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Frontiers in Microbiology 2021Dermatophytes are a homogeneous group of species with low genetic diversity, and there are still many uncertainties about the boundaries among species.
BACKGROUND
Dermatophytes are a homogeneous group of species with low genetic diversity, and there are still many uncertainties about the boundaries among species.
OBJECTIVES
Aiming at clarifying the relationships among species in the genus and introducing suitable genes for multilocus sequence typing (MLST), a new MLST scheme approach was developed to characterize the major pathogenic dermatophytes.
METHODS
We performed maximum parsimony (MP), MrBayes, RAxML, and eBURST analyses, based on the MLST scheme to scrutinize the evolution within 95 clinical isolates and four reference strains belonging to the four major dermatophytes species. Then, the discriminatory power, pairwise genetic distances, ratio dN/dS, and sequence types (STs) of these isolates were determined. Also, to study taxonomy, sequences of the internal transcribed spacer (ITS), ( and -α (α) genes of other dermatophytes species available in the GenBank were analyzed.
RESULTS
Findings of the present study indicated that three genes: , ITS, and α, which showed the greatest diversity among dermatophyte species, were suitable for MLST. The most prevalent STs were seen among the species of . Also, two new genotypes, i.e., XXVII and XXVIII, were introduced for and . The least informative sites were found in , , and , while the most informative sites were observed in . Furthermore, the most informative locus was α. The phylogenetic tree, constructed by the combination of the three genes, shows a new topological pattern that confirms the derivation of the anthropophilic and zoophilic genera from the geophilic genus. Also, the phylogenetic analyses and pairwise distances of the combination of the three loci showed that and were a species complex, where is derived from .
CONCLUSIONS
Results of this study showed that MLST is very effective in determining the boundaries between species and taxonomy. Considering that there is no database for MLST dermatophytes, further studies are needed to determine the suitable genes for MLST. Also, the determination of STs in epidemiological studies and raising epidemiological information are helpful. This study was a new starting point to determine the ST and a foundation for a dermatophyte MLST database.
PubMed: 34149634
DOI: 10.3389/fmicb.2021.643509 -
Journal of Fungi (Basel, Switzerland) Mar 2023Pediatric tinea capitis displays a wide range of prevalence, with significant variability among populations. We retrospectively extracted the medical records of 456...
Pediatric tinea capitis displays a wide range of prevalence, with significant variability among populations. We retrospectively extracted the medical records of 456 pediatric patients diagnosed with tinea capitis during the years 2010-2021, from the dermatology outpatient clinics in two tertiary medical centers. Three species were isolated in 90% of patients: , , and While presented a six-fold increase in incidence during the years 2019-2021, maintained stable incidence rates. Furthermore, terbinafine was the most efficient antifungal agent against , achieving complete clinical clearance in 95% of patients, as compared to fluconazole (68%) and griseofulvin (38%) ( < 0.001). The mycological cure was recorded in 61/90 (68%) of patients with available data, at an average of 10 weeks. For patients with , griseofulvin and fluconazole were equally efficient (73% and 66%, respectively) ( = 0.44). Kerion was described in 36% and 14% of patients with and , respectively, ( < 0.001). In conclusion, since 2019, there has been a significant increase in the prevalence of , establishing this pathogen as the most common cause for tinea capitis in our population. Our data suggest that terbinafine is effective and presents high cure rates for tinea capitis in the pediatric population.
PubMed: 36983534
DOI: 10.3390/jof9030366 -
Clinical, Cosmetic and Investigational... 2022This work aimed to determine the magnitude of tinea capitis, the diversity and species composition of fungi, and the predominant dermatophytes implicated in causing...
OBJECTIVE
This work aimed to determine the magnitude of tinea capitis, the diversity and species composition of fungi, and the predominant dermatophytes implicated in causing tinea capitis.
METHODS
A prospective, cross-sectional study was conducted at a dermatology clinic. Scalp scrapings were collected and cultured, and dermatophyte and non-dermatophyte molds were identified.
RESULTS
Of 364 scalp scrapings, fungi were recovered from 301 (82.7%) clinical samples. About 60.7% of the samples were collected from women, while 39.3% were collected from male study subjects. The association between the magnitude of scalp ringworm and gender was not statistically significant ( = 0.105). Two hundred eighty study subjects were less than 15 years of age, of which 254 were culture positive. The association of tinea capitis and the age of patients was statistically significant ( = 0). Three hundred forty-nine fungal isolates were isolated, of which 54.2% were dermatophytes, while 45.8% were non-dermatophyte molds. The occurrence of dermatophytes in their decreasing order was (138; 73%), (18; 9.5%), (16; 8.5%), (8; 4.5%), (7; 3.7%), (1; 0.5%), and (1; 0.5%).
