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OBJECTIVE To study the antifungal activity of Huangqin decoction （HQD） against Trichophyton mentagrophytes and explore its mechanism. METHODS Minimal inhibitory concentration （MIC）， minimal fungicidal concentration （MFC）， mycelial length， spore germination rate， biomass and mycelium ultrastructure observation were performed to evaluate the antifungal activity of HQD against T. mentagrophytes. The effects of HQD on the cell wall of T. mentagrophytes were detected through sorbitol protection experiment. By measuring the content of ergosterol and the activities of squalene epoxide （SE） and lanosterol 14α-demethylase （CYP51）， the activity of HQD on the cell membrane of T. mentagrophytes was investigated. The effects of HQD on T. mentagrophytes mitochondria were investigated by determining the activities of malate dehydrogenase （MDH）， succinate dehydrogenase （SDH）， and ATPases （including sodium potassium ATPase， calcium magnesium ATPase， and total ATPase）. RESULTS HQD exhibited significant antifungal activity against T. mentagrophytes with MIC of 3.13 mg/mL and MFC of 25 mg/mL. After intervention with HQD， the mycelial length of T. mentagrophytes was significantly shortened （P＜0.05）； spore germination rate， biomass， the content of ergosterol in the cell membrane， the activities of SE and CYP51 in the cell membrane and MDH， SDH and ATPase in mitochondria were all decreased significantly （P＜0.05）； cell structure had been ；damaged to a certain extent， but the integrity of the cell wall had not been affected. CONCLUSIONS HQD shows significant antifungal activity against T. mentagrophytes， the mechanism of which may be associated with reducing the 0791- content of ergosterol in the cell membrane and the activities of SE， CYP51， and mitochondria-related enzymes.
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Objective:To investigate the distribution of pathogenic fungi in patients with tinea capitis diagnosed in Xijing Hospital, Air Force Medical University in the past 10 years.Methods:A total of 871 outpatients or inpatients with tinea capitis were collected from the Department of Dermatology, Xijing Hospital from January 2011 to December 2020, and their clinical data and pathogen distribution were retrospectively analyzed. Pearson chi-square test was used to analyze differences in the pathogen distribution between children and adult patients with tinea capitis.Results:Of 871 patients with tinea capitis, 588 (67.5%) were males and 283 (33.5%) were females; 21 (2.40%) were aged less than 1 year, 266 (30.50%) aged 1 - 3 years, 352 (40.40%) aged 4 - 6 years, 187 (21.50%) aged 7 - 12 years, 4 (0.50%) aged 12 - 18 years, and 41 (4.70%) were aged 18 - 74 years. A total of 705 pathogenic strains were isolated from these patients, including 599 strains of Microsporum canis (85.0%) , 52 strains of Trichophyton mentagrophytes complex (7.4%) , 27 strains of Trichophyton tonsurans (3.8%) , and 18 strains of Trichophyton violaceum (2.6%) . Among the pathogenic fungi of tinea capitis, the proportion of Trichophyton violaceum was significantly higher in adults (8.8%) than in children (2.2%, P = 0.048) . Conclusions:In the past 10 years, the patients with tinea capitis in the Department of Dermatology, Xijing Hospital were mainly children aged 1 - 6 yearswhile adults, and adult patients with tinea capitis were uncommon. The main pathogen of tinea capitis was Microsporum canis, followed by Trichophyton mentagrophytes complex.
