Dermoscopy - a simple and rapid in vivo diagnostic technique for tinea incognito

Abstract Tinea incognito resulting from corticosteroid abuse is becoming very common in the tropics. Its diagnosis is tricky owing to its confusing morphology, as well as practical and technical issues associated with mycological tests. Dermoscopy has now evolved as a novel diagnostic tool for diagnosing tinea incognito in such challenging situations, since the typical hair changes such as Morse-code hairs, deformable hairs, translucent hairs, comma and cork screw hairs, and perifollicular scaling may be seen despite steroid use, irrespective of mycological results.

Profil mycologique de teignes du cuir chevelu vues à l'UPFR Parasitologie - Mycologie du HU-JRA Antananarivo, Madagascar de 2005-2018

Introduction : Les teignes sont des affections fongiques contagieuses causées par plusieurs espèces de dermatophytes. Cette mycose touche essentiellement l'enfant et rarement l'adulte. Les teignes anthropophiles sont fréquentes dans la plupart des pays en voie de développement. Cette affection reste sous-documentée à Madagascar. Notre étude a pour objectif de rapporter les cas de teignes diagnostiqués dans le laboratoire de parasitologie-mycologie au CHU Ravoahangy Andrianavalona Antanananarivo de 2005 à 2018. Méthode : Il s'agit d'une étude rétrospective descriptive incluant tous les dossiers des patients ayant effectué un examen mycologique. Ont été inclus les dossiers comportant comme diagnostic la teigne. Chacun de ces patients a bénéficié d'un examen direct et d'une culture mycologique Résultats : Nous avons colligé en 13 ans 1014 patients confirmés porteurs de mycose. La fréquence des teignes sur l'ensemble des mycoses a été de 5,81% (59/1014). La prévalence brute des teignes a été de 37,57% (59/157). L'âge des patients variait de 2 à 67 ans dont 52,54% sont des enfants moins de 10 ans. La moyenne d'âge est de 13,5 ans. Les teignes étaient plus retrouvées chez les hommes (71,19 %) que chez les femmes (28,81 %) avec un sex ratio H/F de 2,47.Parmi ces patients, 77, 96% ont eu une notion de traitement avant l'examen mycologique. Dix souches de dermatophytes ont été isolées. Parmi les espèces retrouvées, Microsporium langeronii est l'espèce la plus isolée (33,89 %), suivie de Trichophyton mentagrophytes à 20,33 %. Conclusion : La fréquence des teignes n'est pas négligeable à Madagascar atteignant préférentiellement les enfants. Le diagnostic biologique des teignes est indispensable avant de débuter le traitement. L'identification de l'agent causal est importante pour prévenir et contrôler l'infection dermatophytique

Cellular immunodeficiency related to chronic dermatophytosis in a patient with Schistosoma mansoni infection: can schistosomiasis induce immunodeficiency?

Abstract: Here, we describe a case of hepatosplenic schistosomiasis that progressed to widespread persistent dermatophytosis. Significant T and B lymphocytopenia was confirmed. T-cell deficit is associated with increased susceptibility to fungal infections of skin and mucous membranes. The accumulation of a large amount of blood cells in the spleen could have played a crucial role in the development of lymphocytopenia in the present case. Alternatively, the schistosomiasis-induced increase in prostaglandin E2 levels could have inhibited the production of interferon-γ, a cytokine fundamental to fungal resistance. This case shows the potential of hepatosplenic schistosomiasis to impair the immune response.

