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A Rodriguez-Pichardo

Publications and source records attributed to A Rodriguez-Pichardo.

At least 19 recordsLinked to original sources
PubMed2000

Extensive and deep dermatophytosis caused by Trichophyton mentagrophytes var. interdigitalis in an HIV-1 positive patient.

BACKGROUND: Cutaneous infections are common in HIV-1 positive patients and are usually severe, recurrent, and caused by microorganisms that are unusual in immunocompetent patients. OBJECTIVE: We report a case of an HIV-1-positive 23-year-old male, with a history of intravenous drug use, in stage C-II (CDC '86), with a CD4 lymphocyte count of 335 cells/mm3. He had multiple, large erythematous, circinate and pustular plaques on his abdomen, back, arms and legs. RESULTS: We isolated Trichophyton mentagrophytes var. interdigitalis from the lesions. The biopsy showed suppurative deep dermatophytosis and folliculitis. The patient satisfactorily responded to itraconazole (100 mg/d for 14 days). CONCLUSION: This is the first reported case of deep dermatophytosis caused by T. mentagrophytes in an HIV-positive patient.

Adult↗
PubMed1999

Cutaneous T-cell lymphoma and human immunodeficiency virus infection: 2 cases and a review of the literature.

Cutaneous non-Hodgkin's lymphomas are rare in patients with HIV-1 infection and almost all of the cases reported are of T-cell lineage with histopathological features of mycosis fungoides or Sezary syndrome. We studied 2 cases of mycosis fungoides in HIV-1-positive patients who were intravenous drug abusers and were in stage II and IV C2 (CDC'86), respectively. The first patient (stage II) had multiple, erythematous and infiltrated large plaques on the abdomen, back, arms and legs, whereas the second patient (stage IV) had smaller erythematous, slightly scaly and infiltrated pruritic plaques on the trunk and limbs. Their CD4 lymphocyte counts were 634 and 250 cells/mm3, respectively. Biopsies showed features consistent with mycosis fungoides, with an epidermotropic pattern. The immunohistochemical study revealed a T-cell lineage of this atypical infiltrate. Both patients partially responded to topical steroid ointment, showing moderate improvement. Further biopsies performed 6 months later confirmed the prior diagnosis of mycosis fungoides. No tumour stage was observed during a 2-year follow-up. We conclude that mycosis fungoides is rare in HIV-positive patients, but must be included in the differential diagnosis of erythematous plaques in these patients. In suspected, but non-diagnostic cases of mycosis fungoides in HIV-positive patients, only a close clinical and histopathological follow-up can confirm the diagnosis.

Adult↗
PubMed1999

Alopecia areata, stress and psychiatric disorders: a review.

Although the results of some studies have proven negative, the influence of psychological factors in the development, evolution and therapeutic management of alopecia areata is, in general, well documented. Life events and intrapsychically generated stress can play an important role in triggering of some episodes. The comorbidity of psychiatric disorders, mainly generalized anxiety disorder, depression, and phobic states, is high. The role of treatment of concomitant psychopathological disorders is a vital one. Indeed this treatment can positively affect how the patient adapts to his/her alopecia and social setting and perhaps can even lead to a better dermatological evolution of the alopecia. Therefore, controlled studies analyzing the possible links between psychiatric symptoms, treatment with antidepressants or benzodiacepines, evolution of alopecia, medium term prognosis, and immune function are necessary. Basic psychotherapeutic support may prove to be of use in many cases and can be carried out by the dermatologist, although a subgroup of patients may need psychopharmacological or psychotherapeutic specialized treatments. Studies using operative diagnostic criteria and structured interviews are still scarce. Therefore, it seems necessary to design studies using modern psychiatric methodology. Controlled clinical trials to test the efficiency of psychoactive drugs and psychotherapy in the disease are also needed. By studying in depth these and other related aspects, we may improve the clinical management of our patients.

Alopecia Areata↗
PubMed1998

Dermatological findings correlated with CD4 lymphocyte counts in a prospective 3 year study of 1161 patients with human immunodeficiency virus disease predominantly acquired through intravenous drug abuse.

