Mauricio Mota de Avelar Alchorne

Disseminated dermatophytosis caused by Microsporum gypseum in two patients with the acquired immunodeficiency syndrome

Microsporum gypseum is not a common agent of human dermatophytosis. To the best of our knowledge, this fungus has not been described in human immunodeficiency virus (HIV)-infected patients. We report a tinea corporis infection with atypical presentation caused by M. gypseum in two patients with the acquired immunodeficiency syndrome (AIDS) studied at the São Paulo Hospital (São Paulo, Brazil).

Actinic cheilitis: histopathology and p53

Background:  Chronic actinic cheilitis (AC) is a precursor of squamous cell carcinoma (SCC) of the lip.

The oral mucosa in leprosy: a clinical and histopathological study

INTRODUCTION Multibacillary leprosy may involve the oral mucosa, with or without apparent lesions. There are few studies that deal with this issue in the era of multidrug therapy. AIM To assess the frequency of oral mucosa involvement in multibacillary leprosy patients. PATIENTS AND METHODS A transversal study with twenty non-treated multibacillary leprosy patients. The patients were treated in Dracena, São Paulo, between 2000 and 2002. Clinical examination of the oral mucosa was carried out. All patients were submitted to jugal mucosa, soft palate and tongue biopsies, in altered or in pre-established sites. The cross-sections were stained by techniques of hematoxilin-eosin and Ziehl-Neelsen. Granuloma and alcohol-acid-resistant bacilli findings determined the specific histopathological involvement. RESULTS The study involved 19 patients with an average of 2.5 years of disease progression. Specific histopathological involvement occurred in the tongue and soft palate of one lepromatous patient with an apparently normal oral mucosa. CONCLUSIONS (1) Clinical alterations in the oral mucosa does not imply disease involvement, it is necessary to have histopathological confirmation. (2) Apparent specific clinical alterations are rare. (3) The clinically normal oral mucosa can show specific histopathological involvement.

Actinic cheilitis adjacent to squamous carcinoma of the lips as an indicator of prognosis

UNLABELLED Many studies have shown an association between actinic cheilitis and squamous carcinoma of the lips. AIM The aim of the study was to observe the relation between actinic cheilitis and the prognosis of squamous carcinoma of the lips. MATERIALS AND METHODS This is a retrospective cross-sectional cohort study of squamous carcinoma of the lips. Histological sections of squamous carcinoma tumors done at the the Department of Pathology of the Sao Paulo Federal University between 1993 and 2000 were reviewed for evidence of actinic cheilitis in the lip vermillion adjacent to the tumor. Patient reports were reviewed to find information about exposure to sun, metastases and relapses. The occurrence or absence of relapses and metastases was correlated with the presence or absence of actinic cheilitis in the lip vermillion. Data was analyzed by Fishers Exact test. RESULTS Of the 31 selected patients, most were caucasian, males and with lower lip involvement. Statistical analysis demonstrated independence between the occurrence of metastases and relapse and gender, skin color and site (lower or upper lips). There was dependence between actinic cheilitis and solar elastosis, and between the absence of actinic cheilitis and the occurrence of metastases. There was no dependence between the absence of actinic cheilitis and the occurrence of relapses. CONCLUSION It may be concluded that tumors originating from actinic cheilitis have a better prognosis.

Dermatologia na pele negra

This study approaches dermatology in dark skinned individuals. First, it discusses the concepts of race and ethnicity, as well as the classification criteria of the Brazilian population, indicating areas where the dark skinned people are concentrated. Next, it makes one brief explanation on skin color classification systems and describes structural, biological and functional characteristics of the epidermis, dermis and cutaneous attachments that differentiate dark from fair skin. It also approaches some physiological alterations that usually are observed in the skin, nails and in the mucosa of dark skinned people. Also discussed are some patterns of reactions and alterations of lesion color, due to cutaneous hyperpigmentation, which lend unexpected aspects to the dermatosis, making its recognition difficult. Finally, the study highlights some diseases in particular, emphasizing inherent characteristics associated to lesion patterns and the frequency of some dermatoses in the black skin. The aim of this study was to bring data to help the dermatologist be familiar with the different nuances that lesions may present in a more pigmented skin.