CONCLUSION
A high prevalence rate of -induced tinea capitis was reported. The magnitude of scalp ringworm in adults was remarkably high. Therefore, conducting a nationwide epidemiological survey on tinea capitis regardless of age is suggested. The isolation of many non-dermatophyte molds in the current study may shade questions about the perception that tinea capitis is caused by dermatophytes only. Therefore, studies on their potential pathogenic role on skin and skin-related (nail and the scalp) infections appear to be an active field of research.
PubMed: 35847420
DOI: 10.2147/CCID.S367763 -
Cureus Jan 2022Fungal infections may occur within tattoos. These include not only dermatophyte infections (tattoo-associated tinea) but also systemic mycoses (tattoo-associated...
Fungal infections may occur within tattoos. These include not only dermatophyte infections (tattoo-associated tinea) but also systemic mycoses (tattoo-associated systemic fungal infections). The PubMed search engine, accessing the MEDLINE database, was used to search for all papers with the terms: (1) tinea and tattoo, and (2) systemic fungal infection and tattoo. Tattoo-associated tinea corporis has been observed in 12 individuals with 13 tattoos; this includes the 18-year-old man who developed a dermatophyte infection, restricted to the black ink, less than one-month after tattoo inoculation on his left arm described in this report. Tattoo-associated tinea typically occurred on an extremity in the black ink. The diagnosis was established either by skin biopsy, fungal culture, and/or potassium hydroxide preparation. The cultured dermatophytes included , , , , and . Several sources for the tinea were documented: autoinfection (two patients), anthrophilic (tinea capitis from the patient's son), and zoophilic (either the patient's cat or dog). Three patients presented with tinea incognito resulting from prior corticosteroid treatment. Tinea appeared either early (within one month or less after inoculation during tattoo healing) in six patients or later (more than two months post-inoculation in a healed tattoo) in six patients. Injury to the skin from the tattoo needle, or use of non-sterile instruments, or contaminated ink, and/or contact with a human or animal dermatophyte source are possible causes of early tinea infection. Tattoo ink-related phenomenon (presence of nanoparticles, polycyclic aromatic hydrocarbons, and cytokine-enhancement) and/or the creation of an immunocompromised cutaneous district are potential causes of late tinea infection. Treatment with topical and/or oral antifungal agents provided complete resolution of the dermatophyte for all the patients with tattoo-associated tinea. Tattoo-associated systemic fungal infection has been reported in six patients: five men and one patient whose age, sex, immune status, and some tattoo features (duration, color, and treatment) were not reported. The onset of infection after tattoo inoculation was either within less than one month (two men), three months (two men), or 69 months (one man). The tattoo was dark (either black or blue) and often presented as papules (three men) or nodules (two men) that were either individual or multiple and intact or ulcerated. The lesion was asymptomatic (one man), non-tender (one man), or painful (one man). The systemic fungal organisms included species, , , , and . Contaminated tattoo ink was a confirmed cause of the systemic fungal infection in one patient; other postulated sources included non-professional tattoo inoculation, infected tattooing tool and/or ink in an immunosuppression host, and contaminated ritual tattooing instruments and dye. Complete resolution of the tattoo-associated systemic fungal infection occurred following systemic antifungal drug therapy. In conclusion, several researchers favor that tattoo inoculation can be implicated as a causative factor in the development of tattoo-associated tinea; however, in some of the men, tattoo-associated systemic fungal infection may have merely been coincidental.
PubMed: 35174019
DOI: 10.7759/cureus.21210 -
Medical Mycology Journal 2023This is a report of the results of the epidemiological survey on dermatomycoses conducted in 2021. A total of 9,442 patients with dermatomycosis were reported for one...
