Naslov
A case of chronic and extensive dermatomycosis in a diabetic patient

Autori
Peternel, Sandra ; Simonić, Edita ; Brajac, Ines ; Kaštelan, Marija

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
7th EADV Spring Symposium Abstracts on CD-ROM / - , 2010

Skup
7th EADV Spring Symposium

Mjesto i datum
Cavtat, Hrvatska, 13.05.2010. - 16.05.2010

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
dermatomycosis; diabetes mellitus; terbinafine

Sažetak
Aims: We report a case of an unusually widespread and chronic mixed-species dermatomycosis occurring in a diabetic patient. Methods: Diagnosis of dermatomycosis was made by detailed clinical examination of skin lesions, Wood light examination, direct microscopic evaluation of KOH preparations from skin scrapings and identification of fungal species grown in culture on Sabouraud’s dextrose agar. Repeated cultures from multiple sites were performed. A 12-week treatment consisted of topical and systemic terbinafine (250 mg/kg). Results (Case report): A 58-year-old man with 12-year history of diabetes presented with extensive pruritic skin changes. The lesions involved per continuitatem the whole trunk, groin, gluteal regions and lower extremities. The involved skin was diffusely erythematous and lichenified with fine scales and numerous excoriations, sharply demarcated toward the uninvolved skin, with raised borders and no signs of central regression. The patient also had thickened and discoloured toenails and discrete erosions between toes. Wood light examination of lesional skin was negative. Direct microscopic examination of scales obtained from the borders of skin lesions, groin area, toenails and interdigital web spaces revealed numerous mycelial elements. Cultures of skin scrapings yielded Aspergillus fumigatus from the borders of skin lesions and inguinal region, Candida albicans from toenails and both Aspergillus fumigatus and Trichophyton rubrum from interdigital web spaces. A 12-week treatment with oral terbinafine resulted in complete mycological and clinical clearance. Slight residual hyperpigmentation was visible at sites of previously affected skin and strong regrowth of hair was evident at patient’s trunk. Conclusions: Fungi represent a diverse group of pathogens with opportunism being a common ground in the pathogenesis. We report this case for its unusual clinical appearance, chronicity and the presence of multiple causative pathogens, all of which might have been favoured by compromised natural defences due to diabetes mellitus.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA