Rhinosporidiosis: cutaneous manifestation

Abstracts

A rinosporidiose é uma doença infecciosa zooantropofílica mucocutânea causada pelo Rhinosporidium seeberi. Caracteriza-se por massa polipoide, séssil ou pedunculada, eritematosa, moriforme e friável, principalmente, nas mucosas nasais e oculares. A ocorrência na pele é ocasional, por disseminação a partir da mucosa adjacente, inoculação direta ou generalização via hematogênica. Os autores apresentam o caso clínico de um menino de oito anos de idade, com lesão isolada localizada no epicanto medial do olho direito

Doenças parasitárias; Doenças transmissíveis; Rhinosporidium; Rinosporidiose

IMAGES IN TROPICAL DERMATOLOGY

Rhinosporidiosis - cutaneous manifestation^*

Andrelou Fralete Ayres Vallarelli^I; Silvânia Pinheiro Rosa^II; Elemir Macedo de Souza^III

^IPh.D. - Private practice - São Paulo (SP), Brazil

^IIDermatologist and specialist by the Brazilian Society of Dermatology - Private practice - São Paulo (SP), Brazil

^IIIAssistant professor (faculty member) - Assistant professor of Dermatology at the Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP) - São Paulo (SP), Brazil

Mailing address

ABSTRACT

Rhinosporidiosis is an infectious mucocutaneous disease caused by Rhinosporidium seeberi. It is characterized by sessile or pedunculated polyps which are erythematous, moriform and friable and which mainly affect the ocular and nasal mucosa. The occurrence of skin lesions is occasional and due to dissemination from the adjacent mucosa, direct inoculation or hematogenous dissemination. The authors report the clinical case of an eight-year-old boy with an isolated lesion located in the medial epicanthus of the right eye.

Keywords: Communicable diseases; Parasitic diseases; Rhinosporidiosis; Rhinosporidium

Rhinosporidiosis is an infectious mucocutaneous granulomatous disease caused by Rhinosporidium seeberi. It usually affects the nasooropharynx, occasionally affecting the conjunctiva and the lacrimal sac, and sporadically, the urethra, mulatto male patient from the state of Maranhao presenting a sessile tumor genitalia, larynx, paranasal sinuses and the skin (Figures 1 and 2).^1-3 Cases of rhinosporidiosis have with an irregular, friable, been reported in the Americas, Europe, Africa and Asia, with high prevalence in India and Sri Lanka.^{1,2, 4} It is endemic in the western region of northeastern Brazil. It occurs by inoculation of spores present in stagnant water or dust from fields. It is more common in men, especially affecting the nose. Eye infection is more prevalent in women.^1,2,6,8 The histology and/or cytology performed after fine needle aspiration (FNAC) serve to confirm the diagnosis (Figures 3 and 4A).³ The first reference was credited to Malbran (1896). Guilhermo Seeber (1900) reported the causative agent and classified it as a protozoan from the Coccidioidaceae family. A phylogenetic analysis classified it as belonging to the group DRIPs (Dermocystidium, rosette agent, Ichthyophorus, and Psorospernim), an aquatic protistan parasite (Figure 4B).^2,

REFERENCES

• 1. Kumari R, Nath AK, Rajalakshmi R, Adityan B, Thappa DM. Disseminated cutaneous rhinosporidiosis: varied morphological appearances on the skin. Indian J Dermatol Venereol Leprol. 2009;75:68-71.
• 2. Abud LN, Pereira JC. Rinosporidiose nasal - relato de quarto casos e revisão de literatura. Arq Interrn Otorinol. 2007;11:428-35.
• 3. Deshpande AH, Agarwal S, Kelkar AA. Primary cutaneous rhinosporidiosis diagnosed on FNAC: A case report with review of literature. 2009;37:125-7.
• 4. Fredricks DN, Jolley JA, Lepp PW, Kosek JC, Relman DA. Rhinosporidium seeberi: a human pathogen from a novel group of aquatic protistan parasites. Emerg Infect Dis. 2000;6:273-82.
• 5. Fonseca APM, Fonseca WSM, Bona SH, Lopes Filho LL, Araújo RC. Rinosporidiose nasal: relato de dois casos. An Bras Dermatol. 1990;65:123-4.
• 6. Dadá MS, Ismael M, Neves V, Branco Neves J. Two cases of nasal rhinosporidiosis. Acta Otorrinolaringol Esp. 2002;53:611-4.
• 7. Boni ES, Saliba ZM, Sessino DB, Miranda JNR, Boni M. Rinosporidiose da conjuntiva-relato de caso. Arq Bras Oftalmol. 2002;65:103-5.
• 8. Lupi O, Tyring SK, McGinnis MR. Tropical dermatology: fungal tropical diseases. J Am Acad Dermatol. 2005;53:931-51.
• 9. Mattedi MGS, Cunha A, Boni ES, Palhano Júnior L. Rinosporidiose nasal: Relato de um caso. An Bras Dermatol. 1986;61:141-4.

*

Trabalho realizado na Universidade Estadual de Campinas (Unicamp) - São Paulo (SP), Brasil.

Publication Dates

• Publication in this collection
  27 Sept 2011
• Date of issue
  Aug 2011

History

• Accepted
  31 Aug 2010
• Received
  14 Mar 2010