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Primary Care Sep 2018The primary care provider will commonly see skin and soft tissue infections in the outpatient setting. Skin and soft tissue infections range from the uncomplicated... (Review)
Review
The primary care provider will commonly see skin and soft tissue infections in the outpatient setting. Skin and soft tissue infections range from the uncomplicated impetigo to the potentially lethal necrotizing fasciitis. This article reviews these infections based on their underlying etiology: bacterial, fungal, and viral causes. This article discusses the etiology, presentation, evaluation, and management of impetigo, bullous impetigo, erysipelas, cellulitis, periorbital cellulitis, orbital cellulitis, folliculitis, furuncles, carbuncles, abscess, necrotizing fasciitis, sporotrichosis, tinea corporis, tinea pedis, tinea capitis, Herpes Simplex Virus, zoster, molluscum contagiosum, and warts.
Topics: Dermatomycoses; Humans; Skin; Skin Diseases, Bacterial; Skin Diseases, Infectious
PubMed: 30115333
DOI: 10.1016/j.pop.2018.05.004 -
Skinmed 2018A 23-year-old man presented with new-onset pruritic and painful urticarial lesions and targetoid erythematous plaques on both palms, the trunk, and the upper and lower...
A 23-year-old man presented with new-onset pruritic and painful urticarial lesions and targetoid erythematous plaques on both palms, the trunk, and the upper and lower extremities (Figure 1). Additionally, small pustules were discovered on the neck (Figure 2), and there with edematous erythematous vermillion lips with splaying onto the cutaneous lips without ulceration. The patient stated he had had a fever before the eruption, fatigue, chills, myalgias, and sore throat. A chest x-ray was obtained and showed bilateral infiltrates. Two 4-mm punch biopsies were performed on the left forearm and left side of the neck; a resulting section from the left forearm is shown in Figure 3.
Topics: Coccidioides; Coccidioidomycosis; Dermatomycoses; Humans; Male; Young Adult
PubMed: 29551116
DOI: No ID Found -
Anais Brasileiros de Dermatologia 2017Cutaneous mucormycosis is an emerging fungal infection caused by opportunistic fungi of the phylum Glomeromycota. It is frequent in poorly controlled diabetic patients... (Review)
Review
Cutaneous mucormycosis is an emerging fungal infection caused by opportunistic fungi of the phylum Glomeromycota. It is frequent in poorly controlled diabetic patients and individuals with immunosuppression. It is usually acquired by direct inoculation through trauma. The clinical presentation is nonspecific, but an indurated plaque that rapidly evolves to necrosis is a common finding. Diagnosis should be confirmed by demonstration of the etiological agent and new molecular diagnostic tools have recently been described. It is an invasive life-threatening disease and in order to improve survival, a prompt diagnosis and multidisciplinary management should be provided. The treatment of choice is amphotericin B, but new azoles, such as posaconazole and isavuconazole, must be considered.
Topics: Antifungal Agents; Dermatomycoses; Humans; Mucormycosis
PubMed: 29186239
DOI: 10.1590/abd1806-4841.20176614 -
Annales de Dermatologie Et de... Oct 2018Dermatomycoses are dermatological infections very commonly encountered in private dermatological practice since they affect up to one third of the population. However,... (Review)
Review
Dermatomycoses are dermatological infections very commonly encountered in private dermatological practice since they affect up to one third of the population. However, the symptoms are very often shared by other skin infections and disorders and may be highly atypical. It is thus impossible to make a diagnosis with any certainty on clinical grounds alone. For this reason, mycological diagnosis is essential to either confirm or rule out dermatomycosis, and is unavoidable when antifungal therapy is required for the treatment of ringworm of the scalp or beard, or for onychomycosis. It is also vital where therapy guided by the clinical appearance of lesions has failed or in the event of recurring skin lesions. Confirmation of mycosis enables antifungals to be initiated and a negative test warrants investigation for other underlying causes for the lesions seen. However, regardless of the mycological diagnostic technique employed, the quality of the results depends chiefly on the quality of sampling of the infected site, but also on the expertise of the microbiologist. Standard mycological testing remains the most informative, the least expensive and the sole examination capable of isolating the causative fungus irrespective of the type of mycosis, such as dermatophytosis, scytalidiosis, mould-induced ungual infection, candidiasis, or infections due to Malassezia sp. This is the only examination able to identify epidemiological variations. All other more recent techniques are either based upon simple demonstration of the fungal elements involved, without identification of the fungal species in question, or else they are reliant upon a fungal database that is generally highly incomplete.
