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Journal of the European Academy of... Sep 2023Antifungal resistance has become prevalent worldwide. Understanding the factors involved in spread of resistance allows the formulation of strategies to slow resistance... (Review)
Review
Antifungal resistance has become prevalent worldwide. Understanding the factors involved in spread of resistance allows the formulation of strategies to slow resistance development and likewise identify solutions for the treatment of highly recalcitrant fungal infections. To investigate the recent explosion of resistant strains, a literature review was performed focusing on four main areas: mechanisms of resistance to antifungal agents, diagnosis of superficial fungal infections, management, and stewardship. The use of traditional diagnostic tools such as culture, KOH analysis and minimum inhibitory concentration values on treatment were investigated and compared to the newer techniques such as molecular methods including whole genome sequencing, and polymerase chain reaction. The management of terbinafine-resistant strains is discussed. We have emphasized the need for antifungal stewardship including increasing surveillance for resistant infection.
Topics: Humans; Antifungal Agents; Onychomycosis; Terbinafine; Dermatomycoses; Drug Resistance, Fungal
PubMed: 37210652
DOI: 10.1111/jdv.19217 -
The Journal of Infection Jun 2017Tinea capitis is the most important superficial fungal condition in children. It is often unrecognised but the presence of alopecia, scale and lymphadenopathy,... (Review)
Review
Tinea capitis is the most important superficial fungal condition in children. It is often unrecognised but the presence of alopecia, scale and lymphadenopathy, especially in inner-city children should prompt investigation. An understanding of changing epidemiology and prevalence of causative organisms is important in deciding appropriate therapy. The use of diagnostic aids including dermoscopy is increasing and is reported to be helpful in identifying subtle signs. Trichophyton tonsurans accounts for the majority of cases in the UK and terbinafine is increasingly advocated as a safe and effective therapy. Exclusion from school is unnecessary provided the child is receiving appropriate systemic and topical therapy, but family members should be screened and carriers should receive treatment. Steroids and surgical treatments should be avoided. Treatment failure is common and may be multifactorial. Mycological cure after completing treatment should be sought and therefore follow up is necessary for Tinea capitis cases. Development of molecular diagnostic methods may improve our ability to diagnose Tinea capitis accurately and quickly in the future. Emerging new dermatophytoses affecting other anatomical sites are discussed which, although not common in the UK, may be seen due to increasing travel worldwide.
Topics: Antifungal Agents; Arthrodermataceae; Child; Dermatomycoses; Disease Management; Humans; Prevalence; United Kingdom
PubMed: 28646963
DOI: 10.1016/S0163-4453(17)30192-5 -
Current Opinion in Infectious Diseases Apr 2016Cutaneous and subcutaneous mycoses are a source of significant morbidity both in immunocompetent and immunocompromised patients. We here review the latest findings in... (Review)
Review
PURPOSE OF REVIEW
Cutaneous and subcutaneous mycoses are a source of significant morbidity both in immunocompetent and immunocompromised patients. We here review the latest findings in terms of genetic predisposition, epidemiology, clinical manifestations, and therapeutic strategies in these diseases.
RECENT FINDINGS
A growing number of fungal skin and soft tissue infections are reported worldwide. In immunocompromised patients, these infections are often associated with disseminated disease. Skin and soft tissue biopsies usually allow mycological identification. Although tissue culture remains the gold standard, molecular biology is increasingly used and sometimes mandatory for accurate diagnosis. Advances in therapeutics have improved outcome and lowered dissemination risk in patients.
SUMMARY
Cutaneous and subcutaneous mycoses are an evolving field. Clinicians all over the world should be aware of the common manifestations of these diseases - infectious diseases - as they are increasingly reported and may lead to or be associated with dissemination.
