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Recent Patents on Inflammation &... 2020Tinea capitis is a common and, at times, difficult to treat, fungal infection of the scalp. (Review)
Review
BACKGROUND
Tinea capitis is a common and, at times, difficult to treat, fungal infection of the scalp.
OBJECTIVE
This article aimed to provide an update on the evaluation, diagnosis, and treatment of tinea capitis.
METHODS
A PubMed search was performed in Clinical Queries using the key term "tinea capitis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature. The information retrieved from the above search was used in the compilation of the present article. Patents were searched using the key term "tinea capitis" at www.freepatentsonline.com.
RESULTS
Tinea capitis is most often caused by Trichophyton tonsurans and Microsporum canis. The peak incidence is between 3 and 7 years of age. Non-inflammatory tinea capitis typically presents as fine scaling with single or multiple scaly patches of circular alopecia (grey patches); diffuse or patchy, fine, white, adherent scaling of the scalp resembling generalized dandruff with subtle hair loss; or single or multiple patches of well-demarcated area (s) of alopecia with fine-scale, studded with broken-off hairs at the scalp surface, resulting in the appearance of "black dots". Inflammatory variants of tinea capitis include kerion and favus. Dermoscopy is a highly sensitive tool for the diagnosis of tinea capitis. The diagnosis can be confirmed by direct microscopic examination with a potassium hydroxide wetmount preparation and fungal culture. It is desirable to have mycologic confirmation of tinea capitis before beginning a treatment regimen. Oral antifungal therapy (terbinafine, griseofulvin, itraconazole, and fluconazole) is considered the gold standard for tinea capitis. Recent patents related to the management of tinea capitis are also discussed.
CONCLUSION
Tinea capitis requires systemic antifungal treatment. Although topical antifungal therapies have minimal adverse events, topical antifungal agents alone are not recommended for the treatment of tinea capitis because these agents do not penetrate the root of the hair follicles deep within the dermis. Topical antifungal therapy, however, can be used to reduce transmission of spores and can be used as adjuvant therapy to systemic antifungals. Combined therapy with topical and oral antifungals may increase the cure rate.
Topics: Administration, Oral; Administration, Topical; Animals; Antifungal Agents; Child; Child, Preschool; Dermoscopy; Humans; Patents as Topic; Randomized Controlled Trials as Topic; Tinea Capitis
PubMed: 31906842
DOI: 10.2174/1872213X14666200106145624 -
Italian Journal of Dermatology and... Apr 2022Tinea corporis gladiatorum (TCG) is a variety of tinea corporis transmitted by repeated and close skin contacts among athletes, in particular wrestlers and judokas....
Tinea corporis gladiatorum (TCG) is a variety of tinea corporis transmitted by repeated and close skin contacts among athletes, in particular wrestlers and judokas. Trichophyton tonsurans is the most frequently isolated dermatophyte. Cases of TCG were reported in USA, Iran, Japan, Turkey and France, where wrestling or judo are popular. No cases of TCG were reported in Italy. The typical clinical presentation of tinea corporis is not always present in TCG: a bacterial folliculitis-like appearance is not rare. Fluconazole is the therapy of choice.
Topics: Athletes; Humans; Iran; Skin; Tinea; Wrestling
PubMed: 33913669
DOI: 10.23736/S2784-8671.21.06903-0 -
Medical Mycology Journal 2023Trichophyton tonsurans infection has been prevalent among individuals involved in contact sports in Japan since about 2000. The present review focuses on its diagnosis,... (Review)
Review
Trichophyton tonsurans infection has been prevalent among individuals involved in contact sports in Japan since about 2000. The present review focuses on its diagnosis, molecular epidemiology, drug susceptibility, and infection control. The most commonly observed lesions of T. tonsurans, an anthropogenic dermatophyte, are tinea corporis and tinea capitis. However, the presence of asymptomatic carriers must be considered for infection control. Genotypic epidemiology using restriction fragment length polymorphisms (RFLP) in the non-transcribed spacer (NTS) region of the ribosomal RNA gene showed a lack of diversity of genotypes, and only the NTS I genotype is detected at present. In regard to drug susceptibility, terbinafine drug resistance has not been found to be associated with the RFLP genotypes, and it is assumed that there are no terbinafine-resistant strains in Japan. T. tonsurans coexisted with other fungi and bacteria in the scalp of asymptomatic carriers without affecting species diversity. T. tonsurans is an anthropogenic dermatophyte and may be difficult for the human immune system to eliminate. During an infection outbreak, screening of infection and treatment including asymptomatic carriers are essential to eradicate the infection.
