Dos interesantes contaminantes fúngicos filamentosos en muestras clínicas positivas a Trychophyton rubrum: una situación de curiosidad morfológica / Two interesting filamentous fungal contaminants in clinical samples positive to Trychophyton rubrum: a situation of morphological curiosity

Las dermatofitosis corresponden a un grupo de enfermedades micóticas comunes en piel y fanéreas, donde Trichophyton rubrum es el agente causante más frecuente a nivel mundial y presente en nuestros 2 casos de pacientes masculinos con estas micosis, una en uñas y la otra en piel. Sin embargo, el enfoque de esta publicación se basa principalmente en la presencia de 2 interesantes contaminantes (uno en cada caso clínico) presentes solo en los cultivos de las primeras siembras como saprófitos y por ende como propágulos de dispersión, asociados al ambiente y sin intervención clínica demostrada en ambas micosis. La descripción morfofisiológica de estos 2 contaminantes Metarhizium purpureo-genum(similis) y Monascus ruber fue más bien una curiosidad esencial que el micólogo clínico adquiere en su contínua formación y ante la posibilidad de infecciones mixtas, pudiendo conjugar sus hallazgos junto al análisis taxonómico y los factores geográficos y edáficos asociados a su distribución. (AU)

Dermatophytoses belongs to a group of common mycotic diseases in skin and pharynals, where Trichophyton rubrum is the most frequent causative agent worldwide and present in our 2 cases of male patients with these mycoses, one in nails and the other in skin. However, the focus of this publication is mainly about the presence of 2 interesting contaminants (one in each clinical case) present only in the crops of the first sowings as saprophytes and therefore as dispersal propagules, associated with the environment and without clinical intervention demonstrated in both mycoses. The morphophysiological description of these 2 contaminants, Metarhizium purpureogenum (similis) and Monascus ruber was rather an essential curiosity that the clinical mycologist acquires in his continuous training and in the face of the possibility of mixed infections, being able to combine his findings together with the taxonomic analysis and the geographic and edaphic factors associated with its distribution. (AU)

A Clinical and Etiological Analysis of Tinea Incognito Over 10 Years: A Single-Center Experience / 대한의진균학회지

BACKGROUND: Tinea incognito is the dermatophytoses of atypical clinical appearance that is induced by topical and systemic steroid treatment or topical calcineurin inhibitor. OBJECTIVE: The purpose of this study was to investigate the clinical and etiological aspects of tinea incognito. METHODS: In the 10-year-period 2007-2017, we reviewed fifty-one patients with tinea incognito with regards to the age, gender, duration, and associated diseases. The patients with tinea incognito were further evaluated concerning the clinical manifestations and culture of organisms. RESULTS: Age of the tinea incognito was most prevalent in the fifties (23.5%). The male-to-female ratio was 1:1.3. The most common type of infection was tinea corporis (52.9%), followed by tinea faciei (35.3%), tinea manus (5.9%), tinea barbae (3.5%), and tinea cruris (2.0%). The clinical features were to some extent diverse, ranging from eczema-like, seborrheic dermatitis-like, psoriasiform, folliculitis-like, rosacea-like, pyoderma-like, and purpura-like, and discoid lupus erythematosus-like. Trichophyton(T.) rubrum was the most common etiological agent (35.3%), followed by T. mentagrophytes (11.8%), Microsporum(M.) canis (7.8%), T. verrucosum (5.9%), T. erinacei, and M. gypseum (2.0%), respectively. CONCLUSION: Because of the increase in tinea incognito, there is a need for careful mycological examination in patients with tinea incognito.

Prevalence of Dermatophytosis in patients in a tertiary care centre in and around Cuddalore district

