Laboratory of Clinical Research on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil.
Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil.
PLoS Negl Trop Dis. 2018 Apr 23;12(4):e0006434. doi: 10.1371/journal.pntd.0006434. eCollection 2018 Apr.
Pregnant women with sporotrichosis should not receive systemic antifungal therapy except in severe cases when amphotericin B is recommended. Thermotherapy is the most reported treatment described in this group of patients. It entails weeks of daily self-application of heat to the lesions, requires that the patient faithfully apply it, and it could cause skin burns. Cryosurgery is a useful therapeutic tool for many cutaneous infectious diseases, safe for pregnant women, but not well evaluated for sporotrichosis treatment in this group.
The authors conducted a retrospective study describing epidemiological, clinical, and therapeutic data related to four pregnant patients with sporotrichosis treated with cryosurgery. The authors reviewed the clinical records of four pregnant patients diagnosed with cutaneous sporotrichosis and treated with cryosurgery. The sessions were carried out monthly up to clinical cure. Molecular identification of the Sporothrix species was performed in two cases using T3B PCR fingerprinting assays.
All patients were in the second trimester of pregnancy and their age ranged from 18 to 34 years. With regard to clinical presentation, two patients had lymphocutaneous and two had the fixed form. S. brasiliensis was identified in two cases as the causative agent. Cryosurgery was well tolerated and the number of sessions ranged from 1 to 3. All the patients reached a complete clinical cure.
Cryosurgery was a safe, easy to perform and well tolerated method, and therefore it is suggested to be a suitable option for the treatment of cutaneous sporotrichosis in pregnant women.
患有孢子丝菌病的孕妇不应接受全身性抗真菌治疗，除非在严重情况下建议使用两性霉素 B。热疗是该组患者中报道最多的治疗方法。它需要孕妇每周数天每天自行对病变部位进行加热，需要患者忠实执行，并可能导致皮肤灼伤。冷冻疗法是许多皮肤传染病的有用治疗工具，对孕妇安全，但对该组孢子丝菌病的治疗评价不佳。
作者进行了一项回顾性研究，描述了与四名接受冷冻疗法治疗的患有孢子丝菌病的孕妇相关的流行病学、临床和治疗数据。作者回顾了四名被诊断患有皮肤孢子丝菌病并接受冷冻疗法治疗的孕妇的临床记录。每月进行一次治疗，直至临床治愈。在两种情况下，使用 T3B PCR 指纹分析检测对孢子丝菌种进行了分子鉴定。
所有患者均处于妊娠中期，年龄在 18 至 34 岁之间。就临床表现而言，两名患者为淋巴管性皮肤孢子丝菌病，两名患者为固定型。在两种情况下，均鉴定出巴西利昂孢子丝菌为病原体。冷冻疗法耐受性良好，治疗次数从 1 到 3 次不等。所有患者均达到完全临床治愈。
冷冻疗法是一种安全、易于操作且耐受性良好的方法，因此建议将其作为治疗孕妇皮肤孢子丝菌病的一种合适选择。
