Hombre de 18 años con síndrome verrugoso tropical: ¿leishmaniasis o esporotricosis? / An 18-year-old man with tropical verrucous syndrome: Leishmaniasis or sporotrichosis?

Resumen | El síndrome verrugoso tropical comprende condiciones cutáneas infecciosas, crónicas y granulomatosas que cursan con placas, nódulos o úlceras verrugosas, de ahí su nombre. Este síndrome incluye la cromoblastomicosis, la esporotricosis, la paracoccidioidomicosis, la lobomicosis, la leishmaniasis y la tuberculosis cutánea verrugosa, todas ellas enfermedades de amplia distribución en áreas tropicales y subtropicales. Sus diagnósticos pueden ser difíciles y confundirse entre sí, lo cual es más frecuente entre la esporotricosis y la leishmaniasis. Para distinguirlas se recurre a criterios clínicos y epidemiológicos, y a métodos diagnósticos como intradermorreacción, examen directo, biopsia, cultivo, inmunofluorescencia y PCR, algunos de los cuales no son de uso común. El diagnóstico preciso conduce al tratamiento adecuado. Se presenta el caso de un hombre de 18 años con extensas placas verrugosas en una rodilla, inicialmente interpretadas como leishmaniasis verrugosa por la clínica, la epidemiología y la biopsia. Se le trató con Glucantime® durante 20 días, pero no presentó mejoría, por lo que se tomó una nueva biopsia que también se interpretó como leishmaniasis cutánea. La revisión de ambas biopsias evidenció inflamación con granulomas abscedados y presencia de cuerpos asteroides esporotricósicos, que condujeron al diagnóstico de esporotricosis, el cual se confirmó luego con el cultivo del hongo. Las lesiones remitieron con la administración de itraconazol. La clínica y la epidemiología de la leishmaniasis y las de la esporotricosis pueden ser semejantes, por lo que la biopsia y los estudios de laboratorio son esenciales para establecer el diagnóstico. El cuerpo asteroide esporotricósico es patognomónico de esta entidad. Se revisaron los conceptos esenciales de estas condiciones y los criterios para diferenciarlas.

Abstract | The tropical verrucous syndrome includes infectious, chronic, and granulomatous skin conditions appearing with plaques, nodules, or ulcers with a warty surface which gives name to the syndrome. It includes forms of chromoblastomycosis, sporotrichosis, paracoccidioidomycosis, lobomycosis, leishmaniasis, and tuberculosis verrucosa cutis with ample distribution in tropical and subtropical areas. The diagnoses may be difficult and confused among them, especially between sporotrichosis and leishmaniasis. Clinical, epidemiologic, intradermal reactions, direct smears, skin biopsies, cultures, immunofluorescence, and PCR are used to differentiate them, although several of these methods are not commonly used. We present an 18-year-old man with extensive verrucous plaques in one knee interpreted by clinic, epidemiology, and biopsy as verrucous cutaneous leishmaniasis. He was treated with Glucantime® for 20 days without improvement. A new biopsy was made that was also interpreted as cutaneous leishmaniasis. The revision of both biopsies showed inflammation with abscessed granulomas and asteroid sporotrichotic bodies at the center of the granulomas that led to the diagnosis of sporotrichosis later confirmed by the fungus culture. The patient responded to the treatment with itraconazole. As clinical and epidemiological findings of leishmaniasis and sporotrichosis can be similar, skin biopsy and other paraclinical studies are necessary to establish a proper diagnosis. The asteroid sporotrichotic body is pathognomonic of this mycosis. We review here the essential concepts of leishmaniasis and sporotrichosis and the criteria to differentiate them.

Dermatofitos y hongos levaduriformes causantes de micosis superficiales de piel lampiña en un centro dermatológico, San Lorenzo-Paraguay / Dermatophytes and levaduriform fungi causing superficial mycoses of skin in a dermatological center, San Lorenzo-Paraguay

