Clinico-Mycological Characteristics Of Dermatophytosis- A Comparative Study Of The Past And The Present

Background:Incidence and prevalence of dermatophytosis have increased recently. The clinico-mycological characteristics of dermatophytosis in the past and present were compared to determine the difference, if any, that canexplain the present scenario.Material and Methods:Hospital-based cross-sectional study design with retrospective data comparison was done. The clinico-mycological data of 425 patients in 2019 was compared to 124 patients in 2011 with a Chi-square statistic. Result:Significant differences were observed in the following socio-demographic and disease characteristics in the present compared to the past: female gender (57.9% vs.33.9%, P-0.000002), chronicity (29.4% vs. 16.1%, P-0.003), sharing of clothes (35.3% vs. 20.5%, P-0.0014), co-morbidity of atopy (22.6% vs. 6.5%, P-0.00005), prior use of topical antifungals (64.5% vs. 30.7%, P <0.0001), prior use of systemic antifungals (43.1% vs. 13.7%, P <0.0001), prior use of topical steroids (24.7% vs. 12.1%, P-0.0028), and infection in multiple sites (25.2% vs. 11.3%, P-0.001). T.mentagrophyteswas the most common isolate in the present compared to the past (73.6% vs. 32.8%, P-0.0035). Other isolates were T.rubrum(13.2%) and M.gypseum(13.2%) in 2019 and T.rubrum(53.1%), M. gypseum(9.4%),T. schoenleinii(1.6%) and E. floccosum(3.1%) in 2011.Conclusion:T. mentagrophyteshas emerged as thedominant species. Irrational use of topical and systemic antifungals and steroids has increased considerably.Frequent training of general practitionersregarding appropriate management andeducating patients about avoidance of tight-fitting clothing, personal hygiene, and avoidance of over the counter medications, and adherence to treatment schedule can decrease the disease burden to some extent.

Isolation and Molecular Characterization of Trichophyton rubrum from Siddi Tribal Community Residing in North Karnataka Region, India.

Siddi community is the tribal community of African origin living in north Karnataka region since many generations. Few studies have shown the presence of rare dermatophytes of African origin in the Siddi tribal community. This study was performed to detect the presence of such dermatophytes of African origin in the Siddi community. MethodsA total of 1004 samples were collected from 937 patients with superficial infections out of which 102 samples have shown the dermatophytic growth on culture media. All the dermatophytes were identified by phenotypic and physiological characters. ResultsTinea unguium was the prevalent clinical condition and Trichophyton mentagrophytes was the commonest etiological agent to cause dermatophytosis. Two isolates have shown similar macroscopic and microscopic features of as dermatophyte of African origin species (Trichophyton soudanense) and subjected to sequencing of internal transcribed spacer region (ITS) and identified as Trichophyton rubrum. ConclusionsTherefore, presence of rare African species was not seen in the migrated tribal community may be due to the existence of community since more than 5 generations and have adapted to local social and religious practices.

Occurrence of dermatophytoses in patients from the Sistema Único de Saúde

Abstract: Background: Dermatophytosis is a cutaneous disease caused by filamentous keratinophilic fungi belonging to the genera Trichophyton, Microsporum and Epidermophyton, which present a high prevalence in the general population, being among the most common mycoses affecting about 20% of the world's population. Objective: To carry out the epidemiological survey of cases of dermatophytosis in patients from the Sistema Único de Saúde in a regional Laboratory in the period of 5 years (2009 to 2013). Methods: A retrospective study (January 2009 to December 2013) was carried out with a qualitative and quantitative design, through the registry book of the laboratory, Mycology Sector, where cases of patients with suspected dermatomycosis were analyzed. Results: In a 5-year period, a total of 4467 cases were suspected of having a fungal infection. Of these, 68.74% (3071) cases were of dermatomycosis. In relation to cultures with fungal growth, 12.54% (385 cases) were dermatophyte fungi and 7.97% (245 cases) non-dermatophyte fungi were isolated. Among the species identified, there was a higher prevalence of T. rubrum complex (75%), T. mentagrophytes complex (11.68%) and M. canis (7.01%). Regarding the sites analyzed, nail involvement was the most frequent in 75% of the cases. Study Limitations: This work is representative in the studied region. Conclusions: Dermatomycosis samples are the most frequent among all samples of fungal infections from these patients, with the nail being the most affected area and the fungi T. rubrum complex and T. mentagrophytes complex the most frequent.

