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Clinical Images DOI: 10.7241/ourd.20132.58 FACIAL SPOROTRICHOSIS IN CHILDREN FROM ENDEMIC AREA IN PERU Max Carlos Ramírez Soto Source of Support: Nil Competing Interests: None Clinical Pathology Service, Santa Teresa Clinic of Abancay, Apurímac, Peru Corresponding author: Dr. Max Carlos Ramírez Soto maxcrs22@gmail.com Our Dermatol Online. 2013; 4(2): 237-240 Date of submission: 16.11.2012 / acceptance: 17.12.2012 Cite this article: Max Carlos Ramírez Soto: Facial Sporotrichosis in children from endemic area in Peru. Our Dermatol Online. 2013; 4(2): 237-240. Sporotrichosis is a subcutaneous mycosis subacute or chronic evolution, caused by the dimorphic Sporothrix complex, which includes five species: Sporothrix albicans, Sporothrix brasiliensis, Sporothrix globosa, Sporothrix mexicana and Sporothrix schenckii (sensu stricto). The infection occurs after trauma with contaminated material, which inoculated the fungus on the skin. The clinical types of sporotrichosis are lymphocutaneous sporotrichosis, fixed cutaneous (nodulopapular, ulcerative, verrucouse and furunculoide) and extracutaneous [1,2]. It is a mycosis of a universal distribution, but more commonly seen in tropical or subtropical countries. The majority of cases are found in Mexico, Central America and Peru [1]. However, the region of Abancay in Peru is considered hyperendemic and has an annual incidence of 48-60 cases per 100 000 population [3]. Also, the incidence is three times higher in children aged 0-14 in ≥ 15 years of age, approximately 1 case/1000 children 0-14 years and a frequency of 60% [4,5]. In pediatric patients from endemic areas the most anatomical site affected is the facial region (40-42%) [5,6], with lesions on the nose, face, chin, malar, genian and palpebral that is clinically rarely mentioned in the literature [7]. terbinafine at standard doses with favorable response in terms of three to five months of continuous administration [1]. We present photographs of pediatric patients with cutaneous sporotrichosis fixed facial skin and lymphatic topographical characteristics can be useful to be considered in the differential diagnosis against other infections in children from endemic areas also are images of the etiologic agent Sporothrix schenckii. The photographs were obtained from patients treated at Santa Teresa Clinic of Abancay, Peru. Ethical considerations: For taking photographs and publishing these. Informed consent was obtained in writing and signed by the parents of the patients. Figures 3, 4 and 5 represent the palpebral forms sporotrichosis. Magazines were published previously in Peru [5,6,8]. Diagnosis: The gold standard for diagnosis is the mycological culture of secretions from injuries. In the crop in Sabouraud dextrose agar with chloramphenicol at 25 ° C colonies are observed finely radiated creamy white and brown. Lactophenol blue stained observed microscopically thin and branched hifas. In BHI agar at 37°C are observed yeast creamy, moist, and whitish. Microscopically with oval and globular structures [1]. Treatment: In our experience treatment with potassium iodide in the form of saturated (SSKI) at doses of 2-20 drops / 3 times / day is preferred for pediatric cases and lymphocutaneous fixed cutaneous form [5]. Other treatment options are oral imidazole, ketoconazole, itraconazole or fluconazole and Figure 1. Cutaneous lymphatic sporotrichosis crusted-ulcer on the forehead and nose with nodules on the cheeks www.odermatol.com © Our Dermatol Online 2.2013 237
Figure 3. Fixed cutaneous sporotrichosis ulcerated right upper eyelid Figure 2. Sporotrichosis lymphocutaneous on the malar region Figure 5. Fixed cutaneous sporotrichosis right upper eyelid Figure 4. Ulcerated cutaneous lymphatic sporotrichosis in the right lower eyelid with nodules in the malar region Figure 6. Palpebral fixed cutaneous sporotrichosis in child of two years old 238 © Our Dermatol Online 2.2013
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Volume 4, Number 2, April 2013 ISSN
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Editorial Board: Abdel-Naser Mohame
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CONTENTS E d i t o r i a l O r i g
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Original Article DOI: 10.7241/ourd.
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Figure 1. Survival time of HIV/TB-
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Figure 3. A. melanocytic naevus on
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82% of the children belonged to the
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Comment to the article DOI: 10.7241
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The skin around body openings such
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Figure 1. Finger nail dystrophy in
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Comment to the article DOI: 10.7241
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Similar type of rash was also prese
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13. Mastaglia FL, Ojeda VJ: Inflamm
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Figure 1. Atrophic areas on left up
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5. Brocard A, Quereux G, Moyse D, D
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Figure 1. Macroglossia Figure 2. Ma
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Case Report DOI: 10.7241/ourd.20132
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Figure 4a, b. Skin biopsy shows hyp
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Page 46 and 47: Discussion Poikiloderma of Civatte
Page 48 and 49: Case Report DOI: 10.7241/ourd.20132
Page 50 and 51: Comment to the article DOI: 10.7241
Page 52 and 53: Case Report A 56 year old Caucasian
Page 54 and 55: Using a battery of neurotoxic agent
Page 56 and 57: Figure 1. Multiple lesions on the u
Page 60 and 61: Figure 1. a PAS positive accentuati
Page 62 and 63: The patient was put on melanocyl 0.
Page 66 and 67: The type of treatment prescribed by
Page 68 and 69: On the basis of these clinical find
Page 70 and 71: Surgery has been reported to be the
Page 72 and 73: Figure 1. Histological section show
Page 76 and 77: Discussion The breast location of t
Page 78 and 79: Figure 2. The epithelial nests show
Page 82 and 83: Discussion SCACP is one of the cuta
Page 84 and 85: Figure 1. Tumor of the nasal colume
Page 86 and 87: Figure 2. Vesicles and crusts aroun
Page 88 and 89: Outbreaks have occurred recently in
Page 90 and 91: Clasificación En base al epitelio
Page 92 and 93: - Microcefalia, hipoplasia mediofac
Page 94 and 95: Caso Nº 3: · Niña, edad desconoc
Page 98 and 99: Figure 7. Fixed cutaneous sporotric
Page 100 and 101: Letter to the Editor DOI: 10.7241/o
Page 102 and 103: Historical Article DOI: 10.7241/our
Page 104 and 105: Figure 6. Henri Mondor (1885-1962).
Page 108 and 109: Figure 5. Alfred Guido Miescher (18
Page 112 and 113: Names of ''Lines'', in dermatology
Page 114 and 115: Figure 1. Erik Adolf von Willebrand
Page 116 and 117: THOMAS INMAN English physician, 182
Page 118 and 119: There are three type of tinea capit
Page 120: Our Dermatology Online www.odermato
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