Primary cutaneous cryptococcosis in Brazil: report of 11 cases in immunocompetent and immunosuppressed patients

Background Primary cutaneous cryptococcosis is an uncommon infectious disease caused by Cryptococcus neoformans or Cryptococcus gattii affecting immunosuppressed as well as immunocompetent patients. It is often misdiagnosed as it may mimic other cutaneous diseases. Materials and methods We report a series of cases diagnosed from 2005 to 2010 in two general hospitals. The diagnosis in all patients was made on the basis of histopathology and culture. Phenoloxidase and canavanine-glycine-bromothymol blue tests were used in order to identify the Cryptococcus species. Systematic investigation ruled out the systemic involvement in every case. Results Eleven patients, 81.8% male, were diagnosed during this study. The immunosuppression status was identified in 54.5% of patients, and all of them were under corticosteroid therapy due to a variable set of diseases. All patients presented with circumscribed lesions on their upper limbs. Most lesions showed an infiltrative or tumoral aspect with up to 40 cm diameter. Fluconazole, up to 400 mg/daily, was the main therapeutic regimen and proved to be efficient. Conclusions Primary cutaneous cryptococcosis has been diagnosed in both immunosuppressed and immunocompetent patients. Its peculiar clinical aspect could facilitate early diagnosis. Culture and biochemical tests should be performed in order to define the species involved.

Low-level laser therapy on the treatment of oral and cutaneous pemphigus vulgaris: case report

Pemphigus vulgaris is a chronic autoimmune mucocutaneous disease that initially is manifested by painful intraoral erosions and ulcers which spread to other mucosa and the skin, generally more than 5 months after oral lesion manifestation. The treatment consists of prednisone alone or in combination with an immunosuppressive agent, and the clinical response is perceived within 2 to 4 weeks. Low-level laser therapy has been effective in accelerating the healing of injured tissue, thus inducing cell proliferation and increasing ATP, nucleic acid, and collagen synthesis. We reported two cases of pemphigus vulgaris that received systemic treatment associated with low-level laser therapy for oral and cutaneous lesions. We observed prompt analgesic effect in oral lesions and accelerated healing of oral and cutaneous wounds. Therefore, the present report suggests LLLT as a noninvasive technique that should be considered as an adjuvant therapy in oral and skin disorders in patients with PV.

Paracoccidioidomycosis: infiltrated, sarcoid-like cutaneous lesions misinterpreted as tuberculoid leprosy

Os Autores relatam um caso de paracoccidioidomicose diagnosticado como se fora hanseníase tuberculóide, tanto do ponto de vista clínico como histopatológico. Lesão cutânea de padrão sarcoídico é raramente observada como lesão inicial da paracoccidioidomicose em jovens e pode simular outras dermatoses infecciosas ou inflamatórias. O achado histológico de granuloma tuberculóide apresenta dificuldade diagnóstica similar. O tratamento realizado com dapsone, um derivado sulfamídico, pode ter retardado a evolução clínica esperada para o padrão clássico da paracoccidioidomicose tipo juvenil, o qual apenas se materializou 24 meses após a paciente ter iniciado tratamento como hanseníase.

Cutaneous pyogranuloma in a cat caused by virulent Rhodococcus equi containing an 87 kb type I plasmid

A 2-year-old intact male domestic shorthaired cat presented with a chronic, nodular, ulcerated, cutaneous lesion on the right thoracic limb. Histological and cytological examination revealed a pyogranulomatous inflammation with basophilic organisms in the macrophages. A virulent form of Rhodococcus equi containing an 87 kb type I (VapA) virulence plasmid was identified from cultures of biopsy samples. This report describes the clinicopathological features, plasmid profile and virulence of this case of R equi infection.

Cutaneous pythiosis in a dog from Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Collagen dysplasia (cutaneous asthenia) in a cat

Hereditary collagen dysplasias comprise a complex group of connective-tissue disorders that result in the reduced tensile strength of affected tissues. These processes are called cutaneous asthenia in the skin of dogs and cats. We report here the case of a crossbred male cat, aged 6 months, that presented with two skin wounds in the region of the right thorax and right iliac tuberosity. The skin of these regions and of the animal's dorsum was hyperextensible, smooth to the touch, and easily torn with minor trauma. Microscopic examination of skin samples revealed reduced dermal connective tissue consisting of shortened and fragmented collagen fibers. Normal fibers were intermingled with altered fibers. Ultrastructural changes in collagen fibers included disorientation of fibrils within the same bundle, marked spacing differences, and variation in the diameter of transverse sections. The fibrils maintained the transverse striations characteristic of normal collagen.

Hematoporphyrin-based photodynamic therapy for cutaneous squamous cell carcinoma in cats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Cutaneous myxosarcoma in a Syrian hamster (Mesocricetus auratus)

The pathological findings in a 2-years-old Syrian hamster (Mesocricetus auratus) with a cutaneous myxosarcoma are described. Grossly, there was a large cutaneous mass in the right cervical region. Microscopical evaluation revealed a myxosarcoma characterized by pleomorphic, fusiform cells loosely arranged, randomly distributed, and presenting a moderate amount of basophilic amorphous stroma. There were hemorrhagic areas within the tumor. The basophilic amorphous stroma was positive to Alcian blue confirming the presence of a mucopolysaccharide matrix. Immunohistochemically, the neoplastic cells expressed vimentin, and were negative for cytokeratin or glial fibrillary acidic protein (GFAP).

