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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.
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Phytochemicals from Syzygium aromaticum plant extract traditionally used to cure Feet Crack. Molecular docking method applied using “Biovia Discovery Studio”. “High positive values of -CDOCKER energy and -CDOCKER interaction energy” suggested that Myricetin can effectively deactivate the dihydrofolate reductase enzyme thereby interrupting the life cycle of the organism
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Abstract: This article describes the chemical composition of Vernonia chalybaea essential oil, and investigates its antimicrobial, antioxidant and hemolytic activities. The evaluation of the antifungal activity was performed by the broth microdilution method using strains of yeasts and dermatophytic fungi. The checkerboard technique to find antimicrobial modulatory effects was performed using ketoconazole as standard drug. The antioxidant activity was evaluated by DPPH scavenging assay and β-carotene/linoleic-acid system. The toxicity was characterized by the brine shrimp lethality test and hemolysis bioassays. The essential oil was obtained by hydrodistillation and analyzed by GC-MS method, showing to be rich in the sesquiterpenes β-caryophyllene (39.06%) and bicyclogermacrene (19.69%), and also demonstrated a relevant antifungal activity against strains of Trichophyton rubrum. In the modulatory activity assay, the essential oil of V. chalybaea and β-caryophyllene demonstrated a synergistic interaction with ketoconazole, with increasing of its antifungal action. The antioxidant activity was evidenced mainly by β-carotene/linoleic acid system, with IC50 value of 35.87 ± 0.32 µg/mL. The results suggest that V. chalybaea essential oil and β-caryophyllene are valuable natural medicinal agents with antioxidant and antimicrobial activities.
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Humans , Animals , Oils, Volatile/pharmacology , Vernonia/chemistry , Ketoconazole/pharmacology , Antifungal Agents/pharmacology , Artemia , Bacteria/drug effects , Oils, Volatile/chemistry , Linoleic Acid/pharmacology , beta Karyopherins/pharmacology , Fungi/classification , Fungi/drug effects , Anti-Bacterial Agents/pharmacology , Antifungal Agents/chemistry , Antioxidants/pharmacologyABSTRACT
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.
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Objective@#To investigate the effects of exposing Trichophyton rubrum fungus to microwaves at different intensities in terms of the activity of succinic dehydrogenase and beta-(1, 3)-D-glucan synthase.@*Methods@#Trichophyton rubrum organisms were randomly divided into a control group and experimental groups. The experimental groups were incubated at 27 ℃ after direct radiation with 2450 MHz microwaves at 20, 40, 60 or 80 W for 15 min, repeated 8 times. The control group was incubated without any irradiation. Thirty days later, the beta-(1, 3)-D-glucan synthase and succinate dehydrogenase activities were determined using enzyme-linked immunosorbent assays.@*Results@#The enzymatic activity decreased gradually with increasing radiation intensity. When the output power was 80 W, the beta-(1, 3)-glucan-synthase-D activity was 0.730±0.74 U/ml and that of the succinate dehydrogenase was 1.828±1.774 U/L, both significantly lower than in the groups subjected to less powerful irradiation.@*Conclusions@#Microwave radiation can decrease the enzymatic activity of Trichophyton rubrum in a dose-dependent manner. Higher intensity is more effective. Microwave irradiation can decrease the activity of succinate dehydrogenase and beta-(1, 3)-glucan synthase from Trichophyton rubrum in vitro, resulting in the destruction of fungal cell walls and interfering with the tricarboxylic acid cycle, furthering cell death. Moreover, the temperature change possibly also helps promote the biological effects of microwave radiation.