Introducción: las micosis superficiales o dermatomicosis se encuentran entre las enfermedades infecciosas de piel más comunes. Se localizan en las capas superficiales de la piel y sus anexos (pelo y uñas), por esta razón son motivo de consulta dermatológica. De estas micosis, las dermatofitosis, las malasseziosis y las candidiasis cutáneas son las más frecuentes. Objetivo: describir las características epidemiológicas de las micosis superficiales de piel lampiña. Metodología: estudio observacional, retrospectivo y de corte transverso, donde se analizaron fichas epidemiológicas de pacientes que acudieron al Centro de Especialidades Dermatológicas en el periodo comprendido entre julio del 2017 hasta agosto del 2019, con diagnóstico presuntivo de micosis superficiales de piel lampiña. Resultados: se observaron 341 casos de micosis superficiales de piel lampiña. Entre los agentes causales, los dermatofitos fueron los responsables del 56 % (190/341) de los casos; Malassezia spp. 42 % (142/341) y Candida spp. 2 % 9/341. Se observaron 3 casos de micosis mixtas, donde Candida spp. y dermatofitos fueron los agentes causales. Conclusión: entre las micosis superficiales que afectan piel lampiña, se encuentran en primer lugar los dermatofitos seguidos por las malasseziosis. Este reporte constituye un aporte importante para el conocimiento de la epidemiología de las micosis superficiales en nuestro país.

Introduction: superficial mycoses or dermatomycosis are among the most common skin infectious diseases. These are located in the superficial layers of the skin and its annexes (hair and nails), for this reason it´s a frecuent cause of medical consult. Of these mycoses, dermatophytosis, malasseziosis and cutaneous candidiasis are the most frequent. Objectives: describe the epidemiological characteristics of superficial mycoses of skin. Methodology: observational, retrospective and cross-sectional study, where epidemiological records of patients who were attended at the Dermatological Specialties Center were analyzed in the period from July 2017 to August 2019, with presumptive diagnosis of superficial mycoses of skin. Results: 341 cases of superficial mycosis of skin were observed. Among the causative agents, dermatophytes were responsible for 56 % (190/341) of the cases; Malassezia sp. 42 % (142/341) and Candida sp. 2 % (9/341). Three cases of mixed mycosis were observed; Candida spp. and Dermatophytes were the causative agents. Conclusion: among the superficial mycoses of skin, dermatophytes followed by malaseziosis are in the first places. This report constitutes an important contribution to the knowledge of the epidemiology of superficial mycoses in our country.

Incidência de dermatofitoses em cães no período de janeiro de 2016 a janeiro de 2018 em um laboratório veterinário de análises clínicas na cidade de Chapecó ­ SC / Incidence of dermatophytes in dogs in the period from january 2016 to january 2018 in a veterinary laboratory of clinical analisis in the city of Chapecó - SC

Objetivo: Tendo em vista a possibilidade de variação na incidência e prevalência das dermatofitoses de uma região geográfica para outra, e seu potencial zoonótico, o presente trabalho teve como objetivo fornecer dados a respeito da frequência de dermatofitoses em cães na cidade de Chapecó-SC. Métodos: Avaliaram-se resultados de exames micológico direto e cultura fúngica de caninos, emitidos por um laboratório particular de análises clínicas veterinárias na cidade de Chapecó, Santa Catarina. Os dados foram coletados do sistema Multvet e analisados por meio do software IBM SPSS 22.0 através do cálculo de frequência. Resultados: No período compreendido foram solicitados 108 exames para micológico direto e 223 para cultura fúngica. Destes, 81 laudos de micológico direto (75%) e 159 laudos de cultura fúngica (71%) atendiam aos critérios de inclusão, sendo a maioria dos resultados pertencentes a fêmeas com idade entre 1 e 8 anos, sem raça definida (SRD); além disso verificou-se que não houve diferença significativa entre as solicitações dos exames por estação do ano. A respeito da espécie de dermatófito isolado na cultura fúngica, corroborando com demais estudos, o Microsporum canis foi o mais frequente. Conclusão: Visto que as dermatofitoses são consideradas doenças com potencial zoonótico, e sua epidemiologia é conhecida por mudar ao longo do tempo, os resultados desta pesquisa mostraram que tanto o papel do médico veterinário quanto o do patologista clínico são de suma importância para o prognóstico favorável do paciente.

Objective: Given the possibility of occurrence of variance and prevalence of dermatophytosis from one geographical region to another, and its zoonotic potential, the present study had an impact on the frequency of dermatophytosis in dogs in the city of Chapecó SC. Methods: Evaluation of results obtained through direct mycological examination and canine culture issued by a private veterinary clinical anamnesis laboratory in the city of Chapecó, Santa Catarina, with data collected by the IBM SPSS 22.0 system through frequency calculation. Results: No complete year, 108 direct microbial and 223 religious culture tests were requested, at the same time, 81 direct micrological compliments (75%) and 159 fungal culture reports (71%) within inclusion lips, a large majority of the results belonged to female dog aged 1 to 8 years, with no defined race (SRD), and it was found that there was no major difference between examinations by season. Treating the resistance of sexual dermatitis in fungal culture, corroborating other Dermatophytosis is a closed disease with zoonotic potential, and its epidemiology is known to change over time. The results of the research are as important as the role of the veterinarian in clinical pathology are important for the favorable prognosis of the disease patient.