Topics: Antifungal Agents; Dermatomycoses; Fungi; Genetic Predisposition to Disease; Humans; Microbiological Techniques; Soft Tissue Infections
PubMed: 26915073
DOI: 10.1097/QCO.0000000000000252 -
Mycopathologia Oct 2016Diapers create particular conditions of moisture and friction, and with urine and feces come increased pH and irritating enzymes (lipases and proteases). Fungi can take... (Review)
Review
Diapers create particular conditions of moisture and friction, and with urine and feces come increased pH and irritating enzymes (lipases and proteases). Fungi can take advantage of all these factors. Candida yeasts, especially C. albicans, are responsible for the most frequent secondary infections and are isolated in more than 80 % of cases. Correct diagnosis is important for ensuring the correct prescription of topical antimycotics. Nystatin, imidazoles and ciclopirox are effective. It is important to realize there are resistant strains. Dermatophytes can infect the diaper area, with the most common agent being Epidermophyton floccosum. The clinical characteristics of dermatophytosis are different from those of candidiasis, and it can be diagnosed and treated simply. Malassezia yeasts can aggravate conditions affecting the diaper area, such as seborrheic dermatitis, atopic dermatitis, and inverse psoriasis. Additional treatment is recommended in this case, because they usually involve complement activation and increased specific IgE levels. Erythrasma is a pseudomycosis that is indistinguishable from candidiasis and may also occur in large skin folds. It is treated with topical antibacterial products and some antimycotics.
Topics: Antifungal Agents; Dermatitis, Contact; Dermatomycoses; Fungi; Humans
PubMed: 27193417
DOI: 10.1007/s11046-016-0020-9 -
Skinmed 2020
Topics: Dermatomycoses; Foot Dermatoses; Humans; Poetry as Topic
PubMed: 33397573
DOI: No ID Found -
Mycopathologia Feb 2017Dermatophytoses are common superficial fungal infections affecting both humans and animals. They are provoked by filamentous fungi called dermatophytes specialized in... (Review)
Review
Dermatophytoses are common superficial fungal infections affecting both humans and animals. They are provoked by filamentous fungi called dermatophytes specialized in the degradation of keratinized structures, which allows them to induce skin, hair and nail infections. Despite their high incidence, little investigation has been performed for the understanding of these infections compared to fungal opportunistic infections and most of the studies were based on in vitro experiments. The development of animal models for dermatophyte research is required to evaluate new treatments against dermatophytoses or to increase knowledge about fungal pathogenicity factors or host immune response mechanisms. The guinea pig has been the most often used animal model to evaluate efficacy of antifungal compounds against dermatophytes, while mouse models were preferred to study the immune response generated during the disease. Here, we review the relevant animal models that were developed for dermatophyte research and we discuss the advantages and disadvantages of the selected species, especially guinea pig and mouse.
Topics: Animals; Antifungal Agents; Arthrodermataceae; Dermatomycoses; Disease Models, Animal; Guinea Pigs; Host-Pathogen Interactions; Mice
PubMed: 27730454
DOI: 10.1007/s11046-016-0079-3 -
Mycopathologia Feb 2017Dermatophytes evolve along with the geography and socioeconomic conditions. Epidermophyton floccosum, Microsporum audouinii and Trichophyton schoenleinii acted as the... (Review)
Review
Dermatophytes evolve along with the geography and socioeconomic conditions. Epidermophyton floccosum, Microsporum audouinii and Trichophyton schoenleinii acted as the major pathogens of superficial fungal diseases 100 years ago, but their frequency decreased dramatically since the middle of the twentieth century and they are limited to some less-developed countries nowadays; meanwhile, frequency of Trichophyton rubrum, Trichophyton interdigitale, Trichophyton tonsurans and Microsporum canis increased gradually, and these fungi have become the major species globally. Some other dermatophytes, i.e., Trichophyton violaceum, Trichophyton verrucosum and Microsporum ferrugineum, are mainly endemic in some parts of Africa, Asia and Europe. At present, T. rubrum is the leading pathogen for skin and nail fungal infections, whereas M. canis, T. tonsurans and T. violaceum present as the predominant dermatophytes involved in tinea capitis. Population mobility, changes in human lifestyle and advents of antifungal drugs will continually drive the dermatophyte evolution in the skin microenvironment. Comprehensive observation is needed to better understand this kind of organisms and prospect the trends of their changes in future.
