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British Journal of Biomedical Science 2023Diagnosis of superficial/cutaneous fungal infections from skin, hair and nail samples is generally achieved using microscopy and culture in a microbiology laboratory,... (Review)
Review
Diagnosis of superficial/cutaneous fungal infections from skin, hair and nail samples is generally achieved using microscopy and culture in a microbiology laboratory, however, any presentation that is unusual or subcutaneous is sampled by taking a biopsy. Using histological techniques a tissue biopsy enables a pathologist to perform a full examination of the skin structure, detect any inflammatory processes or the presence of an infectious agent or foreign body. Histopathological examination can give a presumptive diagnosis while a culture result is pending, and may provide valuable diagnostic information if culture fails. This review demonstrates how histopathology contributes to the diagnosis of fungal infections from the superficial to the life threatening.
Topics: Humans; Dermatomycoses; Biopsy
PubMed: 37351018
DOI: 10.3389/bjbs.2023.11314 -
Infection Dec 2018
Topics: Aged; Amphotericin B; Antifungal Agents; Debridement; Dermatomycoses; Humans; Male; Mucormycosis; Triazoles
PubMed: 30091018
DOI: 10.1007/s15010-018-1179-4 -
Giornale Italiano Di Dermatologia E... Dec 2017The guideline recommendations, albeit founded on thorough reviews of clinically relevant literature data, are often not immediately adaptable to everyday life.... (Review)
Review
The guideline recommendations, albeit founded on thorough reviews of clinically relevant literature data, are often not immediately adaptable to everyday life. Considering the marked heterogeneity of superficial mycoses, each of them requires specific management in a real life context; in all cases diagnostic confirmation is required with microscopic and culture examination. In tinea capitis oral therapy is necessary (minimum six weeks) and should be continued until clinical and, above all, mycological healing. In cases of tinea corporis, cruris or pedis, it may be necessary to associate oral therapy to topical treatment. The main oral antifungals are fluconazole, itraconazole and terbinafine. Fluconazole has favorable pharmacokinetic and pharmacodynamic characteristics, and is effective in most superficial mycoses, for example in cases of diffuse or recurrent pityriasis versicolor in which oral therapy with an azole derivative is useful. Topical treatment, lasting 6-12 months, is indicated in onychomycosis that is confined to one nail. In frequent cases of onychomycosis involving multiple nails or recurrence, oral therapy is necessary. Pharmacological history is important, given the possible interactions of some systemic drugs. In chronic or recurrent relapsing vulvovaginitis, first-choice therapy is oral fluconazole with a therapeutic regimen that respects the mycotic biorhythm (200 mg on days 1, 4, 11, 26, and subsequently 200 mg/week for 3 months).
Topics: Administration, Topical; Antifungal Agents; Dermatomycoses; Humans; Onychomycosis; Practice Guidelines as Topic; Recurrence; Tinea; Tinea Versicolor
PubMed: 29050446
DOI: 10.23736/S0392-0488.17.05683-8 -
Journal of the American Academy of... Jul 2014Malassezia yeasts have long been considered commensal fungi, unable to elicit significant damage. However, they have been associated with a diversity of cutaneous... (Review)
Review
Malassezia yeasts have long been considered commensal fungi, unable to elicit significant damage. However, they have been associated with a diversity of cutaneous diseases, namely pityriasis versicolor, Malassezia folliculitis, seborrheic dermatitis, atopic dermatitis, psoriasis, and confluent and reticulate papillomatosis. Several hypotheses have been proposed to explain the pathogenic mechanisms of these fungi, but none have been confirmed. More recently, such organisms have been increasingly isolated from bloodstream infections raising serious concern about these fungi. Given the difficulty to culture these yeasts to proceed with speciation and antimicrobial susceptibility tests, such procedures are most often not performed and the cutaneous infections are treated empirically. The recurring nature of superficial skin infections and the potential threat of systemic infections raise the need of faster and more sensitive techniques to achieve isolation, identification, and antimicrobial susceptibility profile. This article reviews and discusses the latest available data concerning Malassezia infections and recent developments about diagnostic methods, virulence mechanisms, and susceptibility testing.