Background: The common cause of skin infections are dermatophytes and opportunistic fungi. Aim of this study was to isolate and identify the fungal agents from clinical samples from patients with different mycoses. Superficial mycoses are among the most frequent forms of human infections, affecting more than 20–25% of the world’ population. They are predominantly caused by a group of closely related keratinophilic mycelia fungi (dermato-phytes) in the genera of Trichophyton, Microsporum, and Epidermophyton. These groups of fungi invade the stratum corneum of the skin or other keratinized tissues derived from the epidermis such as hair and nails. Aim and objectives: The present work aims at evaluation of rate of incidences of dermatophytic infections (group wise), and etiological agents with associated symptoms. In addition, we also determine to test the sensitivity of present diagnostic procedures. Materials and methods: Samples were collected from 100 patients. A portion of each sample was examined microscopically and the remaining portion of each sample was cultured onto plates of Sabouraud’s dextrose agar containing chloramphenicol with and without cycloheximide. Dermatophyte isolates were identified by studying macroscopic and microscopic characteristics of their colonies .Preliminary identification was done by conventional methods and confirmed by Polymerase Chain Reaction – Restriction Fragment length Polymorphism (PCR -RFLP) technique. Results: All over 62/100 specimens were KOH positive and 48/62 (82.7%) samples were culture positive. Of these, highest isolation rate was obtained in opportunistic mycoses such as candidiasis (29/29, 100%). Dermatophytes were isolated in 41/62 (66.3%) specimens and Trichophyton rubrum was the commonest isolate in skin samples (44/62) among the patients suffering from dermatophytosis. Phaeoannellomyces Wernicke was isolated in a patient suffering from tinea nigra. P. Gunasekaran. Prevalence of Dermatophytosis in patients in a tertiary care centre in and around Cuddalore district. IAIM, 2017; 4(8): 91-95. Page 92 The study signifies the importance of mycological examination in the diagnosis of various mycoses for their effective management. Conclusion: Dermatophytoses are distributed worldwide with increased incidence especially in a tropical country like India. Several factors such as age, sex, illiteracy, poor hygiene and social economy influence the dermatophyte infection. In the present study we have attempted to understand the epidemological status of the dermatophytes in a tertiary care centre in Cuddalore, Tamil Nadu, India. Tinea corporis was the predominant clinical site from which dermatophytes were isolated. T. Rubrum and T. Mentagrophytes have been the major etiological agents and that has been evinced by our study.

Dermatofitoses: agentes etiológicos, formas clínicas, terapêutica e novas perspectivas de tratamento / Dermatophytoses: etiologic agents, clinical forms, therapy and new perspectives of treatment

As dermatofitoses têm ocorrência mundial, sendo mais prevalentes em países de clima tropical e subtropical. Dados epidemiológicos indicam que essas micoses estão entre as infecções fúngicas de maior ocorrência. O quadro clínico mais comum de dermatofitose inclui despigmentação, placas anulares, prurido e perda de cabelo, com lesões tipicamente conhecidas como tineas, ocasionadas por fungos filamentosos dermatofíticos de três gêneros anamórficos: Microsporum, Trichophyton e Epidermophyton. O tratamento das dermatofitoses, em geral, está relacionado ao uso de antifúngicos tópicos e/ou sistêmicos, apresentando como problemática o surgimento de espécies multirresistentes. Esta revisão aborda as dermatofitoses e seus agentes etiológicos de forma aprofundada em aspectos epidemiológicos, apresentando a importância clínica do tema, com ênfase na causa, prevenção, tratamento e prognóstico dessa micose cutânea (AU)

Dermatophytoses have worldwide occurrence with higher prevalence in tropical and subtropical countries. Epidemiological data show that these mycoses are among the most frequent fungal infections. The most common symptoms of dermatophytoses include depigmentation, annular plaques, itching and hair loss, with lesions such as tinea, caused by dermatophytic filamentous fungi of three anamorphic genera: Microsporum, Trichophyton and Epidermophyton. Topical and/or systemic antifungalmedications are used in the treatment of dermatophytoses in general, resulting in problems such as the emergence of multidrug-resistant species. This review discusses dermatophytoses and their etiological agents with a focus on epidemiological aspects, presenting the clinical importance of the issue, with emphasis on cause, prevention, treatment and prognosis of this skin mycosis (AU)

Tinea Incognito in Korea and Its Risk Factors: Nine-Year Multicenter Survey

Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids or calcineurin inhibitors. The incidence of TI is increasing nowadays. We conducted retrospective review on 283 patients with TI from 25 dermatology training hospitals in Korea from 2002-2010 to investigate the demographical, clinical, and mycological characteristics of TI, and to determine the associated risk factors. More than half (59.3%) patients were previously treated by non-dermatologists or self-treated. The mean duration of TI was 15.0 +/- 25.3 months. The most common clinical manifestations were eczema-like lesion, psoriasis-like, and lupus erythematosus-like lesion. The trunk and face were frequently involved, and 91 patients (32.2%) also had coexisting fungal infections. Among 67 isolated strains, Trichophyton rubrum was the most frequently detected (73.1%). This is the largest study of TI reported to date and the first investigational report concerning TI in Korea. We suggest that doctors should consider TI when a patient has intractable eczema-like lesions accompanied by tinea pedis/unguium. Furthermore, there should be a policy change, which would make over-the-counter high-potency topical steroids less accessible in some countries, including Korea.

