Sol-Tlapalamatl BS, Frayre GZE, Hernández-Peralta SL, Tarango-Martínez VM

Language: Spanish
References: 10
Page: 63-67
PDF size: 308.13 Kb.

ABSTRACT

Superficial mycoses may act as sentinel manifestations of advanced immunosuppression in patients with HIV, particularly when they present as chronic or mixed fungal infections.
We report the case of a 43-year-old woman with chronic scalp alopecia, oral candidiasis, and onychomycosis. Trichoscopic and mycological studies were performed.
Trichoscopy revealed findings consistent with tinea capitis, characterized by corkscrew hairs, black dots, and perifollicular scaling. Cultures identified Trichophyton tonsurans in the scalp and Candida albicans in the oral mucosa and nail, confirming a mixed fungal infection. HIV serology demonstrated infection with a CD4+ count of 45 cells/μL, consistent with advanced disease (CDC category C3). Treatment with systemic itraconazole at a dose of 200 mg daily for seven weeks resulted in clinical improvement without adverse effects, in conjunction with initiation of antiretroviral therapy.
Disseminated or mixed superficial fungal infections should prompt suspicion of underlying immunosuppression. Comprehensive dermatological evaluation facilitates timely diagnosis and appropriate management of advanced HIV infection.

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