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Objective To investigate the effects of exposing Trichophyton rubrum fungus to microwaves at different intensities in terms of the activity of succinic dehydrogenase and beta-( 1, 3)-D-glucan synthase. Methods Trichophyton rubrum organisms were randomly divided into a control group and experimental groups. The experimental groups were incubated at 27 ℃ after direct radiation with 2450 MHz microwaves at 20, 40, 60 or 80 W for 15 min, repeated 8 times. The control group was incubated without any irradiation. Thirty days later, the beta-( 1, 3)-D-glu-can synthase and succinate dehydrogenase activities were determined using enzyme-linked immunosorbent assays. Results The enzymatic activity decreased gradually with increasing radiation intensity. When the output power was 80 W, the beta-(1,3)-glucan-synthase-D activity was 0.730±0.74 U/ml and that of the succinate dehydrogenase was 1.828±1.774 U/L, both significantly lower than in the groups subjected to less powerful irradiation. Conclusions Microwave radiation can decrease the enzymatic activity of Trichophyton rubrum in a dose-dependent manner. Higher intensity is more effective. Microwave irradiation can decrease the activity of succinate dehydrogenase and beta-( 1, 3)-glucan synthase from Trichophyton rubrum in vitro, resulting in the destruction of fungal cell walls and interfering with the tricarboxylic acid cycle, furthering cell death. Moreover, the temperature change possibly also helps promote the biological effects of microwave radiation.
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To establish the evaluation system for Guinea pig skin infection model of Trichophyton rubrum, and to evaluate different modeling methods and select the best skin infection animal model of Trichophyton rubrum. Methods The evaluation index was determined by literature research and expert consultation , weight of each index was calculated by Delphi Method and the analytic hierarchy process (AHP), to establish a comprehensive evaluation system for Guinea pig skin infection model of Trichophyton rubrum. Furthermore, various skin infection animal models of Trichophyton rubrum were evaluated by this system and the ideal animal model was selected. Results The evaluation system proved to be available. The animal model with immunosuppressive treatment and repeated inoculation with Trichophyton rubrum had better quality and higher success rate. Conclusions The evaluation system established by AHP is clear, simple and convenient; the optimized skin infection animal model of Trichophyton rubrum is suitable for the efficacy evaluation of antifungal infection drugs.
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Objective: To investigate the fungistatic activity and synergistic effects of natural products and their constituents, including traditional oriental medicines (TOMs). Methods: Fungistatic activities of TOMs prepared by hot-water (115 °C) or ethanol (70%; 40 °C) extraction were determined by their minimum inhibitory concentration. To assess possible synergistic effects, minimum inhibitory concentrations of various combinations were evaluated. Results: By evaluating antifungal susceptibility of Trichophyton rubrum, which is a major causative fungus for several types of dermatophytosis, we confirmed that ethanol extracts were more active than hot-water extracts in 25 of the 36 TOMs, suggesting that the constituents with high hydrophobicity tend to contribute significantly to fungistatic activity. We selected four TOMs with high fungistatic activity, including Aucklandiae radix, Gentianae macrophyllae radix, Scutellariae radix, and Galla rhois, and their synergistic effects were investigated through the combination studies between TOMs or TOM-conventional drug terbinafine. In combinations between four TOMs, partial synergistic effects were observed in Aucklandiae radix-Galla rhois and Gentianae macrophyllae radix-Galla rhois combinations, as supported by the lowest fractional inhibitory concentration index value of 0.66 for both combinations. Furthermore, Galla rhois showed the strongest synergistic effect on growth inhibition of Trichophyton rubrum with a fractional inhibitory concentration index value of 0.50 in combination with terbinafine. Conclusions: Our findings indicate that the combination of TOMs and TOM-terbinafine may be effective on treatment for chronic and recurrent dermatophytosis by improving fungistatic activity and led to decrease systemic toxicity in clinical practice.
