamative plates in the neck, trunk and limbs and nail involvement. Cultures for fungus of all these lesions disclosed Microspore canis. The patient was treated with oral griseofulvin, miconazole and topical tolnaftate. Five years later and after several incomplete treatments, the patient returns with a fistulous mass of 12 x 8 cm in the dorsal area whose culture revealed Microspore canis. The mass was excised and oral ketoconazole was indicated. After three months of follow up, the patient was lost from control