Micosis en los pies: descripción clínico-epidemiológica en un centro de referencia de Bogotá, Colombia / Foot mycosis: clinical and epidemiological characterization in one referal center in Bogota, Colombia

Objetivo: Describir las características clínico-epidemiológicas de una población con diagnóstico de infección cutánea micótica en los pies confirmada por examen directo con KOH y cultivo en un centro de referencia de Bogotá, Colombia. Material y método: Estudio observacional descriptivo en el que se incluyeron todos los pacientes con lesiones en los pies que fueron atendidos en el servicio de micología entre el año 2011 y el 2016. Se analizaron las características sociodemográficas, clínicas, etiologías y el perfil de tratamiento por medio de un análisis bivariado. Resultados: Se incluyeron 305 pacientes, de los cuales el 82% residía en zona urbana de la ciudad de Bogotá. El hábito más frecuente fue bañarse descalzo, la forma clínica que predominó fue la interdigital y el 35% de los casos presentó de forma simultánea tiña del pie y onicomicosis. Los agentes etiológicos más comunes fueron los dermatofitos con el 95,2% de los casos. Discusión: La presentación clínica sugestiva de micosis, además del resultado positivo del examen directo y del cultivo, permiten hacer el diagnóstico de estas in fecciones. Las características sociodemográficas de quienes sufren este tipo de micosis en Colombia se relacionan con su contagiosidad y tendencia a la cronicidad. La intervención de tales aspectos debe hacer parte de las estrategias para su prevención.

Objective: To describe the clinical and epidemiological characteristics of the population with cutaneous mycosis in the feet confirmed by positive mycological studies diagnosed in a reference center in Bogota, Colombia. Methods: Descriptive observational study in which all patients with lesions in the feet that were treated in the mycology service between 2011 and 2016 were included. In all cases KOH examination and fungal culture were performed. The sociodemographic and clinical characteristics, etiologies and the treatment profile were assessed using a bivariate analysis. Results: A total of 305 patients were included, of which 61% were men and 82% lived in an urban area of the city of Bogota. The most common behavior was to take a barefoot bath, the most important comorbidities were venous insufficiency and psoriasis, the main clinical form was interdigital and 35% of the cases presented simultaneously tinea pedis and onychomycosis. The group of dermatophytes was the most frequently isolated (95.2%). Discussion: Clinical examination corresponding with mycosis in the feet, direct examination, and positive culture, allow the physician accurate diagnosis and guide the most appropriate treatment of these infections according to their etiology. The sociodemographic characteristics of those who suffer from this mycosis in Co lombia are related to their contagiousness and tendency to chronicity, therefore, the intervention of such aspects must be part of the strategies for their prevention.

Una nueva generación de antifúngicos para el tratamiento de las micosis superficiales / A new generation of antifungals for the treatment of dermatomycosis

Las infecciones fúngicas superficiales responden bien a los tratamientos habituales en la mayoría de los casos pero, en determinadas situaciones, constituyen un problema. En su mayoría se trata de infecciones producidas por levaduras del género Candida y Malassezia y por hongos dermatofitos. Estas infecciones han visto incrementada su prevalencia junto con la selección de determinadas especies, la reducción de la sensibilidad a los antifúngicos y la aparición de fenómenos de resistencia in vitro e in vivo. La investigación para encontrar el antifúngico ideal aún continúa y en este sentido actualmente se están ensayando distintas estrategias de investigación sobre drogas para el tratamiento sistémico y tópico de las dermatomicosis.

Superficial fungal infections frequently caused by Candida spp. and Malassezia spp yeasts and dermatophytes fungi, have good response to common treatments in the majority of cases, but in some cases failure are described. Prevalence of these infections has been increased with the selection of certain species, reduced sensitivity to antifungal agents and the emergence of in vitro and in vivo resistance phenomena. The research to find the ideal antifungal still continues and in this sense are being currently tested different strategies for research on systemic and topical drugs for dermatomycosis treatment.