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Objective:To investigate the fungistatic activity and synergistic effects of natural products and their constituents, including traditional oriental medicines (TOMs).Methods:Fungistatic activities of TOMs prepared by hot-water (115 °C) or ethanol (70%; 40 °C) extraction were determined by their minimum inhibitory concentration. To assess possible synergistic effects, minimum inhibitory concentrations of various combinations were evaluated.Results:By evaluating antifungal susceptibility of Trichophyton rubrum, which is a major causative fungus for several types of dermatophytosis, we confirmed that ethanol extracts were more active than hot-water extracts in 25 of the 36 TOMs, suggesting that the constituents with high hydrophobicity tend to contribute significantly to fungistatic activity. We selected four TOMs with high fungistatic activity, including Aucklandiae radix, Gentianae macrophyllae radix, Scutellariae radix, and Galla rhois, and their synergistic effects were investigated through the combination studies between TOMs or TOM-conventional drug terbinafine. In combinations between four TOMs, partial synergistic effects were observed in Aucklandiae radix–Galla rhois and Gentianae macrophyllae radix–Galla rhois combinations, as supported by the lowest fractional inhibitory concentration index value of 0.66 for both combinations. Furthermore, Galla rhois showed the strongest synergistic effect on growth inhibition of Trichophyton rubrum with a fractional inhibitory concentration index value of 0.50 in combination with terbinafine.Conclusions:Our findings indicate that the combination of TOMs and TOM-terbinafine may be effective on treatment for chronic and recurrent dermatophytosis by improving fungistatic activity and led to decrease systemic toxicity in clinical practice.
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Objectives Aspidin BB, a typical phloroglucinol derivative from Dryopteris fragrans, possesses significant antifungal property. This study aimed to investigate potential mechanism of antifungal activity of Aspidin BB against Trichophyton rubrum which is the most common pathogens responsible for chronic dermatophytosis. Methods The minimum inhibitory concentration (MIC) of Aspidin BB against strains was determined by broth microdilution. The effects of Aspidin BB on ergosterol biosynthesis were investigated by content determination based on UPLC method. Besides, the effects of drugs on squalene epoxidase (SE) in T. rubrum cell membrane were analyzed. Results MIC value of Aspidin BB against T. rubrum was 25.0 μg/mL. Aspidin BB reduced ergosterol content significantly, but no notable effect on squalene epoxidase activity. Conclusion The results suggested that Aspidin BB inhibited ergosterol biosynthesis. However, it was not squalene epoxidase but other components may sever as possible targets in ergosterol biosynthesis pathway.
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Majocchi's granuloma is a well recognized but uncommon infection of dermal and subcutaneous layers that is caused by fungal organism. It often presents as plaques and papules on areas where trauma is common. Majocchi's granuloma appears usually in immunocompromised patient but can also appear in immunocompetent patient. Tinea incognito appears in various forms of skin diseases, but it is rarely presented as Majocchi's granuloma. We report a case of trichophytic granuloma of the knee caused by Trichophyton(T.) rubrum in a 70-year-old male, who showed a pruritic, 7.0 × 2.0 cm sized, erythematous scaly patches with multiple papules on the right knee for 2 months. Fungal culture of the biopsy specimen grew out typical white cottony colonies of T. rubrum. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of T. rubrum strain ATCC 52013 (GenBank accession number KX092384.1). Histiologic examination showed chronic granulomatous inflammation and fungal elements in the dermis. After one month of itraconazole 200 mg/day and sertaconzole cream treatment, the lesion was completely cleared.
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Dermatophytes usually infect keratinized epithelial structures such as hair and nails. However, they can also cause deep and extensive fungal infections, especially in immunocompromised patients. We report a case with multiple dermal abscesses, which is a rare manifestation of Trichophyton rubrum infection. A 54-year-old man presented with multiple subcutaneous nodules in both inguinal areas with associated tinea cruris. Histopathological findings showed abscesses with fungal hyphae highlighted using Periodic acid-Schiff diastase (PAS-D) staining. Trichophyton rubrum was isolated on a fungal culture of the biopsy specimen obtained from a subcutaneous nodule in the inguinal area. The lesions were resistant to treatment with itraconazole (100 mg twice a day for 6 months); thus, we changed the drug to voriconazole (200 mg twice a day for 3 months). In addition, we extracted the remaining big lesions by incision and drainage. The patient was successfully treated with voriconazole and surgical method.