A Clinical and Mycological Study of Dermatophytoses in Chungcheongnam-do Province (2008~2012) / 대한의진균학회지

BACKGROUND: The causative organisms and clinical characteristics of dermatophytoses are altered by various factors such as social environmental change and geographic distribution. OBJECTIVE: The purpose of this research is to investigate the changes and recent clinical and mycological features of dermatophytoses in the Chungcheongnam-do province. METHODS: We performed clinical and mycological studies on 387 cases of dermatophytoses among outpatients of Dermatologic clinic of Soonchunhyang University Cheonan Hospital for 5 years, from January 2008 to December 2012. RESULTS: 1. The age distribution showed patients in their 50s to be the most common. The ratio of male to female was 1.07:1. 2. The seasonal prevalence of dermatophytoses was highest in the summer, but the incidence of tinea capitis was highest in the winter season. 3. The positive rate of KOH examination was 95.1% and that of culture was 58.9%. 4. Trichophyton(T.) rubrum was most prevalent dermatophyte (71.1%), followed by Microsporum(M.) canis (9.2%), T. mentagrophytes (7.9%). CONCLUSION: Compared with previous study, the incidence of T. rubrum infection is rising and in recent years the prevalence of M. canis infection has markedly increased. The rest of causative organisms' proportion is increasing and diversification is observed.

Micosis superficiales en la ciudad de Valparaíso, Chile: Período 2007-2009 / Superficial mycoses in the city of Valparaiso, Chile: Period 2007-2009

Introduction: Superficial mycoses are infections of the keratinous tissue caused by dermatophytes, yeasts and environmental fungi. Objectives: To identify the species of dermatophytes, yeasts and environmental fungi that cause superficial mycosis and analyze their differences by sex, age and location of the lesion, in patients from the region of Valparaiso, during 2007-2009. Materials and Methods: 1004 patients diagnosed with superficial mycoses were studied. All ages and both genera were included. The study was done using direct microscopic examination with 20 percent KOH and culture of the lesions. Fungi identification was mainly morphophysiological. Results: Of the 1004 patients studied, 609 were women and 87.7 percent was 15 years old or younger. Toenail onychomycosis was the most frequent lesion (58.1 percent), followed by tinea pedis and interdigitalis (16.3 percent). In patients younger than 8 years old, tinea capitis by Microsporum canis was the most common mycoses. Among dermatophytes, Trichophyton rubrum (78.9 percent) predominated in most locations, followed by Trichophyton mentagrophytes (14.9 percent) and M. canis (5.4 percent). Candida spp. (95.4 percent) prevailed among the yeasts causing onychomycosis. There were 27 cases of toenail onychomycosis caused by environmental fungi, mainly Fusarium. Conclusions: Our results are consistent with national and international data, where T. rubrum is the predominant agent of dermatomycoses. We report the emergency of agents not described in Chile or Latin America in these infections.

Introducción: Las micosis superficiales son infecciones causadas por dermatofitos, levaduras y hongos ambientales en tejidos queratínicos. Objetivos: Conocer las especies de dermatofitos, levaduras y hongos ambientales que causan micosis superficiales, analizar sus diferencias según sexo, edad y localización en pacientes de la Región de Valparaíso durante el período 2007-2009. Materiales y Métodos: Se estudiaron 1.004 pacientes de todas las edades, con diagnóstico de micosis superficiales. Se realizó examen microscópico directo con KOH al 20 por ciento y cultivos de las lesiones. La identificación de los hongos fue principalmente con morfo-fisiología. Resultados: De 1.004 pacientes evaluados, 609 fueron mujeres y 87,7 por ciento tenían sobre 15 años de edad. La onicomicosis de pie fue la lesión más frecuente (58,1 por ciento), seguida de tinea plantar e interdigital (16,3 por ciento). Bajo 8 años de edad, tinea capitis por Microsporum canis fue la lesión más frecuente. Entre los dermatofitos, Trichophyton rubrum (78,9 por ciento) predominó en la mayoría de las localizaciones, seguido por Trichophyton mentagrophytes (14,9 por ciento) y M. canis (5,4 por ciento). Entre las levaduras predominó Candida spp (95,4 por ciento) como causa de onicomicosis. Hubo 27 casos de onicomicosis de pies por hongos filamentosos ambientales, destacando por frecuencia el género Fusarium. Conclusiones: Los datos presentados coinciden en general con los trabajos nacionales e internacionales, donde T. rubrum predomina en la mayoría de las dermatomicosis. Destaca la aparición de agentes no descritos en Chile ni en Latinoamérica en este tipo de infecciones.

