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Medical Archives (Sarajevo, Bosnia and... Feb 2015Since the prevalence of skin mycotic infections is changing and is area depended we aimed to analyze the frequency of the skin myocotic infections and the appearance...
INTRODUCTION
Since the prevalence of skin mycotic infections is changing and is area depended we aimed to analyze the frequency of the skin myocotic infections and the appearance sites.
MATERIAL AND METHODS
There were involved 560 patients referred to the Dermatology Clinic of University Clinical Center of Kosova during a period of one year.
RESULTS
The mean age of our study group was around thirties with a predominance of female and rural patients. Although most of cases presented with single site disease localization, we observed the increase in number of cases with more than one site localization with age.
CONCLUSION
The increased prevalence skin mycotic infections, as well as more than one place of localization deserve a multidimensional approach.
Topics: Adult; Bosnia and Herzegovina; Dermatomycoses; Female; Humans; Male; Middle Aged; Prevalence; Rural Population
PubMed: 25870481
DOI: 10.5455/medarh.2015.69.58-59 -
Medical Mycology Journal 2013
Topics: Administration, Cutaneous; Anti-Inflammatory Agents; Antifungal Agents; Betamethasone; Dermatomycoses; Fungi; Humans; Morpholines; Ointments; Skin
PubMed: 23470946
DOI: 10.3314/mmj.54.1 -
Annales de Dermatologie Et de... Oct 2018Dermatomycoses are dermatological infections very commonly encountered in private dermatological practice since they affect up to one third of the population. However,... (Review)
Review
Dermatomycoses are dermatological infections very commonly encountered in private dermatological practice since they affect up to one third of the population. However, the symptoms are very often shared by other skin infections and disorders and may be highly atypical. It is thus impossible to make a diagnosis with any certainty on clinical grounds alone. For this reason, mycological diagnosis is essential to either confirm or rule out dermatomycosis, and is unavoidable when antifungal therapy is required for the treatment of ringworm of the scalp or beard, or for onychomycosis. It is also vital where therapy guided by the clinical appearance of lesions has failed or in the event of recurring skin lesions. Confirmation of mycosis enables antifungals to be initiated and a negative test warrants investigation for other underlying causes for the lesions seen. However, regardless of the mycological diagnostic technique employed, the quality of the results depends chiefly on the quality of sampling of the infected site, but also on the expertise of the microbiologist. Standard mycological testing remains the most informative, the least expensive and the sole examination capable of isolating the causative fungus irrespective of the type of mycosis, such as dermatophytosis, scytalidiosis, mould-induced ungual infection, candidiasis, or infections due to Malassezia sp. This is the only examination able to identify epidemiological variations. All other more recent techniques are either based upon simple demonstration of the fungal elements involved, without identification of the fungal species in question, or else they are reliant upon a fungal database that is generally highly incomplete.
Topics: Antifungal Agents; Dermatomycoses; Dermoscopy; Fungi; Humans; Mycological Typing Techniques; Mycology; Onychomycosis; Physical Examination; Scalp; Specimen Handling; Staining and Labeling
PubMed: 30143320
DOI: 10.1016/j.annder.2018.05.006 -
Mycoses Oct 2022The successful diagnosis of dermatomycosis depends on specimen collection. Dermatomycosis is sampled mainly for scales, but there is a lack of research on specimens of...
BACKGROUND
The successful diagnosis of dermatomycosis depends on specimen collection. Dermatomycosis is sampled mainly for scales, but there is a lack of research on specimens of blister fluid.
OBJECTIVES
To explore whether blister fluid can diagnose dermatomycosis and compare blister fluid and scale specimens for dermatomycosis diagnosis.
METHODS
From April to July 2021, we prospectively gathered 34 patients who needed to meet all inclusion criteria simultaneously and collected their blister fluid and scales as specimens. The two samples were tested by fluorescent stain microscopy, fungal culture and PCR, and the diagnosis results were compared.
RESULTS
The blister fluid sample's sensitivity, specificity and accuracy were 90%, 100% and 94.1%, respectively, whereas the scales sample were 60%, 100% and 76.5%, respectively. The positive likelihood ratios were >10 for both blister fluid and scales specimen, and the negative likelihood ratios were not <0.1. On the Youden's index, the blister fluid specimen was 90%, and the scales specimen was 60%. As for the diagnostic odds ratio, both of them were >1. By fungal culture, we detected 14 cases of fungi in blister fluid and eight in scales. On PCR, 22 cases of fungi in blister fluid and ten in scales were identified.
CONCLUSIONS
This study demonstrated that a sample of blister fluid had better sensitivity, accuracy and Youden's index in diagnosing dermatomycosis with blister fluid. Collection of blister fluid might compensate for the inadequacy of collecting only scales specimens for mycological testing.
