Giordano L María Consuelo, De la Fuente L Alicia, Lorca J María Bernardita, Kramer H Daniela
Clínica Alemana, Universidad del Desarrollo, Chile.
Clínica Alemana de Santiago, Chile.
Rev Chil Pediatr. 2018 Aug;89(4):506-510. doi: 10.4067/S0370-41062018005000404.
Tinea nigra is a superficial mycosis caused by Hortaea werneckii. Its clinical characte ristic is the appearance of a blackish brown macula of rapid growth, caused by the pigment produced by the fungus itself. The presence of a dark, fast growing, acral pigmentary lesion causes concern among patients and their treating physician about the possibility of a malignant pigmentary lesion.
To present a series of three clinical cases in pediatric patients with this pathology and to show the tools that help to make a differential diagnosis.
Three patients between three and five years of age, which present a macular pigmented lesion on palms or soles, whose parents reported a rapid growth over a short period of time. Two of the patients reported previous trips to the Caribbean. Clinical and dermatoscopy suspicion of tinea nigra lead to a direct mycological exa mination, which confirmed the diagnosis. In all three cases, treatment with topical antifungals led to complete healing of the lesions.
Although tinea nigra is rare in a dry climate, increasing travel of patients to tropical countries will increase the number of cases. Dermatoscopy and direct mycological examination are the tools that allow performing a correct diagnosis and avoiding unne cessary biopsies and/or surgeries.
黑癣是由威尼克外瓶霉引起的一种浅表真菌病。其临床特征是出现由真菌自身产生的色素导致的快速生长的黑褐色斑疹。深色、快速生长的肢端色素性损害的出现,使患者及其治疗医生担心是否为恶性色素性病变。
介绍三例患有这种疾病的儿科患者的临床病例,并展示有助于进行鉴别诊断的方法。
三名年龄在3至5岁之间的患者,手掌或脚底出现色素性斑疹,其父母报告称在短时间内迅速增大。其中两名患者报告此前去过加勒比地区。临床和皮肤镜检查怀疑为黑癣,遂进行直接真菌学检查,确诊为此病。在所有三例病例中,外用抗真菌药物治疗使皮损完全愈合。
尽管在干燥气候下黑癣较为罕见,但患者前往热带国家旅行的增加将导致病例数上升。皮肤镜检查和直接真菌学检查是能够进行正确诊断并避免不必要的活检和/或手术的方法。