Dermatofitias en niños: revisión retrospectiva de 487 casos en Tucumán-Argentina / Dermatophytoses in children: retrospective revision of 487 cases in Tucumán-Argentina

Los hongos dermatofitos son los agentes causales más frecuentes de micosis . No obstante, la prevalencia de los agentes causales varía en las regiones geográficas, las características demográficas de la población estudiada y la metodología de laboratorio. A fin de determinar la frecuencia de dermatofitos en niños de Tucumán (R. Argentina), se presentan los resultados de una revisión retrospectiva de 9 años (2000-2008) de los protocolos médicos de 712 niños de 0 a 14 años de edad, (413 varones y 299 mujeres), con diagnóstico clínico de micosis en piel, uñas, pelos y cuero cabelludo evaluados en el Hospital del Niño Jesús. Las tineas fueron diagnosticadas en 487 pacientes (68,4 por ciento), predominando en el género masculino. La distribución de los hongos aislados fue: M. canis (78,4 por ciento), T. mentagrophytes (6,4 por ciento), T. rubrum (6,2 por ciento),T. tonsurans (4,5 por ciento), M. gypseum (3,9 por ciento), T. mentagrophytes var. interdigitale (0,4 por ciento) y E. floccosum (0,2 por ciento). Coincidentemente con trabajos previos realizados en nuestra provincia, la tinea capitis es la afección predominante y M. canis sigue siendo su principal agente patógeno más frecuente (93,8 por ciento). La alta proporción de aislamientos de M. canis, indica claramente que las especies zoofílicas son las más prevalentes en nuestra área. El grupo etario de mayor incidencia fue el de 0 a 3 años seguido del grupo de 4 a 6 años de edad.

Dermatophyte fungi are the most frequent agents causing mycosis. However prevalence of the causing agents varies with the geographic regions, demographic characteristics of the studied population and with the laboratory methodology. In order to determine the incidence of Dermatophytes in chidren of Tucumán (R. Argentina), results of a 9-year retrospective revision (2000-2008) of the medical protocols of 712 children of 0 to 14 years of age (413 men and 299 women) diagnosed with mycosis in hair, scalp, skin and nails are reported and who had been evaluated in the Hospital del Niño Jesús. Tinea were diagnosed in 487 patients (68.4 percent), prevailing in the masculine genus. The distribution of isolated fungi was: M.canis, (78.4 percent), T.mentagrophytes (6.4 percent), T.rubrum (6.2 percent), T tonsurans (4.5 percent), M.gypseum (3.9 percent), T.mentagrophytes var. interdigitale (0.4 percent) and E.floccosum (0.2 percent). Coincidently with previous studies accomplished in our province, tinea capitis is the prevailing affection while M.canis continues being its main and most frequent pathogenic agent (93.8 percent). The high number of M.canis isolations show clearly that zoophilic species are the most prevalent in our area. Children aged 0 to 3 year exhibited the highest prevalence followed by those of 4 to 6 year.

A Clinical and Mycological Study of Dermatophytoses in Children / 대한의진균학회지

BACKGROUND: Dermatophytoses in children are commonly seen but relatively infrequent than adults. Dermatophytoses in children can be different clinically and mycologically from those in adults in that children experience rapid physical changes and they have different skin features and environments from those of adults. OBJECTIVE: The goal of this research is to understand the clinical and mycological characteristics of dermatophytoses in children. METHODS: This clinical and mycological investigation was made with 15,684 patients under age 18 who were diagnosed with dermatophytoses from April, 1976 to March, 2005. RESULTS: The results can be summarized as follows: 1. The incidence of dermatophytoses in children to total number of pediatric outpatients was 6.4%. Male patients were 9,475 and female patients were 6,209 leaving male to female ratio of 1.5:1. Dermatophytoses showed high incidence in the age group between 13 and 18 (7,009). 2. Tinea pedis was 4,020 cases and the most common, followed by tinea cruris, tinea capitis, tinea corporis, tinea unguium, tinea faciale. Tinea capitis largely increased in 1980s and is falling off through 1990s, tinea pedis tends to increase since 1990s. The onsets in summer were the most eminent. 3. Among 15,684 cases, 9,395 cases (59.9%) yielded isolated strains on fungal culture. Trichophyton (T.) rubrum was 5,049 strains (53.7%) and the most common among the total isolated 9,395 strains followed by Microsporum (M.) canis, and T. mentagrophytes. M. canis was the most commonly isolated organism in tinea capitis and tinea manus but in other cases T. rubrum was. CONCLUSIONS: Dermatophytoses in children are different clinically and mycologically from those in adults and vary with the change of the times.

Granuloma de Majocchi / Majocchi's granuloma

El granuloma de Majocchi o granuloma dermatofítico es una micosis causada por dermatofitos, regularmente del género Trichophyton, predominando T. rubrum en 50%. Se presenta en pacientes inmunocompetentes o inmunodeprimidos. No se sabe cómo se produce la infección, al parecer inicia con trauma físico que guía a alteraciones del folículo piloso y a la introducción pasiva del hongo. Para el desarrollo de la infección se requieren factores predisponentes y desencadenantes, los más importantes son la diabetes y el uso de esteroides. Clínicamente se clasifica en papular perifolicular o superficial en pacientes inmunocompetentes, y en nodular subcutánea o profunda en pacientes con inmunosupresión. Se confirma el diagnóstico por histopatología, encontrando granulomas en dermis media y profunda, con estructuras dermatofíticas en forma de filamentos o esporas. El tratamiento es con antimicóticos sistémicos. Se hace una revisión del tema resaltando los aspectos etiopatogénicos, clínico-patológicos y terapéuticos de la enfermedad.

