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Dermoscopy of Bacterial, Viral, and Fungal Skin Infections: A Systematic Review of the Literature. Dermatol Ther (Heidelb) 2022; 13:51-76. [PMID: 36417086 PMCID: PMC9823193 DOI: 10.1007/s13555-022-00855-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022] Open
Abstract
Over the last three decades, the use of dermoscopy has been extended to inflammatory and infectious dermatoses. Regarding the latter, while the first applications concerned skin parasitoses, there has been a significant increase in the publication trend regarding nonparasitic dermatoses over recent years, yet data on this topic are sparse and often lack a standardized analytical approach. This systematic literature review summarizes published data on dermoscopy of bacterial, viral, and fungal dermatoses (dermoscopic findings, used setting, pathological correlation, and level of evidence of studies) and provides a homogeneous terminology of reported dermoscopic features according to a standardized methodology. A total of 152 papers addressing 43 different dermatoses and describing 184 different dermoscopic findings were included in the analysis. The majority of them displayed a level of evidence of V (107 single case reports and 40 case series), with only 5 studies showing a level of evidence of IV (case-control studies). Moreover, our analysis also underlined a high variability in the terminology used in published articles (even for the same dermatosis). Therefore, despite significant potential, future studies designed according to a systematic and standardized approach are required for a better characterization of dermoscopy of nonparasitic skin infections.
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Bakos RM, Leite LL, Reinehr C, Escobar GF. Dermoscopy of skin infestations and infections (entomodermoscopy) - Part II: viral, fungal and other infections. An Bras Dermatol 2021; 96:746-758. [PMID: 34620527 PMCID: PMC8790190 DOI: 10.1016/j.abd.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/31/2021] [Accepted: 04/17/2021] [Indexed: 02/03/2023] Open
Abstract
In addition to the infestations and bacterial infections reported in part I, the study of entomodermoscopy also involves descriptions of dermoscopic findings of a growing number of viral and fungal infections, among others. In this article, the main clinical situations in viral infections where dermoscopy can be useful will be described, that is in the evaluation of viral warts, molluscum contagiosum, and even in recent scenarios such as the COVID-19 pandemic. As for fungal infections, dermoscopy is particularly important, not only in the evaluation of the skin surface, but also of skin annexes, such as hairs and nails. The differential diagnosis with skin tumors, especially melanomas, can be facilitated by dermoscopy, especially in the evaluation of cases of verruca plantaris, onychomycosis and tinea nigra.
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Affiliation(s)
| | - Leandro Linhares Leite
- Dermatology Service, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Clarissa Reinehr
- Postgraduation in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Chauhan P, Adya KA. Dermatoscopy of Cutaneous Granulomatous Disorders. Indian Dermatol Online J 2021; 12:34-44. [PMID: 33768021 PMCID: PMC7982032 DOI: 10.4103/idoj.idoj_543_20] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/30/2020] [Accepted: 09/24/2020] [Indexed: 11/04/2022] Open
Abstract
Cutaneous granulomatous disorders represent diseases with underlying granulomas on histology and are broadly divided into infectious and noninfectious disorders. Although histology is sine qua non in diagnosis of granulomatous disorders, lately dermoscopy has come up as a useful tool assisting in diagnosis of granulomatous disorder. Dermoscopy of granulomatous disorder is characterized by localized or diffuse, structureless yellowish-orange areas, along with vessels. Dermoscopic features of granulomatous disorders can be overlapping among various disorders, but detailed accurate assessment of various findings and their pattern may be useful in differentiating among them. In addition to this, peculiar dermatoscopic findings seen can also prove useful in distinguishing between various disorders. Hereby, we discuss dermatoscopic findings of various granulomatous disorders.
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Affiliation(s)
- Payal Chauhan
- Department of Dermatology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttrakhand, India
| | - Keshavmurthy A Adya
- Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, Karnataka, India
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Karrakchou B, Boubnane I, Senouci K, Hassam B. Madurella mycetomatis infection of the foot: a case report of a neglected tropical disease in a non-endemic region. BMC DERMATOLOGY 2020; 20:1. [PMID: 31918687 PMCID: PMC6953183 DOI: 10.1186/s12895-019-0097-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 12/19/2019] [Indexed: 11/28/2022]
Abstract
Background Mycetoma is an uncommon chronic granulomatous infection of cutaneous and subcutaneous tissues that can be caused by filamentous bacteria (actinomycetoma) or fungi (eumycetoma). It is the prerogative of young men between the third and fourth decade and is transmitted through any trauma causing an inoculating point. The classic clinical triad associates a painless hard and swelling subcutaneous mass, multiple fistulas, and the pathognomonic discharge of grains. Although endemic in many tropical and subtropical countries, mycetoma can also be found in non-endemic areas as in Morocco, and causes then diagnosis problems leading to long lasting complications. Therefore, we should raise awareness of this neglected disease for an earlier management. Under medical treatment however, mycetoma has a slow healing and surgery is often needed, and relapses are possible. Case presentation Herein we report a case of a 64 years old patient, with a history of eumycetoma occurring ten years ago treated with oral terbinafine coupled with surgery. A complete remission was seen after 2 years. He presented a relapse on the previous scar 6 months ago. There wasn’t any bone involvement in the magnetic resonance imaging (MRI). The patient was put under oral terbinafine with a slow but positive outcome. Conclusion Through this case report, we perform a literature review and highlight the importance of increase awareness of mycetoma in clinical practice especially in non-endemic regions.
