This is a retrospective study of 160 patients treated in private practice in
São Paulo from March 2003 to March 2015. We analyzed 171 results of
direct mycological examinations and fungal cultures from nail scrapings. The
agreement between direct mycological examination results and fungal culture was
satisfactory, consistent with the literature (kappa 0.603). The main agent
identified was Trichophyton rubrum (51%). We observed an isolation rate of
non-dermatophyte filamentous fungi superior to the literature (34%). Determining
the agent is key to defining the appropriate onychomycosis treatment, and
knowing the epidemiology of patients treated in private practice helps the
dermatologist who works in this context.
Epidermolysis bullosa is a group of mechano-bullous genetic disorders caused by
mutations in the genes encoding structural proteins of the skin. Dystrophic
epidermolysis bullosa is caused by mutations in the COL7A1 gene encoding
collagen VII, the main constituent of anchoring fibrils. In this group, there
are autosomal dominant and recessive inheritances. The pre-tibial form is
characterized by the presence of blisters, milia, atrophic scars and lesions
similar to lichen planus. The diagnosis is clinical and laboratory and subtypes
are distinguished by means of immunohistochemical and ultrastructural studies,
in addition to genetic differentiation. Electron microscopy and immunomapping
are used in the diagnosis.
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