Brote de tinea capitis y otras micosis superficiales en una comunidad urbana de Medellín / Tinea capitis outbreak and other superficial mycosis in an urban community of Medellín

Introducción. Las dermatofitosis son infecciones fúngicas superficiales de epitelios queratinizados. La tinea capitis es una de ellas y afecta a poblaciones escolares vulnerables. Carpinelo es un barrio del área periférica de Medellín con precarias condiciones socioeconómicas. Ante la sospecha de un brote de dermatofitosis, los afectados fueron evaluados. Objetivo. Evaluar clínica y microbiológicamente pacientes del barrio Carpinelo con sospecha de micosis cutáneas para determinar la presencia de un brote por dermatofitos. Materiales y métodos. Se llevó a cabo un estudio descriptivo, de corte longitudinal, con muestreo a conveniencia. Se hizo una búsqueda activa de casos en el Jardín Educativo Buen Comienzo de Carpinelo en niños de la institución y sus familiares. Se evaluaron clínicamente y se tomaron muestras de escamas y cabellos para exámenes directos y cultivos microbiológicos. Se analizó el perfil demográfico, clínico y micológico, con el programa estadístico SPSS™, versión 25. Resultados. Se estudiaron 57 pacientes, 47 eran menores de edad con una media de edad de seis años; se observó una proporción de hombres y mujeres de 2:1. Los pacientes con resultados positivos se diagnosticaron con tinea capitis (78,95 %), tinea faciei (15,79 %) y tinea corporis (10,52 %). El 75,43 % de los pacientes recibió tratamiento previo y de estos el 69,73 % fue con esteroides. El examen directo fue positivo en el 53,84 % y los cultivos en el 46,5 % de los casos. Los agentes aislados fueron: Microsporum canis (77,77 %), Trichophyton spp. (11,11 %), Trichophyton rubrum (5,55 %) y Malassezia spp. (5,55 %). Conclusión. Tinea capitis fue la presentación clínica más común y M. canis el dermatofito más frecuentemente aislado. Llamó la atención el uso de esteroides como primera y única opción del tratamiento empírico' lo cual resalta la importancia del diagnóstico microbiológico para proporcionar la terapia apropiada.

Introduction. Dermatophytoses are superficial fungal infections of the keratinized epithelium like tinea capitis. The latte mainly affects school-vulnerable populations. Carpinelo is a peripheral neighborhood in Medellín with poor socioeconomic conditions and where a suspected tinea capitis outbreak took place. Objective. To study and characterize, clinically and microbiologically, patients with suspected dermatophytosis in Carpinelo. Materials and methods. We carried out a descriptive and longitudinal study with an active case search of tinea capitis in children and their relatives from the Jardín Educativo Buen Comienzo community in Carpinelo. Patients were clinically evaluated, and samples of scales and hair were taken to perform mycological studies with a 10 % potassium hydroxide and culture in Sabouraud and Mycosel agar. We analyzed the data with the statistical program SPSS™. 25 version. Results. Fifty-seven individuals were studied: 47 were children with a mean age of six years and a ratio of 2:1 male to female. Patients with confirmed diagnosis presented the following clinical forms: tinea capitis (78.95%), tinea faciei (15.79%) or tinea corporis (10.52%). Out of the total, 69.76% of the patients had previous treatment with steroids. The direct test was positive in 53.84% of the samples, and 46.15% had positive cultures. The isolated species were: Microsporum canis (77.77%), Trichophyton spp. (11.11%), Trichophyton rubrum (5.55%), and Malassezia spp. (5.55 %). Conclusion.Tinea capitis was the most common clinical form, and M. canis was the most frequently isolated species. The use of steroids as the first and only option for empiric treatment was worth of notice. The findings of this study point out the importance of microbiological diagnosis in choosing the best treatment for the patients.