This is a report of the results of the epidemiological survey on dermatomycoses conducted in 2021. A total of 9,442 patients with dermatomycosis were reported for one year. They include 8,151 (86.3%) with dermatophytosis, 796 (8.4%) with candidiasis, 484 (5.1%) with Malassezia infection, and 11 (0.1%) with deep cutaneous mycosis. In order, the most common types of dermatophytoses were tinea pedis (4,195 cases, 2,341 males and 1,854 females), tinea unguium (2,711 cases, 1,509 males and 1,202 females), tinea corporis (674 cases, 445 males and 229 females), tinea cruris (399 cases, 305 males and 94 females), tinea manus (125 cases, 78 males and 47 females), and tinea capitis (47 cases, 25 males and 22 females). The number of cases of tinea pedis and tinea unguium increased during the summer. A higher percentage of patients were aged 80 or older than in previous surveys. These findings may reflect the increasing percentage of elderly patients seen and the superannuation of the population. As in previous surveys, Trichophyton rubrum and Trichophyton interdigitale were the two most frequently isolated species of fungi causing dermatophytoses. Microsporum canis and Trichophyton tonsurans were the two species most often causing tinea capitis.Regarding cutaneous candidiasis, while candidal intertrigo was the most common in previous surveys, diaper candidiasis in the elderly was the most common in this survey. A background check revealed that this was because a facility included a semi-prophylactic approach to address diaper candidiasis occurring within the ward.Malassezia infections by Malassezia folliculitis clearly increased with each survey. The tendency of certain facilities with many reports of Malassezia folliculitis suggests that it is greatly affected by the presence of physicians familiar with the disease.
Topics: Male; Aged; Female; Humans; Tinea Pedis; Dermatomycoses; Onychomycosis; Japan; Tinea; Candidiasis, Cutaneous; Tinea Capitis; Candidiasis; Folliculitis; Trichophyton
PubMed: 38030276
DOI: 10.3314/mmj.23-00008 -
Frontiers in Cellular and Infection... 2022Drug resistance is one of the major challenges to skin fungal infections, especially in tropical and subtropical infections caused by dermatophytes. This study aimed to...
Drug resistance is one of the major challenges to skin fungal infections, especially in tropical and subtropical infections caused by dermatophytes. This study aimed to determine the antifungal susceptibility of clinically dermatophytes and evaluate point mutations in terbinafine-resistant isolates. A total number of 123 clinical dermatophyte isolates in eight species were evaluated in terms of sensitivity to seven major antifungals. Furthermore, the point mutation in squalene epoxidase () gene responsible for terbinafine resistance was studied. The dermatophytes species were identified by morphological characteristics and confirmed by the ITS sequencing. Also, the phylogenetic tree was drawn using the RAxML analyses for 123 dermatophytes isolates. A new XXIX genotype was also found in 4 isolates. Based on the results obtained, terbinafine was the most effective antifungal drug followed by itraconazole and voriconazole. and were the most susceptible species (MIC = 0.01, 0.09 μg/ml), and was the most resistant species (MIC = 0.125 μg/ml) to terbinafine. Of the 123 dermatophytes isolates, six isolates showed reduced susceptibility to terbinafine, and only had a mutation in gene as a Phe397Leu substitution. Overall, the antifungal susceptibility test is necessary for managing dermatophytosis. These results help physicians to control the course of the disease and provide further insights to select effective drugs for patients with dermatophytosis, especially in tropical and subtropical regions of the world, where dermatophytosis is still a public health problem.
Topics: Antifungal Agents; Arthrodermataceae; Drug Resistance, Fungal; Humans; Microbial Sensitivity Tests; Phylogeny; Point Mutation; Squalene Monooxygenase; Tinea
PubMed: 35372131
DOI: 10.3389/fcimb.2022.851769 -
Indian Journal of Dermatology 2021Chronic dermatophytosis refers to persistent or recurrent episodes of dermatophytosis lasting for more than 1 year despite adequate treatment with topical and systemic...
BACKGROUND
Chronic dermatophytosis refers to persistent or recurrent episodes of dermatophytosis lasting for more than 1 year despite adequate treatment with topical and systemic antifungal agents. The rise in the number of these cases is alarming over the past 5 to 6 years, and a thorough knowledge about the reasons for chronicity of dermatophytosis may go a long way in the treatment and prevention of this infection.
AIMS AND OBJECTIVES
The aim of this study was to investigate the epidemiology, various clinical types, and factors associated with chronicity in patients with chronic dermatophytosis, and to isolate the etiological agents and study the clinicomycological correlation.
MATERIALS AND METHODS
Detailed history and clinical details of all patients with chronic dermatophytosis who presented to our tertiary care center over a span of 1 year were recorded. Skin scrapings from these patients were subjected to potassium hydroxide mount and culture in modified Sabouraud's dextrose agar medium.