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Resumen Los miembros del complejo Trichophyton mentagrophytes representan el segundo grupo en frecuencia de aislamiento de dermatofitos, luego de Trichophyton rubrum. El citado complejo comprende 3grupos principales: 1) Trichophyton benhamiae y especies relacionadas; 2) Trichophyton simii y 2especies relacionadas, Trichophyton quinckeanum y Trichophyton schoenleinii, y 3) T. mentagrophytes, Trichophyton interdigitale y especies relacionadas. Todos estos organismos son difíciles de identificar a través de la morfofisiología. Se presenta en este informe un estudio descriptivo de 17 cepas clínicas aisladas e identificadas en el Laboratorio de Micología de la Universidad de Valparaíso como pertenecientes al complejo T. mentagrophytes, junto con la caracterización de 3cepas de referencia (T. mentagrophytes CBS 318.56, T. interdigitale CBS 428.63, Trichophyton erinacei CBS 511.73), con el objetivo de clasificarlas a nivel de especie. Se realizaron pruebas morfofisiológicas y moleculares por análisis de curvas de melting de alta resolución (high resolution melting analysis) y secuenciación de regiones ITS. Fenotípicamente, se identificaron 3especies incluidas en el complejo. Los análisis moleculares reclasificaron todas las cepas como pertenecientes a T. interdigitale. En conclusión, no se lograron establecer patrones morfofisiológicos confiables para poder diferenciar entre las especies del complejo.
Abstract Trichophyton mentagrophytes complex is the most frequent agent found in dermatophyte isolates after Trichophyton rubrum. It is divided into 3main groups: (1) Trichophyton benhamiae and related species; (2) Trichophyton simii and 2related species, Trichophyton quinckeanum and Trichophyton schoenleinii; and (3) T. mentagrophytes, T. interdigitale, and related species. They are all difficult to identify by morphophysiology. With the aim of classifying them at the species level, a descriptive study was performed on 17 isolated clinical strains identified in the Mycology Laboratory of the Universidad de Valparaíso as belonging to the T. mentagrophytes complex. They were compared with 3 reference strains (T. mentagrophytes CBS 318.56, T. interdigitale CBS 428.63, Trichophyton erinacei CBS 511.73). Morphophysiological and molecular tests were performed by high resolution melting analysis curves and ITS regions sequencing. Phenotypically, 3 species of the complex were identified. Molecular analyses reclassified all the species as belonging to T. interdigitale. In conclusion, no reliable morphophysiological patterns were established to differentiate between the species of the complex. Molecularly, all the strains studied were classified as T. interdigitale.
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Objective To analysis changes in species distribution of pathogenic dermatophytes from patients with tinea capitis in the Hangzhou Third Hospital between 2015 and 2017.Methods Demographic and mycological data were collected from 321 patients with confirmed tinea capitis in the Hangzhou Third Hospital between 2015 and 2017,and analyzed retrospectively.Results Of the 321 patients with tinea capitis,180 were males,and 141 were females.Their age of onset ranged from 1 month to 70 years.There were 154 (47.9％) preschool children and 13 (4.0％) adults.A total of 321 fungal strains were isolated,including 159 (49.5％) strains of Microsporum canis,110 (34.3％) strains of Trichophyton mentagrophytes,38 (11.8％) strains of Trichophyton violaceum,8 (2.5％) strains of Trichophyton tonsurans,4 (1.2％) strains of Microsporum gypseum,and 2 (0.6％) strains of Trichophyton rubrum.There was no significant difference in the distribution of fungal species (x2 =9.09,P ＞ 0.05) or the proportion of anthropophilic and non-anthropophilic dermatophytes among different age groups (x2 =1.85,P ＞ 0.05).The proportion of non-anthropophilic dermatophytes significantly differed among 2015,2016 and 2017 (x2 =23.82,P ＜ 0.01).From 2015 to 2017,the proportions of Microsporum canis were 32.5％,47.6％ and 59.6％ respectively,and the proportions of Trichophyton mentagrophytes were 53.0％,35.4％ and 23.7％ respectively.Conclusions During 2015-2017,the main population with tinea capitis in Hangzhou Third Hospital was preschool children.Moreover,the main pathogenic dermatophyte was Microsporum canis,whose proportion gradually increased year by year,followed by Trichophyton mentagrophytes,whose proportion gradually decreased year by year.