Querión Celso, dermatofitosis del cuero cabelludo infantil / Kerion Celsi, dermatophytosis of the scalp in young boy

Resumen Querión Celso es una micosis ocasionada por hongos dermatofitos que daña el cuero cabelludo principalmente a niños y en raras ocasiones a adultos. La forma de infección para los humanos proviene de los animales y del suelo y se relaciona con mala higiene personal, hacinamiento en las viviendas, condiciones de subdesarrollo y pobreza. Se presenta un caso de un niño de 9 años con una úlcera de 7 cm de diámetro en el cuero cabelludo y en forma de placa circular que presentaba material purulento, pelo quebradizo y un área alopécica. Al inicio, se abordó de manera terapéutica como una infección bacteriana; posteriormente, se solicitó estudio micológico que evidenció una coinfección por el microorganismo Microsporum gypseum. Se le confirmó el diagnóstico de tiña capitis con afección inflamatoria y se le prescribió griseofulvina, lo que resultó en una curación completa.

Abstract Kerion Celsi is a mycosis caused by dermatophyte fungi that mostly affects children and rarely adults, causing damage to the scalp. The form of infection for humans comes from animals and the soil. The infection is related to poor personal hygiene, overcrowded homes, underdeveloped conditions, and poverty. A case of a 9-year-old boy with a 7cm diameter ulcer on the scalp and in the form of a circular plaque that presented purulent material, brittle hair and an alopecic area is presented. Initially it was therapeutically addressed as a bacterial infection, a mycological study was requested, which showed coinfection by the microorganism Microsporum gypseum, the diagnosis of tinea capitis with inflammatory condition was confirmed, and Griseofulvin was prescribed, resulting in complete cure.

Prevalence and risk factors associated with canine dermatophytoses among dogs in Kwara and Osun States, Nigeria

Background: Dermatophytosis (ringworm) is a zoonotic fungal skin infection caused predominantly by Microsporum canis, Microsporum gypseum and Trichophyton spp. It is highly transmissible and, while normally self-limiting, could be problematic due to its potential to cause disease in certain human populations. The occurrence and associated risk factors of dermatophytoses in dogs presented at three veterinary clinics in Osogbo, and Ilorin, Nigeria between July and November 2019 were investigated in this study. Methodology: This was a descriptive cross-sectional study of 325 dogs with lesions suggestive of dermatophytosis, selected by simple random sampling from veterinary clinics of two hospitals, purposively selected for the study due to high patronage of the veterinary hospitals by dog owners. Using conventional mycological sampling techniques, plucked hairs and skin scrapings were obtained the dogs. The samples were emulsified in 10% potassium hydroxide, examined microscopically for fungal elements and cultured using standard mycological procedures. Information on dog demographic characteristics and risk factors for dermatophytosis were collected using structured questionnaire. The association between risk factors and demographic variables with the occurrence of dermatophytoses was determined using Chi-square test (with Odds ratio and 95% confidence interval) and p value < 0.05 was considered statistically significant. Results: Positive cultures for dermatophytes were obtained from samples of 48 (14.8%) dogs with M. canis 37.5% (18/48), M. gypseum 27.0% (13/48) and T. mentagrophytes 8.3% (4/48). Other fungi identified were Aspergillus flavus 12.5% (6/48) and Malassezia canis 12.5% (6/48). The age distribution of positive dogs were < 1 year (50.0%, n=24), 1-3 years (29.2%, n=14) and > 3 years (20.8%, n=10), while the risk factors associated with dermatophytosis included sex of dogs (p=0.0428), history of dermatophytosis (p<0.0001), clinical presentation (p<0.0001) and lesion type, especially kerion and pustular lesions (p=0.0297). Conclusion: These findings established the occurrence of dermatophytosis in dogs kept for companionship (i.e., pets), security and breeding purposes in one northern and southern States of Nigeria. Our findings underscore the need for routine mycological investigations in dogs to facilitate early detection of cases and prompt institution of treatment interventions, thereby preventing zoonotic transmission of dermatophytes to their owners, handlers and veterinarians.

