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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 -
Medicina Clinica Oct 2005
Review
Topics: Antifungal Agents; Clinical Trials as Topic; Dermatomycoses; Humans
PubMed: 16216204
DOI: 10.1157/13079613 -
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 -
Nihon Ishinkin Gakkai Zasshi = Japanese... 2006Environments may act as reservoirs for pathogenic fungi, a determinant of the establishment of fungal infection, or an exacerbating factor of disease. In recent years,... (Review)
Review
Environments may act as reservoirs for pathogenic fungi, a determinant of the establishment of fungal infection, or an exacerbating factor of disease. In recent years, skin disease caused by geophilic fungi has been decreasing, while case reports of zoonoses from various animals are increasing. Outbreaks of anthropophilic T. tonsurans infection pose a problem to medical mycologists. Tinea pedis is the most common exogenous dermatomycosis in Japan. Although T. rubrum is presumed to be the dominant pathogen of this disease, T. mentagrophytes is detected more frequently from various environments, so far, the reason for this discrepancy has not been fully understood. The latest knowledge about the route of dermatophyte foot infection is as follows: (1) Dermatophyte propagules disseminated from patients may contaminate not only bath-mats but also wood floors, Japanese style mattings, concrete floors, slippers, cushions, etc., and from them adhere to healthy skin. (2) The agar stamping method can easily detect dermatophytes from the skin and the environment. (3) Propagules of T. mentagrophytes can survive for more than three months under certain conditions such as in rubber boots. (4) In order to eliminate dermatophytes gathered in socks and footwear, simple procedures (washing, bathing with hot water, or wiping with a towel) are all effective. (5) Prior application of an antifungal agent promptly eradicates dermatophyte propagules adhering to the skin from the environment. The author also mentioned the possibility of asymptomatic dermatophyte colonization, and the high prevalence of dysgeucia in oral carriers of Candida albicans.
Topics: Animals; Antifungal Agents; Dermatomycoses; Disease Reservoirs; Environment; Foot Dermatoses; Humans; Tinea Pedis; Zoonoses
PubMed: 16699484
DOI: 10.3314/jjmm.47.63 -
Medical Mycology Journal 2014
Topics: Arthrodermataceae; Dermatomycoses; Humans; Microscopy; Skin
PubMed: 25231229
DOI: 10.3314/mmj.55.j95 -
Mycoses Sep 2008Fungal infections of the skin and nails are a common global problem. The high prevalence of superficial mycotic infections shows that 20-25% of the world's population... (Review)
Review
Fungal infections of the skin and nails are a common global problem. The high prevalence of superficial mycotic infections shows that 20-25% of the world's population has skin mycoses, making these one of the most frequent forms of infection. Pathogens responsible for skin mycoses are primarily anthropophilic and zoophilic dermatophytes from the genera Trichophyton (T.), Microsporum (M.) and Epidermophyton (E.). There appears to be considerable inter- and intra-continental variability in the global incidence of these fungal infections. Trichophyton rubrum, T. interdigitale (mentagrophytes var. interdigitale), M. canis, M. audouinii, T. tonsurans and T. verrucosum are the most common, but the attack rates and incidence of specific mycoses can vary widely. Local socio-economic conditions and cultural practices can also influence the prevalence of a particular infection in a given area. For example, tinea pedis (athlete's foot) is more prevalent in developed countries than in emerging economies and is likely to be caused by the anthropophilic germ T. rubrum. In poorer countries, scalp infections (tinea capitis) caused by T. soudanense or M. audouinii are more prevalent. This review summarises current epidemiological trends for fungal infections and focuses on dermatomycosis of glabrous skin on different continents.
Topics: Adolescent; Adult; Arthrodermataceae; Child; Child, Preschool; Dermatomycoses; Female; Global Health; Humans; Incidence; Male; Prevalence
PubMed: 18783559
DOI: 10.1111/j.1439-0507.2008.01606.x -
Clinics in Dermatology 2021Over the past 10 years, the environmental and veterinary communities have sounded alarms over an insidious keratinophilous fungus, Pseudogymnoascus destructans, that has...
Over the past 10 years, the environmental and veterinary communities have sounded alarms over an insidious keratinophilous fungus, Pseudogymnoascus destructans, that has decimated populations of bats (yes, bats, chiropterans) throughout North America and, most recently, Northern China and Siberia. We as dermatologists may find this invasive keratinophilous fungus of particular interest, as its method of destruction is disruption of the homeostatic mechanism of the bat wing integument. Although it is unlikely that this pathogen will become an infectious threat to humans, its environmental impact will likely affect us all, especially as recent data have shown upregulation of naturally occurring coronaviruses in coinfected bats. Dermatologists are familiar with keratinophilous dermatophyte infections, but these rarely cause serious morbidity in individual patients and never cause crisis on a population basis. This contribution describes the effects of P destructans on both the individual and the population basis. Bringing the white-nose syndrome to the attention of human dermatologists and skin scientists may invite transfer of expertise in understanding the disease, its pathophysiology, epidemiology, treatment, and prevention.