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ABSTRACT Objective. The dermatophytes are keratinophilic fungi, of importance in public health because of their anthropozoophilic nature. Given the increasing acquisition of exotic animals as pets and the scarce studies on the state of colonization by dermatophytes on these animals; we raised the objective of determine the presence of dermatophytes in clinically healthy rabbits (Oryctolagus cuniculus) from pet stores in Santiago, Chile. Materials and Methods. 42 clinically healthy rabbits were studied. Clinical specimens were obtained from the hairy mantle and cultivated on Sabouraud glucose agar and dermatophyte test medium (DTM™); the identification of the fungal isolates was performed using classic mycological procedures that included direct microscopic examination and the analysis of micromorphological features on culture. Results. Of the total number of rabbits studied, three (7.1%) presented colonization by dermatophytes, being more frequent in males and in those animals that coexisted with Guinea Pigs. The species identified in all three cases was Trichophyton mentagrophytes. Conclusions. This study evidence colonization by dermatophytes in domestic rabbits, important information for veterinarians and owners of pets, at the time of being in contact with this animal species.
RESUMEN Objetivo. Los dermatofitos son hongos queratinofílicos, de importancia en salud pública por su rol antropozoofílico. Dado el aumento en la adquisición de animales exóticos como mascotas y los escasos estudios sobre el estado de colonización por dermatofitos en estos animales, nos planteamos el objetivo de determinar la presencia de dermatofitos en conejos (Oryctolagus cuniculus) clínicamente sanos procedentes de tiendas de mascotas en Santiago de Chile. Materiales y Métodos. Se estudiaron 42 conejos clínicamente sanos. Las muestras clínicas se obtuvieron desde el manto piloso y cultivadas en agar Sabouraud glucosado y dermatophyte test medium (DTM®). La identificación del agente aislado fue realizada por procedimientos micológicos clásicos que incluyeron examen microscópico directo y cultivo. Resultados. Del total de conejos estudiados, tres (7,1%) presentaron colonización por dermatofitos, siendo más frecuente en machos y en aquellos animales que convivían con cuyes. La especie identificada en los tres casos fue Trichophyton mentagrophytes. Conclusiones. Este estudio evidencia la colonización por dermatofitos en conejos domésticos, información importante para médicos veterinarios y propietarios de mascotas, al momento de estar en contacto con esta especie animal.
Subject(s)
Animals , Rabbits , Rabbits , Arthrodermataceae , TineaABSTRACT
Objective:Prepared the specific chicken egg yolk immunoglobulins (IgY) against the cell wall protein of Trichophyton mentagrophytes (tmCWP) and detected its biological activities,which was to establish the basis for the preventment and treatment in dermatophytes disease.Methods: In this work,tmCWP was extracted and purified by cold alkali method,and being used as immunogen to immunized healthy laying hens.The IgY was extracted from the egg yolk by polyethylene glycol method and purified by saturated ammonium sulfate method,respectively.The concentration of the extracted IgY was detected by Bradford method.The purity and molecular weight of the specific anti-tmCWP IgY were analysed by SDS-PAGE.The titer of IgY was obtained by ELISA.The immunoreactivity of IgY was performed by Western blot.Results: The purity of the extracted IgY reached to 87.27％.ELISA indicated that the titer of the specific anti-tmCWP IgY gradual rised 20 days after primary immunization and reached to the highest value (1∶32 000) after 45 days.Western blot revealed that the specific IgY showed a good immunoreactivity and a specifically combination capacity.Conclusion: In our work,the tmCWP could be regarded as the immunogen to prepare the specific anti-tmCWP IgY,which could provide a novel thought for the therapy of Trichophyton mentagrophytes infection.