Etiologia das dermatofitoses diagnosticadas em pacientes atendidos no Laboratório de Micologia Médica no Centro de Biociências da Universidade Federal de Pernambuco, entre 2014-2017 / Diagnosed dermatophytosis etiology in patients at the Laboratory of Medical Mycology at the Center of Biosciences of the Federal University of Pernambuco, in 2014-2017

Objetivo: As dermatofitoses afetam boa parte da população mundial, sendo possível observar diferentes padrões de distribuição regional em relação aos tipos e frequências de espécies isoladas. No Brasil, estas diferenças nos padrões são observadas em diversas regiões, entretanto poucos dados foram publicados na região Nordeste nos últimos anos, gerando uma lacuna de informação sobre o tema. Este trabalho teve como objetivo atualizar os dados sobre a incidência de dermatofitose na região. Métodos: Foram agrupadas as dermatofitoses confirmadas em pacientes atendidos no Laboratório de Micologia Médica da Universidade Federal de Pernambuco, no período de janeiro de 2014 a junho de 2017, avaliando- se as possíveis mudanças nas espécies prevalentes. Resultados: Foram analisados 2.893 laudos, onde 268 foram positivos para dermatofitoses. O sítio de infecção variou significativamente conforme a faixa etária. Quanto à etiologia, o gênero Trichophyton foi isolado em um total de 252 amostras, o gênero Microsporum em 9 amostras e o gênero Epidermophyton em 7 amostras. Conclusão: Sobre a frequência das espécies, Trichophyton rubrum foi o agente etiológico predominante, semelhante ao já relatado em várias regiões do Brasil e do mundo, bem como em estudos anteriores da região. O dermatófito zoofílico mais comum foi Microsporum canis, corroborando com uma tendência já relatada por alguns autores. Trichophyton mentagrophytes foi isolado com maior frequência em pé e pele glabra, local em que se constitui um dos agentes etiológicos mais importantes. Contudo, foi observado um declínio significativo na sua detecção em todas as localizações, o que corrobora com estudos anteriores realizados na mesma região.

Frecuencia de Epidermophyton floccosum en dermatofitos aislados en un laboratorio de la Región de Valparaíso, Chile. Período 1980-2010 / Frequency of Epidermophyton floccosum in isolated dermatophytea laboratory from the Region of Valparaiso, Chile. Time frame: 1990-2010

Resumen Introducción: Las dermatofitosis son infecciones comunes en humanos, provocadas por hongos de los géneros Trichophyton, Microsporum y Epidermophyton. Objetivo: Determinar la frecuencia de E. floccosum en dermatofitos aislados en un laboratorio de la Región de Valparaíso durante las últimas tres décadas. Conocer las localizaciones más frecuentes, los grupos etarios y sexo de los pacientes afectados por este agente. Materiales y Método: Se revisaron los informes de cultivos superficiales con desarrollo de E. floccosum, Microsporum spp y Trichophyton spp de las tres últimas décadas del laboratorio de Micología de la Universidad de Valparaíso. Se registró en una planilla Excel el resultado del cultivo, edad, sexo y ubicación de la lesión de los pacientes. Resultados: El total de dermatofitosis con agente identificado fue de 6.780. En 26 casos hubo desarrollo de E. floccosum, de éstos, 73% (19/26) fueron en hombres y con una edad promedio de 37 años. La frecuencia disminuyó progresivamente desde la década de los ochenta hasta la del 2000. El grupo etario más afectados fue el de 36-60 años. Las localizaciones más frecuentemente afectadas fueron la planta y uñas de los pies. Conclusiones: Existe una disminución progresiva de la frecuencia de aislamiento de E. floccosum en el período estudiado. El sexo masculino y el grupo etario de 36-60 años fueron los más afectados. Las localizaciones más frecuentes fueron la planta y uñas de los pies.

Background: Dermatophytoses are frequent infections in human, which are produced by fungus genera Trichophyton, Microsporum and Epidermophyton. Aim: To determine frequency of E. floccosum in isolated dermatophyte in a laboratory from Valparaíso during the last three decades, in addition to knowing the most frequent localization, age and gender of patients affected by this agent. Method: All superficial culture reports, issued by the Universidad de Valparaíso's mycology laboratory in the last three decades, with E. floccosum, Microsporum spp and Trichophyton spp development, has been reviewed. Patients age, gender, location of the injury and culture report has been registered in an excel spreadsheet. Results: The total number of reports with dermatophyte development in the culture was 6,780. Only 26 cases show E. floccosum development, 73% of this (19/26) were present on men with and average age of 37 years. Frequency did progressively fall since eighty's until 2000 decade. The age group most affected by this etiological agent was 30-36 years. The most frequently localization in both man and woman were foot plant and nails. Conclusions: Frequency of isolation did decrease progressively in dermatophytose by E. floccosum for the study period. Masculine gender and 36-60 age group were the most affected. The most frequently localization were foot plant and nails.