Micosis superficiales en pacientes del estado Anzoátegui, Venezuela, periodo 2002-2012 / Superficial mycoses in patients from Anzoátegui state, Venezuela, period 2002-2012

Las enfermedades fúngicas superficiales que afectan la piel y sus faneras son motivo de consultas en los servicios básicos de triaje y en dermatología. Se encuentran distribuidas en Venezuela con una incidencia de 92,9%. El objetivo del presente estudio fue conocer los géneros y especies que causan dermatomicosis en pacientes residentes del estado Anzoátegui, Venezuela, en el período 2002-2012. Se estudiaron 4257 pacientes con edades entre 7 meses y 79 años. La prevalencia general fue de 30,9%. Las más frecuentes fueron las dermatofitosis (44,7%). M. canis produjo 148 casos de tiña de la cabeza. Tres agentes dermatofiticos representaron el 95% de todos los casos, con predominio significativo de T. mentagrophytes representado por un 50%. La candidosis se presentó en 28,4%. C. albicans, y el complejo C. parapsilosis, fueron responsables del 80% de los casos. Otras especies identificadas fueron C. tropicalis (n = 41; 11,0%), C. glabrata (n = 10; 2,7%), C. guilliermondii (n = 6; 1,6%), C. krusei (n = 4; 1,1%). Pitiriasis versicolor se presentó en (22,4%), y en menor frecuencia la onicomicosis por mohos no dermatofitos, dominando Fusarium oxysporum (n = 34; 65,4%), Aspergillus terreus (n = 16; 30,8%) y Scytalidium dimidiatum (2; 3,8%). Raros casos de onicomicosis por Trichosporon (0,5%) y un caso de tinea negra. Estos resultados revelan una alta frecuencia de las micosis superficiales con predominio de las dermatofitosis indicando la existencia de un problema de salud pública.

Superficial fungal diseases that affect the skin and its appendages are frequently seen in basic triage and in dermatology services. These diseases are distributed in Venezuela with an incidence of 92.9%. The aim of this study was to determine the genera and species that cause dermatomycoses in residents of Anzoátegui state, Venezuela, during the period 2002-2012. A total of 4257 patients with a presumptive diagnosis of superficial mycoses were studied, with ages from 7 months to 79 years. The overall prevalence was 30.9%. The most frequent were dermatophytosis (44.7%). M. canis produced 148 cases of tinea capitis. Three dermatophytic agents represented 95% of all cases, with a significant predominance of T. mentagrophytes with 50%. Candidosis occurred in 28.4%. C. albicans, and the C. parapsilosis complex, were responsible for 80% of the cases. The other species identified were C. tropicalis (n = 41, 11.0%), C. glabrata (n = 10, 2.7%), C. guilliermondii (n = 6, 1.6%), C. krusei (n = 4, 1.1%). Pityriasis versicolor occurred in 22.4% of the cases studied, and less frequently were present onychomycosis produced by a non dermatophytic mold: Fusarium oxysporum (n = 34, 65.4%), Aspergillus terreus (n=16, 30.8%) and Scytalidium dimidiatum (n=2; 3.8%). Rare cases of Trichosporon onychomycosis (0.5%) and one case of black tinea were also found. Health education in the population is recommended to promote measures to prevent transmission of these fungi and prevent the spread of this silent public health problem.

Clinical and Mycological Studies on Dermatomycosis (2001-2010) / 대한의진균학회지

BACKGROUND: The prevalence and clinical characteristics of dermatomycosis are not static but change under the influence of various forces such as geographic factor, social environment and development in prophylaxis and treatment. OBJECTIVE: To investigate the present status of dermatomycosis and changes on the prevalence, sex, age distribution and causative organisms. METHODS: We performed clinical and mycological studies on 7,785 cases of dermatomycosis among outpatients of Dermatologic clinic of Chonnam University Hospital for 10 years, from January 2001 to December 2010. RESULTS: The incidence of dermatomycosis was 12.5% of outpatients and show the highest incidence over 7th decades (24.2%). The incidence of tinea pedis (24.1%) was the highest, followed by onychomycosis (18.1%). Coexisting fungal infections were found 693 (9.2%) and the cases of tinea pedis with onychomycosis were the most common. The positive rate of KOH examination was 49.7% and the positive rate of culture on Sabouraud's dextrose agar media was 36.5%. Trichophyton rubrum was the most common causative organism of dermatomycosis (51.1%), followed by Candida species (33.2%). CONCLUSIONS: Consideration of the changes between current and past epidemiologic, clinical and mycological features in the cutaneous fungal infections are important to investigational efforts, diagnosis, and treatment.