Dermatofitoses: agentes etiológicos, formas clínicas, terapêutica e novas perspectivas de tratamento / Dermatophytoses: etiologic agents, clinical forms, therapy and new perspectives of treatment

As dermatofitoses têm ocorrência mundial, sendo mais prevalentes em países de clima tropical e subtropical. Dados epidemiológicos indicam que essas micoses estão entre as infecções fúngicas de maior ocorrência. O quadro clínico mais comum de dermatofitose inclui despigmentação, placas anulares, prurido e perda de cabelo, com lesões tipicamente conhecidas como tineas, ocasionadas por fungos filamentosos dermatofíticos de três gêneros anamórficos: Microsporum, Trichophyton e Epidermophyton. O tratamento das dermatofitoses, em geral, está relacionado ao uso de antifúngicos tópicos e/ou sistêmicos, apresentando como problemática o surgimento de espécies multirresistentes. Esta revisão aborda as dermatofitoses e seus agentes etiológicos de forma aprofundada em aspectos epidemiológicos, apresentando a importância clínica do tema, com ênfase na causa, prevenção, tratamento e prognóstico dessa micose cutânea (AU)

Dermatophytoses have worldwide occurrence with higher prevalence in tropical and subtropical countries. Epidemiological data show that these mycoses are among the most frequent fungal infections. The most common symptoms of dermatophytoses include depigmentation, annular plaques, itching and hair loss, with lesions such as tinea, caused by dermatophytic filamentous fungi of three anamorphic genera: Microsporum, Trichophyton and Epidermophyton. Topical and/or systemic antifungalmedications are used in the treatment of dermatophytoses in general, resulting in problems such as the emergence of multidrug-resistant species. This review discusses dermatophytoses and their etiological agents with a focus on epidemiological aspects, presenting the clinical importance of the issue, with emphasis on cause, prevention, treatment and prognosis of this skin mycosis (AU)

Current mycological profile of dermatophytosis in a tertiary care set up in North Bengal

To determine the occurrence, distribution and mycological profile of dermatophytosis in North Bengal Medical College and Hospital, in Darjeeling, West Bengal, India. A total of 200 specimens were collected from clinically suspected dermatophytoses from February to April 2013. Samples of skin scrapings, hair shafts and nails were sent to laboratory from dermatology OPD for direct examination, fungal culture and identification. Adult males outnumbered females in all cases of dermatophytosis except tinea corporis. Most cases showed high culture sensitivity except tinea unguium. Trichophyton rubrum was the most commonly isolated fungal organism. This study identifies the clinical distribution and predominant organisms causing dermatophytosis in North Bengal, which may be useful to ascertain the past and present trends in dermatophytosis and provide insight into future diagnosis and treatment

A case of Tinea nigra associated to a bite from a European rabbit (Oryctolagus cuniculus, Leporidae): the role of dermoscopy in diagnosis

We report a case of Tinea nigra in an adolescent living in Itapema, Santa Catarina, Brazil, who presented a hyperchromic macule on the palm of the left hand, close to another erythematous macule caused by a rabbit bite. The patient received guidance on accidents and animal bites and evolved well treated with topical butenafine for the dermatomycosis. The authors also highlight the efficacy of the dermoscopic exam in diagnosing Tinea nigra with animal bite lesions and other traumas.

Relationship between qooba [dermatophytosis] and mizaj temperament

In this study we have tried to assess the Mizaj [temperament] of the patients of Qooba [dermatophytosis]. Among 126 patients we have found that maximum number of patients [46.83%] belonged to Saudawi temperament, followed by Damwi [31.75%], Balghami [24.60%] and Safrawi [13%] temperament

Tiña incógnita: a propósito de dos casos y breve revisión de la literatura / EspañolInglésPortuguésTinea incognito: report of two cases and brief review of literature

Se presentan dos casos de niños con tiña facial modificada por el empleo prolongado de corticoides tópicos de alta potencia. Las típicas placas circulares u ovaladas, únicas o múltiples bien delimitadas de borde eritemato-vesiculoso levantado activo, de extensión periférica con aclaramiento del centro lesional, poco inflamatorias y muchas veces asintomáticas que afectan la cara, tronco y/o extremidadescambian su morfología y evolución debido al efecto inmunodepresor del fármaco.

