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American Family Physician Jan 2003Dermatophytes are fungi that require keratin for growth. These fungi can cause superficial infections of the skin, hair, and nails. Dermatophytes are spread by direct... (Review)
Review
Dermatophytes are fungi that require keratin for growth. These fungi can cause superficial infections of the skin, hair, and nails. Dermatophytes are spread by direct contact from other people (anthropophilic organisms), animals (zoophilic organisms), and soil (geophilic organisms), as well as indirectly from fomites. Dermatophyte infections can be readily diagnosed based on the history, physical examination, and potassium hydroxide (KOH) microscopy. Diagnosis occasionally requires Wood's lamp examination and fungal culture or histologic examination. Topical therapy is used for most dermatophyte infections. Cure rates are higher and treatment courses are shorter with topical fungicidal allylamines than with fungistatic azoles. Oral therapy is preferred for tinea capitis, tinea barbae, and onychomycosis. Orally administered griseofulvin remains the standard treatment for tinea capitis. Topical treatment of onychomycosis with ciclopirox nail lacquer has a low cure rate. For onychomycosis, "pulse" oral therapy with the newer imidazoles (itraconazole or fluconazole) or allylamines (terbinafine) is considerably less expensive than continuous treatment but has a somewhat lower mycologic cure rate. The diagnosis of onychomycosis should be confirmed by KOH microscopy, culture, or histologic examination before therapy is initiated, because of the expense, duration, and potential adverse effects of treatment.
Topics: Antifungal Agents; Arthrodermataceae; Clinical Trials as Topic; Dermatomycoses; Diagnosis, Differential; Humans; Hydroxides; Potassium Compounds
PubMed: 12537173
DOI: No ID Found -
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 -
The Journal of Investigative Dermatology Jul 1976Twenty-five years ago many of the topical remedies for superficial mycoses were irritating, toxic, or allergenic. Total x-ray depilation of the scalp was the accepted... (Review)
Review
Twenty-five years ago many of the topical remedies for superficial mycoses were irritating, toxic, or allergenic. Total x-ray depilation of the scalp was the accepted mode of therapy for tinea capitis. The introduction of topical nystatin for candidiasis and tolnaftate for dermatophytosis were major advances, but tinea capitis, onychomycosis, and chronic tinea pedis still presented problems. Soon after its introduction in 1958, griseofulvin became the definitive form of therapy for all types of dermatophytosis and played a major role in abolishing large-scale epidemics of tinea capitis in some countries. Recently, haloprogin and the imidazole derivatives, miconazole and clotrimazole, which are topically active against dermatophytes and Candida albicans, have become available. Selective indicator media for isolating dermatophytes are useful diagnostic tools, but quicker methods of diagnosis which require little interpretation are still lacking. Epidemiologic studies in Vietnam again revealed the effects of climate and occlusion on the prevalence, incidence, and severity of superficial mycoses and led to renewed interest in host susceptibility, environment, and prevention of infections.
Topics: Administration, Topical; Adult; Animals; Antifungal Agents; Arthrodermataceae; Candidiasis; Dermatomycoses; Female; Griseofulvin; Hair Removal; Humans; Male; Nystatin
PubMed: 778288
DOI: 10.1111/1523-1747.ep12513020 -
Mycopathologia Oct 2016Diapers create particular conditions of moisture and friction, and with urine and feces come increased pH and irritating enzymes (lipases and proteases). Fungi can take... (Review)
Review
Diapers create particular conditions of moisture and friction, and with urine and feces come increased pH and irritating enzymes (lipases and proteases). Fungi can take advantage of all these factors. Candida yeasts, especially C. albicans, are responsible for the most frequent secondary infections and are isolated in more than 80 % of cases. Correct diagnosis is important for ensuring the correct prescription of topical antimycotics. Nystatin, imidazoles and ciclopirox are effective. It is important to realize there are resistant strains. Dermatophytes can infect the diaper area, with the most common agent being Epidermophyton floccosum. The clinical characteristics of dermatophytosis are different from those of candidiasis, and it can be diagnosed and treated simply. Malassezia yeasts can aggravate conditions affecting the diaper area, such as seborrheic dermatitis, atopic dermatitis, and inverse psoriasis. Additional treatment is recommended in this case, because they usually involve complement activation and increased specific IgE levels. Erythrasma is a pseudomycosis that is indistinguishable from candidiasis and may also occur in large skin folds. It is treated with topical antibacterial products and some antimycotics.
Topics: Antifungal Agents; Dermatitis, Contact; Dermatomycoses; Fungi; Humans
PubMed: 27193417
DOI: 10.1007/s11046-016-0020-9 -
The American Journal of Tropical... Sep 2015
Topics: Aged; Colombia; Dermatomycoses; Humans; Male; Paracoccidioides; Paracoccidioidomycosis; Skin
PubMed: 26333727
DOI: 10.4269/ajtmh.15-0062 -
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 -
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 -
Clinical Microbiology and Infection :... Oct 2009The prevalence of cutaneous and soft tissue zygomycosis appears to have increased in recent years. We reviewed 78 case reports of cutaneous zygomycosis published from... (Review)
Review
The prevalence of cutaneous and soft tissue zygomycosis appears to have increased in recent years. We reviewed 78 case reports of cutaneous zygomycosis published from 2004 through 2008. Most patients with cutaneous zygomycosis have underlying conditions such as haematological malignancies, diabetes mellitus or solid organ transplantation, but a large proportion of them are immunocompetent. Trauma is the most common predisposing factor leading to zygomycosis in immunocompetent patients. If the patient is immunocompromised, the infection may disseminate. Cutaneous zygomycosis may be localized, may extend to deep underlying tissues, or may be disseminated. The most common clinical presentation is induration of the skin with surrounding erythema, rapidly progressing to necrosis. Histological examination and culture of soft tissue are important for the diagnosis of cutaneous zygomycosis. Treatment consists of surgical debridement, administration of antifungal agents (amphotericin B formulations and/or posaconazole) and, occasionally, hyperbaric oxygen. Mortality rates are approximately 30%.
Topics: Antifungal Agents; Debridement; Dermatomycoses; Humans; Immunocompromised Host; Risk Factors; Wounds and Injuries; Zygomycosis
PubMed: 19754756
DOI: 10.1111/j.1469-0691.2009.02979.x -
Medical Mycology Journal 2014
Topics: Arthrodermataceae; Dermatomycoses; Humans; Microscopy; Skin
PubMed: 25231229
DOI: 10.3314/mmj.55.j95 -
Journal of Clinical Microbiology Nov 1998
Review
Topics: AIDS-Related Opportunistic Infections; Aspergillosis; Aspergillus; Bone Marrow Transplantation; Burns; Dermatomycoses; Humans; Infant, Newborn; Neoplasms; Organ Transplantation
PubMed: 9774549
DOI: 10.1128/JCM.36.11.3115-3121.1998