Dermatomicosis en ancianos institucionalizados y estudios de sensibilidad in vitro a los antifúngicos sistémicos / Dermatomycosis in institutionalized elderly patients and in vitro sensitivity study to systemic antifungus

Se determinó la prevalencia de dermatomicosis en ancianos institucionalizados de Ciudad Bilívar, Estado Bolívar, Venezuela, y se evaluó la sensibilidad in vitro de los aislamientos clínicos a los antifúngicos itraconazol, fluconazol y terbinafina mediante el método de microdilución en medio líquido, recomendado por el Comité Internacional de Laboratorios Clínicos (M38-P), con algunas modificicaciones. Los hongos fueron identificados mediante métodos tradicionales. Las levaduras se identificaron mediante pruebas bioquímicas, sistema Api 20 C AUX (Biomérieux SA®, France) y crecimiento en medio de Staib. Se estudiaron 74 ancianos, todos recluidos en el Asilo "San Vicente de Paúl" y el Geriátrico "Carlos Fragachán" quienes dieron consentimiento por escrito para participar en el estudio. La edad de los pacientes estuvo comprendida entre 63 y 98 años (80 ± 8,4 años), la mayoría eran hombres (73%). Todos los pacientes tenían lesiones sugestivas de onicomicosis en los pies. El único dermatofito aislado fue Trichophyton rubrum (n=2) el cual resultó sensible al Itraconazol, terbinafina y sensibilidad variable a flucozazol. Asimismo se logró aislar Aspergillus niger (n=5; 6,7%) demostrándose sensible a terbinafina y fluconazol con sensibilidad variable a itraconazol. Candida albicans (n=3; 4,1%) fue sensible a fluconazol, resistentes a itraconazol y variable a la terbinafina. Aspergillus flavus fue aislado en dos casos (2,7%). Además de Geomyces sp, Fusarium oxysporum y Pseudeurotium ovale. Se concluye que existe una prevalencia baja de dermatomicosis en los ancianos institucionalizados de Ciudad Bolívar y que las lesiones clinicamente observadas son debidas a los cambios degenerativos propios de la edad.

A study determine prevalence of dermatomycosis in 74 institutionalized elderly patients was conductted in Ciudad Bolivar, state of Bolivar, Venezuela. Clinical isolates were assayed for in vitro sensitivity to itraconazole, fluconazole, and terbinafine using a slightly modified version of the microdilution method in liquid medium recommended by the International Committee of Clinical Laboratory (M38-P). Traditional methods were used to identify the fungi. The yeasts were identified by Api 20C AUX biochemical testing (bioMérieux SA®, France) and growth on Staib media. The elders, mostly men (73%), from the "San Vicente de Paúl" Nursing Home and the "Carlos Fragachan" Geriatric Hospital, were aged between 63 and 98 (80 ± 8.4 years). All the patients, whose written consent was secured, had lesions suggestive of onychomycosis. Trichophyton rubrum was the only isolated dermatophyte (n=2), which resulted sensitive to itraconazole and terbinafine, with variable sensitivity to fluconazole. Aspergillus niger (n=5;6.7%) was sensitive to terbinafine and fluconazole with variable itraconazole sensitivity. Candida albicans (n=3; 4.1%) was fluconazole sensitive, resistant to itraconazole, and variable to terbinafine. Aspergillus flavus was isolated in two cases 2.7%). Geomyces sp., Fusarium oxysporum, and Pseudeurotium ovale were also isolated. It is concluded that there is a low prevalence of dermatomycosis among institutionalized elders in Ciudad Bolivar, and that the lesions clinically observed were due to degenerative changes naturally occurring with aging.

A Rare Case of a Subcutaneous Phaeomycotic Cyst with a Brief Review of Literature

Phaeohyphomycosis consists of a heterogeneous group of fungal infections caused by more than 80 genera and species. Subcutaneous infection usually follows traumatic implantation of a fungus by a wooden splinter that the fungus inh abits as a saprophyte. The growth of the fungus forms verrucous plaques or a painless subcutaneous abscess. We report a subcutaneous cyst (phaeomycotic cyst) in the leg of a 60-year-old woman that developed after a thorn prick at that site. With the provisional diagnosis of an epidermoid cyst, she was treated with a simple excision of the cyst. However, histopathological examination of the cyst revealed the typical features of fungus, and a definitive diagnosis of a phaeomycotic cyst was made. As the infective aetiology was not considered clinically, the specimen was not sent for microbiological culture, and hence the exact species was not identified. As the lesion was localised, simple excision was sufficient treatment, and no recurrence was observed during 12 months of follow-up.