Several prospective studies on dermatological findings in human immunodeficiency virus (HIV) type 1 infected patients have been published, mostly in populations in which the predominant risk factor for HIV infection is homosexuality. We attempted to identify cutaneous diseases associated with HIV-1 infection and to assess disease progression in a cohort of Spanish patients in whom the predominant cause of HIV infection was intravenous drug abuse. We prospectively examined 1161 HIV-1-positive patients for 38 months. Seventy-four per cent of patients were intravenous drug abusers, whereas heterosexual contact was the only risk factor in 14% and homosexuality in 9%. Centers for Disease Control stage II disease predominated (51%), whereas stage IV disease was less frequent (39%). The mean CD4 count was 353/mm3. We took patients' past and present medical history and performed a complete physical examination as well as taking photographs and carrying out the necessary diagnostic procedures. CD4 counts/mm3 were measured at each visit. A diagnosis of cutaneous disease was made in 799 patients (69%). Oral candidiasis and seborrhoeic dermatitis were the most common skin disorders, followed by xerosis, drug eruptions, dermatophytosis and the papular eruption of acquired immunodeficiency syndrome. Condyloma acuminatum, herpes zoster and herpes simplex were the most frequent viral infections. Conditions that have a statistically significant association with advanced stage and low CD4 levels include drug eruptions, xerosis, light reactions, diffuse alopecia, herpes simplex, oral candidiasis, psoriasis, oral hairy leucoplakia, molluscum contagiosum, Kaposi's sarcoma, furuncles, candidal intertrigo, folliculitis and ungual infection, as well as onychomycosis and tinea pedis or manuum. Dermatoses commonly associated with homosexuality, such as Kaposi's sarcoma and oral hairy leucoplakia, were rare in our patients.

AIDS-Related Opportunistic Infections↗
PubMed1998

Anaerobic bacteria in men with urethritis.

AIM: Investigation of the urethral flora in men with urethritis, with particular reference to anaerobic bacteria. METHODS: Multiple cultures were performed on three urethral samples from 110 men attending the STD Clinic of the School of Medicine in Seville: 35 with no evidence of urethritis (control group), and 75 with urethritis (17 gonococcal urethritis (GU) and 58 non-gonococcal urethritis (NGU)). In the 58 men with NGU, Chlamydia trachomatis was isolated in 16 (27.5%), Ureaplasma urealyticum in 18 (31%), Trichomonas vaginalis in two (3.4%) and no pathogens were isolated in the remaining 22 (38%) patients. RESULTS: Aerobic flora, mainly Staphylococcus spp., were isolated less frequently (41%) in patients with GU than in the control group (80%), and those with NGU (72%). Anaerobic flora were isolated in 62% of patients, with similar isolation rates in each group. Gram-negative anaerobes were more frequently isolated in men with urethritis, especially NGU, compared to controls (P < 0.05). Prevotella spp. and Bacteroides spp. were significantly more frequently isolated in patients with NGU, including Chlamydia-negative NGU. Fusobacterium spp. were more frequent in the Chlamydia-positive NGU than in the controls (P < 0.05). P. magnus was the most frequent anaerobic species found in the control group, while P. prevotii was most frequently seen in the urethritis group. B. ureolyticus, P. prevotii and P. tetradius were more frequent on the NGU group (P < 0.05). B. ureolyticus was commoner in patients with Chlamydia-negative NGU, while P. tetradius and P. asaccharolytica was commoner in those where C. trachomatis was isolated than in the control group. CONCLUSION: Urethral microflora isolated showed ten bacterial genus and 25 different species of anaerobes. The spectrum of these microflora changed with the presence of urethritis and varied with its aetiology.

Adult↗
PubMed1998

Sexually transmitted diseases in 1161 HIV-positive patients: a 38-month prospective study in southern Spain.

BACKGROUND: HIV infection is primarily a sexually transmitted disease (STD), but intravenous drug use (IDU) is the main risk factor for HIV infection in certain areas, including southern Europe. A number of prospective studies of dermatological findings in HIV-1 infected patients have been published, almost all from countries where homosexuality is the main risk factor of HIV infection and without correlation with CD4 cell counts. No STD data is included in those studies. OBJECTIVE: To determine the incidence of STDs in a cohort of 1161 HIV-1-positive patients from Spain, in the previous medical history and during the prospective study. METHODS: We prospectively examined 1161 HIV-1-positive patients for 38 months, 986 men and 175 women. IDU was the risk factor in 74%, while homosexuality was a risk factor in only 9%. CDC stage II was predominant (51%), while stage IV was less frequent (39%). The mean CD4 cell count was 353/mm3. Patients' past and present medical history of STDs was obtained. CD4 cells/mm3 counts were measured at each visit. RESULTS: Six hundred and eighty-four patients had a past history of STD, whilst new infections were diagnosed in 258 individuals (22%) during the 38-month study. Pediculosis pubis (26%), gonorrhoea (22%), syphilis (13%), genital candida infection (11%) and condyloma acuminatum (10%) were the commonest previous STDs, followed by non-gonococcal urethritis (NGU) (5%), genital herpes (4%) and trichomoniasis (2%). During the 38-month study period and with strong recommendation of condom use for sexual intercourse, condyloma acuminatum (7%), scabies (6%), syphilis (4%) and genital herpes (3%) were commonly diagnosed, followed by gonorrhoea (1.8%), NGU (1.6%), genital candida infection (1.5%), pediculosis pubis (0.6%) and trichomoniasis (0.3%). Only genital herpes had a statistically significant association with advanced stage (P = 5.12 x 10(-6)) and low CD4 cell counts (180 +/- 166 cells/mm3). CONCLUSION: Despite the predominance of the IDU factor among our patients, the incidence of STDs in the past medical history was surprisingly high. The incidence of STD during the study was also high, despite the advice of using condoms after the diagnosis of HIV infection. STDs may accelerate the course of HIV infection and be a poor prognostic indicator in these patients. If an HIV-1-positive patient can acquire an STD, he/she can also transmit HIV infection. This indicates that new publicity campaigns are still needed to stop HIV and STDs infection among HIV-positive patients as well as in the general population.

