SPECTRUM OF SUPERFICIAL MYCOSIS IN A TERTIARY CARE HOSPITAL- A MATTER OF CONCERN

BACKGROUND : Superficial mycosis has been recognized as a common fungal condition worldwide, including India. It refers to fungal infection of skin and its appendages. AIM & OBJECTIVES : 1) To determine the frequency of fungal agents isolated from clinically suspected cases of superficial mycoses, in a tertiary health care hospital. 2) To access the risk factors associated with it. 3) To analyse the demographic profile associated with superficial mycosis. MATERIAL & METHODS: The prospective study was carried out, over a period of 12 months (January 2021 to December 2021), samples such as skin scarping, hair plugs and nail clipping obtained from patients were submitted to Department of Microbiology for the fungal etiology. Samples were subjected to direct microscopy by KOH mount and fungal culture as per standard convectional technique. RESULTS: A total of 63 clinically suspected cases of superficial mycosis were enrolled in the study. Among the isolates recovered the most common were Dermatophytes(41.26%) followed by Candida(14.28%), Aspergillus(6.3%), Mucor(3.1%) and remaining 23.80% were sterile. Among the Dermatophytes, T.rubrum 42.30% was the predominant pathogen followed by T.mentagrophytes 34.61%. The most common age group affected was 21-40 years of age with male predominance of male to female ratio of 1.5:1. Out of total of 48 samples of superficial mycosis 26 were positive by direct microscopy and 48 samples were positive both by microscopy and culture. Most of the positive cases were recovered from immunocompromised individuals suffering from diabetes (37.5%) followed by prolonged antibiotic therapy (25.02%), long steroid therapy (12.5%) and chemotherapeutic agents (10.41%). The cases were mainly seen in the months between April to July which correlates the infection with the humid season. CONCLUSION: The study pinpointed dermatophytes as the most common clinical pattern of superficial mycosis with a male predominance. Dermatophytic infection is one of the emerging fungal disease along with non dermatophytic molds, especially in immunocompromised individuals prompt treatment and management can herald the onset of ensuing complications, thereby limiting the morbidity and thus improving the quality of life.

Infection and strain analysis of superficial fungi in 498 cases in Shiyan area / 公共卫生与预防医学

Objective To understand the clinical characteristics, susceptibility factors, and the composition and distribution of pathogenic fungi in Shiyan area. Methods From January 2018 to December 2018, at the outpatient department of Taihe Hospital, a total of 498 patients with superficial mycosis were confirmed by clinical features and microbial identification. Clinical data was collected and statistical analysis of these patients was carried out. Results Among 498 patients, the top three diseases were 123 cases of tinea corporis (24.70%), 110 cases of onychomycosis (22.09%), and 54 cases of body ringworm (10.84%). The top three pathogenic fungi were Trichophyton rubrum (232 strains, 46.59%), Trichophyton interdigitale (71 strains, 14.26%) and Candida albicans (41 strains, 8.23%). There were some differences in the incidence of patients of different genders, ages, and jobs. Conclusion Tinea cruris was the main superficial mycosis in Shiyan area and Trichophyton rubrum was the main pathogen of superficial mycosis. The epidemic trend is similar to that in most regions of the country, but it has its own characteristics.

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.

Micosis superficiales en pacientes embarazadas en un hospital general de segundo nivel de atención / Superficial mycosis in pregnant patients in a general hospital

Resumen: ANTECEDENTES: Las micosis superficiales se generan por contacto directo con el hongo o con una persona o animal infectado, y afectan la piel, los anexos y las mucosas; las pacientes embarazadas son susceptibles a cambios cutáneos fisiológicos y patológicos. OBJETIVO: Describir las micosis superficiales en pacientes embarazadas del Servicio de Obstetricia del Hospital General Dr. Manuel Gea González. MATERIAL Y MÉTODO: Estudio descriptivo, observacional, prospectivo y transversal realizado en pacientes embarazadas de la consulta externa del Servicio de Gineco-obstetricia del Hospital General Dr. Manuel Gea González de julio de 2016 a julio de 2017. RESULTADOS: Se incluyeron 23 pacientes que acudieron al Servicio de Micología; el grupo de edad más afectado fue de 21 a 40 años de edad (86.9%); 17 tuvieron tiña plantar (73.9%) y 4 (17.9%) tuvieron onicomicosis distrófica total. Dos cultivos fueron positivos para Trichophyton rubrum. CONCLUSIONES: Las micosis superficiales fueron poco frecuentes en el grupo estudiado: 17 pacientes con tiña de los pies y 4 con onicomicosis. El agente aislado fue Trichophyton rubrum.

