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Der Hautarzt; Zeitschrift Fur... Oct 2021
Topics: Dermatomycoses; Humans; Mycoses; Nails; Onychomycosis; Skin
PubMed: 34554287
DOI: 10.1007/s00105-021-04886-2 -
Medical Mycology Apr 2023Dermatomycosis of the hair, skin, or nails is one of the most common fungal infections worldwide. Beyond permanent damage to the affected area, the risk of severe... (Review)
Review
Dermatomycosis of the hair, skin, or nails is one of the most common fungal infections worldwide. Beyond permanent damage to the affected area, the risk of severe dermatomycosis in immunocompromised people can be life-threatening. The potential risk of delayed or improper treatment highlights the need for a rapid and accurate diagnosis. However, with traditional methods of fungal diagnostics such as culture, a diagnosis can take several weeks. Alternative diagnostic technologies have been developed which allow for an appropriate and timely selection of an antifungal treatment, preventing nonspecific over-the-counter self-medication. Such techniques include molecular methods, such as polymerase chain reaction (PCR), real-time PCR, DNA microarray, next-generation sequencing, in addition to matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry. Molecular methods can help close the 'diagnostic gap' observed with traditional cultures and microscopy and allow for a rapid detection of dermatomycosis with increased sensitivity and specificity. In this review, advantages and disadvantages of traditional and molecular techniques are discussed, in addition to the importance of species-specific dermatophyte determination. Finally, we highlight the need for clinicians to adapt molecular techniques for the rapid and reliable detection of dermatomycosis infections and to reduce adverse events.
Topics: Animals; Skin; Hair; Real-Time Polymerase Chain Reaction; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Dermatomycoses
PubMed: 36990677
DOI: 10.1093/mmy/myad037 -
American Journal of Clinical Dermatology Oct 2020Coccidioidomycosis is an endemic mycosis of the southern United States, Northern Mexico, and South America. Primary cutaneous coccidioidomycosis, despite being a very... (Review)
Review
Coccidioidomycosis is an endemic mycosis of the southern United States, Northern Mexico, and South America. Primary cutaneous coccidioidomycosis, despite being a very rare clinical presentation, has shown an increasing incidence. An extensive literature search for cutaneous coccidioidomycosis cases was performed using the OLDMEDLINE, PubMed, Cochrane, LILACS and Google Scholar databases for studies published from January 1927 through December 21, 2019. Forty-two observational studies were included totaling 82 cases of primary cutaneous coccidioidomycosis. Narrative reviews, systematic reviews, and meta-analyses were also included. Additionally, an original case was included. Patients with primary cutaneous coccidioidomycosis share the same geographical and epidemiological characteristics as those with pulmonary or disseminated coccidioidomycosis. Most of the imported cases came from endemic areas. A large portion of cases had prior local skin trauma. Tissue culture is still the leading diagnostic method; nevertheless, molecular techniques such as polymerase chain reaction (PCR) are currently relevant to differentiate between species. First-line treatment consists of azoles; however, it has an excellent prognosis even without treatment. Primary cutaneous coccidioidomycosis should be considered a differential diagnosis of unusual infections or neoformations in any part of the body in resident populations of endemic areas or in patients with a previous history of travel to these areas.
Topics: Antifungal Agents; Coccidioides; Coccidioidomycosis; DNA, Fungal; Dermatomycoses; Diagnosis, Differential; Endemic Diseases; Fluconazole; Humans; Incidence; Itraconazole; Mexico; Mycology; Observational Studies as Topic; Polymerase Chain Reaction; Skin; South America; Travel-Related Illness; United States
PubMed: 32557380
DOI: 10.1007/s40257-020-00525-z -
Medical Mycology Journal 2023The Malassezia species are dimorphic fungi that require lipids such as olive oil for their growth. They are constituents of the normal human skin microbiota and can...
The Malassezia species are dimorphic fungi that require lipids such as olive oil for their growth. They are constituents of the normal human skin microbiota and can affix to the host or other surfaces through the establishment of biofilms. Malassezia species are accountable for superficial mycoses like folliculitis. Additionally, they are capable of causing invasive infections, such as of the bloodstream, in neonates and immunocompromised patients, albeit infrequently. Catheter-associated bloodstream infections in neonates are the most commonly reported invasive cases. Remarkably, unlike other invasive fungal infections, neutropenia and the use of broad-spectrum antibiotics do not seem to contribute to the risk of invasive Malassezia infections. Nosocomial outbreaks of Malassezia infections have been reported. While most cases of invasive Malassezia infection are fungemia, they seldom give rise to disseminated lesions in various organs. The diagnosis can be confirmed by the visualization of characteristic yeasts through histologic or cytologic examination of a biopsy or needle aspiration specimen, or via positive culture results from sterile sites. The prognosis for invasive Malassezia infection is generally favorable, with few reports of treatment failure. Nevertheless, due to the limited number of cases, evidence-based treatment recommendations are wanting. Management of invasive Malassezia infections linked to central venous catheters includes removal of the catheter, cessation of intravenous lipid emulsion, and intravenous administration of appropriate antifungal agents.