Majocchi's granuloma or dermatophytic granuloma is a mycosis observed among immunocompetent and immunocompromised patients caused by dermatophytes, particularly Trichophyton rubrum, which may be responsible for 50% of cases. The mechanism by which it occurs is yet unknown although reports suggest it may occur after localized trauma that alters the hair follicle and enables the entrance of the microorganism. Diabetes and the use of topical steroids are among some of the predispEl cuadro 1 no está acotado. Favor de hacerloEl cuadro 1 no está acotado. Favor de hacerloosing factors. Majocchi's granuloma has two clinical presentations, among immunocompetent patients it displays follicular papules and among immunocom-promised patients a subcutaneous nodular type is observed. Diagnosis is confirmed through histopathology, where granulomas and dermatophytes in the form of filaments or spores are observed in the mid and deep dermis. Treatment includes systemic antimycotics. We reviewed the etiopathogenic, clinical, histopathological and therapeutic aspects of Majocchi's granuloma.

Level of Understanding of Importance of Preventing and Treating Dermatophytoses in Diabetic Patients

BACKGROUND: Dermatophytoses tend to have a poorer outcome in diabetic patients than in non-diabetic patients. Therefore, diabetic patients need to pay a closer attention to the prevention and treatment of dermatophytoses. The aim of this study was to determine the level of understanding of the dermatophytoses in diabetic patients and to clarify the factors associated with the level of understanding. METHODS: A questionnaire survey was carried out from June to July, 2005, targeting 200 patients who had visited two hospitals in Seoul for the management of diabetes. There were 163 respondents (response rate 50.9%). The degree of understanding was calculated by giving 1 point to each question, with a maximum of 12 points. RESULTS: The average degree of understanding of dermatophytoses was 6.68 points (SD 1.79). Younger age (P= 0.0002), high education level (P=0.0035), and high income (P=0.0013) were the factors related to a better understanding of dermatophytoses. The patients who had obtained the information on dermatophytoses from the websites, broadcasts, newspapers, or magazines showed higher recognition points than others (P=0.0377). The body mass index, the duration of diabetes, the complications associated with diabetes did not affect the understanding of dermatophytoses. CONCLUSION: There are many diabetes patients who do not know enough about dermatophytoses. Diabetes itself is not related to the level of understanding of dermatophytoses. However, diabetic patients who are older, have a lower level of education, and a low income will need to be informed about prevention and treatment of dermatophytoses.

Level of Understanding of Importance of Preventing and Treating Dermatophytoses in Diabetic Patients

BACKGROUND: Dermatophytoses tend to have a poorer outcome in diabetic patients than in non-diabetic patients. Therefore, diabetic patients need to pay a closer attention to the prevention and treatment of dermatophytoses. The aim of this study was to determine the level of understanding of the dermatophytoses in diabetic patients and to clarify the factors associated with the level of understanding. METHODS: A questionnaire survey was carried out from June to July, 2005, targeting 200 patients who had visited two hospitals in Seoul for the management of diabetes. There were 163 respondents (response rate 50.9%). The degree of understanding was calculated by giving 1 point to each question, with a maximum of 12 points. RESULTS: The average degree of understanding of dermatophytoses was 6.68 points (SD 1.79). Younger age (P= 0.0002), high education level (P=0.0035), and high income (P=0.0013) were the factors related to a better understanding of dermatophytoses. The patients who had obtained the information on dermatophytoses from the websites, broadcasts, newspapers, or magazines showed higher recognition points than others (P=0.0377). The body mass index, the duration of diabetes, the complications associated with diabetes did not affect the understanding of dermatophytoses. CONCLUSION: There are many diabetes patients who do not know enough about dermatophytoses. Diabetes itself is not related to the level of understanding of dermatophytoses. However, diabetic patients who are older, have a lower level of education, and a low income will need to be informed about prevention and treatment of dermatophytoses.

