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Tinea capitis is a scalp infection caused by fungi. In Brazil, the main causative agents are Microsporum canis and the Trichophyton tonsurans. Etiological diagnosis is based on suggestive clinical findings and confirmation depends on the fungus growth in culture. However, it is not always possible to perform this test due to lack of availability. We reveal the dermoscopic findings that enable distinction between the main causative agents of Tinea capitis, M. canis and T. tonsurans. The association of clinical and dermatoscopic findings in suspected Tinea capitis cases may help with the differential diagnosis of the etiological agent, making feasible the precocious, specific treatment.

Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets. As infecções fúngicas superficiais dos cabelos, pele e unhas representam uma causa importante de morbidade no mundo. O tratamento nem sempre é simples, havendo dificuldade na escolha dos esquemas terapêuticos disponíveis na literatura, assim como suas possíveis interações medicamentosas e efeitos colaterais. A primeira parte do trabalho aborda os principais esquemas terapêuticos das micoses superficiais - ceratofitoses, dermatofitoses, candidíase - possibilitando a consulta prática das drogas tópicas e sistêmicas mais utilizadas, sua dosagem e tempo de utilização. Novas possibilidades terapêuticas antifungicas também são ressaltadas, assim como as apresentações disponíneis no mercado brasileiro e mundial.

Sporotrichosis is a subcutaneous fungal infection caused by Sporothrix schenckii and acquired by direct inoculation. Although the majority of cases consist of the classic lymphocutaneous presentation, the frequency of atypical and severe clinical forms of the disease has increased progressively. Systemic and disseminated cutaneous sporotrichosis constitute rare variants and such cases are generally associated with cellular immunodeficiency or debilitated states. The present paper describes the first published case of molluscum-like lesions in disseminated mucocutaneous sporotrichosis. Direct mycological examination and histopathology revealed numerous yeast cells.

Infectious and noninfectious skin diseases are observed in about 90% of HIV patients, and their incidence increases and is more severe as the immune system weakens. Cutaneous manifestations are considered good clinical predictors for the immunological condition of the patient with AIDS and the introduction of highly effective antiretroviral therapy totally changed the prognosis of the mycoses, among other diseases associated with AIDS, permitting longer survival and acceptable level of quality of life for these patients. This contribution describes the systemic mycoses that are more frequent in the seropositive population, that is, patients with HIV/AIDS, which are cryptococcosis, histoplasmosis, coccidioidomycosis, blastomycosis, paracoccidioidomycosis, sporotrichosis, penicilliosis, and aspergillosis. Their causative agents, mode of transmission, clinics, laboratorial diagnosis and therapy, in the aspects related to immunodepressed patients, are reviewed.

Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets. As infecções fúngicas superficiais dos cabelos, pele e unhas representam uma causa importante de morbidade no mundo. O tratamento nem sempre é simples, havendo dificuldade na escolha dos esquemas terapêuticos disponíveis na literatura, assim como suas possíveis interações medicamentosas e efeitos colaterais. A segunda parte do trabalho aborda os principais esquemas terapêuticos das micoses superficiais - ceratofitoses, dermatofitoses, candidíase -, possibilitando a consulta prática das drogas tópicas e sistêmicas mais utilizadas, sua dosagem e tempo de utilização. Novas possibilidades terapêuticas antifúngicas também são ressaltadas, assim como as apresentações disponíveis no mercado brasileiro e mundial.

Sporotrichosis is a subcutaneous mycosis of implantation. It is the only subcutaneous mycosis for which direct examination or histology is of little or no value for diagnosis. The diagnosis solely rests on the isolation of Sporothrix schenckii in culture. On pathologic examination, causative organisms are rarely seen. Staining with fluorescent-labeled antibodies may aid in visualizing the cigar-shaped yeast forms; however, the organisms are still difficult to identify. Topical therapy is not effective. Potassium iodide is an effective treatment for sporotrichosis, but this agent has not been subjected to specific treatment trials comparing its efficacy against azoles or allylamine alternatives. Itraconazole is generally safe and well tolerated, and the relapse rate is low. Terbinafine could be another therapeutic alternative to treat the disease. Since 1998, researchers from Brazil suggested that feline transmission of sporotrichosis in Rio de Janeiro city was associated with a large and long-lasting outbreak of the disease. To understand the outbreak, there have been studies on the epidemiology and antifungal susceptibility of the S schenckii strains through molecular diagnosis. Data suggest that all isolated strains were genetically related.

Sporotrichosis is a subcutaneous fungal infection caused by Sporothrix schenckii and acquired by direct inoculation. Although the majority of cases consist of the classic lymphocutaneous presentation, the frequency of atypical and severe clinical forms of the disease has increased progressively. Systemic and disseminated cutaneous sporotrichosis constitute rare variants and such cases are generally associated with cellular immunodeficiency or debilitated states. The present paper describes the first published case of molluscum-like lesions in disseminated mucocutaneous sporotrichosis. Direct mycological examination and histopathology revealed numerous yeast cells.

For the last 10 years, a steady increment in the diagnosis of nondermatophyte filamentous fungal infections has been observed. This trend also applies to the valuation of the medical mycology. It can be attributed, in part, to the increased concern of the population with the aesthetic aspect, the easiest access to health information, and the increased demand for specialized jobs. Moreover, increase in the diagnosis of new emerging fungi is also caused by the improvement of the diagnostic techniques available as well as the qualification and constant update of the professionals in medical mycology. Another relevant aspect is the valorization of medical mycology in the medical curriculum. Misdiagnosis can lead to treatment failures, because not all nail diseases are caused by fungi. Therefore, the importance of clinical diagnosis is strictly associated with laboratory results.

A 65-year-old Brazilian man presented with an erythematous nodular lesion on the left forearm (Fig. 1). The patient had been treated with multidrug therapy for 8 months for lepromatous leprosy. During therapy, he developed recurrent episodes of reactions which were treated with high doses of prednisone and thalidomide. The histopathology of the cutaneous nodular lesion showed a granulomatous inflammatory infiltrate; some histiocytes contained vacuolations and others demonstrated oval-like or coma-like structures (Fig. 2). The specimen was cultivated in Sabouraud agar at room temperature. The colonies were transferred to Petri dishes containing Niger Seed Agar (NSA) (Fig. 3). The confirmed diagnosis was Cryptococcus neoformans var. neoformans based on microscopy and physiology, including the canavanine-glycine-bromothymol blue (CGB) medium (Lazera MS, Pires FDA, Camillo-Coura L, et al. Natural habitat of Cryptococcus neoformans var. neoformans in decaying wood forming hollows in living trees. J Med Vet Mycol 1996; 34: 127-131). The liquor culture was negative. Hemoculture and urine culture were also negative. Latex agglutination test was blood positive and liquor negative. The patient's hemogram revealed normocytic anemia and normal total and differential white blood count. The CD4 count was 189/m 3 and the CD8 count was 141/m 3 . Serology for anti-human immunodeficiency virus-1 (anti-HIV-1) antibodies was negative. The X-ray of the lungs showed an areolar image in the superior lobe of the right lung. Therapy with prednisone was suspended and fluconazole (300mg/day) was prescribed. The nodular cutaneous lesion regressed completely after 90 days. The patient was submitted to a second skin biopsy for treatment control. The culture of the specimen taken was still positive and the histopathology showed the same picture as before treatment. After 5 months of continued therapy with fluconazole, another biopsy was performed but no fungus was recovered from the specimen.