Introdução: As infeções fúngicas superficiais são as dermatoses infeciosas mais frequentes e a sua incidência continua a aumentar. Os dermatófitos são os principais agentes causais apresentando, contudo, uma distribuição geográfica variável.Material e Métodos: O presente estudo teve como objetivo a caracterização epidemiológica das infeções fúngicas superficiais diagnosticadas nos Serviços/Unidades de Dermatologia pertencentes ao Serviço Nacional de Saúde Português entre janeiro de 2014 e dezembro 2016 através da análise retrospetiva dos resultados das culturas realizadas durante esse período.Resultados: Foram estudados 2375 isolamentos, pertencentes a 2319 doentes. O dermatófito mais frequentemente isolado foi o Trichophyton rubrum (53,6%), tendo sido o principal agente causal da tinha da pele glabra (52,4%) e das onicomicoses (51,1%). Relativamente às tinhas do couro cabeludo, globalmente o Microsporum audouinii foi o agente mais prevalente (42,6%), seguido do Trichophyton soudanense (22,1%). Enquanto na área metropolitana de Lisboa estes dermatófitos foram os principais agentes de tinha do couro cabeludo, nas regiões Norte e Centro o agente mais frequente foi o Microsporum canis (58,5%). Os fungos leveduriformes foram os principais responsáveis pelas onicomicoses das mãos (76,7%).Conclusão: Os resultados deste estudo estão globalmente concordantes com a literatura científica. O Trichophyton rubrum apresenta-se como o dermatófito mais frequentemente isolado em cultura. Na tinha do couro cabeludo, na área metropolitana de Lisboa, as espécies antropofílicas de importação assumem particular destaque.

Dermatitis herpetiformis is a pruritic, blistering skin disease affecting the extensor surface of the limbs, the buttocks and lower back. The autoantigen involved is transglutaminase-3, an enzyme of epidermis. 1 The diagnosis is confirmed by direct immunofluorescence of perilesional skin, with a pathognomonic pattern of granular IgA deposits in papillary dermis, with a false-negative rate of 5%.

A 50-year-old Angolan woman living in Portugal for 2 years presented to our department with a 1-year history of brownish, scaly round patches on her thighs. Her medical history included type II diabetes mellitus, arterial hypertension and dyslipidaemia for approximately 3 years, active smoking and iron deficiency anaemia due to menstrual losses. She did not have relevant family medical history or any previous skin disease. The lesions appeared 1 month after an episode of inaugural unstable angina that required the introduction of acetylsalicylic acid, ticagrelor, carvedilol and nitroglycerin to her usual medications of atorvastatin, lisinopril and metformin. The patches were asymptomatic, started on one thigh and progressed over months to both thighs and lower back, expanding also in size. Cutaneous examination revealed 15 hyperpigmented well-defined perfectly circular patches 1 to 20 cm in diameter on both thighs, buttocks and also the lower back. These lesions were dry and slightly scaly and had no erythema or induration, and some were coalesced (Fig. 1). There were no other skin, mucosal or adnexal changes. Skin biopsy showed hyperkeratosis, follicular plugging, areas of diminished or absent granular layer, hyperpigmentation of the basal layer and a sparse perivascular infiltrate of lymphocytes in the dermis (Fig. 2). Periodic acid-Schiff stain was negative for fungus. The diagnosis of pityriasis rotunda was made based on the clinical and histopathological features.

Generalised eruptive histiocytosis is a self-limited and benign non-Langerhans cell histiocytic disorder, characterised by recurrent crops of symmetrically distributed skin to red to brown coloured papules on the trunk and proximal extremities. Clinical and pathological correlation is required to establish the diagnosis. We herein present the clinical and histological features of generalised eruptive histiocytosis in a 24-year-old female patient.