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Affiliation(s)
- Basma Karrakchou
- Dermatology and Venereology Department, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco.
| | - Ibtissam Boubnane
- Dermatology and Venereology Department, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Karima Senouci
- Dermatology and Venereology Department, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Badreddine Hassam
- Dermatology and Venereology Department, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
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Hay R, Denning DW, Bonifaz A, Queiroz-Telles F, Beer K, Bustamante B, Chakrabarti A, Chavez-Lopez MDG, Chiller T, Cornet M, Estrada R, Estrada-Chavez G, Fahal A, Gomez BL, Li R, Mahabeer Y, Mosam A, Soavina Ramarozatovo L, Rakoto Andrianarivelo M, Rapelanoro Rabenja F, van de Sande W, Zijlstra EE. The Diagnosis of Fungal Neglected Tropical Diseases (Fungal NTDs) and the Role of Investigation and Laboratory Tests: An Expert Consensus Report. Trop Med Infect Dis 2019; 4:E122. [PMID: 31554262 PMCID: PMC6958312 DOI: 10.3390/tropicalmed4040122] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/18/2019] [Accepted: 09/06/2019] [Indexed: 02/07/2023] Open
Abstract
The diagnosis of fungal Neglected Tropical Diseases (NTD) is primarily based on initial visual recognition of a suspected case followed by confirmatory laboratory testing, which is often limited to specialized facilities. Although molecular and serodiagnostic tools have advanced, a substantial gap remains between the desirable and the practical in endemic settings. To explore this issue further, we conducted a survey of subject matter experts on the optimal diagnostic methods sufficient to initiate treatment in well-equipped versus basic healthcare settings, as well as optimal sampling methods, for three fungal NTDs: mycetoma, chromoblastomycosis, and sporotrichosis. A survey of 23 centres found consensus on the key role of semi-invasive sampling methods such as biopsy diagnosis as compared with swabs or impression smears, and on the importance of histopathology, direct microscopy, and culture for mycetoma and chromoblastomycosis confirmation in well-equipped laboratories. In basic healthcare settings, direct microscopy combined with clinical signs were reported to be the most useful diagnostic indicators to prompt referral for treatment. The survey identified that the diagnosis of sporotrichosis is the most problematic with poor sensitivity across the most widely available laboratory tests except fungal culture, highlighting the need to improve mycological diagnostic capacity and to develop innovative diagnostic solutions. Fungal microscopy and culture are now recognized as WHO essential diagnostic tests and better training in their application will help improve the situation. For mycetoma and sporotrichosis, in particular, advances in identifying specific marker antigens or genomic sequences may pave the way for new laboratory-based or point-of-care tests, although this is a formidable task given the large number of different organisms that can cause fungal NTDs.
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Affiliation(s)
- Roderick Hay
- The International Foundation for Dermatology, London W1T 5HQ, UK.
| | - David W Denning
- The Global Fund for Fungal Infections, 1208 Geneva, Switzerland, and the University of Manchester, Manchester M13 9PL, UK.
| | - Alexandro Bonifaz
- Hospital General de México, "Dr. Eduardo Liceaga", CP 06720, Mexico.
| | - Flavio Queiroz-Telles
- Department of Public Health, Hospital de Clinicas, Federal University of Parana, 80060-900 Curriba, Parana, Brazil.
| | - Karlyn Beer
- Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
| | - Beatriz Bustamante
- Tropical Medicine, Infectious Diseases and Dermatology Department at the Hospital Cayetano Heredia, Lima 15102, Peru.
| | | | | | - Tom Chiller
- Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
| | - Muriel Cornet
- Laboratoire de Parasitologie-Mycologie, Grenoble Alpes University, CNRS, Grenoble INP, CHU Grenoble Alpes, F-38000, France.
| | - Roberto Estrada
- Community Dermatology Mexico C.A., Acapulco 39850, Guerrero, Mexico.
| | | | - Ahmed Fahal
- The Mycetoma Research Centre, Khartoum, Soba University Hospital, P.O. Box 102, Sudan.
| | - Beatriz L Gomez
- School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111211, Colombia.
| | - Ruoyu Li
- Peking University First Hospital, Research Centre for Medical Mycology, Peking University, Beijing 100034, China.
| | - Yesholata Mahabeer
- Department of Medical Microbiology, National Health Laboratory Services and School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Berea, Durban 4001, South Africa.
| | - Anisa Mosam
- Nelson R Mandela School of Medicine, University of Kwazulu Natal, Berea, Durban 4001, South Africa.
| | | | | | | | - Wendy van de Sande
- Erasmus MC, Department of Medical Microbiology and Infectious Diseases, 3000 CA Rotterdam, The Netherlands.
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