Abstract: BACKGROUND: Superficial mycoses are generated by direct contact with the fungus or with an infected person or animal, and affect the skin, the attachments and mucous membranes; pregnant patients are susceptible to skin changes, both physiological and pathological. OBJECTIVE: To know the frequency of superficial mycoses in pregnant patients from the obstetrics service of the Hospital General Dr. Manuel Gea González. MATERIAL AND METHOD: A descriptive, observational, prospective and crosssectional study carried out in pregnant patients of the Gineco-Obstetrics Service of the Hospital General Dr. Manuel Gea González, Mexico City, from July 2016 to July 2017. RESULTS: Twenty-three patients were included in the mycology department for their physical examination; the most affected group was between 21 and 40 age years (86.9%); 17 patients presented tinea pedis (73.9%) and 4 (17.9%) onychomycosis. CONCLUSIONS: Superficial mycosis were not frequent in the group of study: 17 patients had tinea pedis and 4 onychomycosis. The causal agent isolated was Trichophyton rubrum.

Frecuencia de tiña del cuerpo en un hospital del estado de Quintana Roo / Frequency of tinea corporis in a hospital in Quintana Roo state

Resumen ANTECEDENTES: las dermatofitosis son micosis superficiales causadas por un grupo de hongos parásitos de la queratina, denominados dermatofitos. Comprenden tres géneros: Trichophyton, Microsporum y Epidermophyton. Son cosmopolitas, predominan en climas cálidos y húmedos, y representan 70 a 80% de todas las micosis. OBJETIVO: identificar la frecuencia de consulta por tiña del cuerpo en una zona urbana tropical. MATERIAL Y MÉTODO: estudio descriptivo, abierto y transversal, en el que durante tres meses en 2015 se registraron todos los pacientes con diagnóstico clínico de tiña del cuerpo que asistieron a la consulta de dermatología de un hospital de segundo nivel de Playa del Carmen, Quintana Roo, México. Se registraron los datos demográficos, tiempo de evolución, topografía y factores predisponentes asociados. Se realizó examen directo en escama con hidróxido de potasio (KOH), cultivo micológico en medio de Sabouraud y examen directo del cultivo con azul de lactofenol para identificar al agente causal. RESULTADOS: de 546 consultas de dermatología general se detectaron 17 pacientes (3%) y se corroboró el diagnóstico con KOH en 14 pacientes (82%, nueve mujeres [64%]), entre éstos hubo crecimiento en el cultivo en 9 muestras (64%). Se aisló Microsporum canis en 4 (44%), Trichophyton rubrum en 4 (44%) y T. mentagrophytes en uno (11%). Los límites de edad fueron 3 y 57 años (4 niños, 28.5%). El tiempo de evolución promedio fue de 15 semanas. La localización más frecuente fueron las extremidades. Los factores predisponentes más comunes fueron el contacto con mascotas infectadas y la administración de corticoesteroides. CONCLUSIONES: la tiña del cuerpo representa 3% de la consulta de dermatología en un hospital de una zona urbana tropical. Fue más frecuente en mujeres, predominó en las extremidades y en 28.5% afectó a población pediátrica. T. rubrum y M. canis fueron los agentes causales más frecuentes.

Abstract BACKGROUND: Dermatophytosis are superficial mycosis caused by dermatophytes, a group of fungi that parasite keratin, and is composed of three genera: Trichophyton, Microsporum and Epidermophyton. They predominate on hot and humid climates, and are responsible of 70-80% of all mycosis. OBJETIVE: To identify the frequency of consultation for tinea corporis. MATERIAL AND METHOD: A descriptive, open and cross-sectional study in which, during three months in 2015, all patients with clinical diagnosis of tinea corporis that attended to the dermatology department in a second level hospital at Playa del Carmen, QR, Mexico, were registered including demographic data, such as progression time, topography and associated predisposing factors; a KOH mount was performed, as well as mycological culture in Sabouraud dextrose agar and microscopic examination of the colony with lactophenol blue to identify the causal agent. RESULTS: Out of 546 visits to the dermatology service, the diagnosis was confirmed in 17 patients (2.5%) and diagnosis was confirmed with a positive KOH mount in 14 patients (82%, nine women [64%]), and in 9 samples there was culture growth (64%). Microsporum canis and Trichophyton rubrum were isolated in 4 cases (44%) each, and Trichophyton mentagrophytes in one case (11%). Age range was 3-57 years, with four children registered (28.5%). The progression time of the disease was 15 weeks in average. The most frequent topography was the extremities. The most common predisposing factors were contact with infected pets and the administration of corticosteroids. CONCLUSIONS: Tinea corporis represents 3% of the dermatology consultation in a second level hospital in urban tropical zone. It is more frequent in female patients, affecting more frequently extremities; 28.5% were children. The isolated causal agents were M. canis and T. rubrum.

