Rocío Orozco-Topete

An epidemic outbreak of Malassezia folliculitis in three adult patients in an intensive care unit : a previously unrecognized nosocomial infection

Background Malassezia is a lipophilic fungus commonly found in normal human skin. Infection of the hair follicle by Malassezia furfur occurs in patients with predisposing factors such as diabetes or immunosuppression, or who are undergoing antibiotic treatment. Malassezia furfur folliculitis is an infrequent nosocomial infection which may be associated with fomite transmission.

Frequency of oral conditions in a dermatology clinic

Background Oral mucosal manifestations may be the initial feature, the most florid clinical feature, or the only sign of mucocutaneous diseases.

Superficial Mycotic Infections of the Foot in a Native Pediatric Population: A Pathogenic Role for Trichosporon cutaneum?

Abstract: Superficial mycotic infections of the feet are usually caused by Tricophyton rubrum, predominantly affecting adults and resulting from the use of occlusive footwear. We carried out a mycologic study of superficial foot infections in a rural school in Mexico where most people wear a leather, nonocclusive sandal. Forty students had clinical signs of 50 fungal infections of the foot: 39 athletes foot and 11 onychomycosis. Thirty‐one boys and 9 girls were studied. Hyphae were seen in 11 cases of athletes foot and 5 of onychomycosis. Twenty‐one cultures were positive (42%). The most frequently isolated fungi were the opportunistic Trichosporon cutaneum in 42.8%, Candida sp. (23.8%), Trichophyton mentagrophytes (23.8%), and Candida glabrata (9.5%). Superficial mycotic infections of the feet and nails were most frequent in children and adolescents who usually wear nonocclusive shoes. The most frequent pathogens were Candida sp. and T. mentagrophytes. It is interesting to note the prevalence of T. cutaneum that has recently been implicated in mycoses of the feet and nails. We did not isolate T. rubrum in any patient.

Amicrobial pustulosis of the folds associated with autoimmune disorders: systemic lupus erythematosus case series and first report on the association with autoimmune hepatitis.

Amicrobial pustulosis of the folds (APF) associated with autoimmune disorders is an infrequent entity characterized by the recurrent appearance of follicular and nonfollicular sterile pustules in the context of autoimmune disease. Most reports on APF suggest systemic lupus erythematosus (SLE) as the major immunological associated disorder but the association with autoimmune hepatitis (AH) has not been previously documented. We describe the clinical and histological characteristics of 5 patients with APF: 4 with SLE and 1 with AH. As APF is an exclusion diagnosis, in order to establish an opportune diagnosis and treatment, physicians should be aware of patients with any autoimmune disease who develop a pustular dermatosis for which cultures and stains are negative. We propose the inclusion of anti-liver kidney microsome antibodies in the minor criteria for APF diagnosis.

Dermoscopy in Active Discoid Lupus

T HEPHOTOGRAPHSINTHISARTICLEWERETAKEN withapolarizedlightnoncontactdermoscope. Theyshowactivediscoidlupusplaquesinthe nose of a 36-year-old woman (patient 1, Figure 1) and on the right cheek of a 21year-oldwoman(patient2,Figure2).Figures1and2show follicularkeratinplugs.Erythemaandpigmentarychanges are variably present. The patients were treated with diflorasone, 0.05%, ointment, and the keratin plugs cleared. Figure3andFigure4 showpatients1and2, respectively, 4 weeks after treatment. A small persistent area of activity is evident in the right lower corner of Figure 3. Keratinplugsareevidentonlyinactivelesions,notinscars or healed skin, which correlates histologically with the hyperkeratosis that is more prominent in the follicular opening. This finding can help the clinician to assess the evolution and response to treatment of discoid lupus lesions.

Are corticosteroids and immunosuppressors an efficacious treatment for bullous lupus erythematosus with systemic manifestations

Auteur(s) : Monica Fernandez-Sanchez1, Yann Charli-Joseph1, Marcela Saeb-Lima2, Linda Garcia-Hidalgo1, Rocio Orozco-Topete1 1Dermatology 2Pathology Dept, Instituto Nacional de Ciencias Medicas y Nutricion “Salvador Zubiran”, Distrito Federal 14000, Mexico Bullous systemic lupus erythematosus (SLE) is an autoantibody-mediated blistering skin disease occurring in patients with SLE, in isolation or in conjunction with systemic manifestations of lupus. It has an acute onset with a rapidly expanding [...]

