Infección cutánea por Mycobacterium marinum. Descripción de tres casos y revisión de la literatura

—Mycobacterium marinum is a causative pathogen of skin and soft tissue infections. Infection often occurs when the microorganism is inoculated by exposure to contaminated water of aquariums and swimming-pools. Mycobacterium marinum is only infectious in erosive skin; therefore, the most common locations are the body areas exposed to traumatism.Three cases of cutaneous infection caused by Mycobacterium marinum are described. Cultures from skin biopsy specimens revealed this organism in all cases. Patients received antibiotic treatment with different response in all of them.We discuss the characteristics of cutaneous infection caused by this mycobacteria, as well as the need of an adequate diferential diagnosis to carry out an appropriate diagnosis and treatment, in order to avoid the appearance of complications.     

Infección cutánea por Staphylococcus lugdunensis: presentación de 16 casos

Introduction and objectiveStaphylococcus lugdunensis belongs to the group of coagulase-negative staphylococci. The aim of this report was to review the clinical and microbiologic features of cases of S. lugdunensis skin infections.Material and methodsObservational study of all cases of skin infections in which S. lugdunensis was isolated by the microbiology department of Hospital General San Jorge in Huesca, Spain, between 2009 and 2016.ResultsWe studied the cases of 16 patients. The most frequent site of infection was the inguinal-perineal region (n = 6, 37.5%), and pustules were the most common presentation (n = 5, 31.3%). Response to treatment was good in 87.6% of the patients (n = 14). However, infection recurred in 3 patients, 2 of whom were on anti-TNF therapy.ConclusionsS. lugdunensis should be considered a possible cause of infection when it is isolated in both skin and subcutaneous tissues, especially in patients on biologic therapies.     

Afectación cutánea específica por enfermedad de Hodgkin

—In Hodgkin's disease, the most frequent skin lesions are non-specific and include pruritis, ichthyosis, urticaria, hyperpigmentation, erythema multiforme and erythema nodosum. Specific cutaneous involvement in Hodgkin's disease occurs in 0.5-7.5 % of diagnosed patients. This involvement often corresponds to cutaneous lesions secondary to known lymph node Hodgkin's disease, and most patients are usually in very advanced stages of the disease.We present the case of a 73-year-old woman diagnosed with lymphocyte-depletion Hodgkin's disease, stage IV, in treatment with palliative radiotherapy. The patient presented with several subcutaneous plaques in the lumbosacral region, erythematous, very infiltrated to palpation, only a few centimeters in diameter and not painful. A biopsy was performed, in which the presence of an infiltrate with anaplastic cells, lymphocytes, eosinophils, Reed-Sternberg cells and Hodgkin's cells could be seen. Immunohistochemistry studies showed positivity for CD30 and CD15 and negativity for CD45, which confirmed the specific skin involvement from the underlying disease.     

Carcinoma de células de Merkel. Presentación de seis casos

—Merkel cell carcinoma is a biologically aggressive primary cutaneous neoplasm that is especially localized to the head and neck in persons of advanced age. It generally presents as a localized skin disease, although on certain occasions, there is evidence of regional lymphatic disease or distant metastasis at the time of the initial diagnosis. We performed a retrospective analysis of the six Merkel cell carcinoma cases diagnosed at the Hospital Clínico San Cecilio in Granada during the period from 1997-2001.