Dermatofitosis por Microsporum gypseum en un niño con inmunodeficiencia primaria / Microsporum gypseum dermatophytosis in a child with primary immunodeficiency

El Microsporum gypseum es un hongo geofílico que puede producir lesiones cutáneas inflamatorias en personas sanas. Se han descripto lesiones más extensas en pacientes inmunocomprometidos. Se presenta el caso de un paciente con dermatofitosis, con exámenes micológicos positivos para Candida sp, Epidermophytom floccosum y Trichophyton tonsurans, al que, ante la mala respuesta al tratamiento con griseofulvina e itraconazol a dosis habituales, se le realizó biopsia cutánea para cultivo que evidenció la presencia de M. gypseum. Debido a la extensión y a la mala respuesta al tratamiento, se realizó evaluación inmunológica y se diagnosticó un defecto en STAT1 con ganancia de función (STAT1-GOF). Los pacientes que tienen esta inmunodeficiencia primaria son susceptibles a las infecciones micóticas, especialmente por Candida, pero también, aunque en menor medida, a virus y bacterias. El paciente aquí presentado recibió tratamiento prolongado con antimicóticos imidazólicos sistémicos, con resolución de las lesiones.

Microsporum gypseum is a geophilic fungus that can cause inflammatory skin lesions in heathy people. More extensive lesions have been described in immunocompromised patients. We present a patient with extensive dermatophytosis, which mycological examination led the identification of Candida sp, Epidermophyton Floccosum and Trichophyton tonsurans and showed poor response to treatment with griseofulvina and itraconazol at usual doses. When skin biopsy was performed, it had positive culture for M. gypseum. Due to the extension and poor response to treatment, immunological assessment was performed and it showed a defect of STAT1 with gain of function (STAT 1-GOF). Patients with primary immunodeficiency are susceptible to fungal infections, especially Candida but also virus and bacteria, although to a lesser extent. The patient received long-term treatment with systemic imidazole antifungal recovering for the lesions.

Disseminated dermatophytosis and acquired immunodeficiency syndrome: literature review and presentation of clinical experience / Dermatofitose disseminada e síndrome da imunodeficiência adquirida: revisão de literatura e apresentação de experiência clínica

Introduction: Dermatophytosis are very common fungal infections caused by the fungal species Microsporum, Epidermophyton or Trichophyton, which mostly affect the skin, the interdigital region, groin and scalp. Although they do not cause serious diseases, in patients with the human immunodeficiency virus the infection manifests itself and evolves exuberantly, usually with extensive and disseminated lesions. Objective: To review the literature on dermatophytosis in people living with human immunodeficiency virus and to present the experience in clinical care in a patient living with human immunodeficiency virus with extensive and disseminated dermatophytosis. Methods: A literature review on the topic was carried out in the PubMed/National Library of Medicine ­ USA databases, using the keywords dermatophytosis, or dermatophytosis associated with the words AIDS, human immunodeficiency virus or immunodeficiency, from 1988­2022. The clinical experience showed a patient living with human immunodeficiency virus developing AIDS and presenting with disseminated skin lesions. Samples of the lesion were collected by scraping, which were submitted to culture and there was growth of fungi of the Trichophyton sp genus. A biopsy of the lesion was also performed using the Grocott-Gomori's Methenamine Silver stain. Results: We found 1,014 articles, of which only 34 presented a direct correlation with our paper, and were used to discuss the main themes narrated in this article. We present clinical experience in the management of a patient with human immunodeficiency virus/AIDS and low adherence to antiretroviral treatment, showing extensive and disseminated erythematous-squamous lesions with a clinical diagnosis of tinea corporis, manifesting with a clinical picture usually not found in immunocompetent patients. The diagnosis was confirmed by laboratory tests with isolation of the Trichophyton sp fungus. The patient was treated with oral fluconazole, with complete remission of the clinical picture after two months. She was also thoroughly encouraged to use the prescribed antiretroviral medication correctly. Conclusion: Dermatophytosis in patients living with human immunodeficiency virus can present extensive and disseminated forms. The antifungal treatment is quite effective, with remission of the condition. Antiretroviral therapy is an important adjuvant for better recovery of the sickness.