Clinico-Mycological study of dermatophytosis in and around Kakinada.

Background: Dermatophytosis is a clinical condition caused by a fungal infection of the skin in humans and domesticated animals. Currently up to 20% of the population may be infected by one of the dermatophytes. Objective: To isolate and identify the fungal agents from clinical samples of dermatophytosis patients in and around kakinada. Materials and Methods: Clinical samples from 150 patients were subjected to potassium hydroxide (KOH) examination and culture. Causative organisms are identified macroscopically and microscopically. Statistical analysis was done by chi square test. Results: Out of 150 samples, 120 shown KOH positive and 66/120 (55%) samples were culture positive. Of these isolation rate of dermatophytes was 70/120 (58.3%) among these, 66 were Trichophyton species, 3 were Microsporum species, 1 was Epidermophyton floccosum. T.rubrum was the major isolate about 35(29.1%) strains. The male to female ratio of the positive cases was recorded as 11:3. The most effected age group was 21-30years (40%) followed by 31-40 years (28.6%). Conclusion: It may concluded from the present study that Tinea corporis is more frequently encountered condition followed by Tinea cruris. T.rubrum was implicated as major predominating species followed by T.mentagrophytes. Unhygienic conditions among low socioeconomic group, frequent migration of laborers, workers, hot and humid climatic conditions may be some of the contributing epidemiological factors. The study signifies the importance of mycological examination of dermatophytoses samples for effective management and also for epidemiological studies.

Epidemiologia e etiologia das dermatofitoses em Pernambuco 2005-2010 / Epidemiology and etiology of the dermatophytosis in Pernambuco, 2005-2010

A presente pesquisa teve como objetivos detectar, isolar e identificar espéciesdermatófitos em amostras de pele, pêlos e unhas de 5.590 pacientes oriundos de hospitais públicos de Pernambuco. Os resultados apontaram o Trichophyton rubrum como a espécie de dermatófito mais incidente. O gênero masculino e faixa etária entre 0-20 anos prevaleceram...

Establishment of an animal model of dermatophytosis and evaluation of the antifungal efficacy on dermatophytosis with this model / 中华皮肤科杂志

Objective To establish an animal model of dermatophytosis and to evaluate antifungal efficacy on dermatophytosis with this model. Methods Animal models of dermatophytosis were established by inoculating dermatophyte suspension onto abraded skin on the back of guinea pigs. Thirty- eight healthy guinea pigs were randomly and equally divided into 2 groups, namely, Trichophyton mentagrophytes group (infected with T. mentagrophytes), and Microsporum canis group (infected with M. canis), and each group was classified into three subgroups, i.e., itraconazole group treated with oral itraconazole of 4 mg per kilogram body weight per day from day 0 to day 14 after infection, terbinafine group treated with oral terbinafine of 5 mg per kilogram body weight per day from day 0 to day 14 after infection, and untreated group receiving no therapy. The therapeutic effect was evaluated according to skin lesion score and fungal examination results on day 8, 11 and 14 after infection. Results Obvious lesions were observed and fungal examination was positive in untreated, infected pigs on day 8 after infection. In T. mentagrophytes-infecyted pigs, the skin lesion score on day 8, 11, 14 was 9, 1 and 0 in itraconazole group, 8, 5, and 1 in terbinafine group, 48, 52, 40 in untreated group, respectively, and there was significant difference between treated and untreated groups on the three time points (all P<0.01); the mycological cure rates on the above time points were 66.7%, 83.3%, 83.3%, in itraconazole-treated pigs, 83.3%, 83.3%, 83.3%, in terbinafine-treated pigs, 0, 0, 0 in untreated pigs, respectively, with no significant difference between itraconazole and terbinafine group (all P>0.05) but statistical difference between untreated and treated groups (all P<0.01) on all time points. Meanwhile, in M. canis-infected pigs, the skin lesion score on day 8, 11, 14 reached 3, 0, 0 in itraconazole group, 9, 2, 0 in terbinafine group, 46, 47, 39 in untreated group, respectively, and mycological cure rates 83.3%, 83.3%, 83.3% in itraconazole group, 83.3%, 83.3%, 83.3% in terbinafine group, 0, 0, 0 in untreated group, respectively; significant difference was noticed in the two parameters between the treated and untreated groups (all P<0.01) but not between the two treated groups (all P>0.05). Conclusion Itraconazol and terbinafine exhibit similar excellent antifungal activity in routine model of T. mentagrophytes-and M. canis-dermatophytosis.