Aspectos epidemiológicos de pacientes com lesões ungueais e cutâneas causadas por Scytalidium spp / Epidemiological aspects of patients with ungual and cutaneous lesions caused by Scytalidium spp

FUNDAMENTO: As dermatomicoses causadas por fungos filamentosos não dermatófitos são infecções raras, exceto as onicomicoses, cuja prevalência vem crescendo nos últimos anos. Dentre esses agentes etiológicos destacam-se o Scytalidium dimidiatum e o S. hyalinum, fungos emergentes responsáveis por micoses em unhas e pele. OBJETIVO: Investigar as características epidemiológicas das onicomicoses e micoses de outras localizações causadas pelos fungos do gênero Scytalidium, utilizando-se como parâmetros sexo, idade e localizações das lesões. MÉTODOS: Avaliaram-se 81 amostras com cultura positiva para o gênero em estudo, oriundas de 74 pacientes encaminhados ao Laboratório de Investigação em Dermatologia (ID) situado na cidade do Rio de Janeiro (RJ), no período de 1997 a 2006. As amostras foram submetidas a confirmação diagnóstica por exame direto e cultura. RESULTADOS: A prevalência de onicomicoses por Scytalidium spp. foi de 0,87 por cento, entre as idades de 41 e 60 anos (48,64 por cento). Em relação à localização das lesões, os pés foram mais acometidos (91,36 por cento), com predomínio do hálux esquerdo. No exame direto, as estruturas mais encontradas foram hifas hialinas; na cultura, a espécie S. dimidiatum foi a mais frequente. CONCLUSÃO: As onicomicoses por Scytalidium spp. são raras e o S. dimidiatum foi a espécie mais isolada neste laboratório no período em estudo.

BACKGROUND: Dermatomycoses caused by non-dermatophyte filamentous fungi are rare infections, except for onychomycosis, whose prevalence has increased over the past few years. Among these etiologic agents, we highlight Scytalidium dimidiatum and S. hyalinum, emergent fungi that cause mycoses that affect the nails and skin. OBJECTIVE: To investigate the characteristics of onychomycosis and other mycoses caused by the fungi Scytalidium spp, using sex, age and site of infection as parameters. METHODS: Eighty-one samples were evaluated showing positive culture for Scytalidium spp, obtained from 74 patients referred to the Laboratory of Investigation in Dermatology (ID) located in the city of Rio de Janeiro, RJ, between 1997 and 2006. The samples were submitted to diagnostic confirmation through direct exam and culture. RESULTS: The prevalence of onychomycosis caused by Scytalidium spp. was of 0,87 percent. The most prevalent age was between 41-60 years (48.64 percent). Regarding the site of infection, the feet (91.36 percent) were most affected, with predominance of the left hallux. Hyaline hyphae were the most common structures in direct examination and the species S. dimidiatum was the most frequent in culture. CONCLUSION: Onychomycosis caused by Scytalidium spp. is rare and S. dimidiatum was the most isolated species in this laboratory during the period of the study.

Correlação epidemiológica entre fungos queratinofílicos isolados do solo e agentes de dermatomicoses / Epidemiological correlation between keratinophilic fungi isolated from soil and dermatomycosis agents

Este trabalho teve como objetivo isolar e identificar os fungos queratinofílicos do solo e correlacioná-los com os agentes de dermatomicose. De acordo com nossos resultados, o predomínio de Trichophyton tonsurans como agente de dermatomicose em crianças na cidade do Recife, PE deve-se provavelmente ao maior contato destas com o solo.

This study had the aim of isolating and identifying keratinophilic fungi from soil and correlating them with dermatomycosis agents. According to our results, the predominance of Trichophyton tonsurans as a dermatomycosis agent among children in the city of Recife, PE, is probably due to children's greater contact with soil.

Superficial Dermatomycosis and the Causative Agents in Korea / 대한의진균학회지

Dermatophytes invades and destroys keratinized tissue of the skin, hairs and nails by keratinase. The prevalence and clinical characteristics of dermatomycosis are changed under the various influences such as geographic factor, social environment and development of therapy. Infections caused by some 10 species of dermatophytes isolated since 1924 in Korea. There was a general rise in the cases of Trichophyton (T.) rubrum infections and in recent years the prevalence of Microsporum (M.) canis infections has markedly increased but those of M. ferrugineum have decreased. The yeasts of genus Malassezia are dimorphic and lipophilic and are numbers of the normal flora in humans. Malassezia yeasts are implicated in various diseases, including pityriasis versicolor, Malassezia folliculitis, seborrheic dermatitis and systemic fungal infections.

