Browsing by Author "Galhardas, C"
Now showing 1 - 6 of 6
Results Per Page
Sort Options
- Adult Tinea Capitis and Tinea Barbae in a Tertiary Portuguese Hospital: a 11-Year AuditPublication . Duarte, B; Galhardas, C; Cabete, JAdult tinea capitis and tinea barbae are nowadays considered uncommon in developed countries. Despite their potential for morbidity and healthcare costs, few series have attempted to characterise these infectious disorders. We conducted a cross-sectional study to analyse the epidemiological, clinical and mycological characteristics of adult tinea capitis and tinea barbae of a large tertiary centre in Southern Europe. All adult patients with a mycological-confirmed tinea capitis or barbae over a 11-year period (January 2008 to December 2018) were considered for the analysis. Concerning tinea capitis, 860 culture-confirmed diagnoses were made during this 11-year period, of which only 15 (1.5%) occurred in adults (15 patients). A disproportionately high number of patients were female and immunocompromised. Microsporum audouinii (20%) and Trichophyton rubrum (20%) were the most common isolates. Half of the cases were initially misdiagnosed. Regarding tinea barbae, 7 cases were diagnosed over this time period. Overuse of topical steroids was widespread in this population. Trichophyton rubrum was the infectious agent in all cases. Initial misdiagnosis was very common (43%). Adult tinea capitis and tinea barbae can still be observed in contemporary practice and remain a public health concern, with the immunosuppressed patient being particularly affected. Initial misdiagnosis is a common occurrence. Anthropophilic fungi are now the most common aetiologic agents of these infections, and they will probably continue to do so as the large urban centres expand peripherally. Awareness for this diagnosis is necessary to prevent unwarranted morbidity and costs.
- A Comparative Study of Onychomycosis and Traumatic Toenail Onychodystrophy Dermoscopic PatternsPublication . Ramos Pinheiro, R; Dias Domingues, T; Sousa, V; Galhardas, C; Apetato, M; Lencastre, ABackground: Onychomycosis (OM) and traumatic onychodystrophy (OD) are common causes of toenail changes. A clinical diagnosis is often impossible without mycology. Dermoscopy is helpful in this setting but yet underexplored. Prospective comparative studies between OM and OD onychoscopic findings have not been previously performed. Objectives: We sought to determine distinguishing dermoscopic presentations of OM and traumatic OD. Methods: We performed a prospective, observational study including patients presenting with ≥1 toenail onychodystrophy. All underwent onychoscopy, clinical and mycological examination. Based on these results, patients received a final diagnosis of OM or OD. Dermoscopic presentations of OM and OD patients were classified in patterns and compared. Results: In all, 110 cases of OM and 82 of traumatic OD were compared. Statistical analyses revealed that the distal pulverized and the irregular spiked macular dermoscopic patterns were predictors of an OM diagnosis. The regular macular, the non-classifiable, the total and partial homogeneous background dermoscopic patterns correlated with traumatic OD diagnosis. Conclusions: We demonstrated that OM and traumatic OD have distinctive onychoscopic presentations. Dermoscopy may be an important ancillary tool to guide their differential.