Epidemiologia, etiologia e formas clínicas das dermatofitoses em Pernambuco, 1995-2005 / Epidemiology, etiology and clinical presentation of dermatophytosis in Pernambuco, 1995-2005

Num total de 1.238 casos de dermatofitoses, ocorridas na Cidade de Recife /PE, observou-se predomínio das tinhas de couro cabeludo (33,7 por cento) e Trichophyton tonsurans (25,5 por cento), entre 1995 e 1999, enquanto as tinhas de pele glabra (35,5 por cento) e Trichophyton rubrum (34 por cento) foram mais freqüentes entre 2000 e 2005. Detectou-se importante redução do Trichophyton mentagrophytes, no último período.

Out of a total of 1,238 cases of dermatophytosis in the city of Recife (Pernambuco), lesions of the scalp (33.7 percent) and Trichophyton tonsurans (25.5 percent) predominated between 1995 and 2000, while lesions of the hairless skin (35.5 percent) and Trichophyton rubrum (34 percent) were the most frequent between 2000 and 2005. A significant reduction in Trichophyton mentagrophytes was detected in the second of these periods.

Freqüência das dermatofitoses em exames micológicos em Hospital Geral de Porto Alegre, Brasil / Frequency of dermatophytosis in mycological examinations at a general hospital in Porto Alegre, Brazil

FUNDAMENTOS- As espécies de dermatófitos podem variar de uma região para outra, tendo esse fato importância epidemiológica e terapêutica. OBJETIVO- Descrever a freqüência dos dermatófitos nos exames micológicos em pacientes ambulatoriais do Hospital de Clínicas de Porto Alegre (HCPA). MÉTODOS - Foi realizada análise retrospectiva dos exames micológicos realizados em pacientes ambulatoriais do Serviço de Dermatologia do Hospital de Clínicas de Porto Alegre (HCPA) durante o período de agosto de 1998 a fevereiro de 2006. Os dados foram comparados com os de trabalhos anteriores locais e de outras cidades do Brasil utilizando o teste do qui-quadrado. RESULTADOS - Das 5.077 amostras coletadas, 2.033 (40,0 por cento) foram positivas para dermatófitos, sendo entre os dermatófitos o Trichophyton rubrum a espécie mais isolada (62,4 por cento), seguido de T. mentagrophytes (18,2 por cento), Microsporum canis (5,7 por cento), Epidermophyton floccosum (2,0 por cento), M. gypseum (1,4 por cento) e T.tonsurans (0,3 por cento). CONCLUSÕES - Não houve variação significativa na epidemiologia dos dermatófitos nos últimos sete anos na cidade de Porto Alegre (p>0,05). Entretanto, o estudo evidencia diferenças na microbiota de Porto Alegre, comparada à de alguns outros centros urbanos do país (p<0,001). Foi observada menor ocorrência de T. tonsurans e M. canis em relação a São Paulo; ao contrário do T. mentagrophytes, que é quase três vezes mais freqüente em Porto Alegre.

BACKGROUND - Dermatophyte species vary in different regions and this fact has therapeutical and epidemiological importance. OBJECTIVE - To determine the frequency and the species of dermato phytes in mycological examinations of patients seen at the outpatients' clinic, Department of Dermatology, Hospital de Clínicas de Porto Alegre. METHODS - A retrospective analysis of mycological examinations performed in outpatients from August 1998 to February 2006. The data were compared to the results of previous studies conducted locally and in other Brazilian cities by means of chi-square test. RESULTS - Out of 5077 samples collected, 2033 (40.0 percent) were positive for dermathophytes. Trichophyton rubrum species more frequently isolated (62.4 percent), followed by T. mentagrophytes (18.2 percent), Microsporum canis (5.7 percent), Epidermophyton floccosum (2.0 percent), Microsporum gypseum (1.4 percent) and T. tonsurans (0.3 percent). CONCLUSION - No significant variation was observed in epidemiological data on dermatophytes in the last seven years in Porto Alegre (p>0.05). However, the study showed differences in the microbiota of Porto Alegre, compared to other Brazilian urban centers (p<0.001). T. tonsurans and M. canis were less frequent than in São Paulo, unlike T. mentagrophytes, which is occurs three times more often in Porto Alegre than in São Paulo.

