Letter - Tropical/Infectious and parasitic dermatology
Chromoblastomycosis in a renal transplant patient
Ingrid Rocha Meireles Holanda
, Priscila Neri Lacerda, Carolina Nunhez da Silva, Rosangela Maria Pires de Camargo, Anna Carolina Miola, Silvio Alencar Marques
Autor para correspondência
Infectious Diseases, Dermatology, Imaging Diagnosis and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
Lido
3469
Vezesque se leu este artigo
1219
Total PDF
2250
Total HTML
Compartilhar estatÃsticas
array:23 [ "pii" => "S0365059623002088" "issn" => "03650596" "doi" => "10.1016/j.abd.2023.02.008" "estado" => "S300" "fechaPublicacion" => "2024-01-01" "aid" => "840" "copyright" => "Sociedade Brasileira de Dermatologia" "copyrightAnyo" => "2023" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "pt" => array:18 [ "pii" => "S2666275223002370" "issn" => "26662752" "doi" => "10.1016/j.abdp.2023.09.018" "estado" => "S300" "fechaPublicacion" => "2024-01-01" "aid" => "840" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "pt" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Cartas ‐ Tropical/Infectoparasitária</span>" "titulo" => "Cromoblastomicose em paciente transplantado renal" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "142" "paginaFinal" => "145" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1354 "Ancho" => 1675 "Tamanyo" => 429122 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Infiltrado inflamatório granulomatoso dérmico associado a abscesso neutrofílico e presença de fungos de coloração acastanhada, corpos muriformes, alguns deles retidos no citoplasma de células gigantes multinucleadas</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ingrid Rocha Meireles Holanda, Priscila Neri Lacerda, Carolina Nunhez da Silva, Rosangela Maria Pires de Camargo, Anna Carolina Miola, Silvio Alencar Marques" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Ingrid Rocha Meireles" "apellidos" => "Holanda" ] 1 => array:2 [ "nombre" => "Priscila Neri" "apellidos" => "Lacerda" ] 2 => array:2 [ "nombre" => "Carolina Nunhez da" "apellidos" => "Silva" ] 3 => array:2 [ "nombre" => "Rosangela Maria Pires de" "apellidos" => "Camargo" ] 4 => array:2 [ "nombre" => "Anna Carolina" "apellidos" => "Miola" ] 5 => array:2 [ "nombre" => "Silvio Alencar" "apellidos" => "Marques" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0365059623002088" "doi" => "10.1016/j.abd.2023.02.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623002088?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275223002370?idApp=UINPBA00008Z" "url" => "/26662752/0000009900000001/v1_202401040746/S2666275223002370/v1_202401040746/pt/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S0365059623001915" "issn" => "03650596" "doi" => "10.1016/j.abd.2023.02.004" "estado" => "S300" "fechaPublicacion" => "2024-01-01" "aid" => "826" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter - Tropical/Infectious and parasitic dermatology</span>" "titulo" => "<span class="elsevierStyleItalic">Mycobacterium</span> abscessus sporotrichoid infection after a dog bite" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "145" "paginaFinal" => "147" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 287 "Ancho" => 955 "Tamanyo" => 33915 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">M. abscessus</span> colonies grew in Lowenstein Jensen culture after 7 days</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Patricia Guadalupe Mendoza-Del Toro (Patricia), Arturo Robles-Tenorio (Arturo), Víctor Manuel Tarango-Martínez (Victor)" "autores" => array:3 [ 0 => array:3 [ "preGrado" => "MD" "nombre" => "Patricia Guadalupe" "apellidos" => "Mendoza-Del Toro (Patricia)" ] 1 => array:3 [ "preGrado" => "MD" "nombre" => "Arturo" "apellidos" => "Robles-Tenorio (Arturo)" ] 2 => array:3 [ "preGrado" => "MD" "nombre" => "Víctor Manuel" "apellidos" => "Tarango-Martínez (Victor)" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275223002229" "doi" => "10.1016/j.abdp.2023.09.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275223002229?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623001915?idApp=UINPBA00008Z" "url" => "/03650596/0000009900000001/v1_202401040817/S0365059623001915/v1_202401040817/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0365059623001897" "issn" => "03650596" "doi" => "10.1016/j.abd.2023.01.005" "estado" => "S300" "fechaPublicacion" => "2024-01-01" "aid" => "824" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter - Dermatopathology</span>" "titulo" => "A new technique of paraffin-embedding of formalin-fixed nail sample, obtained by tangential excision - potato as guide mold" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "139" "paginaFinal" => "141" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1000 "Ancho" => 2925 "Tamanyo" => 359125 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0355" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) The nail matrix biopsy sample is laid flat on a piece of filter paper, in the place corresponding to the drawn diagram. (B) A potato piece of 2<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1.5<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>0.5<span class="elsevierStyleHsp" style=""></span>cm with a slit made in it by means of a scalpel. (C) The piece of potato, with the tissue inside. (D) Longitudinal section demonstrating the components of the nail apparatus. Hematoxylin & eosin, original magnification ×40.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Laura Bertanha, Cristina Diniz Borges Figueira de Mello, Ingrid Iara Damas, Rafael Fantelli Stelini, Nilton Di Chiacchio, Maria Letícia Cintra" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Laura" "apellidos" => "Bertanha" ] 1 => array:2 [ "nombre" => "Cristina Diniz Borges Figueira" "apellidos" => "de Mello" ] 2 => array:2 [ "nombre" => "Ingrid Iara" "apellidos" => "Damas" ] 3 => array:2 [ "nombre" => "Rafael Fantelli" "apellidos" => "Stelini" ] 4 => array:2 [ "nombre" => "Nilton" "apellidos" => "Di Chiacchio" ] 5 => array:2 [ "nombre" => "Maria Letícia" "apellidos" => "Cintra" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275223002199" "doi" => "10.1016/j.abdp.2023.09.