Presentación de siete casos de tiña negra en niños / Reports of seven cases of tinea nigra in children

Introducción: la tiña negra es una micosis superficial causada por el hongo Hortaea werneckii. Se considera una micosis benigna que por lo general es observada en países tropicales. Objetivo: reportar siete casos de tiña negra en niños de dos hospitales de La Habana, Cuba. Métodos: se realizó estudio micológico (examen directo y cultivo) a partir de escamas tomadas mediante raspado de las lesiones a siete niños con diagnóstico clínico presuntivo de tiña negra palmar. Se registraron las características de las lesiones, edad, sexo y factores predisponentes de los pacientes, así como la evolución del cuadro con el tratamiento antifúngico. Resultados: se confirmó la sospecha clínica de tiña negra a través del aislamiento e identificación de Hortae werneckii. Las edades de los pacientes oscilaron entre 3 y 6 años y el 57 por ciento era del sexo femenino. La hiperhidrosis se encontró en el 43 por ciento de los casos. El tratamiento específico con antifúngicos azólicos y terbinafina tópicos fue satisfactorio en 21 días como promedio. Conclusiones: todos los casos con sospecha de tiña negra fueron confirmados de manera oportuna en el laboratorio, lo que permitió descartar enfermedades malignas y aplicar tratamiento específico(AU)

Dermatoscopia de tinha negra palmar com reação inflamatória localizada / Dermoscopy of palmar tinea nigra (TN) with inflammatory located reaction

Introdução: A tinha negra (TN) é uma infecção fúngica assintomática da camada córnea causada pelo fungo demácio Hortaeawerneckii. Caracteriza-se por manchas marrons ou pretas que podem localizar-se nas palmas e plantas. Nos últimos anos a dermatoscopia tem sido utilizada no diagnóstico dessa doença e consiste em uma alternativa para a diferenciação das lesões pigmentares. Objetivo: Este relato visa descrever o primeiro caso de TN com sinais inflamatórios locais e demonstrar a importância da dermatoscopia no auxílio diagnóstico. Conclusões: Neste caso a dermatoscopia permitiu o diagnóstico de TN pelo padrão tipicamente descrito na literatura, assim como a melhor visualização do eritema da erupção disidrosiforme e sua descamação.

Distribución de especies y susceptibilidad antifúngica de Candida spp. causantes de micosis superficiales. Coro, estado Falcón, Venezuela / Species distribution and antifungal susceptibility of Candida spp. causing superficial mycosis. Coro, Falcon state, Venezuela.

Las especies de Candida distintas a C. albicans se describen con frecuencia como agentes causales de micosis superficial y presentan una mayor resistencia al tratamiento con los azoles. Con la finalidad de determinar la distribución de especies y la susceptibilidad antifúngica in vitro de Candida spp., se realizó un estudio ambispectivo donde se analizaron 18 aislados de levaduras obtenidas de muestras de pacientes con diagnóstico de micosis superficial. La identificación taxonómica se realizó mediante la visualización de las características macroscópicas de crecimiento en agar cromogénico y por métodos convencionales. La susceptibilidad a fluconazol y voriconazol se evaluó por el método de difusión en disco. El 88,8% de los aislados provenía de muestras de uñas. C. parapsilosis fue la especie más frecuente, seguida de C. tropicalis, C. albicans y C. krusei, lo cual confirmó el predominio de especies no albicans como causa de micosis superficial. El patrón de susceptibilidad a fluconazol y voriconazol fue similar: todos los aislados de C. parapsilosis y C. albicans resultaron sensibles, mientras que el 83,3% de C. tropicalis mostró sensibilidad a ambos antifúngicos. C. krusei, especie resistente a fluconazol, presentó sensibilidad intermedia al voriconazol. El uso de agar cromogénico permitió detectar infecciones mixtas en muestras de uñas, involucrando en uno de los casos a Candid spp. y C.tropicalis, esta última con resistencia tanto a fluconazol como a voriconazol. Los resultados obtenidos demuestran la importancia de la identificación de especies y la realización de pruebas de susceptibilidad con el fin de evitar fracasos terapéuticos en micosis superficiales. Autor de correspondencia: Leyla Humbría-García. Laboratorio de Micología