Introdução: Dermatofitoses são infecções comuns, causadas pelas espécies fúngicas Microsporum, Epidermophyton ou Trichophyton, que acometem preferencialmente a pele da região interdigital, da virilha e do couro cabeludo. Apesar de não causar doenças graves, em pacientes portadores do vírus da imunodeficiência humana, a infecção se manifesta e evolui de forma exuberante, normalmente com lesões extensas e disseminadas. Objetivo: Fazer revisão de literatura sobre dermatofitose em pessoas vivendo com vírus da imunodeficiência humana e apresentar a experiência na atenção clínica em uma paciente vivendo com o vírus e dermatofitose extensa e disseminada. Métodos: A revisão de literatura sobre o tema baseou-se nos dados do Pubmed/National Library of Medicine, dos Estados Unidos, utilizando-se as palavras-chave dermatofitose, dermatofitose e AIDS, dermatofitose e vírus da imunodeficiência humana, e dermatofitose e imunodeficiência, de 1988­2022. Descreveu-se a experiência clínica na abordagem de uma paciente vivendo com vírus da imunodeficiência humana, a qual desenvolveu AIDS e apresentou lesões cutâneas disseminadas. Por raspado, foram coletadas amostras da lesão e submetidas à cultura, e constatou-se crescimento de fungos do gênero Trichophyton sp. Realizou-se também biópsia da lesão, corada pelo método da metenamina de prata de Grocott-Gomori. Resultados: Foram encontrados 1.014 artigos, dos quais apenas 34 apresentaram correlação direta com nosso trabalho, e foram utilizados para discorrer sobre os principais temas narrados neste artigo. Apresentou-se experiência clínica na abordagem de uma paciente com vírus da imunodeficiência humana/AIDS e baixa adesão ao tratamento antirretroviral, exibindo lacerações eritematoescamosas extensas e disseminadas, com diagnóstico clínico de Tinea corporis, manifestando-se com quadro clínico usualmente não encontrado em pacientes imunocompetentes. O diagnóstico foi confirmado por exames laboratoriais com isolamento do fungo Trichophyton sp. Tratada com fluconazol via oral, a paciente apresentou remissão parcial das infecções aos dois meses e completa aos seis meses. Também foi exaustivamente estimulada a usar corretamente a medicação antirretroviral prescrita. Conclusão: A dermatofitose em pacientes com vírus da imunodeficiência humana pode se apresentar de forma extensa e disseminada. O tratamento antifúngico é eficaz, com remissão do quadro. A terapia antirretroviral é importante adjuvante para melhor recuperação dos enfermos

Dermoscopy of skin infestations and infections (entomodermoscopy) - Part II: viral, fungal and other infections,

Abstract In addition to the infestations and bacterial infections reported in part I, the study of entomodermoscopy also involves descriptions of dermoscopic findings of a growing number of viral and fungal infections, among others. In this article, the main clinical situations in viral infections where dermoscopy can be useful will be described, that is in the evaluation of viral warts, molluscum contagiosum, and even in recent scenarios such as the COVID-19 pandemic. As for fungal infections, dermoscopy is particularly important, not only in the evaluation of the skin surface, but also of skin annexes, such as hairs and nails. The differential diagnosis with skin tumors, especially melanomas, can be facilitated by dermoscopy, especially in the evaluation of cases of verruca plantaris, onychomycosis and tinea nigra.

