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Dermoscopy assisting the diagnosis of mycetoma: case report and literature review.
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PMID:  25184931     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Mycetomas are a chronic skin infection characterized by perilesional edema, formation of sinus tracts, and discharge of purulent or seropurulent exudate containing grains. This report aims to demonstrate the clinical diagnosis (by dermoscopy) of a skin lesion that initially bared no clinical features of a mycetoma.
Authors:
Larissa Montanheiro Dos Reis; Brunno Zeni de Lima; Fernando da Cunha Zillo; Camila Makino Rezende; Lincoln Helder Zambaldi Fabricio; Camila Araujo Scharf Pinto
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Type:  Journal Article    
Journal Detail:
Title:  Anais brasileiros de dermatologia     Volume:  89     ISSN:  1806-4841     ISO Abbreviation:  An Bras Dermatol     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-09-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0067662     Medline TA:  An Bras Dermatol     Country:  Brazil    
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Languages:  eng     Pagination:  832-3     Citation Subset:  IM    
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Journal Information
Journal ID (nlm-ta): An Bras Dermatol
Journal ID (iso-abbrev): An Bras Dermatol
ISSN: 0365-0596
ISSN: 1806-4841
Publisher: Sociedade Brasileira de Dermatologia
Article Information
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©2014 by Anais Brasileiros de Dermatologia
open-access:
Received Day: 24 Month: 7 Year: 2013
Accepted Day: 26 Month: 8 Year: 2013
epub-ppub publication date: Season: Sep-Oct Year: 2014
Print publication date: Season: Sep-Oct Year: 2014
Volume: 89 Issue: 5
First Page: 832 Last Page: 833
PubMed Id: 25184931
ID: 4155970
DOI: 10.1590/abd1806-4841.20143008

Dermoscopy assisting the diagnosis of mycetoma: case report and literature review*
Larissa Montanheiro dos Reis1
Brunno Zeni de Lima1
Fernando da Cunha Zillo2
Camila Makino Rezende1
Lincoln Helder Zambaldi Fabricio1
Camila Araujo Scharf Pinto1
1 Faculdade Evangélica do Paraná (Fepar) - Curitiba (PR), Brazil.
2 Private clinic - Curitiba (PR), Brazil.
Correspondence: MAILING ADDRESS: Camila Araujo Scharf Pinto, Alameda Carlos de Carvalho, 1652, 80730 -200 - Batel - Curitiba - PR, Brazil. E-mail: kmischarf@gmail.com

Mycetoma is a chronic infection of the skin characterized by perilesional edema, formation of sinus tracts, and discharge of purulent exudate containing grains.1 It is confirmed by pathology and culture.2,3 This report outlines the case of a clinically nonspecific cutaneous lesion, in which the dermoscopy led to the clinical hypothesis.

A 47 year-old female, from the urban area of Rondonia, was referred to the Dermatology Service of a Hospital in Curitiba, with an asymptomatic 4 year-old lesion on her left foot that underwent spontaneous resolution. Three months before, a new lesion had appeared in the same area, with serosanguineous drainage. Examination revealed a violate nodular lesion, scaly and rough, on the base of the third left toe (Figure 1). Upon dermoscopy, (DermLite®, Gen, INC.) yellowish and white structures were identified (Figures 2 and 3). Excisional biopsy was performed, pathology with PAS stain showed suppurative granuloma with grains and hyaline septate hyphae (Figure 4). The tissue culture revealed Acremonium sp , confirming the diagnosis of Eumycetoma. The authors established an adjunctive therapy with Itraconazole 100 mg PO bid. The patient remains in remission.

It is known that dermoscopy improves diagnostic accuracy in pigmented lesions. Nowadays, its application is also extending to diagnostic reports of skin infections, as well as to follow-up benign neoplasms.4 As mycetomas are usually clinically evident, there are no studies of their typical features on dermoscopy. However, in uncertain cases, the method is being increasingly applied in clinical practice.5


Notes

Conflict of interest: None

Financial funding: None

*Work performed at the Hospital Universitário Evangélico de Curitiba - Faculdade Evangélica do Paraná (HUEC-Fepar) - Curitiba (PR), Brazil.

How to cite this article: Reis LM, Lima BZ, Zillo FC, Rezende CM, Fabricio LHZ, Pinto CAS. Dermoscopy assisting the diagnose of a Mycetoma: case report and literature review. An Bras Dermatol. 2014;89(5):832-3.

REFERENCES
1. Ruiz LR. Micetomas EumicóticosZaitz C,Campbell I,Marques SA,Ruiz LRB,Framil VMS. Compêndio de Micologia Médica2 ed.Rio de JaneiroGuanabara KooganYear: 2010206211
2. Sampaio SA,Rivitti EA. Micoses profundasSampaio SA,Rivitti EA. Dermatologia3 ed.São PauloArtes MédicasYear: 2008723752
3. Hoffmann Cde C,Danucalov IP,Purim KS,Queiroz-Telles F. Infections caused by dematiaceous fungi and their anatomoclinical correlationsAn Bras DermatolYear: 20118613814121437537
4. Bastos CA. Indicações não tradicionais de dermatoscopiaSurg Cosmet DermatolYear: 20124203205
5. Tedesco-Marchese LM,Castro RM,Lacaz CS,Cucé LC,Salebian A,Sotto MN. Acremoniose cutânea: relato de um casoAn Bras DermatolYear: 1987622530

Figures

[Figure ID: f01]
FIGURE 1 

Papular-nodular lesion, violet to brown, slightly scaly, rough and dull on the base of the third left toe



[Figure ID: f02]
FIGURE 2 

Upon dermoscopy, whitish and yellowish structures



[Figure ID: f03]
FIGURE 3 

Dermoscopy (higher magnification)



[Figure ID: f04]
FIGURE 4 

Suppurative granuloma containing grains and hyaline septate hyphae)



Article Categories:
  • Imaging in Tropical Dermatology

Keywords: Acremonium, Dermoscopy, Mycetoma.

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