Candida species other than C. albicans are often described as causative agents of superficial mycosis and are more resistant to treatment with azoles. In order to determine the distribution of species and in vitro antifungal susceptibility of Candida spp., one ambispective study, which analyzed 18 yeast isolates obtained from samples from patients diagnosed with superficial mycosis, was performed. Taxonomic identification was performed by macroscopic visualization of the growth characteristics in chromogenic agar and by conventional methods. The susceptibility to fluconazole and voriconazole was evaluated by the disc diffusion method. Most of the isolates (88.8%), came from nail samples. C. parapsilosis was the most common species, followed by C. tropicalis, C. albicans and C. krusei, which confirmed the prevalence of non-albicans species as a cause of superficial mycoses. The pattern of susceptibility to fluconazole and voriconazole was similar: all isolates of C. parapsilosis and C. albicans were susceptible, while 83.3% of C. tropicalis showed sensitivity to both antifungals. C. krusei, fluconazole-resistant species showed intermediate susceptibility to voriconazole. The use of chromogenic agar allowed to detect mixed infections in nail samples, involving Candida spp. and C. tropicalis in one case, the latter with resistance to both fluconazole and voriconazole. The results demonstrate the importance of species identification and susceptibility testing to avoid therapeutic failures in superficial mycoses.

Estudio de micosis superficiales en la población de Villa del Prado, provincia de Córdoba, Argentina / Study of superficial mycoses in Villa del Prado population,province of Córdoba, Argentina

Las micosis superficiales son patologías frecuentes en la consulta dermatológica. Según la Organización Mundial de la Salud (OMS), alrededor del 20-25% de la población mundial padece micosis superficiales. Existe poca información de las mismas y en especial de zonas periurbanas. Nuestro objetivo fue obtener datos epidemiológicos acerca de las micosis superficiales e identificar sus agentes etiológicos que afectan piel, pelo y uñas en los pobladores de la comuna de Villa del Prado. El estudio fue descriptivo, prospectivo y transversal. Se incluyeron pacientes mayores de 2 años, con lesiones cutáneas y anexialesque sugirieron micosis superficiales, excluyéndose menores de 2 años, con hepatopatía previa al estudio y embarazadas. El proyecto del área de Responsabilidad Social Universitaria se realizó en los períodos lectivos 2008-2010. Los pacientes fueron atendidosen el dispensario de esa localidad por médicos dermatólogos y residentes. Las bioquímicas micólogas con alumnos de 4º año de la carrera de Bioquímica indicaban la preparación para la toma de muestra y extracción de la misma. Los análisis micológicos se llevarona cabo por metodología clásica. Se realizaron 41 viajes a dicha comunidad, 248 consultas dermatológicas y se atendieron 142 pacientes. Se detectaron 22 pacientes con lesiones micológicas y 19 concurrieron a la toma de muestras. El examen directo resultó positivo en 14 de ellos, uno de los cuales fue Malassezia spp. Los cultivos dieron positivo en 14 pacientes, dos de ellos con dos agentes etiológicos. Se obtuvieron: cuatro Trichophyton rubrum, tres Trichophyton mentagrophytes, cinco Candida albicans, una Candida tropicalis, un Epidermophyton floccosum, un Trichophyton interdigitale y unMicrosporum canis. La mayoría de los aislamientos pertenece al grupo de los dermatofitos, en segundo lugar levaduras del género Candida, y se detectó Malassezia spp.

Superficial mycosis are common dermatologic complaints. According to the World Health Organization (WHO) about 20-25% of the world population suffers from superficial mycosis.There is little information about them especially in peri-urban areas. Our aim was toobtain epidemiological data about superficial mycosis and to identify their etiologicalagents affecting the skin, hair and nails in the population of Villa del Prado community.Our study was descriptive, prospective and cross-sectional. We included patients olderthan 2 years old presenting skin and adnexal lesions suggesting superficial mycosis.Children under 2 years of age, with previous hepatic disease and pregnant women were excluded. The University Social Responsibility project was carried out during 2008-2009-2010 school years. Patients were assisted in Villa del Prado health care center by dermatologists and medical residents. Biochemists specialized in Mycology indicated the preparationfor taking samples to their fourth year students of the Career in Biochemistry.Mycological analyses were performed following the classical methodology. The team went41 times to the community receiving 248 dermatologic consultations; 142 patients wereassisted. In 22 patients mycological lesions were detected; 19 of them went to sampletaking. Direct testing was positive in 14 patients, Malassezia spp being one of them. Cultures were positive in 14 patients, two of them with 2 aethiological agents. 4Trichophyton rubrum, 3 Trichophyton mentagrophytes, 5 Candida albicans, 1 Candida tropicalis,1 Epidermophyton floccosum, 1 Trichophyton interdigitale y 1 Microsporum canis wereobtained. Most isolates belong to the dermatophytes group followed by yeasts of thegenus Candida and Malassezia spp was also detected.