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BACKGROUND: Trichophyton mentagrophytes complex is a heterogeneous group. A new classification, based on molecular biology, has replaced the one based on morphology, physiology, and mating behavior. OBJECTIVE: T. mentagrophytes isolates from Korean patients were classified using the new method and compared with the classic classification. METHODS: During 2010-2011, fungal isolates were collected at the Catholic skin clinic from 562 patients infected with T. mentagrophytes; clinical characteristics were reviewed. Patients were divided into four groups based on the morphological characteristics of the isolates. Thirty-four strains of T. mentagrophytes were randomly selected from the four groups for mycological and molecular biology analyses, including analyses of morphological characteristics, ribosomal DNA (rDNA) internal transcribed spacer (ITS) sequence, and rDNA nontranscribed spacer (NTS) typing. RESULTS: Among the 562 isolates, persicolor (41.6%) was the most common strain type, followed by the powdery (38.4%), downy (11.2%), and granular (8.7%) types. The granular type differed from the other three with respect to the isolation site, patient's age, seasonal variation, and microscopic characteristics. Among the selected 34 strains, the microscopic characteristics varied for each strain. The powdery, persicolor, and downy types had ITS sequences identical to those of the anthropophilic T. interdigitale/A. vanbreuseghemii. The ITS sequence of granular type was similar to that of zoophilic T. interdigitale/A. vanbreuseghemii. The granular type had different NTS types than the other types did. CONCLUSION: The T. mentagrophytes strains isolated were classified as T. interdigitale/A. vanbreuseghemii; the majority (91.7%) was anthropophilic and 8.3% were zoophilic and granular type.
Subject(s)
Humans , Classification , DNA, Ribosomal , Methods , Molecular Biology , Physiology , Seasons , Skin , TrichophytonABSTRACT
Abstract Tinea faciei is a relatively uncommon dermatophyte infection entailing atypical clinical symptoms, usually misdiagnosed and treated with corticosteroids. The authors describe a case of tinea faciei on the right eyebrow caused by Trichophyton interdigitale. The patient was an 18-year-old girl, who had an inflammatory plaque with a scaly, pustular surface on the right eyebrow and upper eyelid, which had persisted for over 1 month. She was once misdiagnosed as having eczema and was treated using corticosteroid cream. A diagnosis of tinea faciei was made based on direct microscopy and culture. The sequencing of the nuclear ribosomal ITS region and β-tubulin gene of the isolate established its T. interdigitale lineage. The patient was cured by treatment with systemic terbinafine in combination with topical application of 1% naftifine-0.25% ketaconazole cream for 2 weeks.
Subject(s)
Humans , Female , Adolescent , Tinea/pathology , Trichophyton/isolation & purification , Eyebrows/microbiology , Eyebrows/pathology , Facial Dermatoses/microbiology , Facial Dermatoses/pathology , Tinea/drug therapy , Urease/analysis , Microscopy, Electron, Scanning , Treatment Outcome , Dermoscopy , Facial Dermatoses/drug therapy , Antifungal Agents/therapeutic use , Naphthalenes/therapeutic useABSTRACT
Zoophilic species of human dermatophytoses, such as Trichophyton mentagrophytes are significantly rare. We present a case of a 42-year-old male who for 2 months had been unsuccessfully treated and then referred to hospital with suspected actinomycosis. Lesions on the skin on his neck, submandibular area, cheeks and groins were consistent with extremely painful, merging inflammatory tumours and infiltrations with the presence of numerous pustules in hair follicles that poured purulent contents forming into yellow crusts after compression. The treatment with terbinafine was successful. The final identification of the Trichopyton mentagrophytes var. granulosum strain was performed based on a microscopic assessment of the culture, and the result of species identification was confirmed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis.
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BACKGROUND: Traditionally, mating types of dermatophytes had been identified by mating experiments. It took a long time and there were many limitations. Recently, we can figure out the fungal mating types using molecular mating type analysis by detecting mating type (MAT) genes. The mating type (+) specific gene of the high-mobility-group (HMG) DNA binding domain and the mating type (-) specific gene of alpha-box were found in Arthroderma simii and A. vanbreuseghemii. OBJECTIVE: We applied this molecular mating type analysis to strains of Trichophyton interdigitale, T. rubrum, Microsporum canis in Korea and compared these results with previous reports. METHODS: Thirty-four strains of T. interdigitale (12 granular types, 9 powdery types, 8 purple-red types, 5 cottony types), 5 strains of T. rubrum, and 5 strains of M. canis were examined. We analyzed ribosomal RNA internal transcribed space 1, 4 sequencing of T. interdigitale subtypes and investigated the mating type of dermatophytes using alpha-box gene and HMG gene primers. RESULTS: Among 12 strains of granular type of T. interdigitale, 9 strains were type (-) and other 3 strains were type (+). All of them were zoophilic. All strains of powdery, purple-red and cottony types of T. interdigitale were type (+) and anthropophilic. In T. rubrum and M. canis, all strains were type (-). These results were matched with previously reported studies. CONCLUSION: The molecular mating type analysis of dermatophytes was quicker method than conventional mating experiments. Moreover, MAT genes are highly conserved even in apparently asexual fungi. The results were well matched with previous reports with traditional mating tests.