Topics: Dermatomycoses; Epidermophyton; Humans; Microsporum; Prevalence; Trichophyton
PubMed: 27783316
DOI: 10.1007/s11046-016-0082-8 -
Medical Mycology Feb 2018In this critical literature review, we summarize the epidemiological trends of dermatophytoses reported in Africa. Our findings clearly emphasize the heavy burden of... (Review)
Review
In this critical literature review, we summarize the epidemiological trends of dermatophytoses reported in Africa. Our findings clearly emphasize the heavy burden of dermatophytosis in Africa. Tinea capitis is the primary clinical presentation of dermatophytosis in African children throughout the entire African continent. The disease affects more than 20% of school-age children in West Africa, while the prevalence ranges from 10% to more than 70% in other regions of Africa. In African adults, the presence of tinea corporis is the most frequent indicator of dermatophytosis. However, epidemiological studies have been primarily conducted on particular patient groups that are not representative of the general population. We examined dermatophyte species distribution patterns. We observed a predominance of anthropophilic dermatophytes, mainly T. violaceum, in the North and East of Africa and both T. soudanense and M. audouinii in the Western and Central regions of the continent. Interestingly, the zoophilic species, M. canis, has recently emerged in North and East Africa. Optimization of both mycology diagnosis capacities and epidemiological methodology would provide insight into the role that climate and other global aspects of the human environment play in dermatophyte epidemiology. We advocate that using a multisectoral and collaborative strategy would strengthen such future studies.
Topics: Africa; Dermatomycoses; Epidermophyton; Humans; Microsporum; Prevalence; Risk Factors; Tinea; Tinea Capitis; Trichophyton
PubMed: 28992062
DOI: 10.1093/mmy/myx048 -
The American Journal of Tropical... Sep 2015
Topics: Aged; Colombia; Dermatomycoses; Humans; Male; Paracoccidioides; Paracoccidioidomycosis; Skin
PubMed: 26333727
DOI: 10.4269/ajtmh.15-0062 -
Der Hautarzt; Zeitschrift Fur... Apr 2017Currently, a mycid is defined as hyperergic reaction that develops from a remote localized infection and in which no fungus is detectable. Criteria for a mycid caused... (Review)
Review
Currently, a mycid is defined as hyperergic reaction that develops from a remote localized infection and in which no fungus is detectable. Criteria for a mycid caused by a dermatophyte (dermatophytid) are (1) proven dermatophytosis elsewhere, (2) no evidence for fungal elements in the lesions of the -id reaction, (3) initially often worsening of the lesions under therapy with highly potent systemic antimycotics, and (4) clearing after the dermatophytosis has been treated sufficiently. The most common dermatophytid is a symmetrical dyshidrotic mycid of the hands in connection with an often highly inflammatory mycotic infection of the feet especially by Trichophyton mentagrophytes. In addition to lichen trichophyticus, dermatophytids associated with tinea capitis may show high clinical variability. They often occur under systemic antimycotic therapy and have to be differentiated from drug reactions. In addition to systemic antimycotic therapy and, if necessary, a short-term application of oral glucocorticoidsteroids, a topical combination of an antifungal and a glucocorticosteroid is effective. It leads to an immediate reduction of inflammation and pruritus, especially if initiation of systemic antifungal therapy has resulted in a flare-up reaction (overtreatment phenomenon).
Topics: Administration, Topical; Antifungal Agents; Arthrodermataceae; Dermatomycoses; Diagnosis, Differential; Drug Combinations; Evidence-Based Medicine; Glucocorticoids; Humans; Treatment Outcome
PubMed: 28116455
DOI: 10.1007/s00105-017-3933-4