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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 -
Der Hautarzt; Zeitschrift Fur... Mar 2021We report on three cases in which Arthroderma (A.) crocatum was isolated from human skin in Germany. The characteristics and epidemiology of this rare geophilic and... (Review)
Review
We report on three cases in which Arthroderma (A.) crocatum was isolated from human skin in Germany. The characteristics and epidemiology of this rare geophilic and probably mostly apathogenic dermatophyte are described paying special attention to its gymnothecia. The combination of KOH mount, culture and genetic analysis is the foundation for clinically meaningful conclusions. It is likely that the prevalence of A. crocatum is currently underestimated.
Topics: Arthrodermataceae; Dermatomycoses; Germany; Humans; Prevalence; Skin
PubMed: 33438045
DOI: 10.1007/s00105-020-04752-7 -
The Journal of Dermatology Dec 2020The "Guidelines for the management of dermatomycosis" of the Japanese Dermatological Association were first published in Japanese in 2009 and the Guidelines Committee of...
The "Guidelines for the management of dermatomycosis" of the Japanese Dermatological Association were first published in Japanese in 2009 and the Guidelines Committee of the Japanese Dermatological Association revised it in 2019. The first guidelines was prepared according to the opinions of the Guidelines Committee members and it was of educational value. The revised version is composed of introductory descriptions of the disease concepts, diagnosis, medical mycology and recent advances in treatment, along with clinical questions (CQ), which is intended to help in general practice for dermatologists. The CQ are limited to those involved in therapy but include some of the recently launched antifungal agents. The level of evidence and the degree of recommendation for each item were reviewed by the committee based on clinical studies published by 2018. For rare dermatomycoses, recommendations by the committee are described in the guidelines. In this field, there are still few good quality studies on treatment. Periodic revision in line with new evidence is necessary.
Topics: Antifungal Agents; Dermatomycoses; Humans
PubMed: 32978814
DOI: 10.1111/1346-8138.15618 -
International Journal of Dermatology Jun 2024Cutaneous fungal infections affect millions around the world. However, severe, multi-resistant fungal infections are increasingly being reported over the past years. As... (Review)
Review
Cutaneous fungal infections affect millions around the world. However, severe, multi-resistant fungal infections are increasingly being reported over the past years. As a result of the high rate of resistance which urged for drug repurposing, statins were studied and found to have multiple pleiotropic effects, especially when combined with other already-existing drugs. An example of this is the synergism found between several typical antifungals and statins, such as antifungals Imidazole and Triazole with a wide range of statins shown in this review. The main mechanisms in which they exert an antifungal effect are ergosterol inhibition, protein prenylation, mitochondrial disruption, and morphogenesis/mating inhibition. This article discusses multiple in vitro studies that have proven the antifungal effect of systemic statins against many fungal species, whether used alone or in combination with other typical antifungals. However, as a result of the high rate of drug-drug interactions and the well-known side effects of systemic statins, topical statins have become of increasing interest. Furthermore, patients with dyslipidemia treated with systemic statins who have a new topical fungal infection could benefit from the antifungal effect of their statin. However, it is still not indicated to initiate systemic statins in patients with topical mycotic infections if they do not have another indication for statin use, which raises the interest in using topical statins for fungal infections. This article also tackles the different formulations that have been studied to enhance topical statins' efficacy, as well as the effect of different topical statins on distinct dermatologic fungal diseases.
Topics: Humans; Antifungal Agents; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Dermatomycoses; Administration, Cutaneous; Drug Repositioning; Drug Interactions
PubMed: 38344878
DOI: 10.1111/ijd.17068 -
Journal of the European Academy of... Jul 2023Malassezia is a lipophilic yeast that is a part of the human mycobiome. Malassezia folliculitis appears when the benign colonization of the hair follicles, by the...
Malassezia is a lipophilic yeast that is a part of the human mycobiome. Malassezia folliculitis appears when the benign colonization of the hair follicles, by the Malassezia yeasts, becomes symptomatic with pruritic papules and pustules. Although Malassezia folliculitis is common in hospital departments, diagnosing and treating it varies among dermatologists and countries. The European Academy of Dermatology and Venereology Mycology Task Force Malassezia folliculitis working group has, therefore, sought to develop these recommendations for the diagnosis and management of Malassezia folliculitis. Recommendations comprise methods for diagnosing Malassezia folliculitis, required positive findings before starting therapies and specific treatment algorithms for individuals who are immunocompetent, immunocompromised or who have compromised liver function. In conclusion, this study provides a clinical strategy for diagnosing and managing Malassezia folliculitis.
Topics: Humans; Malassezia; Dermatomycoses; Folliculitis
PubMed: 36912427
DOI: 10.1111/jdv.18982 -
Nederlands Tijdschrift Voor Geneeskunde Mar 2022Most medical microbiology laboratories in the Netherlands have switched from direct potassium hydroxide microscopy and culture to polymerase chain reaction (PCR) testing...
Most medical microbiology laboratories in the Netherlands have switched from direct potassium hydroxide microscopy and culture to polymerase chain reaction (PCR) testing when diagnosing dermato- and onychomycoses and Candida species in human dander, hair and nails. The predictive value of a PCR test is in most cases higher than the predictive value of KOH microscopy and culture in diagnosing or ruling out a fungal infection and should therefore replace traditional diagnostics in routine care. KOH microscopy and culture should be reserved in cases of therapy failure and suspected false negative PCR testing. An application for a PCR should be performed if there is any doubt about the clinical diagnosis. The application must be accompanied by sufficient clinical information from the patient to enable the microbiologist to determine whether the PCR test used is appropriate.