Micosis mucocutáneas en pacientes con VIH-Sida de la ciudad de Valparaíso, Chile / Mucocutaneous fungal infections in patients with HIV-Aids of Valparaíso, Chile

Introducción: la pandemia del VIH-SIDA continúa en aumento en todo el mundo. Las dermatomicosis en este grupo son más frecuentes que en la población general, destacando la candidiasis oral y la onicomicosis. Métodos: se evaluaron 100 pacientes adultos con diagnóstico de VIH-SIDA y micosis mucocutáneas, en control en el Hospital Carlos van Buren de Valparaíso, Chile, durante los años 2011 y 2012. La identificación de los hongos filamentosos y levaduras se realizó por morfofisiología y pruebas bioquímicas. Para el análisis estadístico se utilizaron los programas Microsoft Excel y Stata 10. Resultados: el promedio de edad fue de 39.37 años. El 88% eran hombres. Las localizaciones más frecuente fueron uña de pie (29,03%), cavidad oral (21,77%) y tronco (17,74%). Las especies más comunes fueron: Trichophyton rubrum (33,06%), Candida albicans (25,8%), Malassezia pachydermatis (9,68%) y Trichophyton mentagrophytes (4,83%). Conclusiones: las dermatomicosis en pacientes VIH-SIDA se presentaron principalmente en hombres. La localización más frecuente fue la onicomicosis de pie y T rubrum, la especie más aislada. Además se destaca el aislamiento de Malassezia pachydermatis en pitiriasis versicolor, en tronco de hombres.

Introduction: HIV-AIDS pandemic continues to increase worldwide. Dermatomycoses in this group are more frequent than in the general population, emphasizing oral candidiasis and onychomycosis. Methods: we evaluated 100 adult patients diagnosed with HIV-AIDS and mucocutaneous fungal infections, in control at the Hospital Carlos van Buren of Valparaiso, Chile, during the years 2011 and 2012. Identification of filamentous fungi and yeast was performed by morphophysiology and biochemical tests. For statistical analysis programs used Microsoft Excel and Stata 10. Results: the mean age was 39.37 years. 88% were men. The most common locations were fingernail foot (29,03%), oral cavity (21,77%) and trunk (17,74%). The most common species were Trichophyton rubrum (33,06%), Candida albicans (25,8%), Malassezia pachydermatis (9,68%) and Trichophyton mentagrophytes (4,83%). Conclusions: dermatomycoses in HIV-AIDS patients occurred mainly in men. The most common was foot onychomycosis and Trichophyton rubrum the most commonly isolated. Also highlights the isolation of Malassezia pachydermatis in tinea versicolor on the trunk of man.

Micoses superficiais na mulher / Superficial mycosis on woman

Micoses superficiais são as infecções cutâneas causadas por fungos que se limitam aos tecidos superficiais queratinizados e semiqueratinizados de pele, unhas e pelos. Englobam as ceratofitoses, dermatofitoses e candidíases. Diagnóstico e tratamento das micoses superficiais são revisados neste trabalho, com ênfase na mulher.

Estudio etiológico y epidemiológico de las micosis cutáneas en un laboratorio de referencia - Antioquia - Colombia / Etiological and epidemiological study on superficial mycoses performed in a referral laboratory center - Antioquia -Colombia

