1
|
de Almeida CÁ, Nakamura R, Leverone A, Costa F, Estrada BD, Haui P, Luz F, Yamada AF, Werner H, Canella C. Imaging features for the evaluation of skin and nail infections. Skeletal Radiol 2024:10.1007/s00256-023-04557-4. [PMID: 38194095 DOI: 10.1007/s00256-023-04557-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024]
Abstract
Clinical manifestations of dermatological and musculoskeletal conditions can sometimes overlap, leading to confusion in diagnosis. Patients with nail and skin infections may undergo imaging examinations with suspicions of muscle, tendon, or joint injuries. Dermatological infections often involve soft tissues and musculoskeletal structures, and their etiology can range from fungi, bacteria, viruses, to protozoa. Relying solely on physical examination may not be sufficient for accurate diagnosis and treatment planning, necessitating the use of complementary imaging exams. The objective of this paper is to present and discuss imaging findings of the main infectious conditions affecting the nail apparatus and skin. The paper also highlights the importance of imaging in clarifying diagnostic uncertainties and guiding appropriate treatment for dermatological conditions.
Collapse
Affiliation(s)
- Carolina Ávila de Almeida
- Diagnósticos da América S/A, DASA, Avenida das Américas 4666, Sala 325, Rio de Janeiro, RJ, 22640-100, Brazil.
| | - Robertha Nakamura
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia Do Rio de Janeiro, Rio de Janeiro, Brazil
- Centro de Estudos das Unhas (CEU), Santa Casa de Misericórdia Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andreia Leverone
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia Do Rio de Janeiro, Rio de Janeiro, Brazil
- Centro de Estudos das Unhas (CEU), Santa Casa de Misericórdia Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávia Costa
- DASA, Clínica Alta Excelência Diagnóstica, Rio de Janeiro, Brazil
| | - Bruna Duque Estrada
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia Do Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Evidence-Based, Health of the Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Priscilla Haui
- Diagnósticos da América S/A, DASA, Avenida das Américas 4666, Sala 325, Rio de Janeiro, RJ, 22640-100, Brazil
| | - Flavio Luz
- Department of Dermatology, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil
| | - Andre Fukunishi Yamada
- Department of Radiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Hospital Do Coração, HCOR, São Paulo, Brazil
| | - Heron Werner
- Diagnósticos da América S/A, DASA, Avenida das Américas 4666, Sala 325, Rio de Janeiro, RJ, 22640-100, Brazil
- Bio Design Laboratory, Pontifícia Universidade Católica (PUC-Rio), Rio de Janeiro, Brazil
| | - Clarissa Canella
- DASA, Clínica Alta Excelência Diagnóstica, Rio de Janeiro, Brazil
- Bio Design Laboratory, Pontifícia Universidade Católica (PUC-Rio), Rio de Janeiro, Brazil
- Department of Radiology of Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil
| |
Collapse
|
2
|
Lemos T, Horwacz N, Baka J, Mourão A, Gripp A, Pires MT, Ceccarelli MA. Dactylitis and Ungual Tuberculosis: An Atypical Presentation of the Disease. Skin Appendage Disord 2023; 9:61-63. [PMID: 36632364 PMCID: PMC9827717 DOI: 10.1159/000526103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/13/2022] [Indexed: 01/14/2023] Open
Abstract
Introduction Tuberculosis is a common infection caused by Mycobacterium tuberculosis in developing countries. Among the extrapulmonary forms of tuberculosis, cutaneous tuberculosis is rare, and even dermatologists are less familiar with its ungual manifestations. Case Presentation We present an exuberant case of ungual tuberculosis in a patient with no personal or family history of immunosuppression, which is the first manifestation of the disseminated form of the disease. Conclusion In our patient, the initial manifestation was related to the nail, probably originating from the progression of bone TB focus, which further progressed with respiratory symptoms and involvement of other organs. We believe this is the first case in which the ungual presentation allowed the diagnosis of disseminated tuberculosis.
Collapse
Affiliation(s)
- Thayane Lemos
- Dermatology, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | - Núria Horwacz
- Dermatology, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | - Jessica Baka
- Dermatology, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | - Alice Mourão
- Dermatology, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | - Alexandre Gripp
- Dermatology, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | - Marianna T.F. Pires
- Medical Clinic, Souza Marques Educational Technical Foundation, Rio de Janeiro, Brazil
| | | |
Collapse
|