Topics: Antifungal Agents; Dermatitis, Seborrheic; Dermatomycoses; Folliculitis; Humans; Malassezia; Microbial Sensitivity Tests; Skin; Tinea Versicolor; Virulence
PubMed: 24569116
DOI: 10.1016/j.jaad.2013.12.022 -
Der Hautarzt; Zeitschrift Fur... Sep 2016Because of high exposure (e. g. swimmers and athletes competing on mats) and disposition (e. g. microtraumata of the skin in runners) athletes are prone to a higher... (Review)
Review
Because of high exposure (e. g. swimmers and athletes competing on mats) and disposition (e. g. microtraumata of the skin in runners) athletes are prone to a higher risk for mycotic infections by dermatophytes. In disciplines with close contact during competition-especially wrestlers and judoists-infections by the anthropophilic Trichophyton (T.) tonsurans are most important (tinea gladiatorum). These infections are highly contagious and often cause small epidemics especially if the primary source of infection is not promptly recognized. The environment of the athletes (e. g. mats) and asymptomatic carriers may be sources of further spread. Tinea pedis with its clinical manifestations seems to be often underdiagnosed and insufficiently treated. Environmental contamination by fungal spores may be responsible for the significantly higher level of mycotic infections of the feet in children and adolescents active in sports. There is a higher risk for spread of the infection to the toe nails (onychomycosis) and for consecutive infections by bacteria (e. g. erysipelas). More rarely infections by zoophilic or geophilic dermatophytes are seen in athletes (e.g. equestrians). Education and more intensive measures of prevention and environmental decontamination are essential for all dermatophytoses associated with sports.
Topics: Dermatomycoses; Disease Outbreaks; Environmental Exposure; Evidence-Based Medicine; Humans; Incidence; Prevalence; Risk Factors; Sports
PubMed: 27385109
DOI: 10.1007/s00105-016-3845-8 -
Current Opinion in Pediatrics Aug 2018An opportunistic mycosis is a fungal agent of low pathogenicity that specifically infects immunocompromised hosts. Advances in transplantation, preterm care,... (Review)
Review
PURPOSE OF REVIEW
An opportunistic mycosis is a fungal agent of low pathogenicity that specifically infects immunocompromised hosts. Advances in transplantation, preterm care, immunosuppressive therapies and intensive care, have lead to the emergence of pediatric patients with serious immunodeficiency who are vulnerable to nonpathogenic fungi.
RECENT FINDINGS
The advent of the use of biologic agents in pediatric disease as well as the advances in care of preterm and immunosuppressed patients opens up a new cohort of patients at risk of opportunistic mycotic infections. Recent cases of cutaneous histioplasmosis as the presenting sign of hyper-IgM syndrome and the case of cutaneous blastomycosis in a patient treated with infliximab underscore the need to have a high clinical suspicion for deep fungal infections in immunosuppressed patients.
SUMMARY
The current review will focus on the cutaneous manifestations of cutaneous infections by Aspergillus, Blastomyces, histoplasmosis, and mucormycosis. Greater understanding of these diseases and high-quality research in identification and treatment can enhance care of patients in the coming future.
Topics: Child; Dermatomycoses; Humans; Immunocompromised Host; Opportunistic Infections
PubMed: 29771758
DOI: 10.1097/MOP.0000000000000651 -
Current Problems in Pediatric and... Jan 2018Cutaneous infections and infestations are common among children and adolescents. Ectoparasitic infestations affect individuals across the globe. Head lice, body lice,... (Review)
Review
Cutaneous infections and infestations are common among children and adolescents. Ectoparasitic infestations affect individuals across the globe. Head lice, body lice, scabies, and infestations with bed bugs are seen in individuals who reside in both resource poor areas and in developed countries. Superficial cutaneous and mucosal candida infections occur throughout the life cycle. Dermatophyte infections of keratin-containing skin and skin structures result in tinea capitis (scalp), tinea corporis (body), tinea pedis (foot), and tinea unguium (nails). Less frequent endemic fungal infections such as blastomycosis, coccidiodomycosis, and histoplasmosis may present with skin findings. This article will describe the epidemiology and transmission of these conditions as well as their clinical manifestations. The approach to diagnosis will be addressed as well as primary prevention and current therapies.