Topics: Blister; Dermatomycoses; Humans; Polymerase Chain Reaction
PubMed: 35815924
DOI: 10.1111/myc.13494 -
Nihon Ishinkin Gakkai Zasshi = Japanese... 2006A statistical 30-year study of dermatomycosis in Sendai National Hospital (1968-1997) revealed many changes in the prevalent diseases: Tinea pedis and tinea unguium... (Review)
Review
A statistical 30-year study of dermatomycosis in Sendai National Hospital (1968-1997) revealed many changes in the prevalent diseases: Tinea pedis and tinea unguium constantly increased during this period, and the ratio of the former associated with nail infection finally reached 30% of all tinea pedis patients. On the contrary, tinea corporis and cruris showed a remarkable decreasing tendency. Patient age distribution of each disease also showed distinctive changes, generally increasing in the older generation and decreasing in the younger. The number of patients with tinea pedis and unguium gradually increased among the middle and older generations, with the peak of the age-distribution curve shifting upward year after year. On the other hand, cases of tinea cruris among the younger generation were few in the latest years, and middle-age patients remained at a low number. In the first stage of this study the kinds of atiologic dermatophytes consisted of multiple species, but after middle period the isolation of Epidermaphyton floccosum decreased. Microsporum canis appeared first in 1976 but in the recent several years has completely disappeared. In the last few years of the period studied Trichophyton rubrum and Trichophyton mentagrophytes were the only isolates found from among all types of dermatophytoses. Infantile candidiasis remarkably increased in 1970-1975 but thereafter decreased rapidlly. Candidial intertrigo also increased in the same period but did not decrease as much thereafter and continued at the same intermediate level. The number of other types of candidiases were not greatly changed throughout the 30-year period. Malassezia infection also showed no remarkable changes, and only 20 cases of sporothrichosis were found. One case of the deep seated form of cutaneous aspergillosis was found, and this was also true of chromomycosis caused by Fonceaea pedrosoi.
Topics: Arthrodermataceae; Candidiasis; Dermatomycoses; Hospitals; Humans; Japan; Malassezia; Sporotrichosis; Tinea Pedis
PubMed: 16465134
DOI: 10.3314/jjmm.47.5 -
The Australasian Journal of Dermatology Aug 2023The incidence and prevalence of recalcitrant cutaneous fungal infections is on the rise. Terbinafine-resistant Trichophyton has not only been widespread in India, but... (Review)
Review
The incidence and prevalence of recalcitrant cutaneous fungal infections is on the rise. Terbinafine-resistant Trichophyton has not only been widespread in India, but has also been reported in countries spread throughout the globe. Strains of yeasts such as Malassezia and Candida, which exist both as commensals and as pathogens to the human skin, have also been found to develop resistance to antifungals. Non-dermatophyte moulds which can colonize and infect damaged nails are especially difficult to treat, not only due to resistance, but also because of poor drug penetration of hard keratin. Psychosocial factors such as the indiscriminate broad-spectrum antifungal use in agriculture and in medicine, and poor adherence to hygienic measures to break the chain of infection contribute to the development of antifungal resistance. Such environments encourage fungi to develop various resistance mechanisms to withstand antifungal treatment. These include: (a) alteration of the drug target, (b) increasing efflux of drug/metabolites, (c) inactivation of drug, (d) bypass mechanisms or substitution of the pathway affected by the drug, (e) stress adaptation mechanisms and (f) biofilm formation. Understanding of such mechanisms and how they arise are crucial for development of new ways to prevent or overcome resistance. Novel antifungal treatments have recently been approved in the United States of America for treatment of vulvovaginal candidiasis. Ibrexafungerp (enfumafungin derivative) and oteseconazole (tetrazole) differ from their respective related drug classes of echinocandins and triazoles by having different structures, which lend these medicines advantage compared to traditional treatment by having a different binding site and more selectivity for fungi respectively. Other drugs designed to circumvent the known mechanisms of antifungal resistance are also at various phases of development. Concurrent measures at an institutional and individual level to address and limit inappropriate antifungal use to reduce development of antifungal resistance should be undertaken in a concerted effort to address this epidemic.
Topics: Female; Humans; Antifungal Agents; Echinocandins; Dermatomycoses; Terbinafine; Candidiasis, Vulvovaginal
PubMed: 37387447
DOI: 10.1111/ajd.14115 -
Revista Iberoamericana de Micologia 2013Diabetic patients are particularly susceptible to fungal infections due to modifications that occur in their immunological system. These modifications compromise natural...
BACKGROUND
Diabetic patients are particularly susceptible to fungal infections due to modifications that occur in their immunological system. These modifications compromise natural defences, such as skin and nails, especially from lower limbs.
AIMS
Assessing the presence of dermatomycosis in lower limbs of Portuguese diabetic patients followed on Podiatry consultation. Determination of possible predisposing factors and the most frequent fungal species associated with the cases are included in the study.
METHODS
A six-month prospective study was carried out in 163 diabetic patients with signs and symptoms of dermatomycosis followed by Podiatry at the Portuguese Diabetes Association in Lisbon. Samples from the skin and/or nails of the lower limbs were collected and demographic and clinical data of those patients were recorded.