We present two cases of children with facial ringworm modified by the prolonged use of high potency topical corticosteroids. The typical circular or oval lesions, single or multiple, with well-defined and raised redscaly edge and active borders with peripheral extension and center clearance; little inflammatory activity and often asymptomatic affecting the face, trunk and / or extremities change theirmorphology and evolution due to immunosuppressive effect of the drug.

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

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

Granuloma de Majocchi / Majocchi's granuloma

El granuloma de Majocchi o granuloma dermatofítico es una micosis causada por dermatofitos, regularmente del género Trichophyton, predominando T. rubrum en 50%. Se presenta en pacientes inmunocompetentes o inmunodeprimidos. No se sabe cómo se produce la infección, al parecer inicia con trauma físico que guía a alteraciones del folículo piloso y a la introducción pasiva del hongo. Para el desarrollo de la infección se requieren factores predisponentes y desencadenantes, los más importantes son la diabetes y el uso de esteroides. Clínicamente se clasifica en papular perifolicular o superficial en pacientes inmunocompetentes, y en nodular subcutánea o profunda en pacientes con inmunosupresión. Se confirma el diagnóstico por histopatología, encontrando granulomas en dermis media y profunda, con estructuras dermatofíticas en forma de filamentos o esporas. El tratamiento es con antimicóticos sistémicos. Se hace una revisión del tema resaltando los aspectos etiopatogénicos, clínico-patológicos y terapéuticos de la enfermedad.

Majocchi's granuloma or dermatophytic granuloma is a mycosis observed among immunocompetent and immunocompromised patients caused by dermatophytes, particularly Trichophyton rubrum, which may be responsible for 50% of cases. The mechanism by which it occurs is yet unknown although reports suggest it may occur after localized trauma that alters the hair follicle and enables the entrance of the microorganism. Diabetes and the use of topical steroids are among some of the predispEl cuadro 1 no está acotado. Favor de hacerloEl cuadro 1 no está acotado. Favor de hacerloosing factors. Majocchi's granuloma has two clinical presentations, among immunocompetent patients it displays follicular papules and among immunocom-promised patients a subcutaneous nodular type is observed. Diagnosis is confirmed through histopathology, where granulomas and dermatophytes in the form of filaments or spores are observed in the mid and deep dermis. Treatment includes systemic antimycotics. We reviewed the etiopathogenic, clinical, histopathological and therapeutic aspects of Majocchi's granuloma.

Adult paratesticular malignant fibrous histiocytoma treated with surgery, systemic chemotherapy and postoperative adjuvant radiotherapy.

Paratesticular malignant fibrous histiocytoma is an extremely rare malignancy of the scrotum. This malignancy has rarely been described in the literature and scant information exists on the optimal management of this cancer. We present here a case of a 57-year-old man with a diagnosis of high-grade malignant fibrous histiocytoma of the left intrascrotal region who underwent radical orchiectomy, systemic chemotherapy and postoperative radiotherapy.

Tiña negra: a propósito de tres casos en el estado Táchira-Venezuela / Tinea nigra: report of three cases in the state of Táchira-Venezuela

La tiña negra es una dermatomicosis superficial, poco frecuente, quiza subdiagnosticada, cuyo agente etiológico es el phaeonnellomyces werneckii. Considerada como enfermedad tropical y subtropical de distribución universal, afecta a personas de ambos sexos, a cualquier edad; siendo los niños y los adolescentes los más afectados. Manifestada clínicamente como maculas hiperpigmentadas, asintomáticas de evolución crónica, localizada en la palma de las manos, aunque también pueden estar presentes en la planta de los pies y otras superficies. El examen micológico directo y cultivo de la lesión confirman el diagnóstico y el tratamiento con topicos de formulación sencilla incluyendo imidazolicos ofrecen buenos resultados.