RESULTS
Sixty-four patients were enrolled in this study with a mean age of 44.5 years. The mean duration of infection was 3.14 years. Tinea corporis was the most common clinical type seen in 46 (71.9%) patients, affecting commonly the waist area in females and the back in males. Bronchial asthma was the most frequent systemic association affecting 20 (31.3%) patients followed by diabetes mellitus, which was present in 13 (20.3%) patients. About 34% patients had a history of long-term steroid use. Among the 28 isolates, was the most frequent species isolated (46.4%), followed by (39.3%). and were isolated from two patients each.
CONCLUSION
Extensive area of involvement, atopy, diabetes, and long-term use of systemic corticosteroids were associated with chronicity. Unlike in the yesteryears, has emerged as the most common etiological agent of chronic dermatophytosis.
PubMed: 34759422
DOI: 10.4103/ijd.IJD_539_20 -
Plants (Basel, Switzerland) Sep 2019Although orthodox medications are available for skin diseases, expensive dermatological services have necessitated the use of medicinal plants as a cheaper alternative....
Although orthodox medications are available for skin diseases, expensive dermatological services have necessitated the use of medicinal plants as a cheaper alternative. This study evaluated the pharmacological and phytochemical profiles of four medicinal plants (, , , and ) used for treating skin diseases. Petroleum ether and 50% methanol extracts of the plants were screened for antimicrobial activity against six microbes: , , , , and using the micro-dilution technique. Antioxidant activity was conducted using 2,2-diphenyl-1-picryhydrazyl (DPPH) free radical scavenging and β-carotene linoleic acid models. Cytotoxicity was determined against African green monkey Vero kidney cells based on the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) colorimetric assay. Spectrophotometric and Gas Chromatography-Mass Spectrometry (GC-MS) methods were used to evaluate the phytochemical constituents. All the extracts demonstrated varying degrees of antimicrobial potencies. , and were most susceptible at 0.10 mg/mL. In the DPPH test, EC values ranged from approximately 6-93 µg/mL and 65%-85% antioxidant activity in the β-carotene linoleic acid antioxidant activity model. The phenolic and flavonoid contents ranged from 3.5-64 mg GAE/g and 1.25-28 mg CE/g DW, respectively. The LC values of the cytotoxicity assay ranged from 0.015-5622 µg/mL. GC-MS analysis revealed a rich pool (94-198) of bioactive compounds including dotriacontane, benzothiazole, heptacosane, bumetrizole, phthalic acid, stigmasterol, hexanoic acid and eicosanoic acid, which were common to the four plants. The current findings provide some degree of scientific evidence supporting the use of these four plants in folk medicine. However, the plants with high cytotoxicity need to be used with caution.
PubMed: 31540194
DOI: 10.3390/plants8090350 -
International Journal of Infectious... Aug 2020
PubMed: 32497801
DOI: 10.1016/j.ijid.2020.05.116 -
Biomedica : Revista Del Instituto... Aug 2023Introduction. Tinea capitis is a mycosis of keratinized tissue, which affects the scalp and may cause alopecia, pruritus, and desquamation. This type of mycosis is more...
Introduction. Tinea capitis is a mycosis of keratinized tissue, which affects the scalp and may cause alopecia, pruritus, and desquamation. This type of mycosis is more frequent in school-age children, and it may represent a public health problem; the main etiological agents reported for Colombia are zoophilic dermatophytes. Objective. To characterize an outbreak of Tinea capitis in 32 children from a rural school in the department of Cauca. Materials and methods. We conducted an epidemiological field study using a structured survey to characterize sociodemographic aspects and predisposing factors for this mycosis. We collected samples of affected scalp scales and hair for mycological studies. The children and the general population received recommendations, about these mycoses’ prevention, from Cauca’s health authorities and the local hospital. The parents verbally approved the informed consent. Results. The etiological agent isolated in 63% of the collected samples was Trichophyton tonsurans, an anthropophilic dermatophyte, and the main predisposing factor was sharing razors (87.5%). Conclusions. Ideally, mycological studies define the etiological agent to propose therapeutics and recommendations in agreement with management guidelines. Implementation of multidisciplinary measures to control the outbreak and educate the population is required.
Topics: Child; Humans; Colombia; Tinea Capitis; Disease Outbreaks; Hair; Public Health
PubMed: 37721918
DOI: 10.7705/biomedica.6793