Effect of photodynamic therapy on the healing of cutaneous third-degree-burn: histological study in rats

The aim of this study was to conduct a histological assessment of the effect of photodynamic therapy (PDT) on the repairing of third-degree-burn wounds made on the backs of rats with a heated scalpel. Ninety-six rats were divided into groups: G1, control (n = 24), cold scalpel; G2, burned, heated scalpel (n = 24); G3, low-level laser therapy (LLLT) (n = 24), on burns; and G4, photodynamic therapy (PDT) (n = 24), toluidine-O blue (100 A mu g/ml) and LLLT treatment on burns. The laser (685 nm) was applied in continuous mode, 50 mW, 4.5 J/cm(2), contact mode at nine points (9 s/point). Eight animals in each group were killed at 3 days, 7 days or 14 days after surgery, and tissue specimens containing the whole wounded area were removed and processed for histological analysis; the results were statistically analyzed with Kruskal-Wallis and Dunn's tests (P < 0.05). The results demonstrated significant differences between G2 and G3, and between G2 and G4, at both 3 days and 7 days, with regard to acute inflammation scores; G1 and G2 showed significant differences when compared with G4 at 3 days, with regard to neo-angiogenesis scores; G1 and G2 were statistically different from G3 and G4 at both 3 days and 7 days, with regard to re-epithelization scores; G2 showed statistically significant differences when compared with G3 and G4 with regard to collagen fiber scores at 7 days. LLLT and PDT acted as a biostimulating coadjuvant agent, balancing the undesirable effect of the burn on the wound healing process, acting mainly in the early healing stages, hastening inflammation and increasing collagen deposition.

Evaporative cooling and cutaneous surface temperature of Holstein cows in tropical conditions

Foram estudados os efeitos da temperatura cutânea (Ts) sobre a taxa de termólise por evaporação cutânea (Es) de vacas Holandesas cronicamente expostas ao sol, considerando a pigmentação do pelame. Dezesseis vacas puras de origem foram medidas quanto à evaporação e à temperatura cutâneas às 13 h, após 6 horas de exposição ao sol, no mesmo local (flanco, pescoço e glúteo) e considerando separadamente as malhas negras e as brancas. A evaporação cutânea foi medida por meio de cápsula ventilada. Nas áreas negras a taxa de sudação (138,9 ± 8,5 g.m-2.h-1), a taxa de termólise por evaporação cutânea (93,3 ± 5,7 W.m-2) e a temperatura da superfície cutânea (33,1 ± 0,2°C) foram maiores que nas áreas brancas (109,5 ± 9,7 g.m-2.h-1, 73,6 ± 6,5 W.m-2 e 32,6 ± 0,2°C, respectivamente). Há uma relação exponencial entre evaporação e temperatura cutâneas, que pode ser representada pela equação Es = 31,5+3,67 exp{(Ts-27,9)/2,19115}, com coeficiente de determinação r²=0,68. A taxa de termólise por evaporação cutânea permanece quase constante (cerca de 48 W.m-2) até que a temperatura cutânea atinge aproximadamente 31°C.

Effects of a single near-infrared laser treatment on cutaneous wound healing: Biometrical and histological study in rats

Background: Low intensity laser therapy has been recommended to support the cutaneous repair; however, so far studies do not have evaluated the tissue response following a single laser treatment. This study investigated the effect of a single laser irradiation on the healing of full-thickness skin lesions in rats.Methods: Forty-eight male rats were randomly divided into three groups. One surgical lesion was created on the back of rats using a punch of 8 mm in diameter. One group was not submitted to any treatment after surgery and it was used as control. Two energy doses from an 830-nm near-infrared diode laser were used immediately post-wounding: 1.3 J cm(-2) and 3 J cm(-2). The laser intensity 53 mW cm(-2) was kept for both groups. Biometrical and histological analyses were accomplished at days 3, 7 and 14 post-wounding.Results: Irradiated lesions presented a more advanced healing process than control group. The dose of 1.3 J cm(-2) leaded to better results. Lesions of the group irradiated with 1.3 J cm(-2) presented faster lesion contraction showing quicker re-epithelization and reformed connective tissue with more organized collagen fibers.Conclusions: Low-intensity laser therapy may accelerate cutaneous wound healing in a rat model even if a single laser treatment is performed. This finding might broaden current treatment regimens. (c) 2007 Elsevier B.V. All rights reserved.

Cutaneous hypersensitivity induced in rabbits by extracts of the tick Amblyomma cajennense (Acari : Ixodidae)

The cutaneous hypersensitivity test was used to correlate host resistance to ticks and type of reactions elicited by Amblyomma cajennense (Fabricius, 1787) tick extract in rabbits. Rabbits were divided into 3 groups of 2 animals each: naive, pre-infested and control. Cutaneous hypersensitivity was induced by intradermal inoculation of 25 mug extract in 0.03 rut of phosphate buffered saline (PBS) in rabbit ears. Control rabbits were inoculated with PBS only. The ear thickness was measured with a Mitutoyo(R) device before and 10 min, 1, 2,4,18, 24,48,72 and 96 h post-inoculation (PI). Pre-infested rabbits showed an immediate type reaction within the 1st 10 min PI (60 % increase in ear thickness) and a delayed reaction (18 h) (85 % increase), whereas the naive rabbits showed only the immediate reaction within the 1st 4 h (60 % increase). PBS induced only mild reactions. These results point out the crucial role of the cellular immune response of rabbits in the expression of resistance to A. cajennense.