Perfect media for isolation of fungi from patients with dermatophytosis

Three types of ordinary media were tested in order to assess perfect one for isolation of dermatophytes from patients with dermatophytosis disease. Tinea pedis was preferred to give a positive growth on all three tested media, whereas Tinea corporis was favorable to grow on the PDA and Tinea cruris on SDA. SDA and PDA were appeared as successful media for specimen culturing, in contrast with CDA and Candida albicanis was the best fungi species grown on these media, followed by T. mentagrophytes

Tinea Capilatis causada por Trichophyton rubrum en un adulto portador de artritis reumatoidea / Tinea capilatis caused by T. rubrum in adult patient with rheumatoid arthritis

Presentamos un caso de tinea capilatis causada por Trichophyton rubrum en una mujer de 47 años de edad con artritis reumatoidea. Creemos que esta enfermedad crónica la volvió susceptible a esta dermatofitosis poco común

Granuloma de Wilson-Majocchi / Majocchi's granuloma

El granuloma tricofítico de Majocchi-Wilson es una foliculitis con perifoliculitis granulomatosa dérmica, producida por dermatofitos. Su expresión clínica puede variar en función del estado inmune del paciente. Presentamos el caso de una paciente transplantada renal, inmunosuprimida, que desarrolló una dermatofitosis extensa, sobre la que se produjeron múltiples granulomas tricofíticos. Revisión del tema

study of dermatophytoses in a central hospital in Asir region, Saudi Arabia

Sick leave, lead to loss of workdays and national money. This study evaluates a general belief, that a large number of Sick Leave Notes [SLN] are issued from. Accident and Emergency Department [A/E]. We found that only 3.5% out of all patients attending A/E were issued SLN. 97% patients were issued leave for one to two days only, these patients had mild to moderate illness only, and the leave was justified. We conclude that A/E doctors do not issue large number of SLN, most of the SLN are justified

study of dermatophytoses in a central hospital in Asir region, Saudi Arabia

The causes of dermatophytoses are known to differ from place to place, even within the same country. In the Kingdom of Saudi Arabia [KSA], studies on dermatophytoses have been reported from eastern province only. In an attempt to assess the situation in another part of the country, various species of dermatophytes isolated at Asir Central Hospital [ACH] in Asir region of KSA were studied. All the positive fungal cultures excluding candida and saprophytes reported from the microbiology laboratory of ACH between 1988 and 1992 were studied retrospectively through mycology records. Out of 588 specimens, 63 were reported to be positive. Among dermatophytes, Trichophyton genus was found to be commonest [65.08%] followed by Microsporum genus [19.05%] and Epidermophyton [3.17%] genera. Trichophyton infection was the predominant cause of disease of the hands and feet, 20 out of 28 cases, of the microsporum group, 7 out of 12 were isolated from scalp. Seven out of 10 cases of tinea capitis were caused by microsporum species. Trichophyton genus was more commonly isolated, overall from cases of dermatophytoses in Asir region of KSA. However, tinea capitis was predominantly caused by micorsporum species

Aclinicomycological study of superficial fungi in Lahore

A clinicomycological study on 230 suspected patients, who attended the dermatology outpatient department of Services Hospital, Lahore from October 1991 to April 1992, was performed to determine the causative fungi and their clinical manifestations. In all patients, fungal hyphae were demonstrated on potassium hydroxide [KOH] mount. Fungal cultures were positive in 222 [95.52%] patients, and negative in 8 [3.48%] patients. The most prevalent aetiological agent identified was Trichophyton tonsurans; the predominant clinical type was Tinea corporis [36.94%] in adults and Tinea capitis [9.91%] in children. The majority of the patients [86.9%] were recorded as symptomatic

Ceratofitose negra / Tinea nigra

É apresentada uma atualizaçäo bibliográfica sobre ceratofitose negra, uma dermatose pouco diagnosticada em nosso meio e de tratamento relativamente fácil. O fungo é estudado quanto à sua morfologia e modo de esporulaçäo, que motivaram a troca da sua classificaçäo taxonômica por diversas vezes