-
International Journal of Trichology 2017Tinea capitis is the most common pediatric superficial dermatophyte infection. The causative species vary, as for instance, Microsporum canis predominates in Europe,...
Tinea capitis is the most common pediatric superficial dermatophyte infection. The causative species vary, as for instance, Microsporum canis predominates in Europe, while Trichophyton tonsurans predominates in North America. Tinea capitis does not respond well to topical therapy alone, thus oral therapy is requisite. The drug of choice is griseofulvin; however in some countries, it is no longer available. Fungal culture should be requested in the persistent, scalp lesion and trichoscopy can put forward a speedy diagnosis by its characteristic findings. Scalp dermoscopy or "trichoscopy" represents a valuable, noninvasive technique for the evaluation of patients with hair loss due to tenia capitis. It is simple, quick, and easy to perform.
PubMed: 28839385
DOI: 10.4103/ijt.ijt_54_16 -
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 -
Journal of Clinical and Diagnostic... Feb 2017Dermatophytes are keratinophilic fungi causing superficial cutaneous infections that account 20-25% of the global population. As per literature search, there is a dearth...
INTRODUCTION
Dermatophytes are keratinophilic fungi causing superficial cutaneous infections that account 20-25% of the global population. As per literature search, there is a dearth in the study on virulence factors of dermatophytes from the Indian sub-continent and moreover the association of the virulence factors and the host tissue in vitro helps in understanding the host-pathogen interaction.
AIM
To analyse the enzymatic and non-enzymatic virulence activities of dermatophytes on solid media.
MATERIALS AND METHODS
A total of 11 isolates, three standard American Type Culture Collection (ATCC) strains- - 28188, - 9533, - 28942, one CBS KNAW Fungal Biodiversity Centre strain- - 243.66 five clinical isolates- , , var. , , , and two laboratory isolates - and were screened for the production of virulence enzymes such as phospholipase, lipase, protease, gelatinase and non-enzyme virulence factors (haemolytic activity) of dermatophytes. The clinical isolates were identified from a tertiary care hospital, Chennai. These dermatophytes were tested upon specific substrates on solid media such as egg yolk, tween 80, bovine serum albumin, gelatin powder and sheep blood respectively.
RESULTS
The virulence activity of phospholipase, lipase, protease and gelatinase was observed from all the dermatophyte species. , ATCC strain, var. , , ATCC strain, and CBS strain produced complete haemolysis, whereas other dermatophytes showed no haemolytic activity.
CONCLUSION
Phospholipase, lipase, protease and gelatinase act as enzymatic virulence marker and the complex, complex and showed complete haemolysis and hence they may also act as a non-enzymatic virulence marker for dermatophytes.
PubMed: 28384862
DOI: 10.7860/JCDR/2017/23147.9410 -
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 -
International Journal of Trichology 2017Synthetic hair implants are considered in alopecia when the patient requests an immediate result with minor surgery and with a poor donor area. However, the procedure...
Synthetic hair implants are considered in alopecia when the patient requests an immediate result with minor surgery and with a poor donor area. However, the procedure has historically been marred by poor quality fiber and performance resulting in serious complications. Nevertheless, companies continue to market the procedure with the claim that previous problems have been sorted out. We report a case of inflammation in synthetic hair implants, in which microbiological studies revealed infection with and . The procedure was performed by a hair stylist. The patient experienced symptoms at the site of the implants. Nevertheless, he had the artificial implants repeated. Despite persistent symptoms of peri-implantitis, medical assistance was not sought. It is the view of the International Society of Hair Restoration Surgery that artificial hair fiber implants represent a surgical procedure and as such should be confined to experienced and licensed medical doctors in a reputable medical clinic. As with any surgical procedure, complications may occur which should be handled under a physician's care. Usually, problems result from lack of asepsis during the procedure, lack of patient hygiene, excessive quantity and density of implanted fibers in one session, incorrect choice of implant area, and poor aftercare. In cases, where implant-related problems cannot be resolved within 15 days of antibiotic and anti-inflammatory treatment, an extended microbiological work-up is warranted, and it may be necessary to remove the fibers that may harbor microbial biofilms.
PubMed: 28839395
DOI: 10.4103/ijt.ijt_112_16 -
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 -
Current Medical Mycology Mar 2023Among different clinical entities of dermatophytosis, tinea capitis (TC) is considered a major public health challenge in the world, especially in regions with poor...
