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Hombre de 18 años con síndrome verrugoso tropical: ¿leishmaniasis o esporotricosis?

The tropical verrucous syndrome includes infectious, chronic, and granulomatous skin conditions appearing with plaques, nodules, or ulcers with a warty surface which gives name to the syndrome. It includes forms of chromoblastomycosis, sporotrichosis, paracoccidioidomycosis, lobomycosis, leishmanias...

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Autores principales: Macías, Paola, Ordóñez, Juliana, Arenas, Claudia M., Rodríguez, Gerzaín
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Instituto Nacional de Salud 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8372839/
https://www.ncbi.nlm.nih.gov/pubmed/34214265
http://dx.doi.org/10.7705/biomedica.5757
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author Macías, Paola
Ordóñez, Juliana
Arenas, Claudia M.
Rodríguez, Gerzaín
author_facet Macías, Paola
Ordóñez, Juliana
Arenas, Claudia M.
Rodríguez, Gerzaín
author_sort Macías, Paola
collection PubMed
description The tropical verrucous syndrome includes infectious, chronic, and granulomatous skin conditions appearing with plaques, nodules, or ulcers with a warty surface which gives name to the syndrome. It includes forms of chromoblastomycosis, sporotrichosis, paracoccidioidomycosis, lobomycosis, leishmaniasis, and tuberculosis verrucosa cutis with ample distribution in tropical and subtropical areas. The diagnoses may be difficult and confused among them, especially between sporotrichosis and leishmaniasis. Clinical, epidemiologic, intradermal reactions, direct smears, skin biopsies, cultures, immunofluorescence, and PCR are used to differentiate them, although several of these methods are not commonly used. We present an 18-year-old man with extensive verrucous plaques in one knee interpreted by clinic, epidemiology, and biopsy as verrucous cutaneous leishmaniasis. He was treated with Glucantime® for 20 days without improvement. A new biopsy was made that was also interpreted as cutaneous leishmaniasis. The revision of both biopsies showed inflammation with abscessed granulomas and asteroid sporotrichotic bodies at the center of the granulomas that led to the diagnosis of sporotrichosis later confirmed by the fungus culture. The patient responded to the treatment with itraconazole. As clinical and epidemiological findings of leishmaniasis and sporotrichosis can be similar, skin biopsy and other paraclinical studies are necessary to establish a proper diagnosis. The asteroid sporotrichotic body is pathognomonic of this mycosis. We review here the essential concepts of leishmaniasis and sporotrichosis and the criteria to differentiate them.
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spelling pubmed-83728392021-08-19 Hombre de 18 años con síndrome verrugoso tropical: ¿leishmaniasis o esporotricosis? Macías, Paola Ordóñez, Juliana Arenas, Claudia M. Rodríguez, Gerzaín Biomedica Presentación De Caso The tropical verrucous syndrome includes infectious, chronic, and granulomatous skin conditions appearing with plaques, nodules, or ulcers with a warty surface which gives name to the syndrome. It includes forms of chromoblastomycosis, sporotrichosis, paracoccidioidomycosis, lobomycosis, leishmaniasis, and tuberculosis verrucosa cutis with ample distribution in tropical and subtropical areas. The diagnoses may be difficult and confused among them, especially between sporotrichosis and leishmaniasis. Clinical, epidemiologic, intradermal reactions, direct smears, skin biopsies, cultures, immunofluorescence, and PCR are used to differentiate them, although several of these methods are not commonly used. We present an 18-year-old man with extensive verrucous plaques in one knee interpreted by clinic, epidemiology, and biopsy as verrucous cutaneous leishmaniasis. He was treated with Glucantime® for 20 days without improvement. A new biopsy was made that was also interpreted as cutaneous leishmaniasis. The revision of both biopsies showed inflammation with abscessed granulomas and asteroid sporotrichotic bodies at the center of the granulomas that led to the diagnosis of sporotrichosis later confirmed by the fungus culture. The patient responded to the treatment with itraconazole. As clinical and epidemiological findings of leishmaniasis and sporotrichosis can be similar, skin biopsy and other paraclinical studies are necessary to establish a proper diagnosis. The asteroid sporotrichotic body is pathognomonic of this mycosis. We review here the essential concepts of leishmaniasis and sporotrichosis and the criteria to differentiate them. Instituto Nacional de Salud 2021-06-15 /pmc/articles/PMC8372839/ /pubmed/34214265 http://dx.doi.org/10.7705/biomedica.5757 Text en https://creativecommons.org/licenses/by/4.0/Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons
spellingShingle Presentación De Caso
Macías, Paola
Ordóñez, Juliana
Arenas, Claudia M.
Rodríguez, Gerzaín
Hombre de 18 años con síndrome verrugoso tropical: ¿leishmaniasis o esporotricosis?
title Hombre de 18 años con síndrome verrugoso tropical: ¿leishmaniasis o esporotricosis?
title_full Hombre de 18 años con síndrome verrugoso tropical: ¿leishmaniasis o esporotricosis?
title_fullStr Hombre de 18 años con síndrome verrugoso tropical: ¿leishmaniasis o esporotricosis?
title_full_unstemmed Hombre de 18 años con síndrome verrugoso tropical: ¿leishmaniasis o esporotricosis?
title_short Hombre de 18 años con síndrome verrugoso tropical: ¿leishmaniasis o esporotricosis?
title_sort hombre de 18 años con síndrome verrugoso tropical: ¿leishmaniasis o esporotricosis?
topic Presentación De Caso
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8372839/
https://www.ncbi.nlm.nih.gov/pubmed/34214265
http://dx.doi.org/10.7705/biomedica.5757
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