Tiña incógnita: serie de casos y revisión bibliográfica

Rivero, Juncal Ruiz; Cembranos, M.D. Mendoza; Blanco, María Cristina Ciudad

doi:10.1016/j.piel.2014.06.014

Cited by 2 publications

(3 citation statements)

References 15 publications

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“…Los dermatofitos son hongos con gran capacidad para parasitar estructuras queratinizadas como la piel, pelo y uñas, porque usan la queratina como fuente de energía. 8,9 Los dermatofitos que parasitan al ser humano son del género Trichophyton, Microsporum y Epidermophyton. 8,10,11 Cuando afectan la piel, lo común es que aparezcan placas eritematosas, con borde activo circinado, papular o vesiculoso y áreas de pseudocuración central que suelen acompañarse de descamación moderada a intensa y casi siempre pruriginosas.…”

Section: Discussionunclassified

“…También se ha encontrado una incidencia alta de TI en pacientes con tratamientos inmunosupresores sistémicos, por lo que debe tenerse especial cautela con las lesiones dermatológicas de estos pacientes. 3,9,13 No se ha encontrado predominio de edad o sexo en estudios de poblaciones variadas, 1,3 pero algunos autores refieren que son más frecuentes en niños y mujeres, 3,15 como los dos casos descritos.…”

Section: Discussionunclassified

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Tiña incógnita facial. Informe de dos casos

Castro¹,

Hernández²,

Enamorado³

2019

Acta Pediatr Mex

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ANTECEDENTES: La tiña incógnita es una infección dermatofítica, con una morfología modificada debido al uso inapropiado de esteroides tópicos, sistémicos o inhibidores de la calcineurina. Este problema es más frecuente en casos de tiñas faciales y constituye un reto diagnóstico que requiere historia clínica minuciosa, examen físico y estudios complementarios. En países tropicales, en vías de desarrollo, las dermatofitosis son un problema de gran prevalencia debido a múltiples factores: clima cálido, hacinamiento, contacto con animales y malos hábitos de higiene. Honduras no es la excepción y, además de los factores mencionados, la venta de medicamentos sin prescripción favorece la automedicación. Otro factor contribuyente es la no disponibilidad de exámenes de laboratorio en la mayor parte de los centros asistenciales estatales, lo que dificulta la confirmación diagnóstica de una dermatosis.CASOS CLÍNICOS: Se comunican dos casos de tiña facial incógnita en dos pacientes del sexo femenino en edad pediátrica ocasionadas por Trichophyton verrucosum y tratadas con la combinación de antimicóticos tópicos y sistémicos con excelentes resultados.CONCLUSIÓN: Es imporante concientizar a los profesionales de la salud acerca del riesgo del uso inapropiado de esteroides y de inhibidores de la calcineurina en dermatosis eritematoescamosas, sobre todo las faciales.

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Section: Discussionunclassified

Tiña incógnita facial. Informe de dos casos

Castro¹,

Hernández²,

Enamorado³

2019

Acta Pediatr Mex

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“…Too often a diagnosis of skin mycosis (scalp, body, folds, and nails) is made based on clinical observation alone and this can lead to misdiagnosis and inappropriate treatment. As well as cost implications, inappropriate treatment can mask the fungal infection [15][16][17][18][19]. Moreover, systemic antifungal therapy can have serious consequences when prescribed to certain patient groups, e.g.…”

Section: Discussionmentioning

confidence: 99%

Cost analysis of inappropriate treatments for suspected dermatomycoses

Fiammenghi¹,

Patalano²,

Conte³

et al. 2015

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Superficial mycoses are estimated to affect more than 20-25% of the world's population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1) to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2) to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital " Federico II") in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination) were defined as inappropriate: (1) cortisone in a patient with at least one positive site; (2) antifungals in (a) patients with all negative sites or (b) ineffective antifungal treatment (in terms of drug chosen, dose or duration) in those with all positive sites; or (3) antibiotics; (4) antivirals or (5) antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease with respect to the total consumption of drugs at the time of access to the Mycology Laboratory of € 34,781. Thus, our cost analysis shows that it is important to obtain a reduction of costs for pathologies that need to be confirmed by examinations before starting treatment.

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Tiña incógnita: serie de casos y revisión bibliográfica

Cited by 2 publications

References 15 publications

Tiña incógnita facial. Informe de dos casos

Tiña incógnita facial. Informe de dos casos

Cost analysis of inappropriate treatments for suspected dermatomycoses

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