Estudio clínico-epidemiológico de las micosis superficiales en conejos de bioterio convencional / Clinical Epidemiological Study of Superficial Mycoses in Rabbits from Conventional animal facilities

Las micosis superficiales son afecciones causadas por hongos que viven sobre la piel y/o en sus anexos. Se realizó un estudio en 214 conejos Nueva Zelanda blancos (Oryctolagus cuniculus) de entre 19 días y 5 años de edad, reproducidos por más de 16 años en el Bioterio del Instituto Nacional de Higiene "Rafael Rangel", con la finalidad de determinar la incidencia y prevalencia de las micosis superficiales y los factores epidemiológicos asociados. El estudio contempló la clínica, el laboratorio y su epidemiología. El tamaño de la muestra se estimó por el programa Epi-Info versión 5,01, estableciéndose 15% de frecuencia esperada, 5% de error y un nivel de 95% de confianza. Se evaluó el estado general de los animales, así como la presencia de alopecias y lesiones descamativas. La toma de muestras de pelos y escamas epidérmicas fue realizada por tracción mecánica y raspado. Se realizó examen directo de las muestras con KOH al 10% más tinta Parker y se sembraron en tubos de agar Mycosel y Lactritmel. Para establecer el patrón de ocurrencia de las micosis se determinó incidencia acumulada, incidencia y prevalencia en tasas y proporciones. Los principales hongos hallados causantes de micosis superficiales fueron: T. mentagrophytes (dermatofito) y Scopulariopsis sp. (no dermatofito). Se obtuvo una incidencia acumulada de 45% en doce meses de observación y 8% de casos sospechosos por animal-mes. La prevalencia osciló entre 3,6% y 4,8% en casos confirmados. Los resultados aportan información para la aplicación de buenas prácticas de laboratorio y contribuyen con el programa de control de calidad del biomodelo.

The superficial mycoses are diseases caused by fungi that live on the skin and/or in their annexes. It was carried out a study in 214 white New Zealand rabbits (Oryctolagus cuniculus) between 19 days and 5 years of age, reproduced for more than 16 years, in the animal facilities of the National Institute of Hygiene «Rafael Rangel¼, to determine the incidence and prevalence of the superficial mycoses and the associated epidemic factors. The study contemplated the clinic, laboratory and epidemiology. The size of the sample was estimated by Epi- Info version 5,01 program settling down 15% of prospective frequency, 5% error and 95% confidence level. Alopecia and descamative lesions, as well as the general state of the animals, was evaluated. Hair samples and epidermal flakes was taking out by mechanical traction and rasped. Direct exam with 10% KOH plus Parker ink was carried out and the samples were seeded in Mycosel and Lactritmel agar tubes. It was determined: accumulated incidence, and prevalence in rates and proportions to establish the occurrence pattern of the mycoses. The main fungi causing superficial mycoses were: T. mentagrophytes (dermatophyte) and Scopulariopsis sp. (nondermatophyte). An accumulated incidence of 45% was obtained in twelve months of observation and 8‰ of suspicious cases per animal-month. The prevalence oscillated between 3,6% and 4,8% in confirmed cases. This result give information for good laboratory practices application and contributes with the quality control program of the biological models.

Dermatofitosis diseminada crónica asociada a fagocitosis deficiente tratada con antimicóticos e inmunoestimulación fagocitaria / Antifungal and phagocytic immunostimulation treatment of chronic disseminated dermatophytosis

Se presenta el caso de un hombre de 39 años de edad con dermatofitosis crónica diseminada. De las lesiones se aislaron Trichophyton rubrum var. vellosa típica, T. tonsurans y Candida albicans, todos sensibles in vitro a compuestos azólicos. La actividad fagocítica in vitro comparada con un control normal mostró deficiencia en la misma. Se indicó tratamiento con itraconazol e inmunoestimulación con antígeno bacteriano. Durante los dos últimos años el paciente se ha mantenido clínica y micológicamente sano y su actividad fagocitaria es normal. En los pacientes con dermatofitosis crónica recidivante es recomendable la valoración de la respuesta inmune y la inmunomodulación puede ser útil como parte del tratamiento.

A 39 years old man with a long-standing disseminated dermatophytosis even with several antifungal treatments is presented. From lesions, Trichophyton rubrum var. typical downy, T. tonsurans and Candida albicans were isolated and showed sensivity to azolic compounds in vitro. The phagocytic activity in vitro compared with normal control was depressed. Treatment with itraconazole and immunomodulation using a bacterial antigen was indicated. During the last two years the patient has been clinical and mycologically healthy, and his phagocytosis activity has become normal. In patients with chronic and relapsing dermatophytosis, the immune response evaluation is recommended, and immunomodulation could be useful as a rational measure in patients with a particular immunodeficiency.