Clinical and Mycological Studies on Dermatomycosis (1991-2000) / 대한의진균학회지

BACKGROUND: The prevalence and clinical characteristics of dermatomycosis are changed under the various influences such as geographic factor, social environment and development of therapy. OBJECTIVE: The purpose of this study was to evaluate the present status of dermatomycosis and changes on the prevalence, sex and age distribution and causative organisms. METHODS: We performed clinical and mycological studies on 7,568 cases of dermatomycosis among outpatients of Dermatologic clinic of Chonnam University Hospital for 10 years, from January 1991 to December 2000. RESULTS: The incidence of dermatomycosis was 17.6% of out-patients and show the highest incidence in the fourth decades (18.8%). The ratio of male to female was 1.3:1, showing slightly male-predominant pattern. The incidence of Tinea pedis (28.9%) was the highest, followed by Onychomycosis (16.3%), Tinea corporis (11.2%), Tinea cruris (10.1%), Tinea versicolor (9.3%), Tinea manus (8.0%), Candidiasis (6.9%), Tinea faciale (5.5%) and Tinea capitis (3.2%). Coexisting fungal infections were found 846 patients (11.2%) and the cases of Tinea pedis with onychomycosis were the most common. The positive rate of KOH examination was 50.8% and the positive rate of culture on Sabouraud's dextrose agar media was 31.4%. Trichophyton(T.) rubrum was the most common causative organism of dematomycosis (67.7%), followed by Candida albicans (13.0%), Microsporum(M.) canis (9.9%), T. mentagrophytes (7.4%), Epidermophyton floccosum (0.5%), M. gypseum (0.5%), T. verrucosum (0.4%), T. tonsurans (0.3%) and T. violaceum (0.2%). CONCLUSION: Compared with previous studies, the incidence of dermatomycosis increased, especially in females and was evenly distributed throughout all ages. The frequency of tinea pedis and tinea cruris decreased, but increased in onychomycosis.

Clinical and mycological studies on dermatomycosis / 대한피부과학회지

We performed clinical and mycological studies on 1715 cases of dermatomycosis in Chonnam University Hospital for 3 years, from January 1988 to Dccember 1990. The resuts are sumerized as follows . 1. The incidence of dermatomycosis was 13.28% out of a t.otal of 12915 out-patients. 2. Among the age groups, the incidence rate was highest in the third deacde(22.6%). 3. The ratio of male to female patients was 1.4:1(1014:702). 4. The seasonal prevalence of dermatomycosis was highest in t,tu. simmer. 5. The incidence of dermatomycosis was Tinea pedis(29.7%), Tinea versicolor(19.8%), Tinea cruris(11.8% ), Candidiasis(8.6% ), Tinea corporis(8.3% '), Onychomycosis(7.8%), Tinea manus(7.0%)Tinea capit,is(3.6%), Tinea faciei(3.1%) and Sporotrichosis(0.4%) in decreasing order of frequency. 6. Coexisting fungal infections were found in 438 pat.ient,s(25.5% ), and the cases of Tinea manus wit.h Tinea pedis was the most common. 7. In dermatophytosis, a positive rate for the KOH mount examination was 52.4%, and a positive rate of culture on ordinary Saborauds dextrose agar media was 41.4%. 8. Trichophyton rudrum was the most, common causative orgariisn of dermatophytosis(45.9%) with Candida albicans(23.2%), Trichophyton mentagrciphtes(17.1%), Microsporum canis(8.9%), Epidermophyton floccosum(2.5%), Trichophton ferrugineum(1.2%), Microsporum gypseum(0.6% ), Trichophyton violaceum(0.4%), presenting in decreasing order of frequency.