Dos interesantes contaminantes fúngicos filamentosos en muestras clínicas positivas a Trychophyton rubrum: una situación de curiosidad morfológica / Two interesting filamentous fungal contaminants in clinical samples positive to Trychophyton rubrum: a situation of morphological curiosity

Las dermatofitosis corresponden a un grupo de enfermedades micóticas comunes en piel y fanéreas, donde Trichophyton rubrum es el agente causante más frecuente a nivel mundial y presente en nuestros 2 casos de pacientes masculinos con estas micosis, una en uñas y la otra en piel. Sin embargo, el enfoque de esta publicación se basa principalmente en la presencia de 2 interesantes contaminantes (uno en cada caso clínico) presentes solo en los cultivos de las primeras siembras como saprófitos y por ende como propágulos de dispersión, asociados al ambiente y sin intervención clínica demostrada en ambas micosis. La descripción morfofisiológica de estos 2 contaminantes Metarhizium purpureo-genum(similis) y Monascus ruber fue más bien una curiosidad esencial que el micólogo clínico adquiere en su contínua formación y ante la posibilidad de infecciones mixtas, pudiendo conjugar sus hallazgos junto al análisis taxonómico y los factores geográficos y edáficos asociados a su distribución. (AU)

Dermatophytoses belongs to a group of common mycotic diseases in skin and pharynals, where Trichophyton rubrum is the most frequent causative agent worldwide and present in our 2 cases of male patients with these mycoses, one in nails and the other in skin. However, the focus of this publication is mainly about the presence of 2 interesting contaminants (one in each clinical case) present only in the crops of the first sowings as saprophytes and therefore as dispersal propagules, associated with the environment and without clinical intervention demonstrated in both mycoses. The morphophysiological description of these 2 contaminants, Metarhizium purpureogenum (similis) and Monascus ruber was rather an essential curiosity that the clinical mycologist acquires in his continuous training and in the face of the possibility of mixed infections, being able to combine his findings together with the taxonomic analysis and the geographic and edaphic factors associated with its distribution. (AU)

Dermatophytoses in patients attended from a private clinical analysis laboratory in João Pessoa-PB, between 2015 to 2019 / Dermatofitoses em pacientes atendidos em um laboratório privado de João Pessoa-PB, entre 2015 a 2019

Introduction: dermatophytoses or "tineas" are characterized by being mycoses caused by fungi of the genera Epidermophyton, Trichophyton and Microsporum. These mycotic infections can present themselves as a form of lesions that affect the skin, hair and nails of individuals of both genders and all ages. Objective: to elucidate the epidemiological profile of dermatophytoses in patients examined by a private clinical analysis laboratory in João Pessoa-PB, between 2015 and 2019. Methodology: this is an epidemiological, analytical, retrospective and documentary study, in which data collection took place at the Clinical Pathology Laboratory ­ "HEMATO", located in João Pessoa ­ PB. Results: the profile of those affected was predominantly female (58.5%), 18 to 59 years old (38.4%), white (53.6%) and with lesions, mainly in skin glabrous (38.5%), feet (33.3%) and nails (12.8%). When relating the age group to the injury site, it was noticed that injuries on glabrous skin, feet and nails, were more frequent in individuals aged 18 to 59 years, while injuries to the scalp were mostly found in individuals younger than 18 years old. The most prevalent species were M. canis (31.9%) and T.rubrum (31.9%). When correlating the fungal species with the lesion site, it was noted that M. canis was the main agent responsible for lesions in glabrous skin, scalp and hands, while T. rubrum was predominantly observed in nails and T. mentagrophytes in feet. Conclusion: it is concluded that the data present in this research can promote the development of indicators and public policies for the population most susceptible to dermatophytosis.

