Pseudomembranous-like Tinea of the Scrotum Infected by Microsporum Gypseum in a Young Man

Subcutaneous Panniculitis-like T-Cell Lymphoma Without Erythema and Subcutaneous Tumors

We report a case of subcutaneous panniculitis-like T-cell lymphoma with diffuse indurated lesions without erythema. A 27-year-old man was referred to us with a 1-month history of fever, general fatigue and indurated skin lesions. The initial examination revealed indurated skin lesions without erythema and subcutaneous tumors in the right lower abdomen, back and buttocks. Histopathology showed a panniculitis predominantly in lobular pattern, and infiltration of atypical lymphocytes in the subcutaneous tissue. Characteristically, there was rimming of individual fat cells by surrounding atypical lymphocytes. Results of laboratory examinations showed hemophagocytic syndrome (HPS). Based on these findings, we made a diagnosis of subcutaneous panniculitis-like T-cell lymphoma without erythema and subcutaneous tumors with HPS. To our knowledge, there has been no report of SPTCL with diffuse indurated lesions without erythema, tumors, or plaque, all of which are considered to be typical characteristics of SPTCL. Positron emission tomography / computed tomography (PET/CT) showed noticeable thickening of diffuse subcutaneous involvement throughout the body. Hence, PET/CT is a useful for the detection of SPTCL as well as its distribution.

Updates on Genital Dermatophytosis

Dermatophytes are a group of keratinophilic fungi, which normally cause superficial infection of skin, hair and nails. Based on ecology, they are classified into three groups: anthropophilic, zoophilic and geophilic. Superficial dermatophytic infection of the genital region is called genital dermatophytosis, tinea genitalis or pubo-genital dermatophytosis. In this review, we would like to discuss briefly, the various clinical presentations of genital dermatophytosis, current changes in the taxonomy and nomenclature, introduction of new diagnostic techniques and briefly describe some common dermatophytes and their sources. Also, there are serious concerns associated with the recent development of antifungal resistance among the dermatophytes. We are also facing the scenario of hard-to-treat dermatophytosis.

Favus of Scrotum Due to Trichophyton rubrum in Immunocompetent Patients: A Clinical, Mycological and Ultrastructural Study

PURPOSE

To characterize the clinical and mycological features of favus of scrotum due to Trichophyton rubrum.

METHODS

A single-site prospective study was carried out in an outpatient dermatology clinic. Microscopic examination and fungal culture were done using skin scrapings. Scales on the scrotum were stained with PAS and visualized by microscopy, including in vivo reflectance confocal microscopy (RCM). Two strains were analyzed by RAPD typing. Scutular lesions were fixed for scanning electron microscopy (SEM) and transmission electron microscopy (TEM).

RESULTS

Cultures of the scale from the scrotum and/or groin in all patients showed a growth of T. rubrum. T. rubrum strains from scrotum and groins in one patient were demonstrated as the same strain by RAPD typing. The average age of patients was 34.1 ± 12.78 years. The mean course was 8.2 ± 5.07 days. All the patients received only topical treatment for 2 weeks without recurrence. Direct smear, calcofluor-white staining and in vivo RCM study of the scrotal favus in patients showed a massive number of septate branching hyphae, while fewer septate hyphae in scales in the groin. Abundant hyphae were found only in the outer layer of the stratum corneum of the scrotum under SEM and TEM with intact bilateral cell walls, and normal nucleus, liposomes and reticulum. Few distorted hyphae structures, cell wall degeneration, degenerated cytoplasm and the autophagy phenomenon could be seen in scales from groin under TEM.

CONCLUSIONS

Scrotal favus due to T. rubrum is still a true infection, which most often occurred in immunocompetent patients.