- Estudo Retrospectivo dos Fungos Patogénicos isolados no Departamento de Micologia do Hospital do Desterro em 2006 e no 1º Trimestre de 2007Publication . Dias Coelho, J; Rocha-Páris, F; Galhardas, C; Barata Feio, AAs infecções fúngicas superficiais são uma patologia muito frequente na prática clínica. Os organismos responsáveis são os dermatófitos, leveduras e bolores, havendo variação dos principais agentes etiológicos consoante a localização cutânea da infecção. Os dermatófitos são os principais responsáveis. Com o objectivo de melhor caracterização dos diferentes agentes patogénicos das dermatofitias, foi efectuado um estudo retrospectivo dos exames micológicos realizados no Departamento de Micologia do Hospital do Desterro no período de 2006 e 1º trimestre de 2007. Neste período foram colhidas 215 amostras de escamas, cotas e unhas de doentes com suspeita clínica de infecção fúngica. Foram isolados dermatófitos em 90 amostras (41,9%). O género mais frequentemente isolado foi o Trichophyton mentagrophytes (44%). A tinea capitis foi a localização mais frequente (63%), sendo o principal agente o Trichophyton mentagrophytes var. granulare (51%), seguido do Trichophyton saudanense (32%) e do Microsporum canis (9%). Na tinea unguium (17%) foram encontradas 2 espécies: o Trichophyton rubrum (53%) e o Trichophyton mentagraphytes var. interdigitale (47%). Na tinea pedis, corporis, manuum e cruris o agente mais frequente foi o Trichophyton rubrum. Salienta-se assim a importância do Trichophyton saudanense na tinea capitis e a baixa prevalência de M. canis nesta patologia na nossa amostra. Em relação à literatura obtivemos um predomínio de T. mentagrophytes o que poderá em parte dever-se a termos uma elevada percentagem de amostras provenientes do couro cabeludo, local em que o T. rubrum não é a espécie dominante.
- Onychomycosis in Patients with Chronic Leg Ulcer and Toenail AbnormalitiesPublication . Cabete, J; Apetato, M; Galhardas, C; Lestre, SNails have a limited number of reactive patterns to disease. Accordingly, toenail changes of different etiologies may mimic onychomycosis. OBJECTIVE To determine the prevalence of toenail onychomycosis among patients with leg ulcer and toenail abnormalities attending a dermatology clinic. METHODS A cross-sectional study was conducted through the analysis of clinical records and results of mycological examination. RESULTS A total of 81 patients were included, with a median age of 76.0 years. Most ulcers were of venous etiology, followed by those of mixed and arterial pathogenesis. The mycological evaluation confirmed the diagnosis of onychomycosis in 27.2% of the patients. The etiologic agent was a dermatophyte in 59.1% of isolates in nail samples, while Trichophyton interdigitale was the most frequent fungal species (40.9%). CONCLUSIONS Most toenail abnormalities in patients with chronic leg ulcer were not onychomycosis. This study highlights the importance of systematic mycological examination in these patients, in order to avoid overtreatment with systemic antifungals, unnecessary costs and side effects.
- Tinea Faciei in a Central Portuguese Hospital: A 9-Year SurveyPublication . Borges, A; Brasileiro, A; Galhardas, C; Apetato, MTinea faciei is a relatively uncommon dermatophytosis that affects the glabrous skin of the face. The aim of this study was to analyse the epidemiologic, clinical and mycological features of tinea faciei cases diagnosed at the Dermatology and Venereology Department of Hospital Santo António dos Capuchos (Lisbon, Portugal). Consecutive cases diagnosed between 2008 and 2016 were studied retrospectively. A total of 72 tinea faciei cases have been diagnosed, involving 37 male and 35 female, aged between 8 months and 86 years. The majority were observed in patients younger than 12 years of age (59.72%). Anthropophilic isolates (mainly Microsporum audouinii, Trichophyton soudanense and Trichophyton rubrum) accounted for 75.7% of the identified dermatophytes. One quarter of the patients were also affected by dermatophytosis in other areas, such as the scalp. Only 10 cases were previously treated with topical steroids due to misdiagnosis. Most patients were treated with topical and systemic antifungal therapy with total resolution of skin lesions, without relapse or side effects. In contrast to other European studies, anthropophilic dermatophytes were the main causative agents of tinea faciei. As previously described to tinea capitis, this result is probably due to changes in the epidemiology of dermatophytes worldwide.
- Trichoscopy as an Additional Tool for the Differential Diagnosis of Tinea Capitis: a Prospective Clinical StudyPublication . Brasileiro, A; Campos, S; Cabete, J; Galhardas, C; Lencastre, A; Serrão, V