Subject(s)
Arthrodermataceae , DNA , Fungi , Genes, Mating Type, Fungal , Korea , Microsporum , RNA, Ribosomal , TrichophytonABSTRACT
Dermatophytosis was found on the right front leg of a 4-month-old female African lion cub (Panthera leo) kept at a zoo with locally marginal alopecia. For diagnosis, culturing on sabouraud dextrose agar was performed and skin scrapings from the lesion were analyzed. The ones from the culture and skin scrapings were identified as Trichophyton mentagrophytes. A zookeeper that had been in contacted with the lion for artificial rearing developed skin lesions with well-defined erythematous plaques on the right arm about 1 month after the lesion in the lion was observed. The ringworm was probably transmitted from the lion through continuous contact.
Subject(s)
Female , Humans , Infant , Agar , Alopecia , Arm , Diagnosis , Glucose , Leg , Lions , Skin , Tinea , TrichophytonABSTRACT
Trichophyton(T.) mentagrophytes is a zoophilic or anthropophylic dermatophyte causing cutaneous human fungal disease. Atypical, disseminated clinical presentations may be seen in immunocompromised patients. It is also hard to diagnose tinea corporis when patients are using corticosteroid or have other dermatologic diseases. Herein, we report on an interesting case of tinea corporis caused by T. mentagrophytes in a patient with Cushing syndrome. A 75-year-old woman presented with pruritic, scaly, erythematous patches, papules and plaques on the face, neck, trunk and extremities for 7 months. She had been diagnosed with psoriasis at the local clinic and taking steroid (prednisolone, 20 mg/day) intermittently for 17 years. Potassium hydroxide smear showed several hyphae on microscope. Fungus culture showed a growth of colonies with whitish granular colonies surface and yellowish brown colored reverse. Characteristic grape-shaped microconidia, spiral hyphae and macroconidia were shown on the lactophenol cotton blue stain identified the colony as T. mentagrophytes. Lesions showed a marked improvement with oral itraconazole 200 mg/day for 14 days and topical lanoconazole cream for 30 days. It is important that when patient has eczematous lesions which are resistant to treatment, we should consider tinea incognito.
Subject(s)
Aged , Female , Humans , Arthrodermataceae , Cushing Syndrome , Extremities , Fungi , Hyphae , Immunocompromised Host , Itraconazole , Neck , Potassium , Psoriasis , Tinea , TrichophytonABSTRACT
Tinea barbae is a dermatophyte infection of the bearded areas of the face and neck. The incidence of tinea barbae has decreased as improved sanitation. We report a case of tinea barbae in a 49-year-old-man, who presented with relatively well-defined erythematous patch with pustules on the upper lip. A fungal culture from tissue of the lesions was grown on Sabouraud's dextrose agar and showed typical Trichophyton mentagrophytes. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of Arthroderma vanbreuseghemii IHEM 4411. The patient was treated with oral itraconazole for 3 months. The skin lesions improved 3 months after treatment, and recurrence has not been observed.
