Ramón Felipe Fernández Martínez

Dermatofitosis por Trichophyton rubrum. Experiencia de 10 años (1996-2005) en un servicio de dermatología de un hospital general de la Ciudad de México

Resumen Las dermatofitosis son las micosis mas comunes, siendo Trichophyton rubrum el agente causal hasta en el 80% de los casos. El objetivo de este estudio fue describir las dermatofitosis causadas por T. rubrum en un periodo de 10 anos (1996-2005) en un centro de referencia dermatologico. Para ello, se recopilaron los datos de pacientes con dermatofitosis demostrada por T. rubrum por cultivo micologico. Se encontraron 776 dermatofitosis por T. rubrum, con un discreto predomino de afeccion en las mujeres (56,2%). Los grupos etarios mas afectados fueron los de la tercera a la quinta decada de la vida. La mayor prevalencia se presento en las mujeres dedicadas al hogar, con un 33,5%. El 63% presento tina de las unas, el 22,7% tina de los pies, el 5,2% tina del cuerpo, y el 2,8% tina de la ingle. En las tinas de las unas, la mas afectada fue la una del primer dedo del pie (58,9%). La variante clinica distrofica total fue la mas frecuente (50,7%). Por examen directo se encontro algun elemento fungico en el 92% de los casos.

Oral Candida spp carriers: its prevalence in patients with type 2 diabetes mellitus.

BACKGROUND: Prevalence of oral candidiasis in diabetic patients is 13.7-64%. Candida albicans was the most frequently isolated species (75-86.5%). OBJECTIVE: To obtain the prevalence of Candida carriers among patients with type 2 diabetes mellitus to identify the species of the yeast. Study design: It is an open, observational, descriptive, cross-sectional, and prospective study. METHODS: We included voluntary patients from the National Diabetes Marathon and performed a blood glucose measurement, sialometry test, Gram-stained exfoliative cytology, and culture on Sabouraud dextrose agar and CHROMagar Candida TM. Results were analyzed using descriptive statistics. RESULTS: We examined 141 patients (mean age 57 years): 103 women (73%) and 38 men (26.9%). Exfoliative cytology was positive in 32 cases (23 with oral lesions); 78 had oral lesions but no Candida (93.9%). Candida was isolated in 58 patients (41.1%), 21 (45.6 %) had blood glucose greater than 126 mg/dl, and 37 (38.9%) had less than 126 mg/dl. The most frequent species was C. albicans (82.7%). Forty-two Candida carriers had salivary flow greater than 20 mm (72.4%), and 16 (27.5%) had hyposalivation. Candida was isolated in 25 of 79 patients with dental prosthesis (31.6%), 9 of 15 were smokers (60%), and 22 of 71 had symptoms (30.9%). CONCLUSIONS: Prevalence of oral Candida carriers in patients with type 2 diabetes mellitus in Mexico was similar to that found in other countries; exfoliative cytology was effective in finding Candida; salivary flow rate, use of prosthesis, and presence of oral lesions and symptoms were similar in oral Candida carriers and negative patients. Most smokers were Candida carriers.