[Multicentric and localized tineas in immunocompromised patients].
From the dermatological point of view, multifocal or multicentric tineas are widespread dermatophytic infections affecting two or more anatomical areas. In the immunosuppressed patient, these lesions are frequently atypical and the risk factors are not well established. The aims of this study were: to determine the risk factors associated to multicentric tinea in immunocompromised patients; to evaluate the immune response by trichophytin and candidin skin test, to determine the etiological agent and to quantify some serum interleukines. Thirty-six multicentric tinea and 37 localized tinea patients, both with immunocompromised factors, were included. By means of a questionnaire several risk factors were identified; the trichophytin and candidin skin test was evaluated after 48 hours. Mycological direct examination and culture were performed. The interleukins IL-2, IL-4, IL-10 and interferon gamma were quantified by ELISA. Statistical analysis was made by Chi-square, U Mann Whitney and logistic regression. In disseminated tinea patients a predominance of females (69%) versus localized tinea patients (30%) was observed. Prednisone, azathioprine and cyclophosphamide treatment was associated to multicentric tinea. Trichophytin was negative in all disseminated tinea patients and positive in only three localized tinea cases, candidin was positive in six and eight cases of multicentric and localized tinea respectively. Trichophyton rubrum was the most frequent etiological agent. No differences in interleukin concentrations were found. Female gender and some immunosuppressor treatments were associated with a high probability to develop multicentric tinea. In this study a defect in the cellular immune response was the possible explanation for the extensive reactions.
García de Acevedo
Beatriz
B
Departamento de Dermatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México D.F., Mexico.
Villa
Antonio
A
Hernández-Hernández
Francisca
F
López-Martínez
Rubén
R
Llorente
Luis
L
Orozco-Topete
Rocío
R
D048909:Diabetes Complications / Q000276:immunology; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007378:Interleukins / Q000097:blood; D007428:Intradermal Tests; D016030:Kidney Transplantation; D008297:Male; D008800:Mexico / Q000453:epidemiology; D009928:Organ Specificity; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology / Q000276:immunology; D012216:Rheumatic Diseases / Q000150:complications / Q000276:immunology; D011795:Surveys and Questionnaires; D014005:Tinea / Q000097:blood / Q000453:epidemiology* / Q000276:immunology
D007166:Immunosuppressive Agents; D007378:Interleukins