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275223002199?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623001897?idApp=UINPBA00008Z" "url" => "/03650596/0000009900000001/v1_202401040817/S0365059623001897/v1_202401040817/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter - Tropical/Infectious and parasitic dermatology</span>" "titulo" => "Chromoblastomycosis in a renal transplant patient" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "142" "paginaFinal" => "145" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ingrid Rocha Meireles Holanda, Priscila Neri Lacerda, Carolina Nunhez da Silva, Rosangela Maria Pires de Camargo, Anna Carolina Miola, Silvio Alencar Marques" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Ingrid Rocha Meireles" "apellidos" => "Holanda" "email" => array:1 [ 0 => "ingmeireles@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Priscila Neri" "apellidos" => "Lacerda" ] 2 => array:2 [ "nombre" => "Carolina Nunhez da" "apellidos" => "Silva" ] 3 => array:2 [ "nombre" => "Rosangela Maria Pires de" "apellidos" => "Camargo" ] 4 => array:2 [ "nombre" => "Anna Carolina" "apellidos" => "Miola" ] 5 => array:2 [ "nombre" => "Silvio Alencar" "apellidos" => "Marques" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Infectious Diseases, Dermatology, Imaging Diagnosis and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1288 "Ancho" => 2175 "Tamanyo" => 299596 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Velvety greenish-black culture, with a central elevation. Mycosel agar. (B) Microculture showing the presence of <span class="elsevierStyleItalic">Cladosporium</span>-type sporulation with erect conidiophores, and short chains with two to three conidia. (Staining: cotton blue). <span class="elsevierStyleItalic">Fonsecaea</span> spp</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Chromoblastomycosis is a subcutaneous mycosis caused by the traumatic implantation of dematiaceous fungi, primarily affecting the lower limbs of male rural workers in tropical and subtropical regions.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is rarely reported in immunosuppressed hosts, particularly in solid-organ transplant recipients or in association with neoplastic diseases.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> This report describes a 63-year-old male construction worker, living in an urban area, who reported an injury in the right forearm after local trauma caused by a tree branch three years ago. Growth was slow and progressive, with mild local pruritus. The patient was hypertensive and had received a renal transplant five years before due to chronic kidney disease, probably secondary to the use of non-steroidal anti-inflammatory drugs and taking, used tacrolimus 2 mg/day, sirolimus 2 mg/day and prednisone 5 mg/day.</p><p id="par0010" class="elsevierStylePara elsevierViewall">On examination, an infiltrated erythematous-squamous plaque measuring 2.5 × 3.0 cm including the scarring area, was observed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Dermoscopy, using a Heine device, model Delta 30, under polarized light, showed reddish-pink background, scales, reddish-orange ovoid structures interspersed with brown dots and extravascular red lacunnae in an area not covered by squamous crusts (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Histopathology showed the presence of a dermal granulomatous inflammatory infiltrate, associated with neutrophilic microabscess and frequent round, brownish fungal structures, characteristic of sclerotic or muriform cells, some of them inside the cytoplasm of multinucleated giant cells (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) presenting equatorial septation. Culture on Mycosel agar showed a greenish-black velvety colony with central elevation (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>A) and the microculture revealed <span class="elsevierStyleItalic">Cladosporium</span>-type sporulation with erect conidiophores, short chains, and two to three conidia at or near the apex, compatible with <span class="elsevierStyleItalic">Fonsecaea</span> spp. (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>B). Due to the COVID-19 pandemic, the patient was reassessed nine months after the initial appointment, reporting that the lesion was stable. He informed the replacement of sirolimus by mycophenolate mofetil during the period and underwent surgical excision, with a 5-mm margin. The patient returned for reavaliation two months after surgery with good healing and no signs of recurrence (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>), maintaining the scarred aspect at the time of the last reassessment, corresponding to the 9<span class="elsevierStyleSup">th</span> month after the surgical procedure.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The countries with the highest prevalence of chromoblastomycosis are Brazil, Mexico, Venezuela, India, Australia, and China<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In Brazil, this mycosis occurs in most states, and the state of Pará presents the highest incidence.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The lower limbs are the most affected areas, followed by the upper limbs, and males aged between 20‒60 years, with rural activity are the common denominator in 90% of cases.