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Humans , Middle Aged , Abscess , Amylases , Arthrodermataceae , Biopsy , Drainage , Hair , Hyphae , Immunocompromised Host , Itraconazole , Methods , Tinea , Trichophyton , VoriconazoleABSTRACT
Dermatophytes usually infect keratinized epithelial structures such as hair and nails. However, they can also cause deep and extensive fungal infections, especially in immunocompromised patients. We report a case with multiple dermal abscesses, which is a rare manifestation of Trichophyton rubrum infection. A 54-year-old man presented with multiple subcutaneous nodules in both inguinal areas with associated tinea cruris. Histopathological findings showed abscesses with fungal hyphae highlighted using Periodic acid-Schiff diastase (PAS-D) staining. Trichophyton rubrum was isolated on a fungal culture of the biopsy specimen obtained from a subcutaneous nodule in the inguinal area. The lesions were resistant to treatment with itraconazole (100 mg twice a day for 6 months); thus, we changed the drug to voriconazole (200 mg twice a day for 3 months). In addition, we extracted the remaining big lesions by incision and drainage. The patient was successfully treated with voriconazole and surgical method.
Subject(s)
Humans , Middle Aged , Abscess , Amylases , Arthrodermataceae , Biopsy , Drainage , Hair , Hyphae , Immunocompromised Host , Itraconazole , Methods , Tinea , Trichophyton , VoriconazoleABSTRACT
Objective Trichophyton rubrum strains can cause superficial infection and also deep tissue infection, but relevant animal model has not been reported yet.The aim of this study was to construct an animal model of granuloma infected by T.rubrum. Methods Three T.rubrum strains isolated from clinical granuloma tissues, 2 T.rubrum strains isolated from tinea infection and a standard strain of ATCCMYA4438 were selected.Corticosteroids were given to the Balb/C mice before and after the injection of the T. rubrum and mucin suspension and the mice model of granuloma was established.Direct microcopy, culture and histopathologic method were adopt to verify the infection effects. Results The mice inoculated with the T.rubrum granuloma strains with mucin suspension were examined after 21 days in the condition of applying appropriate dose of glucocorticoids.Direct microscopic examination showed the slender mycelium, fungal culture showed the growth of colony and histopathology showed excessive keratinization of foot tissue, formation of granuloma in the dermis with inflammatory cell infiltration of neutro-philic granulocyte and lymphocytes.However, the mice inoculated with the T.Rubrum tinea strains with mucin suspension showed the negative result. Conclusion The rubrum granuloma mice model can be es-tablished using the clinical isolates of T.rubrum granuloma strains with the mucin and glucocorticoids interventions.
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Kerion celsi is a severe inflammatory type of tinea capitis that presents as a boggy mass studded with broken hairs, oozing purulent material from follicular orifices. This infection is caused most commonly by zoophilic or geophilic pathogens. Trichophyton(T.) rubrum is an anthropophilic dermatophyte that is found all over the world. It has become one of the most important causative agents in tinea unguium and tinea pedis. But, kerion celsi caused by T. rubrum is rare. Kerion celsi is uncommon in adult. We report a case of kerion celsi caused by T. rubrum in a 72-year-old woman. She presented with localized tender erythematous plaques with pustules with oozing purulent material on the frontal scalp. A fungal culture from tissue of the lesions was grown on Sabouraud's dextrose agar and showed typical whitish cottony colonies of T. rubrum. The nucleotide sequence of internal transcribed spacer region for clinical isolate was identical to that of T. rubrum strain UZ1588_14 (GenBank accession number KP326579.1). She was treated with 200 mg of oral itraconazole daily for 3 months. The skin lesions improved 1 month after treatment, and recurrence has not been observed.
