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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Instituto Nacional de Salud
2021
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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. |
format | Online Article Text |
id | pubmed-8372839 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Instituto Nacional de Salud |
record_format | MEDLINE/PubMed |
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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