Introducción: las micosis superficiales son infecciones frecuentes de los tejidos queratinizados, causadas por levaduras, dermatofitos, mohos ambientales. Su etiología varía de acuerdo a la población de estudio. Objetivo: determinar la frecuencia etiológica y algunas características poblacionales y clínicas de los pacientes con diagnóstico presuntivo de micosis superficiales, que consultaron al Instituto Colombiano de Medicina Tropical (I.C.M.T.) durante el período 2008 al 2011. Materiales y métodos: se realizó un estudio descriptivo de corte retrospectivo en el que se analizaron los datos poblacionales y los resultados micológicos de 2 282 muestras provenientes de 1 645 pacientes con diagnóstico presuntivo de micosis superficiales. Resultados: el 71,8 % de los pacientes fueron de género femenino y la edad promedio fue 44,3 años. De las 2 282 muestras se reportó identificación micológica en 82,6 %, siendo los microorganismos más frecuentemente aislados Candida spp (25 %), Fusarium spp, Trichophyton mentagrophytes y Candida krusei (10 % cada uno) y Rhodotorula spp en 8 %. La onicomicosis, tanto de manos como de pies, fue la infección fúngica superficial encontrada con mayor frecuencia. Conclusiones: las micosis superficiales son enfermedades comunes, con variaciones en su frecuencia según la edad, el sexo y la región de donde provienen los pacientes. Su diagnóstico oportuno constituye una de las principales herramientas para un tratamiento adecuado y bien dirigido, evitando así fallas terapéuticas y aparición de cepas de hongos resistentes.

Introduction: Superficial mycoses are frequent infections caused by yeasts, dermatophytes and environmental molds on keratinized tissue. Objectives: To characterize the species of dermatophytes, yeasts and environmental molds that cause superficial mycoses and to analyze their relationship to sex, age and localization in patients evaluated at the Tropical Medical Institute in Valle de Aburrá Antioquia during the time period 2008-2011. Materials and methods: A descriptive retrospective cross-sectional study was performed, and 2282 samples from 1645 patients were included. Patients of all ages were included with a presumptive diagnosis of a superficial mycosis. A KOH was performed with culture of material from the lesions. The characterization of the fungi was done according to morphology and biochemical studies. Results: Out of 1645 patients 1182 (71.8 %) were women and the average age was 44.3 years. From the 2282 samples taken the mycological identification could be done in 82,6 % of them and the microorganisms most frequently isolated were Candida spp (25 %); Fusarium spp, Trichophyton mentagrophytes and Candida Krusei each represented 10 % and Rhodotorula was isolated in 8 % of samples. Hand and feet onychomycosis was the most frequent superficial fungal infection. Conclusions: Superficial mycoses are frequent pathologies that vary according to age, sex and the diagnostic methods used. The pertinent diagnosis constitutes one of the main tools for a timely and efficacious treatment, avoiding therapeutic failures and the appearance of resistant strains.

A study of superficial mycoses in tertiary care hospital.

Background & Objectives: Fungal infections are extremely common in the tropical regions and some of them are serious .Fungi produce diverse human infections ranging from superficial skin infections to systemic disease .The study of superficial mycosis is important due to the frequent occurrence in dermatology clinics. The present study was undertaken with a view to find out the clinical pattern of dermatophytic and non – dermatophytic fungi (superficial mycosis) and most common fungal pathogens in tertiary care hospital affiliated with medical college in Western India from August 2007 to July 2008. Methods: A clinical and mycological study of superficial mycosis was conducted on 215 cases (138 males and 77 females). Direct microscopy by KOH (potassium hydroxide) mount and culture was undertaken to isolate the fungal pathogen in each case. Results: Commonest age group involved was adults of 19-59 years age. Tinea corporis was the most common clinical presentation and Trichopyton rubrum was the most common fungal pathogen isolated. Dermatophytosis was the commonest superficial fungal infection and found in 147/215 cases (68.4%). Non dermatophytic fungus like pityriasis versicolor and yeast like candida species were isolated in 48/215(22.3%) cases and 20/215 (9.3%) cases respectively. The KOH positivity rate was 72.4% and total culture positivity rate was 62.8%.Interpretation & conclusion: Along with dermatophytes, nondermatophytic fungi are also emerging as important causes of superficial mycosis. Direct microscopy and culture both are important tools for diagnosis of the fungal infections.