Topics: Antifungal Agents; Dermatomycoses; Dermoscopy; Fungi; Humans; Mycological Typing Techniques; Mycology; Onychomycosis; Physical Examination; Scalp; Specimen Handling; Staining and Labeling
PubMed: 30143320
DOI: 10.1016/j.annder.2018.05.006 -
Medical Mycology Journal 2019Cutaneous cryptococcosis is classified either as primary or secondary based on the route of infection. The disease can also be classified either as localized cutaneous... (Review)
Review
Cutaneous cryptococcosis is classified either as primary or secondary based on the route of infection. The disease can also be classified either as localized cutaneous cryptococcosis or cutaneous manifestations of disseminated cryptococcosis. However, from a physician's point of view, whether lesions are localized to the skin or are disseminated/systemic is more important than the route of infection. The Clinical Practice Guidelines for Diagnosis and Treatment of Cryptococcosis, which was established in 2019 by the Japanese Society for Medical Mycology, adopted the latter classification. Localized cutaneous cryptococcosis is defined as a condition in which lesions are confined within a limited part of the skin, not systemically disseminated at the same time, and are associated with neither cryptococcal fungemia nor antigenemia. This type of cutaneous cryptococcosis is uncommon in Japan. Only 65 cases were reported during the 50-year study period from 1968 to August 2018, with the patients divided into two groups: immunocompromised patients (n=44, 68%) and immunocompetent patients (n=21, 32%). None of the patients were infected with the human immunodeficiency virus (HIV). Localized cutaneous cryptococcosis can also occur in non-HIV-infected patients and well-appearing individuals, therefore, it is considered an important infection in routine dermatology practice. Here, we outline the classification, diagnosis, and treatment of cutaneous cryptococcosis and present a summary of cutaneous cryptococcosis cases reported in Japan.
Topics: Adult; Aged; Aged, 80 and over; Child; Cryptococcosis; Dermatomycoses; Female; Humans; Immunocompetence; Immunocompromised Host; Male; Middle Aged
PubMed: 31787730
DOI: 10.3314/mmj.19.008 -
Ugeskrift For Laeger Nov 2020In this review, we discuss Malassezia folliculitis (MF), which is an inflammation in the hair follicles caused by different Malassezia species. The prevalence of MF in... (Review)
Review
In this review, we discuss Malassezia folliculitis (MF), which is an inflammation in the hair follicles caused by different Malassezia species. The prevalence of MF in the population worldwide ranges from 1% to 17%. Clinically, it may be difficult to distinguish from acne vulgaris, as it presents as erythematous 2-4 mm large papules and pustules on the back, chest and neck. Adequate diagnostic methods, including microscopy or biopsy, are essential to confirm the MF diagnosis, and to ensure initiation of the appropriate anti-fungal treatment.
Topics: Acne Vulgaris; Biopsy; Dermatomycoses; Folliculitis; Humans; Malassezia
PubMed: 33215579
DOI: No ID Found -
International Journal of Dermatology Apr 2017Phaeohyphomycosis is an infrequent infection in human beings. However, in recent years, its prevalence has augmented in immunosuppressed patients (mostly in solid organ...
BACKGROUND
Phaeohyphomycosis is an infrequent infection in human beings. However, in recent years, its prevalence has augmented in immunosuppressed patients (mostly in solid organ transplanted patients). Infection can be mucocutaneous or disseminated. In the former, the fungus inoculation occurs mainly through traumatism. Lesions may be polymorphic and asymptomatic, isolated or multiple, and are usually localized in exposed areas of the limbs and head. Treatment is not standardized. When possible, surgical resection of the lesion is combined with systemic antifungals.
METHODS
We communicate three phaeohyphomycosis cases with cutaneous compromise.
RESULTS
The cases we present show diverse clinical characteristics and varied severity and evolution.
CONCLUSION
It is important for dermatologists to recognize this cutaneous fungus infection because the diagnosis using microscopic examination and mycological culture depends on the clinical suspicion.