Topics: Humans; Tinea; Tinea Capitis; Genotype
PubMed: 37648498
DOI: 10.3314/mmj.23-001 -
Journal of Clinical Medicine Jul 2022Tinea gladiatorum (TG) is a fungal skin infection that occurs among wrestlers and other contact sport athletes with a varied prevalence rate. The most common causative... (Review)
Review
Tinea gladiatorum (TG) is a fungal skin infection that occurs among wrestlers and other contact sport athletes with a varied prevalence rate. The most common causative factor responsible as well for local outbreaks of the infection is an anthropophilic dermatophyte species- (). The purpose of this study was to gather current data about TG, including epidemiology, possible diagnosing methods, clinical features, treatment approaches, and potential prevention techniques. We also performed a systematic review of studies describing TG incidence. The prevalence of the disease varied from 2.4% up to 100%. That wide range of variability forces medical practitioners to update knowledge about TG and points to the fact that it still may be a diagnostic and therapeutic challenge. Spreading awareness among athletes and trainers is one of the most important preventive steps.
PubMed: 35887830
DOI: 10.3390/jcm11144066 -
Frontiers in Microbiology 2021Dermatophytes are a group of molds characterized by the ability to produce keratinases, thereby carving out for themselves specific ecological niches. Their traditional... (Review)
Review
INTRODUCTION
Dermatophytes are a group of molds characterized by the ability to produce keratinases, thereby carving out for themselves specific ecological niches. Their traditional division into three genera, , , and has been expanded to nine and the species in each genus were modified. Dermatophytes are among the most prevalent causes of human and animal mycoses. Their epidemiology is influenced by various factors. These factors may be evolutive such as the predilected environment of the fungus, namely, humans (anthropophilic), animals (zoophilic), or environment (geophilic), is evolutionary and thus may require centuries to develop. Many other factors, however, result from a variety of causes, affecting the epidemiology of dermatophytoses within a shorter time frame.
OBJECTIVE
This review aims at summarizing the factors that have modified the epidemiology of dermatophytoses during the last decades.
RESULTS
Geographic and climatic conditions, demography such as age and gender, migration, socio-economic conditions, lifestyle, and the environment have had an impact on changes in the epidemiology of dermatophytoses, as have changes in the pattern of human interaction with animals, including pets, farm, and wild animals. A typical example of such changes is the increased prevalence of , which spread from Latin America to the United States and subsequently becoming a frequent etiological agent of tinea capitis in Africa, Middle East, and other areas.
CONCLUSION
The comprehension of the epidemiology of dermatophytoses has a major bearing on their prevention and treatment. Since it is undergoing continuous changes, periodic assessments of the most recent developments of this topic are required. This article aims at providing such an overview.
PubMed: 34421872
DOI: 10.3389/fmicb.2021.713532 -
Mycopathologia Feb 2020The anthropophilic dermatophyte Trichophyton tonsurans and its zoophilic counterpart T. equinum are phylogenetically closely related. The barcoding marker rDNA internal...