Topics: Dermatomycoses; Humans; Nails; Netherlands; Polymerase Chain Reaction
PubMed: 35499577
DOI: No ID Found -
Nature Reviews. Microbiology Mar 2021The recent introduction of Pseudogymnoascus destructans (the fungal pathogen that causes white-nose syndrome in bats) from Eurasia to North America has resulted in the... (Review)
Review
The recent introduction of Pseudogymnoascus destructans (the fungal pathogen that causes white-nose syndrome in bats) from Eurasia to North America has resulted in the collapse of North American bat populations and restructured species communities. The long evolutionary history between P. destructans and bats in Eurasia makes understanding host life history essential to uncovering the ecology of P. destructans. In this Review, we combine information on pathogen and host biology to understand the patterns of P. destructans spread, seasonal transmission ecology, the pathogenesis of white-nose syndrome and the cross-scale impact from individual hosts to ecosystems. Collectively, this research highlights how early pathogen detection and quantification of host impacts has accelerated the understanding of this newly emerging infectious disease.
Topics: Animals; Ascomycota; Chiroptera; Communicable Diseases, Emerging; Dermatomycoses; Ecosystem
PubMed: 33462478
DOI: 10.1038/s41579-020-00493-5 -
La Tunisie MedicaleDermatomycosis are fungal infections of the skin and/or phanera, which are often benign but can have an impact on the vital and functional prognosis in diabetic patients.
BACKGROUND
Dermatomycosis are fungal infections of the skin and/or phanera, which are often benign but can have an impact on the vital and functional prognosis in diabetic patients.
AIM
The aim of our work was to study the epidemiological, clinical and mycological profile of dermatomycosis in diabetic patients.
METHODS
This was a retrospective descriptive study carried out in the Parasitology-Mycology Laboratory of Charles-Nicolle Hospital over a three-year period (2016-2018). We collected diabetic patients who were referred for suspected dermatomycosis.
RESULTS
Dermatomycosis was confirmed in 799 of the 1007 diabetic patients referred to our laboratory (79.34%) and in 1055 lesions among the 1344 sites sampled (78.50%). Among patients with dermatomycosis, a female predominance was observed with a sex- ratio=0.83. The mean age of the patients was 57.11 [2-82]. The patients with type 2 diabetes were the most affected (86.35%) (p=0.038). The mean duration of lesion progression was 5.0±5.5 years. The most common dermatomycoses were toenail onychomycoses (59.62%), followed by fingernail onychomycoses (15.26%), plantar keratoderma (10.24%), and intertrigo in small skin folds (5.59%). Dermatophytes were the most frequently isolated fungi (80.1%; p<0.001), with predominance of Trichophyton rubrum (78.8%). Candida albicans was the most frequently isolated yeast (11.8%).
CONCLUSIONS
Dermatomycosis are common in diabetic patients. Although they are often benign, these fungal infections can engage the functional prognosis or even become life-threatening in case of diabetes. Mycological diagnosis is necessary in case of clinical suspicion in order to confirm the diagnosis, guide the treatment and avoid complications.
Topics: Diabetes Mellitus, Type 2; Female; Hospitals; Humans; Onychomycosis; Referral and Consultation; Retrospective Studies
PubMed: 35261020
DOI: No ID Found -
Mycopathologia Oct 2023Tinea capitis is an important superficial fungal infection with a global distribution. It mainly affects prepubertal children and is more common in males. Anthropophilic... (Review)
Review
Tinea capitis is an important superficial fungal infection with a global distribution. It mainly affects prepubertal children and is more common in males. Anthropophilic and zoophilic dermatophytes are responsible for most infections. The pathogen spectrum of tinea capitis varies across different regions and changes over time, and is influenced by multiple factors, such as economic development, changes in lifestyle, immigration and animal distribution. This review aimed to clarify the demographic and etiological characteristics of tinea capitis worldwide and determine the common trends of causative pathogens. By mainly analyzing the literature published from 2015 to 2022, we found that the incidence and demographic characteristics of tinea capitis remained generally stable. Zoophilic Microsporum canis, anthropophilic Trichophyton violaceum and Trichophyton tonsurans were the predominant pathogens. The pathogen spectra in different countries changed in different directions. In some countries, the main pathogen shifted to an anthropophilic dermatophyte, such as T. tonsurans, Microsporum audouinii or T. violaceum; in contrast, it shifted to a zoophilic agent, such as M. canis, in some other countries. Dermatologists are advised to continue monitoring the pathogen spectrum and implement preventive measures according to the reported changes.
Topics: Child; Male; Animals; Humans; Tinea Capitis; Microsporum; Dermatomycoses; Causality; Incidence; Trichophyton
PubMed: 37012556
DOI: 10.1007/s11046-023-00710-8 -
Journal of Drugs in Dermatology : JDD Dec 2023Despite the limited use of nystatin for tinea infections, physicians may continue to use it.
BACKGROUND
Despite the limited use of nystatin for tinea infections, physicians may continue to use it.
METHODS
We assessed the National Ambulatory Medical Care Survey for all to determine the extent of topical nystatin use in tinea infections.
RESULTS
Topical nystatin was used at 4.3% (2.1%, 6.0%) of all tinea infection visits. It was not used at visits with dermatologists and was most common among family medicine physicians (P=.02).
DISCUSSION
Physicians are continuing to use nystatin for the treatment of tinea infections. Dermatologists have discontinued this treatment regimen, whereas other specialties have an opportunity to further improve their knowledge in this regard. J Drugs Dermatol. 2023;22(12):e49-e50. doi:10.36849/JDD.5606e.
Topics: Humans; Nystatin; Arthrodermataceae; Tinea; Administration, Topical; Glucocorticoids
PubMed: 38051827
DOI: 10.36849/JDD.5606