Topics: Amphotericin B; Antifungal Agents; Dermatomycoses; Fasciitis, Necrotizing; Fatal Outcome; Female; Humans; Immunocompromised Host; Itraconazole; Lung Diseases; Male; Middle Aged; Phaeohyphomycosis
PubMed: 28295266
DOI: 10.1111/ijd.13590 -
Seminars in Cutaneous Medicine and... Sep 2014Coccidioidomycosis is a common, environmentally acquired, pulmonary fungal infection in arid and semi-arid regions of the West, especially Arizona and California. The... (Review)
Review
Coccidioidomycosis is a common, environmentally acquired, pulmonary fungal infection in arid and semi-arid regions of the West, especially Arizona and California. The infection is frequently associated with striking cutaneous manifestations. Reactive, immunologically mediated eruptions include erythema nodosum, a generalized exanthem, Sweet syndrome, and reactive granulomatous dermatitis. Less commonly, the skin can harbor the actual organisms as a result of dissemination from the lungs. Dermatologists may play a key role in the recognition of coccidioidomycosis
Topics: Biopsy; Coccidioides; Coccidioidomycosis; Dermatomycoses; Diagnosis, Differential; Humans; Lung Diseases, Fungal; Skin
PubMed: 25577855
DOI: 10.12788/j.sder.0111 -
Veterinary Journal (London, England :... Apr 2024Malassezia are members of the mycobiome of dogs and cats. In the presence of an underlying disease, these yeasts can proliferate, attach to the skin or mucosa to induce... (Review)
Review
Malassezia are members of the mycobiome of dogs and cats. In the presence of an underlying disease, these yeasts can proliferate, attach to the skin or mucosa to induce a secondary Malassezia dermatitis, otitis externa or paronychia. Since allergic dermatitis is one of the most common underlying causes, diagnostic investigation for allergy is often indicated. Cats may suffer from various other underlying problems, especially where Malassezia dermatitis is generalised. Malassezia dermatitis in dogs and cats is chronic, relapsing and pruritic. Direct cytology from dermatological lesions and the ear canal, showing "peanut-shaped" budding yeasts, facilitates a rapid and reliable diagnosis. Topical treatment includes antiseptic and antifungal azole-based products. Systemic treatment with oral antifungals is indicated only in severe or refractory disease. Identification and treatment of the underlying cause is essential for an optimal response. In this evidence-based narrative review, we discuss the clinical presentation of Malassezia dermatitis in dogs and cats, underlying comorbidities, and diagnostic considerations. Treatment is discussed in light of emerging evidence of antifungal resistance and the authors' clinical experience.
Topics: Animals; Cats; Dogs; Malassezia; Dermatomycoses; Cat Diseases; Antifungal Agents; Dog Diseases; Neoplasm Recurrence, Local; Dermatitis
PubMed: 38431127
DOI: 10.1016/j.tvjl.2024.106084 -
The Australasian Journal of Dermatology Aug 2023The incidence and prevalence of recalcitrant cutaneous fungal infections is on the rise. Terbinafine-resistant Trichophyton has not only been widespread in India, but... (Review)
Review
The incidence and prevalence of recalcitrant cutaneous fungal infections is on the rise. Terbinafine-resistant Trichophyton has not only been widespread in India, but has also been reported in countries spread throughout the globe. Strains of yeasts such as Malassezia and Candida, which exist both as commensals and as pathogens to the human skin, have also been found to develop resistance to antifungals. Non-dermatophyte moulds which can colonize and infect damaged nails are especially difficult to treat, not only due to resistance, but also because of poor drug penetration of hard keratin. Psychosocial factors such as the indiscriminate broad-spectrum antifungal use in agriculture and in medicine, and poor adherence to hygienic measures to break the chain of infection contribute to the development of antifungal resistance. Such environments encourage fungi to develop various resistance mechanisms to withstand antifungal treatment. These include: (a) alteration of the drug target, (b) increasing efflux of drug/metabolites, (c) inactivation of drug, (d) bypass mechanisms or substitution of the pathway affected by the drug, (e) stress adaptation mechanisms and (f) biofilm formation. Understanding of such mechanisms and how they arise are crucial for development of new ways to prevent or overcome resistance. Novel antifungal treatments have recently been approved in the United States of America for treatment of vulvovaginal candidiasis. Ibrexafungerp (enfumafungin derivative) and oteseconazole (tetrazole) differ from their respective related drug classes of echinocandins and triazoles by having different structures, which lend these medicines advantage compared to traditional treatment by having a different binding site and more selectivity for fungi respectively. Other drugs designed to circumvent the known mechanisms of antifungal resistance are also at various phases of development. Concurrent measures at an institutional and individual level to address and limit inappropriate antifungal use to reduce development of antifungal resistance should be undertaken in a concerted effort to address this epidemic.
Topics: Female; Humans; Antifungal Agents; Echinocandins; Dermatomycoses; Terbinafine; Candidiasis, Vulvovaginal
PubMed: 37387447
DOI: 10.1111/ajd.14115