Topics: Infant, Newborn; Humans; Malassezia; Dermatomycoses; Antifungal Agents; Invasive Fungal Infections; Central Venous Catheters; Catheter-Related Infections
PubMed: 38030275
DOI: 10.3314/mmj.23-003 -
The New England Journal of Medicine Aug 2023
Topics: Humans; Infant, Newborn; Dermatomycoses; Head; Suppuration
PubMed: 37548327
DOI: 10.1056/NEJMicm2301685 -
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 -
Journal of Microbiology and... May 2021is the most abundant genus in the fungal microflora found on human skin, and it is associated with various skin diseases. Among the 18 different species of that have... (Review)
Review
is the most abundant genus in the fungal microflora found on human skin, and it is associated with various skin diseases. Among the 18 different species of that have been identified to date, and are the most predominant fungal species found on human skin. Several studies have suggested a possible link between and skin disorders. However, our knowledge on the physiology and pathogenesis of in human body is still limited. is unable to synthesize fatty acids; hence, it uptakes external fatty acids as a nutrient source for survival, a characteristic compensated by the secretion of lipases and degradation of sebum to produce and uptake external fatty acids. Although it has been reported that the activity of secreted lipases may contribute to pathogenesis of , majority of the data were indirect evidences; therefore, enzymes' role in the pathogenesis of infections is still largely unknown. This review focuses on the recent advances on in the context of an emerging interest for lipases and summarizes the existing knowledge on , diseases associated with the fungus, and the role of the reported lipases in its physiology and pathogenesis.
Topics: Dermatomycoses; Fungal Proteins; Humans; Lipase; Lipid Metabolism; Malassezia; Sebum; Skin; Virulence
PubMed: 33526754
DOI: 10.4014/jmb.2012.12048 -
Frontiers in Immunology 2023Dermatophytosis is a common superficial infection caused by dermatophytes, a group of pathogenic keratinophilic fungi. Apart from invasion against skin barrier, host... (Review)
Review
Dermatophytosis is a common superficial infection caused by dermatophytes, a group of pathogenic keratinophilic fungi. Apart from invasion against skin barrier, host immune responses to dermatophytes could also lead to pathologic inflammation and tissue damage to some extent. Therefore, it is of great help to understand the pathogenesis of dermatophytes, including fungal virulence factors and anti-pathogen immune responses. This review aims to summarize the recent advances in host-fungal interactions, focusing on the mechanisms of anti-fungal immunity and the relationship between immune deficiency and chronic dermatophytosis, in order to facilitate novel diagnostic and therapeutic approaches to improve the outcomes of these patients.
Topics: Humans; Arthrodermataceae; Dermatomycoses; Virulence; Tinea; Immunity
PubMed: 38022599
DOI: 10.3389/fimmu.2023.1285887 -
Skinmed 2020
Topics: Dermatomycoses; Foot Dermatoses; Humans; Poetry as Topic
PubMed: 33397573
DOI: No ID Found -
Journal de Mycologie Medicale Mar 2023Dermatophytosis is a common superficial fungal infection of the skin and its appendages caused by dermatophytes. Recent times have witnessed a dynamic evolution of... (Review)
Review
Dermatophytosis is a common superficial fungal infection of the skin and its appendages caused by dermatophytes. Recent times have witnessed a dynamic evolution of dermatophytes driven by their ecology, reproduction, pathogenicity and host immune response, influenced by population migration and socioeconomic status. Dermatophytes establish infection following successful adherence of arthroconidia to the surface of keratinized tissues. The proteolytic enzymes released during adherence and invasion not only ascertain their survival but also allow the persistence of infection in the host. While the cutaneous immune surveillance mechanism, after antigen exposure and presentation, leads to activation of T lymphocytes and subsequent clonal expansion generating effector T cells that differentially polarize to a predominant Th17 response, the response fails to eliminate the pathogen despite the presence of high levels of IFN-γ. In chronic dermatophytosis, antigens are a constant source of stimulus promoting a dysregulated Th17 response causing inflammation. The host-derived iTreg response fails to counterbalance the inflammation and instead polarizes to Th17 lineage, aggravating the chronicity of the infection. Increasing antifungal resistance and recalcitrant dermatophytosis has impeded the overall clinical remission. Human genetic research has the potential to generate knowledge to explore new therapeutic targets. The review focuses on understanding specific virulence factors involved in pathogenesis and defining the role of dysregulated host immune response against chronic dermatophytic infections for future management strategies.
Topics: Humans; Arthrodermataceae; Dermatomycoses; Host-Pathogen Interactions; Tinea; Inflammation; Trichophyton
PubMed: 36272379
DOI: 10.1016/j.mycmed.2022.101331