Subject(s)
Humans , Agar , Arthrodermataceae , Base Sequence , Glucose , Incidence , Itraconazole , Lip , Neck , Recurrence , Sanitation , Skin , Tinea , TrichophytonABSTRACT
Trichophyton mentagrophytes is a fungus causative agent of dermatophytosis, affecting humans worldwide. This has driven the search for products for the treatment of these infections. Accordingly, the aim of this study was to investigate the antifungal activity of the Cymbopogon winterianus essential oil against T. mentagrophytes. The antifungal tests consisted of antifungal screening, determination of MIC and MFC, analysis of the essential oil's effects on mycelial growth, germination of fungal spores, fungal viability, morphogenesis, cell wall (test with sorbitol) and cell membrane (cell leakage test) of T. mentagrophytes. Upon screening, the oil inhibited all strains, with zones of growth inhibition of 24-28 mm in diameter. The MIC was 312 μg/mL and CFM was 2500 μg/mL for almost all the strains tested. There were morphological changes in the conidia group, form and pigmentation of hyphae. The antifungal action of the product does not involve the cell wall and its action may involve the fungal plasma membrane. It is concluded that C. winterianus essential oil constitutes a potential antifungal product, especially for the treatment of dermatophytosis.
Trichophyton mentagrophytes é um fungo causador de dermatofitoses, afetando humanos em todo o mundo. Isto direciona a busca de produtos para o tratamento destas infecções. Assim, este estudo teve por objetivo investigar a atividade antifúngica do óleo essencial de Cymbopogon winterianus contra T. mentagrophytes. Os ensaios antifúngicos foram constituídos do screening antifúngico, da determinação CIM e CFM, da análise dos efeitos do óleo essencial no crescimento micelial, na germinação dos esporos, na viabilidade fúngica, na morfogênese, na parede celular (ensaio com sorbitol) e na membrana celular (ensaio de lise celular) de T. mentagrophytes. No screening, o óleo inibiu todas as cepas, com zonas de inibição de crescimento de 24-28 mm de diâmetro. A CIM foi de 312 μg/mL e a CFM foi de 2500 μg/mL para quase todas as cepas testadas. O óleo essencial inibiu o desenvolvimento micelial, a germinação dos esporos e a viabilidade fúngica. Houve alterações morfológicas no agrupamento dos conídios, na forma e pigmentação das hifas. A ação antifúngica do produto não envolve a parede celular e parece estar envolvida com a membrana celular fúngica. Pode-se concluir que o óleo essencial de C. winterianus se apresenta como um potencial produto antifúngico, especialmente para o tratamento das dermatofitoses.
Subject(s)
Cymbopogon , Oils, Volatile/analysis , Trichophyton , Trichophyton/isolation & purification , Trichophyton/pathogenicity , Antifungal Agents/analysis , Antifungal Agents/pharmacology , Antifungal Agents/isolation & purification , Dermatomycoses , MycologyABSTRACT
Tinea manuum comprises roughly 5% of all cases of tinea, and the main culprit is known to be Trichophyton (T.) rubrum, T. mentagrophytes var. erinacei is a dermatophyte that may be transmitted from hedgehogs, and it has been reported in Korea now that vast diversity of pets are brought into existence. Tinea manuum caused by T. mentagrophytes var. erinacei, is frequently localized to the initial site of exposure, and thus may be confused with hand eczema or pompholyx. The patient visited the outpatient clinic with an erythematous scaly patch with pustule on the right finger after being initially misdiagnosed with housewife eczema. Numerous hyphae were evident on KOH smear examination, and confirmative diagnosis of tinea manuum caused by T. mentagrophytes var. erinacei was made after culturing scales from the lesion for molecular biological analyses. The patient is currently under follow-up without relapse after being treated systemic and topical antifungal agents.