A Clinical and Mycological Study on Dermatophytoses in Children / 대한의진균학회지

BACKGROUND: Dermatophytoses account for 5~15% of disorders seen in pediatric clinics. Clinical charateristics and therapeutic strategies of children are differ from adults. OBJECTIVE: We performed retrospective study in order to observe clinical and mycological features of dermatophytoses in pediatric patients including therapeutic strategies. METHODS: This clinical and mycological investigation was made with 404 cases of dermatophytoses among out-patients in the Department of Dermatology of Severance Hospital, Yonsei University College of Medicine, from February, 1996 to January, 2001. RESULTS: Dermatophytoses showed high incidence in 14~15 years of age group (54 cases), less than 1 year of age group (35 cases) and 13~14 years of age group (32 cases). The ratio of male to female was 1.3 : 1. Especially in patients with tinea cruris, which was the most prominent diseases showing male predominance, the sex ratio was 3.4 : 1. The incidence of each type of dermatophytoses was the highest in Tinea (T.) corporis (21.6%), followed by T. capitis (20.3%), T. pedis (19.8%), T. cruris (13.6%), Onychomycosis (13.6%), T. faciei (7.5%) and T. manus (3.6%). The mean-duaration before diagnosis was longest in onychomycosis (529 days), followed by T. cruris (367 days), T. pedis (273 days), T. capitis (144 days), T. manus (139 days), T. corporis (138 days) and T. faciei (77 days). The most common cultured organism was Microsporum (M.) canis (24 cases) followed by Trichophyton (T.) mentagrophytes (22 cases), T. rubrum (20 cases) and M. gypseum (1 case). The treatment with topical antifungal agents (62%) was more commonly used than the treatment with oral antifungal agents (38%). The type of dermatophytoses that is the most resistant to topical and oral antifungal agents was tinea capitis caused by M. canis. CONCLUSION: The incidence of T. capitis in children was much higher than that in adults and the response to antifungal agents in children showed resistance to first-line therapy in T. capitis caused by M. canis.

A Clinical and Mycological Study on Dermatophytoses in Children / 대한의진균학회지

BACKGROUND: Dermatophytoses account for 5~15% of disorders seen in pediatric clinics. Clinical charateristics and therapeutic strategies of children are differ from adults. OBJECTIVE: We performed retrospective study in order to observe clinical and mycological features of dermatophytoses in pediatric patients including therapeutic strategies. METHODS: This clinical and mycological investigation was made with 404 cases of dermatophytoses among out-patients in the Department of Dermatology of Severance Hospital, Yonsei University College of Medicine, from February, 1996 to January, 2001. RESULTS: Dermatophytoses showed high incidence in 14~15 years of age group (54 cases), less than 1 year of age group (35 cases) and 13~14 years of age group (32 cases). The ratio of male to female was 1.3 : 1. Especially in patients with tinea cruris, which was the most prominent diseases showing male predominance, the sex ratio was 3.4 : 1. The incidence of each type of dermatophytoses was the highest in Tinea (T.) corporis (21.6%), followed by T. capitis (20.3%), T. pedis (19.8%), T. cruris (13.6%), Onychomycosis (13.6%), T. faciei (7.5%) and T. manus (3.6%). The mean-duaration before diagnosis was longest in onychomycosis (529 days), followed by T. cruris (367 days), T. pedis (273 days), T. capitis (144 days), T. manus (139 days), T. corporis (138 days) and T. faciei (77 days). The most common cultured organism was Microsporum (M.) canis (24 cases) followed by Trichophyton (T.) mentagrophytes (22 cases), T. rubrum (20 cases) and M. gypseum (1 case). The treatment with topical antifungal agents (62%) was more commonly used than the treatment with oral antifungal agents (38%). The type of dermatophytoses that is the most resistant to topical and oral antifungal agents was tinea capitis caused by M. canis. CONCLUSION: The incidence of T. capitis in children was much higher than that in adults and the response to antifungal agents in children showed resistance to first-line therapy in T. capitis caused by M. canis.

A Clinical and Mycological Study of Dermatophytoses in Soldiers of Kangwon Province / 대한피부과학회지