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–5</span></a> The most prevalent etiological agent is <span class="elsevierStyleItalic">Fonsecaea pedrosoi</span> (66%–96% of cases), followed by <span class="elsevierStyleItalic">Cladophialophora carrionii</span>, and <span class="elsevierStyleItalic">Phialophora verrucosa</span>.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–5</span></a> The clinical manifestation of chromoblastomycosis is polymorphic and may present as a verrucous, nodular, tumor-like, cicatricial, or infiltrated plaque.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The evolution of lesions associated with post-transplant immunosuppression does not differ, in most cases, from that observed in immunocompetent patients, i.e., slow, indolent growth.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–5</span></a> It can be speculated that tacrolimus, due to its antifungal action, is also effective in delaying lesion progression.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The presence of diseases or the use of associated immunosuppressive medications was described in only 0.2% of the reported cases, with solid-organ transplantation being the most common, followed by HIV infection, rheumatoid arthritis, systemic lupus erythematosus (SLE), bladder cancer, celiac disease, pernicious anemia and non-Hodgkin's lymphoma.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Dermoscopy usually shows the presence of reddish-black dots that represent the transepidermal elimination of inflammatory cells, fungal elements, or hemorrhage. Yellow-orange ovoid structures on a pinkish-white background, polymorphic vessels, scales, and crusts may also be seen.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> The treatment of choice for chromoblastomycosis, whenever possible, is surgical removal, with or without clinical treatment or adjuvant physical treatments that can reduce the lesion diameter and allow surgical excision. Long-term postoperative follow-up is recommended, as recurrence is possible. Itraconazole 200–400 mg/day for a variable time, or in combination with terbinafine 500 mg/day are the most used antifungals. Posaconazole is an alternative treatment after failure of or intolerance to classical clinical treatment.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Physical therapeutic methods such as thermotherapy, cryotherapy, laser therapy, and photodynamic therapy may be effective or useful as adjunct treatments.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Chromoblastomycosis constitutes a diagnostic challenge in immunosuppressed patients, as it is rarely observed or reported in the literature. It is important to be aware of drug interactions between systemic antifungals and the immunosuppressive therapy being used, which may constitute an important limiting factor for treatment.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0040" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors’ contributions</span><p id="par0045" class="elsevierStylePara elsevierViewall">Ingrid Rocha Meireles Holanda: Design and planning of the study; drafting and editing of the manuscript; collection, analysis, and interpretation of data; effective participation in research orientation; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the literature; critical review of the manuscript; approval of the final version of the manuscript.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Priscila Neri Lacerda: Design and planning of the study; drafting and editing of the manuscript; collection, analysis, and interpretation of data; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the literature; critical review of the manuscript.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Carolina Nunhez da Silva: Drafting and editing of the manuscript; collection, analysis, and interpretation of data; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the literature; critical review of the manuscript.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Rosangela Maria Pires de Camargo: Drafting and editing of the manuscript; collection, analysis, and interpretation of data; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the literature; critical review of the manuscript.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Anna Carolina Miola: Drafting and editing of the manuscript; collection, analysis, and interpretation of data; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the literature; critical review of the manuscript.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Silvio Alencar Marques: Design and planning of the study; drafting and editing of the manuscript; effective participation in research orientation; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the literature; critical review of the manuscript; approval of the final version of the manuscript.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0075" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Authors’ contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-10-25" "fechaAceptado" => "2023-02-16" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "⋆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Study conducted at the Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.