The anthropophilic dermatophyte Trichophyton tonsurans and its zoophilic counterpart T. equinum are phylogenetically closely related. The barcoding marker rDNA internal transcribed spacer (ITS) shows limited variation between these two species. In the current study, we combined molecular approaches with phenotypic data to determine the species boundaries between T. tonsurans (n = 52) and T. equinum (n = 15) strains originating from humans (n = 40), horses (n = 26), and a mouse (n = 1). Culture characteristics and physiology on Trichophyton agar media 1 and 5 were evaluated. Multi-locus sequencing involving ITS, partial large rDNA subunit (LSU), β-tubulin (TUB), 60S ribosomal protein (RPB), and translation elongation factor-3 (TEF3) genes, and the mating-type (MAT) locus was performed. Amplified fragment length polymorphism data were added. None of the test results showed complete mutual correspondence. With the exception of strains from New Zealand, strains of equine origin required niacin for growth, whereas most strains from human origin did not show this dependence. It is concluded that T. tonsurans and T. equinum incompletely diverged from a common lineage relatively recently. MAT1-1 and MAT1-2 are the main distinguishing genes between the two species.
Topics: Amplified Fragment Length Polymorphism Analysis; Animals; Biodiversity; DNA, Ribosomal; Genes, Mating Type, Fungal; Horses; Humans; Mice; Multilocus Sequence Typing; Trichophyton
PubMed: 31278475
DOI: 10.1007/s11046-019-00344-9 -
Medical Mycology Jan 2022Trichophyton tonsurans is a cosmopolitan dermatophyte, highly prevalent in Africa, South America, and endemic in North America, where it is mostly related to cases of...
UNLABELLED
Trichophyton tonsurans is a cosmopolitan dermatophyte, highly prevalent in Africa, South America, and endemic in North America, where it is mostly related to cases of tinea capitis. Recently, it was also reported in Chile for the first time in two outbreaks occurred in Santiago. In the present study, we sequenced the variable internal repeat (VIR) region of a Chilean isolate and compared its genotype with those of several global T. tonsurans isolates. The results showed that the Chilean isolate presented a new genotype which was strictly correlated with isolates from Europe, USA and Mexico.
LAY SUMMARY
Trichophyton tonsurans is a fungus able to cause superficial mycosis infecting skin and hair. It is an emerging pathogen worldwide and some cases were recently reported also in Chile for the first time. We investigated by molecular techniques which geographical area could be the source of infections.
Topics: Arthrodermataceae; Chile; Genotype; Humans; Tinea Capitis; Trichophyton
PubMed: 34919706
DOI: 10.1093/mmy/myab077 -
The Journal of Dermatology Jul 2022Trichophyton tonsurans is the most prevalent fungus which causes dermatophytosis among contact sports players in Japan. We previously surveyed the epidemic of...
Trichophyton tonsurans is the most prevalent fungus which causes dermatophytosis among contact sports players in Japan. We previously surveyed the epidemic of T. tonsurans in Japan from early 2000, and determined the genotypes of isolates by analysis of restriction enzyme fragment length polymorphisms in the non-transcription spacer (NTS) region of ribosomal RNA gene, which enabled discrimination of eight genotypes, namely NTS I to NTS VIII. In the present study, we performed genotyping of T. tonsurans isolated between 2016 and 2020, and investigated the trend of the epidemic and resistance of the pathogen to antibiotic terbinafine (TBF). Regardless of which contact sport they played, the genotype of all 123 strains of T. tonsurans isolated from athletes was NTS I. Genotypes NTS II and III, which were isolated in considerable numbers mainly from wrestlers between 2000 and 2015, were conspicuously absent. TBF susceptibility was screened in 237 T. tonsurans strains isolated between 2000 and 2020 with 28 of these further assessed for minimum inhibitory concentration of TBF and squalene epoxidase gene sequences. None of the strains showed TBF resistance. TBF may still be effective to control the epidemic of T. tonsurans.