Dermatomicosis y onicomicosis en estudiantes de una escuela de policia / Dermatomycosis and onycomycosis in trainees of a police academy

Con el fin de conocer la prevalencia de las dermatomicosis y de las micosis ungueales se evaluaron clinica y micologicamente en dos oportunidades 213 hombres jovenes que estaban recibiendo entrenamiento en una escuela de policia. El estudio inicial se hizo al ingreso a la escuela en abril de 1988 y en el se encontro que 126 individuos tenian algun tipo de micosis superficial y que las dermatofitosis constituian el 65.5% de las 200 lesiones diagnosticadas. Los agentes mas frecuentes de dermatofitosis fueron: T. mentagrophytes y E. floccosum. Tambien se encontraron: candidiasis, trichosporiasis, pitiriasis, infecciones mixtas e infecciones por hongos ambientales. Se prescribio tratamiento topico convencional a todos los individuos afectados. Cuatro meses despues de la encuesta inicial, inmediatamente antes del egreso, se llevo a cabo un segundo estudio de caracteristicas similares; en esa oportunidad se incluyeron los 145 individuos que aun permanecian en la escuela; en 105 de ellos se comprobo algun tipo de micosis superficial, con un total de 185 lesiones; se hallaron las mismas entidades que en el primer estudio y nuevamente predominaron las dermatofitosis cuya causa mas frecuente fue el E. floccosum seguido por el T. mentagrophytes. Se obtuvieron muestras de diferentes areas humedas de uso comun, como banos, vestier y piscina; de ellas se aislaron T. rubrum y T. mentagrophytes. Ademas de la alta prevalencia inicial de dermatofitosis y micosis ungueales, reveladora de la importancia de estas enfermedades en las comunidades de origen, los resultados del ...

In order to determine the prevalence of dermatomycosis and ungueal mycosis, we studied 213 young men who were enrolled at a police academy. They received both clinical and mycological evaluation on two separate occasions, the first one at the time of admission In apr1l1988; at this point we found that 126 of them (59.2%) had some type of superficial mycosis and that dermatophytosis represented 65.5% of the 200 lesions observed. The most frequent causative agents were: T. mentagrophytes (30.5%) y E. floccosum (18.3%). Candidiasis, trichosporiasis, pitiriasis, mixed infections and infections caused by environmental fungi were also found. AII received conventionaliocal therapy. Four months later, just before the end of their training, the 145 that were still at the academy were evaluated for the second time. In 105 of them (72.4%), some type of superficial mycosis was diagnosed, for a total of 185 lesions. Findings were similar to those of the first evaluation with dermatophytosis predominating (63.8%). E. floccosum was found in 27.1 % and T. mentagrophytes in 14.4%. Samples were also obtained from public areas specially moist ones like showers, vestiers and swimming pool and from them T. rubrum and T. mentagrophytes were isolated. Besides the high initial prevalence of dermatomycosis and ungueal mycosis which reveal their importance in the environment of people evaluated, our study allows us to postulate that special conditions tied to policemen training (Intense physical exercise, sweating, insufficient drying after shower, boot wear), favor occurrence and persistence of these mycosis

A Clinical and Mycological Studies of Dermatomycosis ( 1976 ~ 1985 ) / 대한피부과학회지

This study was done with 5,980 cases of dermatomycosis of dermatological patients in Chnnnam University Hospital for 10 years(1976~1985). And the literatures concerning all fungal diseases reported in Korea were reviewed. The results were summarized as follows ; Among total dermatological patients, the average annual incidence of dermatomycosis was about 15+3%. Dermatophytosis was the most prevalent(77.34%), followed by candicliaais(14.38%), tinea versicolor(7.78%), sporotrichosis(0.45%). Of dermatophytosis, the decreasing orders of clinical localization by the incidence were T.pedis(42.2%), T.cruris(25.9%), T. manum(10.3% ), T. corporis(10.0%), T. ungium (6.2%), T.facialis(4.2%), and T. capitis(2.2%). The organisms identified from dermato phytoses were generally 9 species ; the decreasing orders of frequency were Trichophyton rubrum(59.4%), T. mentagrophyte(27.9%), Microsporum canis(8.5%), Epidermophyton floccosum(2.4%), T. ferrugineum(0.9%), and others(M. gypseum, T. schonleinii, T. violaceum, T. verrucosum). The most common causative organism was T. rubrum, but that of T. corporis and T. capitis was M. canis, which showed a continuous increase on the annual variation of dermatophytes. Of candidiasis, the most common clinical form was cutaneous candidiasis, which was prevalent under 10 years old. But vulvo-vaginitis and paronychia highly developed between 3rd and 5th decades. The occasion with precipitating faetors was 10.4% of total candidiasis, of which tuberculosis and diabetes mellitus were prevalent. Of T. versicolor patients, the peak age was 3rd decades but some cases were infant and child. Of sporotrichosis, the most common clinical location and form were hand and lym phatic respectively. The peak age was between 4th and 5th decades, and the most prevalent occupation was farmer. Of other deep mycosis, there were each case of cryptococcosis, systernic candidiasis, and Wangiella derm,atitidies infection.