Topics: Animals; Ascomycota; Biological Products; Chiroptera; Dermatomycoses; Humans
PubMed: 34272026
DOI: 10.1016/j.clindermatol.2020.07.005 -
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 -
Parassitologia Jun 2004Dermatomycosis are mycotic diseases of skin caused by a few mycetes: dermatophytes, and some opportunistic fungi as Malassezia, Candida (not C. albicans), Trichosporon,... (Review)
Review
Dermatomycosis are mycotic diseases of skin caused by a few mycetes: dermatophytes, and some opportunistic fungi as Malassezia, Candida (not C. albicans), Trichosporon, Rhodutorula, Cryptococcus or Aspergillus, Geotrichum, Alternaria, etc. Dermatophytes are a group of closely related filamentous fungi that invade keratinized tissue (skin, hair, nails) of humans and other animals and produce infection called dermatophytosis or ringworm or "tinea". The etiological agents of dermatophytosis are classified in three genera: Microsporum, Trichophyton and Epidermophyton (Deuteromycetes). On the basis of their primary habitat dermatophytes are divided in Anthropophilic dermatophytes (parasitic organisms that infect humans), Zoophilic dermatophytes (parasitic organisms that infect animals, but also humans: agents of zoonosis) and Geophilic dermatophytes (saprobic fungi associated with keratinous materials in soil). In the soil there are also structure associated with contagion, ("spore", "arthroconidium", or "clamydospore") of anthropophilic and zoophilic dermatophytes that may persist for years, in the environment, in hair or skin scales. Since on the skin of animals there are many saprobic organisms (Malassezia) and many fungi may infect the fur, it is important to make an accurate diagnosis. Dermatophytosis are communicable diseases acquired from infected animals or from fomites. Infections caused by dermatophytes is a ringworm. These infections may range from mild and superficial, almost subclinical, to a few areas of scaling to a highly inflammatory reaction with extensive areas of scarring and alopecia. Granuloma formations (mycetoma-like) may occur especially in cats. Dermatophytes, as filamentous fungi, undergo radial fungi: collection of skin material is best made by collecting the scales near the edges of the rings. Hairs are best sampled by plucking; a scalpel may be used to scrape scales; brushes have also been used. Sample materials are best transported in dry packet. The Wood's light may be used to identify infected fluorescent hairs. Direct microscopy, although false negative up to 50% of cases, is a highly efficient screening technique. Scraping and hairs should mixed to 10-15% KOH. Culture is a valuable adjunct to direct microscopy and is essential to identify more dermatophytes. A medium selective against most nondermatophytic moulds and bacteria is used as a primary isolation medium. Many typical isolates of common dermatophytes can be identified directly from primary isolation media. Identification characters include: colony pigmentation, texture, morphological structure (macroconidia, microconidia, spirals, pectinate branches, etc). Nutritional requiment, growth in special media, "in vitro" perforation, mating studies are procedures used to identify atypical isolates. Serological approaches have revealed difficulties. Many kinds of molecular biologic techniques have been made available for clinical diagnosis recently; almost all of these techniques involve the polymerase chain reaction (PCR).
Topics: Alopecia; Animals; Animals, Domestic; Antibodies, Fungal; DNA, Fungal; Dermatomycoses; Disease Vectors; Humans; Mycology
PubMed: 15305713
DOI: No ID Found -
Journal of Wildlife Diseases Apr 2023Emergent fungal pathogens in herpetofauna are a concern in both wild and captive populations. We diagnosed dermatomycosis by Paranannizziopsis australasiensis in two...
Emergent fungal pathogens in herpetofauna are a concern in both wild and captive populations. We diagnosed dermatomycosis by Paranannizziopsis australasiensis in two panther chameleons (Furcifer pardalis) and suspected it in eight others captured from an established free-living nonnative population in Florida, USA. Chameleons developed skin lesions following recent exposure to cold weather conditions while housed in captivity, approximately 10 mo after capture and 12 wk after being placed in outdoor enclosures. Affected animals were treated with oral voriconazole and terbinafine until most cases resolved; however, medications were ultimately discontinued. Paranannizziopsis australasiensis has not previously been described in chameleons, nor in animals originating from a free-ranging population in the USA. Although the source of P. australasiensis infection is uncertain, we discuss several scenarios related to the pet trade and unique situation of chameleon "ranching" present in the USA.
Topics: Animals; Florida; Lizards; Onygenales; Dermatomycoses
PubMed: 36996061
DOI: 10.7589/JWD-D-22-00018