Introdução: dermatofitoses ou tineas se caracterizam por serem micoses causadas por fungos dos gêneros Epidermophyton, Trichophyton e Microsporum. Essas infecções micóticas podem se apresentar na forma de lesões que acometem pele, pelo e unhas de indivíduos de ambos os gêneros e todas as idades. Objetivo: elucidar o perfil epidemiológico de dermatofitoses de pacientes atendidos por um laboratório privado de análises clínicas em João Pessoa-PB, entre 2015 a 2019. Metodologia: trata-se de um estudo epidemiológico, analítico, retrospectivo e documental, em que a coleta de dados ocorreu no Laboratório de Patologia Clínica ­ HEMATO, localizado em João Pessoa ­ PB. Resultados: o perfil de acometidos foi predominantemente de indivíduos do sexo feminino (58,5%), com 18 a 59 anos de idade (38,4%), brancos (53,6%) e com lesões, principalmente, em pele glabra (38,5%), pés (33,3%) e unhas (12,8%). Ao relacionar a faixa etária com o local da lesão, percebeu-se que lesões em pele glabra, pés e unhas, foram mais frequentes em indivíduos de 18 a 59 anos, enquanto que lesões no couro cabeludo foram majoritariamente encontradas em indivíduos menos de 18 anos. As espécies mais prevalentes foram M. canis (31,9%) e T. rubrum (31,9%). Ao correlacionar a espécie fúngica com o local da lesão, notou-se que M. canis foi o principal agente responsável por lesões em pele glabra, couro cabeludo e mãos, enquanto T. rubrum foi predominantemente observado em unhas e T. mentagrophytes em pés. Conclusão: os dados obtidos nesta pesquisa podem fomentar o desenvolvimento de indicadores e políticas públicas para a população mais susceptível às dermatofitoses.

Evaluation of susceptibility and response in the surface of agents of surface mycoses (Trichophyton mentagrophytes; T. tonsurans) to antifungal drugs of interest in a medical clinic / Avaliação da susceptibilidade e resposta in vitro de agentes de micoses superficiais (Trichophyton mentagrophytes; T. tonsurans) à drogas antifúngicas de interesse em clínica médica

INTRODUCTION: The resistance of fungal species to drugs usually used in clinics is of great interest in the medical field. OBJECTIVE: To evaluate susceptibility and in vitro response of species of Trichophyton spp. to antifungal drugs of interest in clinical medicine. METHODS: 12 samples of clinical isolates from humans were used, nine of T. mentagrophytes and three of T. tonsurans. Susceptibility tests were performed according to the agar diffusion (AD) and broth microdilution (BM) methods. RESULTS: In the AD method, the species T. tonsurans presented a percentage of sensitivity of 33% in relation to amphotericin B and 66% to itraconazole, with 100% resistance to ketoconazole and fluconazole. T. mentagrophytes also showed 100% resistance to ketoconazole in this technique, with 11% sensitivity to ketoconazole, 22% to itraconazole and 22% of samples classified as sensitive dose dependent. In the MC method, the species T. tonsurans presented a sensitivity percentage of 66%, 55% and 33% in relation to ketoconazole, fluconazole and itraconazole, respectively. The T. mentagrophytes species presented sensitivity percentages of 11%, 11%, 33% and 55% for amphotericin B, itraconazole, ketoconazole and fluconazole, respectively. CONCLUSION: There was resistance in vitro of the species of T. mentagrophytes and T. tonsurans against the antifungal fluconazole and relative resistance against ketoconazole in the AD method. In BM, however, important percentages of sensitivity were observed for the two species analyzed in relation to the antifungals fluconazole and ketoconazole when compared to itraconazole and amphotericin B.