BACKGROUND AND PURPOSE
Among different clinical entities of dermatophytosis, tinea capitis (TC) is considered a major public health challenge in the world, especially in regions with poor health and low income. Therefore, this study aimed to provide a retrospective analysis of the patients suspected of TC who were referred to the medical mycology laboratory of Mazandaran, a northern province of Iran.
MATERIALS AND METHODS
A retrospective analysis was performed on the patients suspected of TC who were referred to the medical mycology laboratory from July 2009 to April 2022. Hair roots and skin scrapings were collected from the participants. The laboratory diagnosis was confirmed by direct microscopic examination and culture. Finally, 921 out of 11095 (8.3%) patients were suspected of TC.
RESULTS
Based on the findings, TC was confirmed in 209 out of 921 patients (22.7%). In terms of gender, 209 TC patients (75.1%) were male. Moreover, the male to female ratio of TC patients was 1:3.0. (146/174, 83.91%) was the most etiological agent, followed by (13/174, 7.47%), (9/174, 5.17%), (3/174, 1.71%), (2/174, 1.15%) and (1/174, 0.57%). Besides, endothrix (77.0%) was the most prevalent type of hair invasion.
CONCLUSION
The results revealed the predominance of , as a causative agent of TC. Despite the prevalence of TC, the absence of appropriate consideration highlights that it is a neglected complication among children.
PubMed: 37867593
DOI: 10.18502/CMM.2023.345026.1395 -
Indian Journal of Dermatology 2018The incidence of dermatophytosis is increasing over the last few years and there are many cases which are recurrent and chronic.
BACKGROUND
The incidence of dermatophytosis is increasing over the last few years and there are many cases which are recurrent and chronic.
AIM
The aim was to study the host and pathogen factors in dermatophytosis, to identify the species responsible, and to study the histopathological features of chronic dermatophytosis.
MATERIALS AND METHODS
It was a descriptive study conducted in the Department of Dermatology for a period of 1 year and all patients who were clinically diagnosed as dermatophytosis were included. Isolated hair, and nail involvement were excluded from the study. Epidemiological parameters and treatment history were analyzed, scrapings, and fungal culture were done in all patients. Histopathological examination was done in patients with chronic dermatophytosis who had applied topical steroids.
RESULTS
Chronic dermatophytosis was seen in 68%; tinea corporis was the most common presentation; topical steroid application was seen in 63%; azoles were the most common antifungals used; varied morphologies such as follicular and nonfollicular papules, arciform lesions, pseudoimbricata were seen in steroid modified tinea. and were the most common species isolated in culture, but rare species such as , , , and were also isolated from chronic cases. Histopathology showed perifolliculitis in steroid modified tinea. Minimal inhibitory concentration was lowest for itraconazole in susceptibility studies.
CONCLUSION
Chronicity in dermatophytosis is due to various factors such as topical steroid application, noncompliance, and change in predominant species.
PubMed: 30504978
DOI: 10.4103/ijd.IJD_177_18 -
Journal of Korean Medical Science Feb 2016Since 1995, Trichophyton tonsurans has been one of the causative agents of dermatophytosis in Korea. Herein we evaluate 77 patients infected with T. tonsurans who...
Since 1995, Trichophyton tonsurans has been one of the causative agents of dermatophytosis in Korea. Herein we evaluate 77 patients infected with T. tonsurans who visited an outpatient clinic between 2004 and 2014. Infections due to T. tonsurans were diagnosed by mycological examination, which included direct microscopic examination using 15% KOH and culture in potato dextrose agar complemented with 0.5% chloramphenicol. The annual prevalence of infection due to T. tonsurans was the highest in 2014 (15 cases) but remained constant in non-gladiators between 2004 and 2014. The ratio of male to female patients was 1:0.3. The spring season presented the highest incidence compared with other seasons, with 27 cases. The incidence of infections due to T. tonsurans among gladiators was highest in spring compared with the other seasons whereas the incidence in non-gladiators was the highest in the winter. The body site most commonly affected was the face. Tinea corporis was the most common subtype of dermatophytosis caused by T. tonsurans. Herein, we demonstrate that the prevalence of infection with T. tonsurans remain constant throughout the study period in Korea.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Disease Outbreaks; Female; Humans; Infant; Male; Middle Aged; Prevalence; Republic of Korea; Retrospective Studies; Seasons; Tinea; Trichophyton; Young Adult
PubMed: 26839486
DOI: 10.3346/jkms.2016.31.2.296