POEMS syndrome: Are current diagnostic criteria too exclusive?

POEMS: polyneuropathy, organomegaly, endocrinopathy, elevated serum M protein, and skin changes P OEMS syndrome is a rare multisystem disease typically associated with monoclonal plasma cell disorders. In 1980, Bardwick et al coined the acronym to embody a syndrome characterized by polyneuropathy, organomegaly, endocrinopathy, elevated serum M protein, and skin changes. No acknowledged set of criteria existed for the diagnosis of the POEMS syndrome; although most authors stipulated that at least 3 or 4 of the 5 features for which the acronym stands were required, ambiguity remained. Current criteria were proposed by Dispenzieri et al, who established that the diagnosis should be based on two essential major variables (polyneuropathy and monoclonal gammopathy) and at least one minor variable: Castleman’s disease, sclerotic bone lesions, organomegaly (splenomegaly, hepatomegaly, lymphadenopathy), edema (peripheral edema, ascites, pleural effusion), endocrinopathy (adrenal, thyroid, pituitary, parathyroid, gonadal, pancreatic), skin changes (cherry, lobular, tufted or glomeruloid type hemangiomas, hyperpigmentation, hypertrichosis, thickened skin, leukonychia) or papilledema. Other features common for this disease, but not included in these criteria, are fever, arthralgia, pulmonary hypertension, fatigue, weight loss, diarrhea, thrombocytosis, polycythemia, and renal involvement. Because of the numerous cutaneous findings in patients with POEMS syndrome, dermatologists should have a thorough knowledge of this entity.

Oral and cutaneous lymphomas other than mycosis fungoides and sézary syndrome in a mexican cohort: Recategorization and evaluation of international geographical disparities

Background: Nonmycosis fungoides/Sézary syndrome (non-MF/SS) primary cutaneous lymphomas (PCL) are currently categorized under the 2005-World Health Organization/European Organization for Research and Treatment of Cancer (WHO-EORTC) classification for PCL. These differ in behavior from secondary cutaneous lymphomas (SCL) and to lymphomas limited to the oral cavity (primary oral lymphomas [POL]) both categorized under the 2016-WHO classification for lymphoid neoplasms. Aims: This study aims to report the first series of non-MF/SS PCL, SCL, and POL in a Mexican cohort, examine the applicability of current classification systems and compare our findings with those from foreign cohorts. Materials and Methods: Eighteen non-MF/SS PCL, four SCL, and two POL with available tissue for morphology and immunophenotypic assessment were reclassified according to the 2005-WHO/EORTC and 2016-WHO classifications. Results: Non-MF/SS PCLs were primarily of T-cell origin (61%) where CD30+ lymphoproliferative disorders predominated, followed by Epstein–Barr virus-induced lymphomas, and peripheral T-cell lymphomas, not otherwise specified. Primary cutaneous B-cell lymphomas (BCL) were primarily of follicle center cell origin followed by postgerminal lymphomas of the diffuse large BCL variety. Conclusions: Most non-MF/SS PCL, SCL, and POL can be adequately categorized according to the 2005-WHO/EORTC and 2016-WHO classification systems, even when dealing with clinically atypical cases. The relative frequencies in our cohort hold closer similarities to Asian registries than from those of Europe/USA, supporting the concept of individual and/or racial susceptibility, and the notion of geographical variances in the rate of lymphomas. In particular, such disparity may arise from viral-induced lymphomas which might show partial geographical restriction.

Inflammatory Idiopathic Myopathies: Clinical, Laboratory Features andPrognostic Observations in 118 Hispanic-Mestizo Patients

Objective: To determine the clinical and laboratory features, malignancy, outcome and their association in a Hispanic mestizo population with Inflammatory Idiopathic Myopathies (IIM). Material and methods: The medical records of Hispanic mestizo patients with dermatomyositis, polymyositis or overlap syndrome from a single center were reviewed. Several variables were studied with emphasis on malignancy. Results: We report the clinical and laboratorial features of 118 patients with IIM; the female to male ratio was 2.3:1. Elevated CK, proximal weakness, compatible biopsy and elevated LDH were the most frequent findings. Malignancy was found in 9,3%, gynecological tumors were the most common (55%). Mortality was 10.2%, mainly related to infections and respiratory failure. Conclusions: The overall rate of malignancy in this large series of patients with IIM was 9.3%. The majority of our patients reached a good outcome. No risk factors for malignancy were found.