Trichosporon species isolated from the perigenital region, urine and catheters of a Brazilian population

The present study aimed to 1) determine the colonization rates of medically important Trichosporon species on normal perigenital skin and 2) determine the isolation rates of Trichosporon spp. isolated from the urine and catheters of Brazilian patients hospitalized in the Intensive Care Unit (ICU). The overall colonization rate of Trichosporon spp. was 11.15 percent (112 isolates). The most common species isolated from normal perigenital skin was T. cutaneum (29.46 percent), followed by T. asteroides (20.53 percent), T. ovoides (15.17 percent), T. inkin (10.71 percent), T. mucoides (8.92 percent), and T. asahii (6.25 percent). From urine and catheters, T. asahii was the species most commonly isolated (76.5 percent; n =23), followed by T. inkin (16.6 percent; n = 5) and T. asteroides (6.6 percent; n = 2). In addition, the highest isolation rate occurred in subjects in the 71- to 80-year-old age range (36.7 percent; n= 11), followed by 61 to 70 (26.7 percent; n = 8), 51 to 60 (13.3 percent; n = 4), 31 to 40 (13.33 percent; n = 4), and 41 to 50 (10 percent; n =3). We concluded that 6 medically important species of the genus Trichosporon colonize the perigenital region in a normal population. The identification of these species is possible by means of classical methods but often requires repeated analyses repetitions due to difficulties in the assimilation process. In contrast, only 3 species of Trichosporon were isolated from urine and catheters.

Diferencias por género en el diagnóstico de micosis superficiales: análisis de 30.590 pacientes / Gender differences in diagnosis of superficial mycosis: analysis of 30.590 cases

Los micosis superficiales corresponden o las afecciones de piel, pelos, uñas y mucosas por diversos especies de hongos. Sus principales agentes etiológicos corresponden a dermatofitos, levaduras del género Candiada y Malassezia sp. El objetivo de nuestro trabajo fue caracterizar y analizar las dermatomicosis superficiales según género, poro lo cual se realizó un estudio retrospectivo durante el periodo comprendido entre enero de 1999 y diciembre de 2006 en el Laboratorio de Dermatología del Hospital Clínico de la Universidad de Chile. En el período observado se analizaron 30.590 registros de pacientes. El porcentaje de resultados positivos fue menor en mujeres que en hombres, tanto para micológicos (56% vs 66%, P < 0,00 1) como para cultivos (32% vs 39%, P < 0,00 1). Se observó que las mujeres tuvieron significativamente más presencia de levaduras en el examen micológico directo, desarrollo de Candida sp en el cultivo y mayor afectación de uñas de manos que los hombres.

Superficial mycosis (SM) includes various fungi species that affect skin, hair, nails and mucous membranes. The main a etiologic agents are dermatophytes, and Candida and Malassezia sp, yeasts. The aim of this study is to characterize SM and analyze its relation with gender. A retrospective study was realized in the Laboratory of Dermatology, University of Chile Clinical Hospital, between January 1999 and December 2006. 30,590 patient charts were reviewed. Women showed o lower percentage of positive results thon men in direct microscopic tests (56% vs, 66%, P < 0,00 1) and culture tests (32% vs, 39%, P < 0,00 1). Women had significantly higher yeast counts in direct microscopic tests, higher frequency of Candida sp. in cultures, and greater involvement of finger nails than men.

Micosis superficiales diagnosticadas en el Laboratorio de micología médica de la Universidad de Costa Rica / Superficial mycosis diagnosed in the laboratory of medical mycology of Costa Rica University

Las micosis superficiales son causa frecuente de consulta, tanto en los servicios de dermatología como en medicina general. En estas afecciones resulta de gran interés el realizar los estudios microbiológicos para hacer el diagnóstico diferencial y para conocer el agente etiológico causante de la patología, no sólo por los aspectos epidemiológicos que esto implica, sino también por el tratamiento. En este estudio se recolectaron 265 muestras de piel y uñas de personas que acudieron al servicio de diagnóstico de la Sección de Micología Médica de la Facultad de Microbiología, Universidad de Costa Rica. Las afecciones en uñas representaron el 67,5 por ciento de los casos atendidos. Trichophyton rubrum es el hongo más aislado; otros dermatofitos y Candida sp también se aislaron de uñas y de piel. Fusarium sp, que es un hongo filamentoso no dermatofito, se aisló de uñas de manos y pies. Este hallazgo es relevante, dado que Fusarium sp., como agente emergente de onicomicosis, no responde bien al tratamiento con fluconazol.

Superficial mycosis is a frequent cause of consultation in Dermatology and Gene- ral Medicine. The microbiological stu- dies of this fungal condition are important not only to do the differential diagnosis, but also to establish the causing agent of the disease as well as its epidemiological aspects and the treatment. In this study 265 skin and nail samples have been collected from individuals at the Laboratory of Medical Mycology of School of Microbiology, Costa Rica University. Nail diseases represent 67,5% of the total cases studied. Trichophyton rubrum was the most frequent isolated fungus; also, other dermatophytes and Candida sp. were isolated from nail and skin. Fusarium sp., a filamentous non-dermatophyte fungus, was isolated from both finger and toe nails. This fin- ding is of relevant, since Fusarium sp., an emergent etiological agent of onychomycosis, does not respond well to treatment based on fluconazol.