Topics: Adolescent; Animals; Bedbugs; Candidiasis; Candidiasis, Cutaneous; Child; Dermatomycoses; Humans; Lice Infestations; Onychomycosis; Pediculus; Scabies; Scalp Dermatoses; Skin; Skin Diseases, Parasitic; Tinea; Tinea Capitis; Tinea Pedis
PubMed: 29198783
DOI: 10.1016/j.cppeds.2017.11.001 -
Medical Mycology Journal 2019We report here the results of the 2016 epidemiological survey of dermatomycosis in Japan. In total, 6,776 cases were analyzed as follows: dermatophytosis, 5,772 cases... (Review)
Review
We report here the results of the 2016 epidemiological survey of dermatomycosis in Japan. In total, 6,776 cases were analyzed as follows: dermatophytosis, 5,772 cases (85.2%); candidiasis, 757 cases (11.2%); Malassezia infection, 235 cases (3.5%); and other fungal infections, 11 cases (0.2%). In dermatophytosis, tinea pedis was the most frequent (3,314 cases: male, 1,705; female, 1,609), followed by tinea unguium (1,634 cases: male, 766; female, 868), tinea corporis (423 cases: male, 241; female, 182); tinea cruris (316 cases: male, 242; female, 74); tinea manuum (58 cases: male, 29; female, 29); tinea capitus, Celsus' kerion (26 cases: male, 19; female, 7); and tinea barbae (1 case: male, 1). The most frequent pathogen was Trichophyton rubrum. In candidiasis, candidal intertrigo was the most frequent (181 cases: male, 98; female, 83), followed by oral candidiasis (165 cases: male, 84; female, 81), genital candidiasis (119 cases: male, 45; female, 74), diaper candidiasis (113 cases: male, 49; female, 64), erosio interdigitalis (63 cases: male, 13; female, 50), onychomycosis (41 cases: male, 17; female, 24), onychia et paronychia (28 cases: male, 2; female, 26), and angular cheilitis (23 cases: male, 6; female, 17). Although the number of cases varied depending on the role of each cooperating medical institution in the area and on population composition, no significant differences in the frequencies of clinical types were observed.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Candidiasis; Child; Child, Preschool; Dermatomycoses; Female; Humans; Infant; Japan; Malassezia; Male; Middle Aged; Onychomycosis; Prevalence; Sex Factors; Time Factors; Tinea; Tinea Capitis; Tinea Pedis; Trichophyton; Young Adult
PubMed: 31474694
DOI: 10.3314/mmj.19.007 -
Annales de Dermatologie Et de... Mar 2018
Review
Topics: Anti-Bacterial Agents; Antifungal Agents; Dermatomycoses; Diagnosis, Differential; Humans; Skin Diseases, Bacterial; Thrombophlebitis
PubMed: 29475618
DOI: 10.1016/j.annder.2018.01.018 -
Anais Brasileiros de Dermatologia 2015Coccidioidomycosis is a highly prevalent disease in the Western hemisphere. It is considered one of the most virulent primary fungal infections. Coccidioides species... (Review)
Review
Coccidioidomycosis is a highly prevalent disease in the Western hemisphere. It is considered one of the most virulent primary fungal infections. Coccidioides species live in arid and semi-arid regions, causing mainly pulmonary infection through inhalation of arthroconidia although many other organs can be affected. Primary inoculation is rare. Since the first case of coccidioidomycosis was reported in 1892, the skin has been identified as an important target of this disease. Knowledge of cutaneous clinical forms of this infection is important and very useful for establishing prompt diagnosis and treatment. The purpose of this article is to provide a review of this infection, emphasizing its cutaneous manifestations, diagnostic methods and current treatment.
Topics: Coccidioidomycosis; Dermatomycoses; Female; Humans; Lung Diseases, Fungal; Male; Risk Factors; Skin
PubMed: 26560205
DOI: 10.1590/abd1806-4841.20153805