M. Mosca

Superficial mycoses observed at the Department of Dermatology of the University of Pavia. A 13-year survey.

Over a period of 13 years, 4100 specimens were cultured for fungi. Pityriasis versicolor (Malassezia furfur) was demonstrated in 17.6%, dermatophytosis in 34.6% and candidiasis in 10.8%. The most frequently isolated strains were M. canis (31.5%), T. rubrum (26.3%), E. floccosum (19.7%), T. mentagrophytes (19.3%) for the dermatophytes and C. albicans (88.9%). Those rarely seen were: M. gypseum, T. violaceum, M. audouini, T. schoenleinii. We observed the absolutely complementary results of the microscopic examinations and the cultures of the specimens.

Primary unusual cutaneous cryptococcosis in an HIV former drug-abuser patient

Summary. We describe an HIV‐positive patient suffering from cutaneous cryptococcosis who was a former intravenous drug abuser and who presented a nodulo‐ulcerated lesion on the back of his left hand. This was caused 4 months previously when the patient was injured by a pigeon nesting in an abandoned house. After fluconazole treatment for 4 months, no other visceral infections were recorded 18 months after complete healing of the lesion.

Pityriasis versicolor in a newborn Pityriasis versicolor bei einem Neugeborenen

Summary. Pityriasis versicolor is a superficial mycosis that rarely afflicts children. We present a case in a 2‐month‐old male baby in good health, with hyper‐ and hypopigmented macules located in the cervical region and on the scalp, face and chest. Moreover, we report our record of cases in infancy and the predisposing factors.

Pityriasis versicolor in the aged: a clinical investigation and epidemiological survey in 190 elderly hospitalized patients.

Abstract190 subjects over 60 yrs of age, hospitalized for long stays were checked for scaling and hyperpigmented patches of P. versicolor. 20 patients (10.5%) showed no clinical lesions; 170 patients (89.5%) showed scaling and/or hyperpigmented patches of which 13 patients (6.8%) on direct microscopic exam showed hyphae and yeasts of M. furfur, 64 (33.6%) only globular forms of P. orbiculare and 113 cases (59.4%) showed no fungal elements. Woods light examination showed that 38 subjects (20%) were 6 positive for M. furfur and 23 for P. orbiculare while in the other 9 no fungal elements were observed on microscopic exam. Whereas 48/132 patients negative to Woods light were positive for yeasts on microscopic exam (false negative). This study indicates that P. versicolor is not rare in the elderly and that Woods light examination is not diagnostic. There was no relationship between P. versicolor and underlying illness.

Hepatosplenic infection caused by Candida parapsilosis in patients with acute leukaernia

Zusammenfassung. Candida parapsilosis ist als Erreger der hepatolienalen Candidose ungewöhnlich. In dieser Arbeit werden zwei Fälle von Candida parapsilosis‐bedingter hepatolienaler Candidose an zwei Patienten mit akuter Leukämie vorgestellt. Die mykologische Diagnose erfolgte an Kulturen aus Material von offenen LeberMilz‐Biopsien bei herabgesetzter Dosierung der systemischen antimykotischen Therapie. Der Bericht bestätigt die Wichtigkeit einer frühzeitigen Diagnose dieser Erkrankung als Entscheidungshilfe für eine angemessene antimykotische Chemotherapie.

Specific and non-specific parameters of the host defence system in patients with superficial fungal infections

Summary. Some measures of systemic host defences, i.e. white cell counts, lymphocyte subsets, delayed‐type hypersensitivity and polymorphonuclear leucocyte functions, were evaluated in 42 patients suffering from cutaneous superficial mycoses and in 35 healthy volunteers. Patients were divided according to the extent of their lesions into two groups: group A (30 patients) with skin involvement ≥30% and group B (12 patients) with skin involvement ≤1%. No significant abnormalities in systemic defence mechanisms were observed in group B patients, whereas multiple alterations of polymorphonuclear phagocyte activities, i.e. chemotaxis, phagocytosis, mitogeninduced superoxide anion production, were observed in patients with extensive lesions. The values of these phagocytic functions remained significantly reduced (P<0.01) in these patients after recovery and during a 6‐month follow‐up period.

White sponge naevus: una rara patologia del cavo orale

White sponge naevus (WSN) is a rare, benign, autosomal dominant disorder that involves non cornifying stratified squamous epithelia: predominantly the oral mucosa, less frequently nose, oesophagus, anogenital area. This is an inherited condition, but in literature we can find also case report with negative familial background. Clinically it is characterized by asymptomatic, bilateral, white, soft and spongy plaques in the oral mucosa and the onset is usually in early childhood. The histological features include epithelial thickening, parakeratosis and vacuolization of the suprabasal layer of oral epithelial keratinocytes. In 1995 Richard et all and Rugg et all show that mutation in the mucosal K4 and/or K13, the specific keratins of the buccal, nasal, esophageal mucosae and anogenital epithelia, is associated with WSN. Even if it is a benign condition, it is important to make a differential diagnosis from other white lesions of the oral mucosa, that are potentially malignant. No standard treatment exists, although numerous therapies have been tested. We report a case of a young female patient who presents oral WSN, treated successfully with topical tetracycline; in our case we have used tetracycline ophthalmic cream, because in Italy there is no tetracycline solution.

Studio preliminare sull’utilizzo degli Atopy Patch Test nella diagnosi della dermatite atopica

Atopic dermatitis is a chronic relapsing dermatitis evolving, with clinical, morphological and topographical characteristics for each age, due to the interaction between genetic factors (predisposing) and environmental factors (triggers). The pathogenesis of the disease is not yet known; unlike previously believed, has now been shown that in the pathogenesis, in addition to the known type I immunological reaction, comes in an immune cell-mediated type IV. For this reason it has become increasingly common practice of testing epicutaneous, using as allergens substances known to be held liable for allergic reactions of type I, the Atopy Patch Test. Our study aims to assess the utility, reproducibility and safety in using these tests for diagnostic analysis of atopic dermatitis. The results obtained confirm the usefulness of this test in understanding the mechanism of allergy in atopic subjects and to define the clinical relevance of allergens in triggering atopic dermatitis. By the results obtained we can say that the usefulness of this test seems more obvious to environmental allergens that food allergens, according to reports in the literature.

Eruzione vescicolo-bollosa in un bambino

We report the case of a 3 years old man who presented vesiculobullous lesion localized on the arms, on the legs and on the palmar region. Laboratory findings (Ab antigliadina, BP180, BP230, indirect immunofluorescence), RAST and IgE were done. Antibody assay and indirect immunofluorescence were negatives; IgE were elevated, some allergens were positives, stings of some insect were markedly positives. Clinical laboratory data, familiary anamnesis for atopia and the stagionality of the lesions has make possible diagnosis of stings insect ipersensibility.

Dermatite atopica con manifestazione di prurigo in gravidanza: descrizione di un caso clinico

We report a case of a 29 years old woman affected by atopic dermatitis who presented a worsening of the clinical after discontinuation of therapy after discovering she is pregnant. During the pregnancy you can attend to changes of evolution of disease; if we assist with worsening should be a therapy without adversely affecting the fetus. So is preferable to administer topical medications as first choise; if necessary you can administer systemic antihistamines.