No abstract

Here, we review the human botfly (Dermatobia hominis), which belongs to a group of Diptera generically known as "myiasis-causing flies," characterized by the ability of their larvae to develop in animal flesh. In addition to its medical and economic importance, there is an academic interest in this botfly because of its peculiar biology, particularly because a phoretic diptera is needed to complete the life cycle. The larvae penetrate the host's skin, causing furuncle-like lesions that are pruritic, painful, and resemble subcutaneous nodules, producing irreversible perforations in the skin. Although D. hominis is distributed from Mexico to Argentina, a review performed by our working group from 1999 to 2015 determined that the countries with the highest infection rates in travelers are Belize, Bolivia, and Brazil. Interestingly, infected men show a higher variation in the distribution of the lesions than in women. Many treatment schemes have been suggested, including the application of highly dense liquids to the lesion to cause anoxia in the D. hominis larvae. We showed, for the first time, a Bayesian inference between D. hominis and other myiasis-causing flies. The flies grouped into two main clusters according to their capacity to produce facultative and obligatory myiasis, and D. hominis was phylogenetically close to Cuterebra spp.

Tepescohuite is an extract obtained from the bark of the Mimosa tenuiflora tree and is used as an empirical treatment in wounds for its healing and antiseptic properties. Venous leg ulcers (VLUs) are a common health care problem in most countries with a high rate of morbidity. The standard of care is moist interactive healing and compression; however, the ideal topical treatment is yet to be established. This study is designed to evaluate the effectiveness and safety of M. tenuiflora cortex extract (MTC-2G) in the treatment of VLUs in an Interdisciplinary Wound and Ostomy Care Center (IWOCC). A randomised, placebo-controlled, double blind clinical trial was conducted to compare the use of a hydrogel containing MTC-2G with the hydrogel alone in VLUs. The study included all patients with venous ulcers referred to the IWOCC. Laboratory tests and tissue biopsies were performed at the beginning and at the end of the study. The patients were instructed to daily cleansing followed by topical application of the hydrogel and compression. Forty-one patients were included, 22 patients received the MTC-2G and 19 patients received the hydrogel only. Of the 41 patients, 32 completed the study, 18 in the experimental arm and 14 in the control group, 19 were women and 13 men. The mean age of the subjects was 60 years. The mean time from presentation was 38 months. The mean surface reduction was 6·29 cm(2) [confidence interval (IC) 95%: 3·28-9·29] (P = 0·0001) in the MTC-2G group and 5·85 cm(2) (95% CI: 3·58-8·12) (P = 0·001) in the hydrogel group. There was no significant difference between the groups (P = 0·815). No changes in the laboratory parameters were noted. In the histology, there were not any differences between groups either. A hydrogel containing MTC-2G was not superior to a hydrogel alone in the treatment of VLUs.

No abstract

Onychomatricoma has a classical clinical appearance; however, it is difficult to identify, as it is not until surgery, when the typical filiform projections are more visible, that the diagnosis can be made. Onychomatricoma is a rare tumor. The involvement of the entire nail matrix, with secondary nail dystrophy, in both cases presented here makes them interesting case reports of this unusual form of tumor.

No abstract

These results suggest that HLA-DR6 confers protection against the development of onychomycosis in a Mexican Mestizo population. Having an affected first-degree relative significantly increases the risk of onychomycosis, suggesting genetic susceptibility.

A 43‐year‐old woman presented with a soft, smooth, cystic, slightly erythematous, dome‐shaped nodule, 6 × 8 mm in diameter, located on the dorsum of the middle finger of the right hand, between the proximal fold and the distal interphalangeal joint, lateral to the midline ( ). The nail of the affected finger showed longitudinal grooving and mild distal transverse overcurvature. The lesion had been present for 3 months and was tender upon pressure. 1 Digital mucoid cyst, lateral to the midline of the third finger, causing nail deformity Clinical examination revealed early signs of osteoarthritis and Heberden’s nodes on the distal interphalangeal joints of both hands. Previous treatment included the intake of nonsteroidal anti‐inflammatory drugs (NSAIDs) indicated by a rheumatologist. An X‐ray of the right hand showed decreased joint spaces between the second and third phalanges of the middle finger. Diagnosis of a digital mucoid cyst (with nail deformity secondary to the former) was made. Surgical excision was performed. During surgery, a pedicle connecting the cyst to the joint capsule was clearly observed and two satellite lesions were also found ( ). The cyst and its satellite lesion, including the communicating tract, were totally removed. 2 (A) direct link of the cyst to the distal interphalangeal joint during surgery is clearly observed The histopathologic study showed large cystic spaces containing mucin (colloidal iron stain) which were lined in some areas by synovial membrane ( ). The histopathologic report was compatible with a digital mucoid cyst of the ganglion type. 3 Large cystic spaces containing mucin lined, in some areas, by synovial membrane (×100, original magnification) Six months after excision, no recurrence has been detected, and the nail plate deformities have improved.