Tungiasis: a poorly-known diagnosis in Europe. Two paradigmatic cases from Portugal

Tungiasis is a cutaneous parasitosis caused by infestation of the skin by gravid fleas of the genus Tunga, mainly Tunga penetrans. This flea is very common in tropical and subtropical regions of the globe, but not in Europe. The infestation is acquired by walking barefoot or lying in places where the flea is present, usually beaches or sandy soils. We report two unrelated cases of imported tungiasis in Portugal that presented to our clinic in the same week. We draw attention to one of the most common dermatological diseases in travelers returning from tropical countries, the diagnosis of which is primarily clinical but nonetheless is largely unfamiliar to clinicians attending those patients.info:eu-repo/semantics/publishedVersio

Cutaneous Phaeohyphomycosis Caused by Alternaria alternata Unresponsive to Itraconazole Treatment

Cutaneous alternariosis is an opportunistic infection that has been described mainly in patients treated with corticosteroids. We report a case of dermal alternariosis occurring in a woman treated with corticosteroids after a neurosurgery that was unresponsive to itraconazole. Treatment with intravenous voriconazole was initiated, followed by oral protocol, with marked improvement of the lesions

Giant pilomatricoma in a patient with tuberous sclerosis, both diagnosed in the adult life.

Pilomatricoma is a relatively common benign skin neoplasm originating from the hair follicle matrix cells. β-Catenin is a subunit of the cadherin protein complex. It acts as an intracellular signal transducer that influences cell differentiation and proliferation. This protein was recently involved in the formation of hair follicle-related tumours, including pilomatricomas. Tuberous sclerosis (TS) is an inherited neurocutaneous disease, which is characterised by pleomorphic features involving many organs, hamartomas in multiple organ systems and by the fact that it is usually diagnosed early in life. We reported a case of a Caucasian patient with TS and a giant pilomatricoma, both diagnosed in the adult life

Rapidly lethal dermatomyositis associated with cutaneous lymphangitis carcinomatosa

A 70-year-old woman with a recent diagnosis of dermatomyositis (DM) presented to the dermatology department for study of a probably paraneoplastic syndrome. On examination, we observed discrete, indurated, reddish, painful plaques and nodules on her abdomen and both thighs. A cutaneous biopsy from an abdominal nodule, performed as part of the paraneoplastic workup, was suggestive of cutaneous lymphangitis carcinomatosa, secondary to unknown malignancy. An extensive investigation to locate the site of the primary tumour revealed no specific findings. A course of palliative chemotherapy with cisplatin and 5-fluorouracil was then given, but the patient's condition deteriorated and 6 months after her initial observation the patient died. We describe this case because, to our knowledge, the association between DM and cutaneous lymphangitis carcinomatosa has not been described yet in the literature and to highlight that, DM can be a rapidly lethal disease

Kikuchi´s disease of the xanthomathous type with cutaneous manifestation

Kikuchi's disease is a benign, self-limiting disease, whose pathogenesis remains unknown. Patients most often present with cervical lymphadenopathy, sometimes associated with fever and leukopenia. It has been reported that up to 40% of patients with Kikuchi's disease have also cutaneous eruptions, but no specific skin changes have been described. Kikuchi's disease can be subclassified into three histologic subtypes: a proliferative type, a necrotizing type and a xantomathous type. Most patients with Kikuchi's disease require no specific treatment, because the disease regresses spontaneously, within a few weeks to months. We report a case of a 31-year-old woman with xanthomatous type of Kikuchi's disease, whose first manifestation was the onset of erythematous papules with central suppuration on her face and on her left hand