BACKGROUND: Dermatophytoses are common disorders. Prevalence of dermatophytoses is not static but dynamic under the influence of various forces such as climate, migration of people and development of prophylaxis and therapy. OBJECTIVE: This study was made in order to investigate the clinical and mycological status of dermatophytoses in soldiers of Kangwon province, such as incidence and monthly distribution of the diseases and a variety of the causative organisms. METHODS: We performed the clinical and mycological study on 177 patients with dermatophytoses which was diagnosed by KOH examination and fungal culture at the outpatient department of dermatology of Chuncheon Armed Forces General Hospital from October, 1997 to September, 1998. RESULTS: The incidence of dermatophytoses was 12.7% of a total of 1393 outpatients. Tinea pedis(47.5%) developed most frequently, followed by tinea cruris(29.9%), tinea manus (10.2%), tinea corporis(5.6%), tinea faciale(3.4%), tinea unguium(2.8%), and tinea capitis(0.6%) in decreasing order. The mean age of the patients was 21.9 years(range, 20-24). The incidence of dermatophytoses by rank was highest in private 1st class group(32.8%), followed by corporal group(28.8%), private group(24.3%), sergeant group(13.6%), and new private group(0.6%) in decreasing order. There were coexisting fungal infections in 27 patients(15.3%), and the case of tinea pedis with tinea unguium was the most common. The positive rate of KOH examination was 96.6% and the positive rate of fungal culture on Sabouraud dextrose agar media with cycloheximide was 66.1%. The most common organism cultured was Trichophyton(T.) rubrum(94.0%), followed by T. mentagrophtes(5.1%) and T. verrucosum(0.9%). CONCLUSION:These results are higher incidence of dermatophytoses than those of previous studies. The incidence of tinea pedis was also higher than the previous studies. These are probably due to tight-fitting army boots in summer and spreading of infection among non-infected soldiers living together. The most common causative organism was T. rubrum.

The Use of Antifungal Agents in the Treatment of Dermatophytoses in Childhood / 대한의진균학회지

Dermatophytoses commonly generated in childhood, which account for 7~15% of total pediatric skin diseases, do not show much differences with skin symptoms of adult dermatophytoses, but occasionally show far atypical appearances, leading to very difficult determination to make for its diagnosis. In addition, another striking difference to note is that patients or guardians prefer to treating the fungal infections with topical agent applications rather than in oral treatment approach. Normally, most of the dermatophytoses can be sufficiently treated only by the topical agents, and this approach is further recommended in that treating the children should be considered putting its top priority on whether or not the drugs have any side effects, and the patients are well responded to the drugs. For these reasons, treating with topical agents should be considered to apply in the first place. Despite the above approach, immunosuppressive children and patients with tinea capitis or onychomycosis do not have other treatment choices than oral antifungal agents. Since tinea capitis are very common in most children, selecting an appropriate oral antifungal agents becomes more important. Considering the use of oral drugs for children patients are not yet officially approved, clinicians are sometimes faced with their decisions hard to make which new antifungal agents to apply, or how many dosages or how long the selected antifungal agents should be taken. Based on the research information that has been partly investigated to the present time in the United States, the authors reviewed the methods of using oral antifungal agents in the treatment of dermatophytoses in children.

Two Cases of Dermatophytoses Caused by Trichophyton rubrum in Newborn Infants / 대한의진균학회지

Dermatophytoses of newborn infants are known to be very unusual, although cutaneous candidosis in infancy is relatively common. We report two cases of dermatophytoses seen in a 33-day-old infant and a 63-day-old infant. The dorsum of the foot of the former showed an annular lesion with crusty border of about 3 weeks duration and the chin of the latter showed an annular lesion with intensely inflamed border of about 5 weeks duration. From the two patients, Trichophyton rubrum was isolated. The articles describing dermatophytoses in infancy in the Korean literature did not report any cases similar to ours.

Dermatophytoses in Kyongju Area / 대한피부과학회지

BACKGROUND: Because of the differences in dermatophytoses by ographic distribution in Korea, we studied the incidence of dermatophytoses in the Kyongju area. OBJECTIVE: The purpose of the study was to investigate the recant clinical and mycological features of dermatophytoses in the Kyongju area. METHODS: We evaluated the clinical and mycological aspects flermatophytoses in 431 patients from September 1992 to August 1994 in the Kyongju area. RESULTS: 1) The incidence of dermatophytoses was 7.8% out of a total of 5,549 out patients. 2) The incidence of dermatophytoses was Tinea(T.) pedis (36%), T. unguium (30.2%), T. corporis (12.0%), T. cruris, (11.5%), T. manus (7.3%), T. faic (2.2%), T. capitis (0.6%) in order of decreasing frequency. 3) Among the age groups, the in idence rate was highest in the third decade (21.3%). 4) The ratio of male to female patients was 1.5: l.5) Coexisting fungal infections were found in 1 patients (41.0%), and the cases of T. pedis with T. unguium was the most common. 6) In dercimatophytoses, the positive rate of KOH mount examination was 95.7 %, and the positive rate of culture was 77.6%. 7) Trichophytone T. rubrum was the most common causative organism of dermatophytoses (91.8%), T. mentagrophages (4.3%), T. verrucosum (2,3%), Microsporum(M.) canis (1.0%), M. gypseum (0.3%). Epidermoplyte floccosum (0.3%), presenting in order of decreasing freqiency. CONCLUSION: We find that the incidence rate of T. veriosum infection & coexisting dermatophytosis in the Kyongju area are higher than previous studies in Korea