INTRODUÇÃO: A resistência de espécies fúngicas às drogas usualmente empregadas no meio clínico é motivo de grande interesse na área médica. OBJETIVO: Avaliar susceptibilidade e resposta in vitro de espécies de Trichophyton spp. a drogas antifúngicas de interesse em clínica médica. MÉTODOS: Foram utilizadas 12 amostras de isolados clínicos de humanos, sendo nove de T. mentagrophytes e três de T. tonsurans. Foram realizados testes de susceptibilidade segundo os métodos de difusão em ágar (DA) e microdiluição em caldo (MC). RESULTADOS: No método de DA, a espécie T. tonsurans apresentou percentual de sensibilidade de 33% em relação à anfotericina B e de 66% ao itraconazol, com 100% de resistência frente ao cetoconazol e ao fluconazol. A espécie T. mentagrophytes também apresentou 100% de resistência frente ao cetoconazol nesta técnica, com 11% de sensibilidade ao cetoconazol, 22% ao itraconazol e 22% das amostras classificadas como sensível dose dependente. No método de MC, a espécie T. tonsurans apresentou percentual de sensibilidade de 66%, 55% e 33% em relação ao cetoconazol, fluconazol e itraconazol, respectivamente. A espécie T. mentagrophytes apresentou percentuais de sensibilidade de 11%, 11%, 33% e 55% para anfotericina B, itraconazol, cetoconazol e fluconazol, respectivamente. CONCLUSÃO: Houve resistência in vitro das espécies do T. mentagrophytes e T. tonsurans frente ao antifúngico fluconazol e resistência relativa frente ao cetoconazol no método de DA. Na MC, no entanto, foram observados importantes percentuais de sensibilidade das duas espécies analisadas frente aos antifúngicos fluconazol e cetoconazol quando comparadas ao itraconazol e à anfotericina B.

Tinea corporis by Nannizia gypsea: delayed diagnosis due to unusual presentation

Abstract Fungal infections by dermatophytes can present with unusual clinical manifestations, which can cause diagnostic difficulties. The authors present the case of a patient with cutaneous infection by Nanizzia gypsea, initially treated erroneously with topical corticosteroids due to a wrong diagnosis. It was cured after antifungal treatment.

Research progress in pharmacology and toxicology of evodiamine / 中国中药杂志

Evodiamine, a bioactive indole alkaloid from Evodia rutaecarpa, E. rutaecarpa var. officinalis, or E. rutaecarpa var. bodinieri, has been extensively investigated due to its pharmacological activities in recent years. At present, evodiamine is proved to significantly suppress the proliferation of a variety of cancer cells and mediate cell processes such as cell cycle arrest and cell migration. In addition, evodiamine displays significant pharmacological activities against cardiovascular diseases(hyperlipidemia, etc.), and tinea manus and pedis. Recently, evodiamine has been found to have potential toxic effects, such as hepatotoxicity, nephrotoxicity, and cardiotoxicity. However, the pharmacological and toxicological mechanism of evodiamine is not clear, and its toxicity in vitro and in vivo has been rarely reported. Therefore, this study reviewed the pharmacological and toxicological articles of evodiamine in recent years, aiming at providing new ideas and references for future research.

Dermatomicosis superficiales: cuando el diagnóstico lo entrega la histología / Superficial dermatomycosis: when the diagnosis is provided by histology

Superficial dermatomycosis are prevalent pathologies in the medical field and their diagnosis is fundamentally clinical. Histopathology is not considered part of his study, however, the diagnosis is exceptionally obtained by biopsy, when dermatomycosis was not suspected. Unpublished retrospective work is carried out on patients who had the histopathological diagnosis of superficial dermatomycosis between the years 2000-2019 at the HCUCH, based on selection criteria, obtaining 19 patients, in which the following were analyzed: age, gender, clinical characteristics, location, presumptive diagnosis and mycological and histological examinations. He stressed, as was our hypothesis, that dermatomycosis was not clinically suspected, since the presumptive diagnoses were various dermatoses. The most suspected dermatosis was psoriasis, as a result that 57.8% of the dermatoses studied had erythematous scaly plaques on examination. Another relevant fact is that only 21% of the cases underwent a direct mycological prior to the biopsy, which was negative ('' false negative''). It is concluded, then, that superficial dermatomycosis should be considered clinical simulators of other dermatoses, so clinical suspicion and support of mycological examination and fungal culture is essential. (AU)

Efficacy of guava 5% cream vs. clotrimazole 1% cream in the treatment of Tinea corporis of patients seen at the Family Medicine Department of Quezon City General Hospital