Topics: Antifungal Agents; Arthrodermataceae; Genotype; Humans; Japan; Terbinafine; Trichophyton
PubMed: 35411639
DOI: 10.1111/1346-8138.16387 -
Mycoses Feb 2023Trichophyton tonsurans tinea capitis has become a growing epidemiological concern. Yet, its clinical manifestations and treatment response, specifically among adults,...
BACKGROUND
Trichophyton tonsurans tinea capitis has become a growing epidemiological concern. Yet, its clinical manifestations and treatment response, specifically among adults, have only been described among small sample size studies.
OBJECTIVE
To assess clinical manifestations and treatment outcome of T. tonsurans tinea capitis among adults.
PATIENTS AND METHODS
A retrospective cohort study was carried out among 111 adults with T. tonsurans tinea capitis. Diagnosis was confirmed by fungal culture or polymerase chain reaction. Examinees' demographics, disease characteristics and treatment response were measured. The risk factors for the treatment failure were evaluated.
RESULTS
The mean age was 20.1 years (±3.1), with men (98.2%) outnumbering women. The follow-up lasted 12.2 months (±5.6). The majority of T. tonsurans tinea capitis was seen in the occipital area (87.6%). In 78.9% of the cases, the scalp manifestation was non-inflammatory (scaly plaques and papules:76.1% and seborrhoea-like: 2.8%). 21.1% of cases presented with inflammatory tinea capitis (21.1%; Kerion: 10.1% and pustular: 11%). Concomitant involvement of other than scalp areas was common: tinea corporis was seen in 38.7% of the cases; tinea faciei and barbae in 24.3%; nape and anterior neck in 76.6% and 2.7% of the cases, respectively. An adequate treatment course with oral terbinafine resulted in 83.2% clinical cure rate. Treatment failure was significantly associated with concomitant tinea corporis (odds ratio 3.9; 95% confidence interval 1.3-12.1, p-Value< .02).
CONCLUSION
The most common clinical presentation of T. tonsurans tinea capitis included occipital scaly plaques and papules with concomitant non-scalp lesions. Oral terbinafine was found to be highly effective. Concomitant tinea corporis increased the risk for treatment failure.
Topics: Male; Adult; Female; Humans; Young Adult; Terbinafine; Retrospective Studies; Trichophyton; Tinea Capitis; Tinea
PubMed: 36219520
DOI: 10.1111/myc.13536 -
Indian Dermatology Online Journal 2022Tinea pseudoimbricata is a variant of dermatophytosis characterized morphologically by concentric scaly rings resembling tinea imbricata with an culture isolate other...
INTRODUCTION
Tinea pseudoimbricata is a variant of dermatophytosis characterized morphologically by concentric scaly rings resembling tinea imbricata with an culture isolate other than Trichophyton concentricum. To date, no large case report series is available.
AIM
To study the clinical profile and the fungus isolated in patients with tinea pseudoimbricata.
MATERIALS AND METHODS
In this case series, all the patients with tinea imbricata with an isolate other than Trichophyton concentricum were subjected to a detailed history and clinical examination. Scrapings of the scales were investigated with potassium hydroxide examination and culture in Sabouraud Dextrose Agar enriched with cycloheximide and chloramphenicol. The results obtained were tabulated and analyzed.
RESULTS
A total of 42 patients fulfilling the above culture criteria were included in the present study. A majority were in the age group of 21-40 years (54.70%) with a male preponderance (M:F = 2:1). All the patients had abused steroids for more than 4 weeks and had multiple site involvement. Trichophyton tonsurans (42.8%) was the predominant isolate cultured, followed by Trichophyton mentagrophytes.
CONCLUSION
Hence, as per our study, tinea pseudoimbricata is encountered more often nowadays due to the misuse of topical steroids and to diagnose tinea pseudoimbricata culture is mandatory. The morphology of concentric rings is not restricted to Trichophyton concentricum, but can occur with other species depending on the clinical scenario.
PubMed: 35198471
DOI: 10.4103/idoj.IDOJ_832_20