A mucosa oral na hanseníase: um estudo clínico e histopatológico

INTRODUCAO: a anseniase multibacilar pode causar comprometimento da mucosa oral, com ou sem lesoes aparentes. Ha poucos estudos que tratam deste assunto na era da multidrogaterapia. OBJETIVO: Verificar a frequencia do comprometimento da mucosa oral em pacientes de hanseniase multibacilar. CASUISTICA E METODOS: Foi realizado um estudo transversal em vinte pacientes de hanseniase multibacilar, nao-tratados, atendidos consecutivamente em Dracena, Sao Paulo, entre o periodo de 2000 e 2002. Foi realizado exame clinico completo da mucosa oral. Os pacientes foram submetidos a biopsias na mucosa jugal, na lingua e no palato mole, em alteracao ou em pontos pre-estabelecidos. Os cortes foram corados pelas tecnicas da hematoxilina-eosina e Ziehl-Neelsen. O encontro de granuloma e bacilos alcool-acido-resistentes ao exame histopatologico determinou o comprometimento especifico. RESULTADOS: O estudo envolveu 19 pacientes multibacilares com tempo medio de evolucao de 2,5 anos. Ocorreu comprometimento histopatologico especifico em apenas um paciente virchowiano, com mucosa oral clinicamente normal, na lingua e no palato mole. CONCLUSOES: 1. Alteracao clinica na mucosa oral nao implica em comprometimento pela doenca, e necessario confirmacao histopatologica. 2. Alteracoes clinicas especificas aparentes sao raras. 3. A mucosa oral clinicamente normal pode exibir comprometimento histopatologico especifico.

Mycetoma caused by Fusarium solani with osteolytic lesions on the hand: case report

Eumycetoma is a mycotic disease caused by saprophytic soil fungi that are usually inoculated through minor injuries. A case of mycetoma in a Brazilian farmer aged71 years is reported. This patient presented erythema and edema on the dorsal surface of the left hand with multiple crusted and cicatricial lesions. No macroscopic grains were observed. The histopathological findings showed grains consisted of numerous hyphae which stained well with Gomori-Grocott method. This material obtained by cutaneous biopsy was submitted to culture on Sabouraud’s medium and the colonies were identified as Fusarium solani. The radiological studies revealed bone osteolytic lesions and the ultrasound showed pseudocysts and fistulae at the site of this infection. The patient was treated with oral ketoconazole with a good clinical response.

Epidemiology of Kaposi's sarcoma in patients with acquired immunodeficiency syndrome in São Paulo, Brazil

Background  Kaposis sarcoma (KS) is the most frequent neoplasm in patients with acquired immunodeficiency syndrome (AIDS). Although many studies on KS epidemiology have been performed in other countries, few have been carried out in Brazil despite the high incidence of AIDS.

Lymphoscintigraphic analysis in chromoblastomycosis.

Background One of the main complications of chromoblastomycosis is lymphedema. The purpose of this study was to evaluate the lymphatic system of the limbs of patients with chromoblastomycosis using lymphoscintigraphy. It is a reliable, objective and noninvasive means of supporting the diagnosis of lymphedema.

Tinea cruris epidemiology (São Paulo, Brazil)

In order to determine the epidemiology of tinea cruris in São Paulo, Brazil, an investigation was carried out from April 95 to March 1997. A total of 2000 individuals were studied, of whom 105 were suspected of having tinea cruris infection. Direct microscopy and/or culture were positive in 66 [62.8%] of the cases. Erythematous-scale plaques and erythematous-liquenificated plaques were the most frequently found clinicaltypes. T. rubrum was the prevalent dermatophyte in 90% of the cases, followed by T. tonsurans (6%) and T. mentagrophytes (4%).