</p>" ] ] "multimedia" => array:4 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1193 "Ancho" => 2925 "Tamanyo" => 452121 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Infiltrated plaque lesion, on the right forearm, showing surface covered by squamous crusts. (B) Dermoscopy under polarized light showed a reddish-pink background (asterisk), desquamation (black arrow), reddish-orange ovoid structures interspersed with brown dots (yellow arrow) and extravascular red lacunnae in an area not covered by squamous crusts (arrowhead)</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1354 "Ancho" => 1675 "Tamanyo" => 430035 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dermal granulomatous inflammatory infiltrate, associated with neutrophilic abscess and the presence of brownish-colored fungi, muriform bodies, some of them inside the cytoplasm of multinucleated giant cells (Hematocylin & eosin 40X)</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1288 "Ancho" => 2175 "Tamanyo" => 299596 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Velvety greenish-black culture, with a central elevation. Mycosel agar. (B) Microculture showing the presence of <span class="elsevierStyleItalic">Cladosporium</span>-type sporulation with erect conidiophores, and short chains with two to three conidia. (Staining: cotton blue). <span class="elsevierStyleItalic">Fonsecaea</span> spp</p>" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 2045 "Ancho" => 1508 "Tamanyo" => 450260 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Late postoperative period, two months after excisional surgery</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chromoblastomycosis: an etiological, epidemiological, clinical, diagnostic and treatment up-date" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.C. Brito" 1 => "M.J.S. Bittencourt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Bras Dermatol" "fecha" => "2018" "volumen" => "93" "paginaInicial" => "495" "paginaFinal" => "506" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chromoblastomycosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Queiroz-Telles" 1 => "S. De Hoog" 2 => "D.W.C.L. Santos" 3 => "C.G. Salgado" 4 => "V.A. Vicente" 5 => "A. Bonifaz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Microbiol Rev" "fecha" => "2017" "volumen" => "30" "paginaInicial" => "233" "paginaFinal" => "276" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chromoblastomycosis in solid organ transplant recipients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Kumbhakar" 1 => "B.A. Miko" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Curr Fungal Infect Rep" "fecha" => "2019" "volumen" => "13" "paginaInicial" => "139" "paginaFinal" => "145" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The global burden of chromoblastomycosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.W.C.L. Santos" 1 => "C.M.P.S. Azevedo" 2 => "V.A. Vicente" 3 => "F. Queiroz-Telles" 4 => "A.M. Rodrigues" 5 => "G.S. Hoog" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "PLoS Negl Trop Dis" "fecha" => "2021" "volumen" => "15" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Therapeutic management of subcutaneous phaeohyphomycosis and chromoblastomycosis in kidney transplant recipients: a retrospective study of 82 cases in a single center" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.C.C. Lima" 1 => "D.W.C.L. Santos" 2 => "S.H. Hirata" 3 => "A.S. Nishikaku" 4 => "M.M.S.E.S. Enokihara" 5 => "M.M. Ogawa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ijd.15948" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol" "fecha" => "2022" "volumen" => "61" "paginaInicial" => "346" "paginaFinal" => "351" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34633082" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tacrolimus as antifungal agent" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Antypenko" 1 => "F. Meyer" 2 => "Z. Sadykova" 3 => "L.A. Garbe" 4 => "K.G. Steffens" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Acta Chim Slov" "fecha" => "2019" "volumen" => "66" "paginaInicial" => "784" "paginaFinal" => "791" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34057481" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S021391111930175X" "estado" => "S300" "issn" => "02139111" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermoscopy of chromoblastomicosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Chauhan" 1 => "R. Jindal" 2 => "N. Shirazi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/idoj.IDOJ_213_18" "Revista" => array:7 [ "tituloSerie" => "Indian Dermatol Online J" "fecha" => "2019" "volumen" => "10" "paginaInicial" => "759" "paginaFinal" => "760" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31807473" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1885585719304153" "estado" => "S300" "issn" => "18855857" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Unusual presentation of chromoblastomycosis due to Cladophialophora carrionii in a renal and pancreas transplant recipient patient successfully treated with posaconazole and surgical excision" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Dupont" 1 => "T.A. Duong" 2 => "S. Mallet" 3 => "M.F. Mamzer-Bruneel" 4 => "E. Thervet" 5 => "M.E. Bougnoux" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Transpl Infect Dis" "fecha" => "2010" "volumen" => "12" "paginaInicial" => "180" "paginaFinal" => "183" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009900000001/v1_202401040817/S0365059623002088/v1_202401040817/en/main.assets" "Apartado" => array:4 [ "identificador" => "95150" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter - Tropical/Infectious and parasitic dermatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009900000001/v1_202401040817/S0365059623002088/v1_202401040817/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623002088?idApp=UINPBA00008Z" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 32 | 7 | 39 |
| 2024 Outubro | 144 | 71 | 215 |
| 2024 Setembro | 201 | 103 | 304 |
| 2024 Agosto | 182 | 141 | 323 |
| 2024 Julho | 170 | 109 | 279 |
| 2024 Junho | 129 | 78 | 207 |
| 2024 Maio | 127 | 60 | 187 |
| 2024 Abril | 134 | 95 | 229 |
| 2024 Março | 127 | 82 | 209 |
| 2024 Fevereiro | 401 | 119 | 520 |
| 2024 Janeiro | 375 | 103 | 478 |
| 2023 Dezembro | 51 | 54 | 105 |
| 2023 Novembro | 95 | 82 | 177 |
| 2023 Outubro | 68 | 104 | 172 |
| 2023 Setembro | 14 | 11 | 25 |
Mostrar tudo