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Adult , Aged , Female , Humans , Agar , Arthrodermataceae , Base Sequence , Glucose , Hair , Itraconazole , Onychomycosis , Recurrence , Scalp , Skin , Tinea Capitis , Tinea Pedis , TrichophytonABSTRACT
A series 305 extracts from 61 traditional medicinal plants (belonging to 33 different families) used in treating skin diseases in Hyderabad Karnataka region were subjected to antidermatophytic screening against Trichophyton rubrum (MTCC 1344). Pet ether, chloroform, ethyl acetate, methanol and aqueous extracts of each plant were tested for their antifungal activity using agar well diffusion method at sample concentration of 5 & 2.5 mg/ml. The results indicated that out of 61 plants, 18 exhibited very effective antidermatophytic activity in methanolic extracts, effective activity observed in 13 plants in different extracts, whereas 26 plants showed moderate activity, 04 plants showed weak activity. The minimum inhibitory concentrations of 18 very effective plants were determined. On the basis of the results obtained, the crude extracts of Allium sativam Linn., Annona reticulata L., Annona squamosa L., Argemone mexicana L., Butea monosperma, Ceasalpinia bonducella, Citrus medica L., Corchorus oleterius L., Emblica officinalis, Euphorbia tirucalli L., Ficus racemosa L., Gymnosporia montana, Lawsonia inermis L., Solanum nigrum L., Sterculia foetida L., Tribulus terrestris L., Vitex negundo L., and Zingiber officinale exhibited significant antidermatophytic activity (T. rubrum) and properties that support folkloric use in the treatment of skin diseases as broad-spectrum antimycotic agents. This probably explains the use of these plants by the indigenous people against dermatological infections.
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There are few studies on the role of innate immune response in dermatophytosis. An investigation was conducted to define the involvement of Toll-Like Receptors (TLRs) 2 and 4 in localized (LD) and disseminated (DD) dermatophytosis due to T. rubrum. Fifteen newly diagnosed patients, eight patients with LD and seven with DD, defined by involvement of at least three body segments were used in this study. Controls comprised twenty skin samples from healthy individuals undergoing plastic surgery. TLR2 and TLR4 were quantified in skin lesions by immunohistochemistry. A reduced expression of TLR4 in the lower and upper epidermis of both LD and DD patients was found compared to controls; TLR2 expression was preserved in the upper and lower epidermis of all three groups. As TLR4 signaling induces the production of inflammatory cytokines and neutrophils recruitment, its reduced expression likely contributed to the lack of resolution of the infection and the consequent chronic nature of the dermatophytosis. As TLR2 expression acts to limit the inflammatory process and preserves the epidermal structure, its preserved expression may also contribute to the persistent infection and limited inflammation that are characteristic of dermatophytic infections.
A literatura sobre o papel da resposta imune inata em dermatofitose é escassa. Este estudo se propôs a investigar a participação dos receptores do tipo Toll 2 e 4 (TLRs) 2 e 4 em pacientes com dermatofitose localizada (LD) e disseminada (DD, definida como lesões em pelo menos três segmentos corpóreos distintos), causadas por Trichophyton rubrum. Foram analisados cortes histológicos de 15 pacientes recém-diagnosticados, oito com LD e sete com DD. O grupo controle foi composto por 20 amostras de pele de indivíduos saudáveis submetidos a cirurgia plástica. TLR-2 e TLR-4 foram quantificados em lesões cutâneas por imunohistoquímica. Encontramos uma expressão reduzida de TLR-4 na epiderme superior e inferior nos dois grupos, LD e DD, quando comparados com o grupo controle; a expressão de TLR-2 foi preservada na epiderme superior e inferior de todos os três grupos. Como a sinalização por TLR-4 induz produção de citocinas inflamatórias e recrutamento de neutrófilos, a menor expressão desta molécula provavelmente contribui para a não resolução da infecção e conseqüente natureza persistente da dermatofitose. Como a sinalização via TLR-2 tem sido descrita como fator de regulação do processo inflamatório e de preservação da estrutura epidérmica, a sua expressão inalterada nas lesões dos pacientes com DD e DL pode contribuir também para a persistência da infecção e do reduzido processo inflamatório que são característicos das infecções por dermatófitos.
