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An. Bras. Dermatol. vol.86 no.4 Rio de Janeiro July/Aug. 2011
IMAGES IN TROPICAL DERMATOLOGY
Rhinosporidiosis - cutaneous manifestation*
Andrelou Fralete Ayres VallarelliI; Silvânia Pinheiro RosaII; Elemir Macedo de SouzaIII
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
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,
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. [ Links ]
2. Abud LN, Pereira JC. Rinosporidiose nasal - relato de quarto casos e revisão de literatura. Arq Interrn Otorinol. 2007;11:428-35. [ Links ]
3. Deshpande AH, Agarwal S, Kelkar AA. Primary cutaneous rhinosporidiosis diagnosed on FNAC: A case report with review of literature. 2009;37:125-7. [ Links ]
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. [ Links ]
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. [ Links ]
6. Dadá MS, Ismael M, Neves V, Branco Neves J. Two cases of nasal rhinosporidiosis. Acta Otorrinolaringol Esp. 2002;53:611-4. [ Links ]
7. Boni ES, Saliba ZM, Sessino DB, Miranda JNR, Boni M. Rinosporidiose da conjuntiva-relato de caso. Arq Bras Oftalmol. 2002;65:103-5. [ Links ]
8. Lupi O, Tyring SK, McGinnis MR. Tropical dermatology: fungal tropical diseases. J Am Acad Dermatol. 2005;53:931-51. [ Links ]
9. Mattedi MGS, Cunha A, Boni ES, Palhano Júnior L. Rinosporidiose nasal: Relato de um caso. An Bras Dermatol. 1986;61:141-4. [ Links ]
Mailing address: Received on 14.03.2010. Conflict of interest: None * Work conducted at University of Campinas (Unicamp) - São Paulo (SP), Brazil.
Andrelou Fralete Ayres Vallarelli
Rua Dr. Antônio da Costa Carvalho, 577 - Ap. 91 - Cambuí
13024-050 Campinas - SP, Brazil
Phone: (19) 3234-2404 E-mail: email@example.com
Approved by the Editorial Board and accepted for publication on 31.08.2010.
Financial funding: None
Received on 14.03.2010.
Conflict of interest: None
* Work conducted at University of Campinas (Unicamp) - São Paulo (SP), Brazil.