The Epidemiologic Study on Epidermophyton floccosum(1976-1997) / 대한의진균학회지

BACKGROUND: E. floccosum was known to be the frequent dermatophyte of tinea cruris and fourth causative agent of dermatophytosis in Korea. However, its incidence has been decreasing. OBJECTIVE: The purpose of this study was to investigate epidemiologic aspects of E. floccosum. METHOD: We performed the epidemiologic study on 900 patients with E. floccosum infections in from January 1976 to December 1997. RESULTS AND CONCLUSION: The incidence of dermatophytosis was 16.5% out of a total of 614,139 outpatients, and that of E. floccosum was 0.9% out of a total of 101, 314 dermatophytosis. Among the age groups, the incidence rate was high in the first decade (29.4%) and second decade (41.7%). The ratio of male to female patients was 6.6:1. The prevalence of the month was high in the August, September and October. Involved sites were groin (85.8%), foot (6.2%), trunk (3.7%), hand (1.3%), leg (1.0%), toenail (0.8%), face (0.7%) and arm (0.6%) in decreasing order of frequency. We found that the incidence of E. floccosum had been markedly decreasing since 1986.

Random Amplified Polymorphic DNA for Classification and Identification of Dermatophytes / 대한의진균학회지

BACKGROUND: Dermatophytoses are infections of keratinized tissues, that is, the epidermis, hair and nails, caused by a group of specialized fungi, the dermatophytes. Laboratory diagnoses of dermatophytes such as Tricophyton, Microsporum and Epidermophyton are made by microscopic examination and in vitro culture but they are either time consuming of lacking specificity. OBJECTIVE: In order to develop and apply more rapid and precise diagnostic tests for fungal pathogens to facilitate the improved identification of dermatophytes, we investigated random amplified polymorphism DNA for classification and identification of dermatophytes. METHODS: Amplification reactions were performed in volumes of 5011 containing 10mM Tris-HCl(pH 8.3), 50mM KCl, 1.5mM MgCl2, 0.01% (w/v), gelatin, 200mM dNTP mixture, 50pM primer, Taq polymerase (0.025 units/ microliter), DNA 0.001 microgram/microliter. The optimal condition to. PCR was 2 cycles (denaturing 94 degrees C 2min, annealing 33 degrees C 2min, extension 72 degrees C 4min), 40 cycles, and extension (72 degrees C 10min). RESULTS: RAPD showed interspecies polymorphism in but it had identical patterns in intraspecies. CONCLUSION: It was confirmed that RAPD PCR analysis with optimal conditions is a fast, economical and reproducible method for identification and classification of dermatophytes isolates.

Skin Verrucous Hyperplasia Caused b y Epidermophyton floccosum and Candida ciferrii:a Case Report / 中华皮肤科杂志

Several years after trauma,a patien t suffered from skin verrucous hyperplasia for more than 30years,accompanied by ulcer occasio nally,on the feet,ankles and legs su ccessively.Mycological examinati on(9times)had been done before treatment.Slig ht septate hyphae and /or spores were demonstrated by direct mi-croscopy(5times);and yellowish green colony grew on S abouraud agar at 25℃for 2times,it wa s identified as Epidermophyton floccosum.Yeast -like colony grew on Sabourau d agar at 25℃for 5times,it was identi fied as Candida ciferrii by API.After treatment,Candida ciferrii could still be detected by mycologic al examination(6times),but no Epidermophyton floccosum was found.Slight septate hyphae were demonstrated in stratum spinosum,stratum granulosum and stratum corneum by histopathological examination.Isolated or clustered blastospores,spores and chlamydospores were demonstrated in stratum c orneum by histopathological examin ation.Therefore,it was concluded that the skin verrucous hyperplasia in this c ase is caused by mixed infection of Epidermophyton floccosum and Candida ciferrii.The patient was treated with flucon azole capsule 50mg daily for5weeks,followed by terbinafine tab let 250mg daily for 36weeks,and then250mg twice daily for 18weeks.In the 5th week of terbinafine therapy,a part of the lesions on the shin of left leg healed.No further therapeutic effect was observed.