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Keratinocytes/metabolism , Tinea/metabolism , /metabolism , /metabolism , Case-Control Studies , Immunohistochemistry , Tinea/pathologyABSTRACT
Objective There have been a few reports on chronically recurrent and generalized superficial mycosis caused by trichophyton rubrum.This article was to investigate the cause, diagnosis and therapy of the mycosis. Methods 5 patients with chron-ically recurrent and generalized superficial mycosis caused by trichophyton rubrum were collected from June 2012 to June 2014 in our hospital.Bacterioscopic examination and cultivation were made on skin lesions of the patients.A typical patient who had 7-year course of desease with toenails seriously infected and widespread skin eruption was selected for histopathology examination on skin lesions, mi-crobiology and molecular biology study on 4 bacterial strains isolated from skin lesions in different parts, and in vitro chemosensitivity assay for drug selection.PCR (rDNA ITS sequence analysis) was performed for diagnosis and early treatment. Results Microscopic examintion on skin lesions demonstrated numerous septate, branched hyphae.Cultivation and molecular biology study identified tricho-phyton rubrum.The strain was identified as trichophyton rubrum by ITS sequence analysis and the isolated strains from different lesions were the same fungal species.Histopathology examination revealed slight hyperplasia of squamous epithelium , epidermal hyperkeratini-zation and the upper dermis presented a sparse perivascular lymphocytic infiltrate.The PAS-stain confirmed the presence of few hyphae in the horny layer.The pathogen of this case was trichophyton rubrum. A combination therapy with systemic itraconazole and topically applied terbinafine hydrochloride cream was successful.A follow-up examina-tion one year later showed no recurrence of symptoms. Conclusion The isolation and identification of pathogen is the key to the diagnosis of chronically recurrent and generalized superficial mycosis, with ad-ditional attention to all or none toenail infection.The therapy should not focus simply on the tinea corporis, while comprehensive treatment combined with chemosensitivity assay is preferred.
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We report a case of Majocchi's granuloma in a 71-year-old immunocompetent male patient, who presented with a 6-month history of mass with multiple erythematous nodules and indurated plaques with scale on the left cheek. Even though the lesion strongly suggested cutaneous tumor, the histopathologic findings were consistent with the Majocchi's granuloma, showing numerous hyphae, perifolliculitis and granulomatous inflammation with central abscess formation in the dermis. Trichophyton rubrum was isolated from the biopsy specimen fungus culture. The cutaneous lesion was treated with oral administration of itraconazole (200 mg/day) and topical lanoconazole cream for 4 weeks, and successfully treated.
Subject(s)
Aged , Humans , Male , Abscess , Administration, Oral , Biopsy , Cheek , Dermis , Fungi , Granuloma , Hyphae , Inflammation , Itraconazole , TrichophytonABSTRACT
Trichophyton(T.) rubrum is an anthropophilic dermatophyte that is found all over the world. It has become one of the most important causative agents in tinea pedis and onychomycosis. But tinea capitis caused by T. rubrum is rare. Tinea capitis is uncommon in an adult. We report a case of tinea capitis caused by T. rubrum in an 81-year-old woman. She presented with localized asymptomatic well-demarcated thick scaly erythematous patches on the fronto-vertex scalp for 6 months. She was diagnosed as seborrheic dermatitis in local clinic and was treated with topical steroid. However, the lesion was not improved and spreading. Culture from scalp lesion of patient was grown on Sabouraud's dextrose agar and showed typical whitish cottony colonies of T. rubrum. She was treated with 200 mg of oral itraconazole daily for 8 weeks. The skin lesions improved 8 weeks after treatment, and recurrence has not been observed.