Table 1. Characteristics of individuals with radiation port dermatophytosis*
|
|
Patient 1 |
Patient 2 |
Patient 3 |
Patient 4 |
|
Demographics |
||||
|
A/S/R |
32/ M/W |
33/M/SA |
50/M/B |
68/M/W |
|
Cancer |
|
|
|
|
|
Malignancy |
NFS |
UC |
SCC |
Adeno |
|
Location |
R axillae |
Nasopharynx |
Larynx |
Prostate |
|
XRT features |
||||
|
Type |
SvGR+ |
SvGR+ |
SvGR+ |
PBǂ |
|
Dose |
28 Gy |
19.8 Gy |
9 Gy§ |
70.9 Gyǁ |
|
Onset¶ |
3 |
2 |
1 |
<1 |
|
Tinea Corporis |
||||
|
Location |
Neck and shoulder |
Face and neck |
Neck |
L thigh |
|
Morphology |
Multiple erythematous patches with scaling and pustules at their border |
Multiple hypopigmented plaques with a peripheral collarette of scale |
Verrucous, crusted plaques of coalescent erythematous papules and plaques |
Raised plaque with extensive erythema and scaling |
|
Diagnosis |
||||
|
KOH prep** |
+ |
+ |
+ |
- |
|
Culture |
Tr++ |
NP |
MC |
NP |
|
Biopsy |
NP |
NP |
NP |
+ǂǂ |
|
Treatment |
||||
|
Topical agent |
AS |
AC |
AC |
AC/CC |
|
Duration |
2 |
2-4§§ |
2 |
4 |
|
Citation |
||||
|
Reference |
1,2 (C1) |
3 |
2 (C2) |
CR |
*Abbreviations alphabetical: A, age (years); Adeno, adenocarcinoma; AC, antifungal cream; AS, antifungal solution; B, black; CC, corticosteroid; CGE, cobalt gray equivalent; CR, current report; Gy, gray; KOH, 10% potassium hydroxide; L, left; M, man; MC, microsporum canis; NFS, neurofibrosarcoma; NP, not performed; prep, preparation; R, race; R, right; S, sex; SA, Saudi Arabian; SCC, squamous cell carcinoma; SvGR, supervoltage gamma rays; Tr, trichophyton rubrum; UC, undifferentiated carcinoma; W, white; XRT-radiation therapy; +, positive; -, negative
+Total radiation dose of supervoltage gamma rays (approximately 1.3 MeV, originating from radioisotope cobalt 60)
ǂTotal radiation dose of proton beam ( 2225 MeV of protons)
§Estimated value based on the information in reference 2
ǁThe conversion 1 cobalt gray equivalent = 1.1gray was used to calculate 78 CGE = 70.9 Gy
¶Number of weeks after initiation of radiation therapy
**The presence or absence of branching hyphae
++The fungal culture was discarded prior to definitively identifying the culture. However, the presentation of a white, fluffy colony with a red back is highly suggestive of Trichophyton rubrum
ǂǂPeriodic acid-Schiff stain demonstrates hyphae in the stratum corneum
§§After completion of radiation therapy most of the hypopigmented plaques had undergone desquamation but treatment with the antifungal cream completely resolved the tinea corporis.