Dermatofitose por Tricophyton rubrum como infecção oportunista em pacientes com doença de Cushing

Abstract

Abstract:Trichophyton rubrum is a common agent found in superficial mycoses, which present ample nonin?ammatory lesions, with chronic evolution, especially in immunocompromised patients. The hypercortisolism in Cushing's syndrome increases the risk of infections as a result of the immunosuppressive effect of glucocorticoids. The reported cases here refer to two different types of dermatophytosis caused by Trichophyton rubrum in patients with Cushing's disease, resistant to antifungal treatment. The disease remitted after the levels of cortisol went back to normal. Keywords: Cushing's syndrome; Dermatomycoses; Immunosuppression; Onychomycosis Resumo: O dermatófito Trichophyton rubrum é um agente comum nas micoses superficiais, podendo apresentar lesões extensas pauci-inflamatórias de evolução crônica, especialmente em imunocomprometidos. O hipercortisolismo, na síndrome de Cushing, aumenta o risco de infecções, resultado do efeito imunossupressor dos glicocorticóides. Os casos relatados apresentam duas formas distintas de dermatofitose, em pacientes com doença de Cushing, causadas por Tricophyton rubrum e posterior remissão após normalização da cortisolemia.

Indian association of dermatologists, venereologists and leprologists (IADVL) task force against recalcitrant tinea (ITART) consensus on the management of glabrous tinea (INTACT)

“…[ 77 ] Spontaneous remission rarely occurs even when the underlying cause has been eliminated. [ 78 ] Therefore, every patient with dermatophytosis requires topical and/or systemic antifungal therapy.…”

Severe Dermatophytosis and Acquired or Innate Immunodeficiency: A Review

“…Among the cases of severe dermatophytosis with microbiological confirmation, 28 have been reported in the English language literature since 1979 [ 17 , 19 , 21 , 25 , 31 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 ]. The patients were mainly men [ 19 ] aged from 15 to 75 years.…”

Clinical and biochemical manifestations of Cushing’s

“…During active CS, autoimmune disorders improve but, during remission, they may worsen and new ones may develop [78,79]. There is a high risk of superficial fungal, opportunistic (Cryptococcus Neoformans, Candida and Norcardia species, Trichophyton Rubrum) or bacterial infections [80,81].…”