Subject(s)
Humans , Ambulatory Care Facilities , Antifungal Agents , Arthrodermataceae , Eczema , Eczema, Dyshidrotic , Fingers , Follow-Up Studies , Hand , Hedgehogs , Hyphae , Korea , Recurrence , Tinea , Trichophyton , Weights and MeasuresABSTRACT
Previously, we reported that epigallocatechin 3-O-gallate (EGCg) has growth-inhibitory effect on clinical isolates of Candida species. In this study, we investigated the antifungal activity of EGCg and antifungal agents against thirty-five of dermatophytes clinically isolated by the international guidelines (M38-A2). All isolates exhibited good susceptibility to EGCg (MIC50, 2-4 microg/mL, MIC90, 4-8 microg/mL, and geometric mean (GM) MICs, 3.36-4 microg/mL) than those of fluconazole (MIC50, 2-16 microg/mL, MIC90, 4-32 microg/mL, and GM MICs, 3.45-25.8 microg/mL) and flucytosin (MIC50, MIC90, and GM MICs, >64 microg/mL), although they were less susceptible to other antifungal agents, such as amphotericin B, itraconazole, and miconazole. These activities of EGCg were approximately 4-fold higher than those of fluconazole, and were 4 to 16-fold higher than flucytosin. This result indicates that EGCg can inhibit pathogenic dermatophyte species. Therefore, we suggest that EGCg may be effectively used solely as a possible agent or combined with other antifungal agents for antifungal therapy in dermatophytosis.
Subject(s)
Antifungal Agents/pharmacology , Arthrodermataceae/drug effects , Catechin/analogs & derivatives , Microbial Sensitivity TestsABSTRACT
Kerion celsi is a severe inflammatory type of tinea capitis that presents as an inflammatory, boggy plaque studded with broken hairs. It usually occurrs in children between the age of 4 and 14 years which is caused by zoophilic pathogens such as Microsporum(M.) canis, Trichophyton(T.) mentagrophytes, and T. verrucosum. Recently various mammals have become a pet in Korea and there has been increase in reports of dermatophytosis transmitted from these pets sporadically. We report a case of kerion celsi caused by T. mentagrophytes probably transmitted from rabbit in a 34-year-old adult male patient. The patient had localized, tender to mild pruritic, erythematous plaque with pustular nodules and irregular hair loss on the right temporal scalp for 2 months. Culture from a scalp lesion of patient on Sabouraud's dextrose agar showed typical T. mentagrophytes. He was treated with 250 mg of terbinafine daily for 12 weeks and short term therapy of low dose of prednisolone. He was cured without recurrence.
Subject(s)
Adult , Child , Humans , Male , Agar , Glucose , Hair , Korea , Mammals , Naphthalenes , Prednisolone , Recurrence , Scalp , Tinea , Tinea Capitis , TrichophytonABSTRACT
Tinea capitis, a dermatophyte infection involving the hair shaft on the scalp, is primarily a disease of preadolescent children. Trichophyton or Microsporum species of dermatophytes transmitted by humans or animals are commonly associated with this disease. Clinical presentations are seborrheic-like scale, 'black dot' pattern, inflammatory tinea capitis with kerion or tiny pustules in the scalp. We report an interesting case of tinea capitis with rapid progression caused by Trichophyton mentagrophytes in an 11-year-old girl. The patient was treated with 125 mg of oral terbinafine and topical flutrimazole cream for one month.
Subject(s)
Animals , Child , Humans , Arthrodermataceae , Clotrimazole , Hair , Microsporum , Naphthalenes , Scalp , Tinea , Tinea Capitis , TrichophytonABSTRACT
Clinical features of the dermatophyte infections of the glabrous skin can be altered by inappropriate treatment such as topical steroid treatment. We describe a case of dermatophyte infection with changes in clinical feature related to antifungal treatment. A 23-year-old woman presented with reddish annular scaly lesions on her right forearm. On the basis of the detection of hyphae on KOH examination, oral terbinafine 250 mg/day in combination with topical isoconazole was used for 3 weeks, but scattered papulopustules on erythematous bases occurred. Histopathologic examination revealed the presence of hyphae within the follicular infundibulum. Oral itraconazole 100 mg/day was administered for 2 weeks in combination with topical flutrimazole and produced a good clinical response. At her visit about 7 weeks after stopping itraconazole, agminated papulopustules on erythematous bases were seen on her right forearm. Trichophyton mentagrophytes was isolated on the culture of skin scraping from the surface of agminated lesions. She was successfully treated with oral fluconazole 150 mg weekly for 6 weeks and topical flutrimazole and isoconazole.