Adolescent↗
PubMed1994

Familial pachydermodactyly.

Pachydermodactyly is a rare form of digital fibromatosis. There are only 15 cases reported in the literature, all with a negative family history. Only one of the previously reported cases was a woman. We now report 2 female cases, mother and daughter, who, to the best of our knowledge, are the first patients with familial pachydermodactyly. The histological evolution of this disease over the years had not been previously reported.

Adult↗
PubMed1993

Dual genitotropic human papillomavirus infections in genital warts.

BACKGROUND AND METHODS: We have carried out a prospective study of dual genitotropic human papillomavirus (HPV) infections by means of two different DNA detection methods in biopsy specimens obtained from patients who were examined for genital warts at the STD clinic of the School of Medicine in Seville, between January 1990 and December 1991. RESULTS: 100 patients with a clinical diagnosis of condilomata acuminata were seen during the study period. DNA of the genitotropic HPV 6/11, 16/18 and 31/33/35 was detected by an in situ hybridisation method in 75 (77%) of the 98 evaluable samples; one of the genotypes tested in 59 (61%) samples, and two or more genotypes tested in the remaining 16 (15%) samples. In 21 (98%) of the 23 negative samples by in situ hybridisation, we were able to detect DNA of genital HPV using a polymerase chain reaction amplification method (PCR). Among the 34 samples where PCR was applied we confirmed the presence of two different HPV genotypes in eight samples. CONCLUSIONS: The frequency of dual infections with human genitotropic papillomavirus in genital warts was 8%, although we believe that this rate should be higher as we have not used the PCR method in all of the samples.

Adolescent↗
PubMed1991

Sexually transmitted diseases in homosexual males in Seville, Spain.

BACKGROUND AND METHODS: The absence of any official statistics on the prevalence of STD in homosexual men in Spain induced us to carry out a prospective study of new homosexual patients who consulted the STD Clinic of the School of Medicine in Seville, between January 1988 and December 1989. The aim of the study was to determine the prevalence of symptomatic and asymptomatic infections in this group of patients. RESULTS: 1805 patients were seen during the study period; 318 patients were homosexual of whom 309 agreed to participate in the study. Of the 309 homosexual men, 108 (35%) had symptoms and the remaining 201 (65%) were asymptomatic. In the symptomatic group the diagnoses were: syphilis 28 (25.9%); urethritis 40 (37%) (of these 40, 11 had Neisseria gonorrhoeae, five had Chlamydia trachomatis, five had Ureaplasma urealyticum, one had Herpes simplex virus and in 18 no pathogen was detected); genital herpes seven (6.4%). Eleven (10%) had concomitant infections. The following infections were found in the asymptomatic group: syphilis 23 (11.4%), N gonorrhoeae six (3%), C trachomatis two (1%), Herpes simplex virus one (0.5%). Antibodies against HIV were detected in 30 (9.6%) of the total group. CONCLUSIONS: Sexually transmitted diseases are common amongst homosexual men in Seville and many of these are asymptomatic.

Adult↗
PubMed1991

Chloracne caused by ingestion of olive oil contaminated with PCDDs and PCDFs.

1. All members of a Spanish family (father, mother and six children) developed chloracne. 2. The causative agent was found to be the family's stock of olive oil, which had become contaminated with polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), pentachlorophenol, and hexachlorobenzene. 3. The more highly chlorinated PCDDs, in particular octachlorodibenzo-p-dioxin, were the predominant congeners in the oil. 4. Three members of the family exhibited either an overt or a sub-clinical disturbance of kidney function. The father also had a chronic respiratory problem. These changes could not be unequivocally attributed to the PCDDs. 5. Experimental toxicity of the oil was limited to the development of an hepatic porphyria in mice. 6. A serum sample, taken 5 years after consumption of the oil ceased, contained high levels of the PCDDs and PCDFs. Extrapolation back to ingested dose was used to validate dosage estimates. 7. The use of toxicity equivalence factors (TEFs) provided estimates of cumulative dosage to produce chloracne as 0.13-0.31 micrograms 2378-TCDD kg-1 (using EPA TEFs) or 6.7-16 micrograms 2378-TCDD kg-1 (using Nordic/NATO TEFs). 8. This is the first incident in which human toxicity is related primarily to ingestion of PCDDs and for which estimates of dosage can be made.

Acne Vulgaris↗