Prevención y control de las micosis superficiales en el personal de tropa de paracaidistas, en Venezuela / Prevention and Control of superficial mycosis in Venezuelan Paratroopers

Las micosis superficiales constituyen un importante problema de salud en el personal de tropa de las instituciones militares en general. Considerando esto se realizó un estudio con el objetivo de proporcionar a este personal una propuesta para un programa orientado a la prevención y control de estas patologías. Para ello se desarrolló un censo de los registros de morbilidad del módulo asistencial de la 42 Brigada de Paracaidistas, una revisión del plan administrativo vigente (PAV)del módulo asistencial de esa unidad militar y la aplicación de un cuestionario estructurado con la finalidad de precisar el conocimiento y las vivencias que tiene el personal de tropa sobre las medidas preventivas que se llevan a cabo en dicho módulo. Los resultados revelaron que la morbilidad específica por micosis superficiales representa 28.3% de la morbilidad general; que la micosis mas frecuente es la tiña pedis; y el rango o jerarquía donde prevalecen las micosis es en soldados. De lo pautado en el P.A.V. del módulo asistencial, como medida preventiva se cumplió la charla en un 75%, se omitieron las revistas profilácticas en los meses de enero y febrero y las inspecciones sanitarias se cumplieron en un 25%. Al aplicar el cuestionario se encontró que 58% del personal de tropa recibe la información de micosis a través de charlas,22% no puede cumplir con las medidas preventivas por falta de tiempo y problemas con el suministro de agua y 30% no puede cumplir con el tratamiento porque no se lo entregan en la farmacia del módulo y proponen para informarse sobre micosis superficiales charlas, folletos, videos, afiches y carteleras.

Superficial mycosis are an important health problem in enlisted military personnel. Considering this situation, a study was carried on, as to provide this personnel with a proposal for a health program aimed to the prevention and control of these pathologies. A review of the morbidity register in the Health Care Module of the 42 nd. Paratroopers brigade was performed plus an exam of the Health Care Module of the unit. A structured questionnaire was applied, as to assess the knowledge and personnal experience of the troop with the preventive measures recommended. Results revealed that specific morbidity for superficial mycosis represents 28.3% within general morbidity. The most frequent mycosis being ringworm and the group mainly affected were low degree troopers. Among methods stablished in the P.A.V. (In Force Anministrative Plan) as preventive measures lectures were performed as much as 75%; prophylactic checkups were not performed during January and February and sanitary inspections were completed in 25%. When the structured questionnaire was applied, 58% of the interviewed confirm that mycosis information was receided during lectures; 22% could not fulfill the preventive measures because of time limitations and or problems of water supply. 10% could not apply the recommended treatment because it wasn´t supplied by the unit drugstore. The interviewed suggested as the best means to be informed on superficial mycosis: lectures, pamphlets, videos, posters and billboards.

Diagnoses and Differential Diagnoses of Superficial Mycoses / 대한의진균학회지

The diagnoses of superficial mycoses such as dermatophytosis, cutaneous candidiasis and Malassezia infections are relatively easy, and direct smear with KOH and culture with Sabouraud's dextrose agar media are the most useful and valuable methods. Recently, the incidence of onychomycosis has been increasing and some other diagnostic methods, especially for onychomycosis, and their significance has been introduced and investigated. This review was focused especially on the findings and significance of histopathologic and KONCPA methods (KOH Treated Nail Clippings Stained with PAS) for the diagnosis of onychomycosis. Summaries and brief comments were also made for the findings and significance of other diagnostic methods as well as for the differential diagnoses of superficial mycoses.

A Rapid Simple Stain for the Diagnosis of Superfical Mycosis with Mixed Chlorazol Black E Solution / 대한피부과학회지

We compared the sensitivity and practicability for the direct examination of fungal hypae between the specimens treated with mixed Chlorazol black E solution and simple KOH(potassium hydroxide) solution in 118 cases of superficial myosis. The results were as follows: Higher positivity of fungal hypae in the specimens treated with mixed Chlorazol black E solution(99. 2%) than simple KOH solutiion(87. 3%.). 2, It was time-saving and easy to detect fungal hypae in the specimens treated with mixed Chlorazol black E solution than simple K(3H solution.