RESULTS
Trichophyton rubrum was the most frequently isolated dermatophyte (12.1%), followed by Trichophyton mentagrophytes (7.7%) and Trichophyton tonsurans (4.4%). Our study showed positive associations between type 2 diabetes and the presence of dermatomycosis in the studied population (p=0.013); this association was also shown between the occurrence of dermatomycosis and the localization of the body lesion (p=0.000). No other predisposing factor tested was positively associated with infection (p>0.05).
CONCLUSIONS
Data on superficial fungal infections in diabetic patients are scarce in Portugal. This study provides information on the characterization of dermatomycosis in lower limbs of diabetic patients.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Candidiasis, Cutaneous; Child; Child, Preschool; Dermatomycoses; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Foot; Disease Susceptibility; Female; Foot Dermatoses; Fungi; Humans; Immunocompromised Host; Infant; Leg; Male; Middle Aged; Obesity; Occupations; Onychomycosis; Podiatry; Portugal; Referral and Consultation; Tinea Pedis; Trichophyton; Young Adult
PubMed: 23147514
DOI: 10.1016/j.riam.2012.09.007 -
The Indian Journal of Child Health Jul 1961
Topics: Child; Dermatomycoses; Humans; Infant
PubMed: 13722116
DOI: No ID Found -
Family Practice Dec 1999Diagnosing dermatomycosis from a clinical image is not always easy. Microscopy of a potassium hydroxide preparation (KOH-test) and culturing are seldomly used in general... (Comparative Study)
Comparative Study
BACKGROUND
Diagnosing dermatomycosis from a clinical image is not always easy. Microscopy of a potassium hydroxide preparation (KOH-test) and culturing are seldomly used in general practice. Cyanoacrylate surface skin scraping (CSSS) is a new diagnostic tool that may be useful and simple.
OBJECTIVES
We aimed to investigate the diagnostic value of signs and symptoms, the KOH-test and the CSSS, in patients with erythematosquamous skin lesions, using the culture as the gold standard. Our goal is to formulate an optimal algorithm for the diagnosis of mycosis, based on one or more of these tests and including both optimal accuracy and costs.
METHODS
Scales from 148 consecutive general practice patients were tested using a KOH-test, CSSS and culture. Clinical data were collected using a questionnaire.
RESULTS
Twenty-six (18%) positive fungal cultures were identified. The sensitivity of the clinical diagnosis was 81% and its specificity 45%; for the KOH-test, these figures were 12 and 93% respectively; and for the CSSS, 62 and 88%, respectively. The positive predictive value of the clinical diagnosis was 24% and the negative predictive value 92%; for the KOH-test these figures were 25 and 83%, respectively, and for the CSSS, 52 and 92%, respectively. Determining CSSS in all patients proved to be the most accurate policy (accuracy = 83%). The likelihood ratio of CSSS in all patients was 5.17 for a positive test result and 0.43 for a negative test result. An approach in which CSSS is obtained in only those patients whom the physician considers by clinical examination to have dermatomycosis, with no testing in other patients, results in positive and negative likelihood ratios of 4.69 and 0.56, respectively. Such a policy would result in an overall sensitivity of 50%, a specificity of 89%, a positive predictive value of 50% and a negative predictive value of 89%.
DISCUSSION
The clinical picture of dermatomycosis is not very reliable. The combination of a clinical judgement if this is negative and an additional CSSS in the case of a positive clinical judgement provides us with the best cost-benefit ratio, if both diagnostic accuracy and logistic considerations are taken into consideration.
Topics: Belgium; Cyanoacrylates; Dermatomycoses; Family Practice; Female; Health Surveys; Humans; Hydroxides; Incidence; Male; Potassium Compounds; Predictive Value of Tests; Risk Factors; Sensitivity and Specificity; Skin; Skin Tests; Surveys and Questionnaires; Tinea; Trichophyton
PubMed: 10625138
DOI: 10.1093/fampra/16.6.611 -
Journal of Veterinary Diagnostic... May 2016Chronic dermatomycosis was identified in 3 central bearded dragons (Pogona vitticeps), held as companion animals by the same owner. Clinical signs of dermatomycosis...
Chronic dermatomycosis was identified in 3 central bearded dragons (Pogona vitticeps), held as companion animals by the same owner. Clinical signs of dermatomycosis included subcutaneous masses as well as crusty, erosive, and ulcerative skin lesions. The facial region was affected in 2 of the 3 cases. Masses were surgically excised, and histology confirmed necrotizing and granulomatous inflammatory processes associated with fungal hyphae. Two of the bearded dragons were euthanized because of their deteriorating condition. In both cases, postmortem histology confirmed systemic fungal infections despite treatment of 1 animal with itraconazole. In the third bearded dragon, therapy with voriconazole at 10 mg/kg was initially effective, but mycotic lesions reappeared 15 months later. Nannizziopsis chlamydospora was identified by PCR and subsequent DNA sequencing in 2 of these cases.
Topics: Animals; Antifungal Agents; Chrysosporium; Dermatomycoses; Diagnosis, Differential; Euthanasia, Animal; Female; Itraconazole; Lizards; Male
PubMed: 26951329
DOI: 10.1177/1040638716636422