Objective@#To determine the efficacy of Guava 5% cream compared to Clotrimazole 1% cream in the treatment of Tinea corporis of patients seen at Family Medicine Department of Quezon City General Hospital@*Design@#Randomized therapeutic clinical trial@*Setting@#Department of Family and Community Medicine Out Patient Department of Quezon City General Hospital@*Study Subjects@#Patients, male or female, 19 years old and above who consulted at Family and Community Medicine Department of Quezon City General Hospital@*Method@#The study was done from August- September 2019. Fifty subjects were randomly assigned to either Group A (25) or Group B (25) using systematic sampling method. Patients in Group A were instructed to apply on affected area Clotrimazole 1% Cream twice a day for 2 weeks, while patients on Group B applied Guava 5% cream twice a day for 2 weeks. Patients were instructed follow up on Week 1 for improvement, Week 2 for evaluating outcome of treatment and Week 4 to check for recurrences@*Results@#Total severity scores of both Groups A and B at Week 1, Week 2 and Week 4 were similar with p-values of 0.014, 0.480 and 0.386 respectively. Both groups were comparable as to the treatment outcome for Tinea corporis. Guava 5% cream is shown to be cost-effective considering the equally-effective treatment outcome and the lower average treatment cost@*Conclusion@#This study has shown that Guava 5% cream is equally effective as, and cheaper than Clotrimazole 1% cream, thus considered to be a cost-effective treatment for Tinea corporis.

Medicinal plants for Dermatophytosis: Senna Alata (Linn.) Roxb., Allium sativum (Linn.) and Cymbopogon citratus (DC.) Stapf

@#Skin mycoses have been a major problem affecting millions around the globe. The threat of resistance to synthetic antifungal agents however is a major obstacle in its management. As an alternative to these, a thorough investigation of natural products is being performed to develop medicines that are effective and safe. In this review, we described three antifungal herbal plants that are available in the Philippines, namely Senna alata (Linn.) Roxb. (akapulko), Allium sativum (Linn.) (garlic) and Cymbopogon citratus (DC.) Stapf (lemongrass). In vitro studies showed promising results that can be used as a basis for drug formulation for community use as well as commercial products. So far, there have been no reported toxic effects from these plants. The common ground for these plants’ mechanism of action was the effect of their phytochemicals in the cell membrane and cell wall organelles, inhibition of major biosynthetic pathways, and prevention of biofilm formation. Formulation and clinical studies also revealed promising results comparable to the synthetic ones.

Analysis of Adult Patients with Tinea Capitis in Southeastern Korea

BACKGROUND: Tinea capitis is a cutaneous infection of dermatophytes and predominant in children. Although tinea capitis in Korea is controlled by oral antifungal medications and concerted public health initiatives, it's still a health issue.OBJECTIVE: To investigate changes in the epidemiological and mycological characteristics of adult patients with tinea capitis in southeastern Korea.METHODS: Using medical records from Kyungpook National University Hospital and Catholic Skin Clinic from 1989 to 2018, we retrospectively investigated the epidemiological and mycological characteristics of 266 adult patients (aged over 20) with tinea capitis.RESULTS: Among total 266 patients, 239 were KOH-positive. The annual incidence of tinea capitis ranged from 3 to 18 between 1989 and 2018. Of the total, 54 (20.30%) were male and 212 (79.70%) were female. Eighty patients (30.08%) were in their seventies, the most commonly affected age group. Of the remaining, 58 (21.80%) were in their sixties, and 41 (15.41%) in eighties. Among all, 77 (28.95%) visited the hospital in summer, 72 (27.07%) in spring, 64 (24.06%) in winter, and 53 (19.92%) in fall. Dermatophytes were cultured from 171 patients. Microsporum canis was the most common dermatophyte (42.48%), while Trichophyton rubrum was the second (15.79%). Of the 266 patients, 186 (69.92%) lived in urban areas and 80 (30.08%) in rural areas.CONCLUSION: The epidemiological and mycological characteristics of adult patients with tinea capitis were different from those of children in terms of annual incidence, sex distribution, and isolated dermatophytes. These results provide useful information for the treatment and prevention of tinea capitis.