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1.
Cureus ; 16(5): e60162, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38868264

RESUMO

BACKGROUND: Dermatophytosis, a major cause of superficial fungal infections, requires topical and systemic antifungals. Amorolfine, a morpholine derivative, is a new topical antifungal available in cream and lotion formulations. OBJECTIVE: To evaluate the efficacy and safety of amorolfine lotion 0.25% compared to amorolfine cream 0.25% in patients with dermatophytosis. METHODS: A multi-center randomized, two-arm, active-controlled, parallel, non-inferiority phase III clinical trial involving 284 dermatophytosis patients was conducted, with the test arm using amorolfine lotion and the reference arm using amorolfine cream. The study drugs were applied once daily in the evening for four weeks and patients were followed up for another two weeks. The primary endpoint was clinical cure, while secondary endpoints included mycological cure, composite cure, global efficacy assessment, and post-treatment relapse. Safety and tolerability were assessed. RESULTS: Amongst the enrolled patients, 69.9% and 68.1% of patients had tinea corporis, while 30.1% and 31.9% had tinea cruris. The majority of patients in both groups (99.3% test and 97% reference) achieved a clinical cure at the end of treatment. Mycological cure was achieved by 98.6% and 96.3% respectively. A composite cure was achieved by 98.6% in the test arm versus 96.3% in the reference arm. A total of two AEs were reported in two (1.4%) patients in the test group and three AEs were reported in three (2.1%) patients in the reference group, all of the AEs were mild and resolved within three days without supportive medication. No severe adverse effects were reported in any of the study subjects. CONCLUSION: Amorolfine lotion 0.25% w/v showed a non-inferior clinical, mycological, and composite cure in dermatophytosis patients, was well-tolerated, and had a similar safety profile to amorolfine cream 0.25% w/w.

3.
Int J Dermatol ; 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38712801

RESUMO

INTRODUCTION: Recalcitrant dermatophytosis is an emerging phenomenon that occurs worldwide, and Trichophyton indotineae is currently the prominent cause. MATERIALS AND METHODS: Skin specimens from patients with tinea infection were obtained by scrubbing and then sectioned into three fragments. Two fragments were subjected to direct microscopic examination and culture, while the third portion was utilized in the PCR method. RESULTS: Isolates were morphologically identified as Trichophyton mentagrophytes/interdigitale complex (n = 60 [83.33%]), Microsporum canis (n = 8 [11.11%]), Trichophyton rubrum (n = 3 [4.16%]), and Epidermophyton floccosum (n = 1 [1.38%]). Among 60 T. mentagrophytes complex isolates, 53 (88.33%) were classified as T. indotineae and seven as T. interdigitale genotype II. The disease duration was longer in the T. indotineae group (P = 0.035). Both Gradient PCR and skin-sampling methods yield similar results in terms of positive and negative cases (P = 1.0000). The time patients stopped their medication did not impact the positive case numbers (P = 0.803). Gender had no effects on the frequency (P = 0.699). Familial contamination, dermatologic disorder, and other underlying conditions did not differ in the two group infections (P > 0.05). Steroid usage is strongly associated with the emergence of tinea infection (P < 0.04). The duration of antifungal administration had a substantial effect on the emergence of resistant organisms (P = 0.05). CONCLUSIONS: Steroid usage, T. indotineae involvement, and prolonged exposure to antifungals were the solid and influential factors in recalcitrant involvement. Regarding quick and suitable diagnosis and treatment, which is essential in preventing recalcitrant cases, we suggest that direct skin sample PCR can meet the demands.

5.
J Fungi (Basel) ; 10(4)2024 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-38667966

RESUMO

While typically exhibiting characteristic features, fungal infections can sometimes present in an unusual context, having improbable localization (eyelid, face, or joint); mimicking other skin diseases such as eczema, psoriasis, or mycosis fungoides; and appearing with unexpected color, shape, or distribution. The emergence of such a challenging clinical picture is attributed to the complex interplay of host characteristics (hygiene and aging population), environment (climate change), advances in medical procedures, and agent factors (fungal resistance and species emergence). We aim to provide a better understanding of unusual epidemiological contexts and atypical manifestations of fungal superficial diseases, knowing that there is no pre-established clinical guide for these conditions. Thus, a literature examination was performed to provide a comprehensive analysis on rare and atypical superficial mycosis as well as an update on certain fungal clinical manifestations and their significance. The research and standard data extraction were performed using PubMed, Medline, Scopus, and EMBASE databases, and a total of 222 articles were identified. This review covers published research findings for the past six months.

6.
J Am Acad Dermatol ; 2024 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-38574764

RESUMO

Trichophyton indotineae has emerged as a novel dermatophyte species resulting in treatment recalcitrant skin infections. While the earliest reports came from India, T. indotineae has now spread to many parts of the world and is rapidly becoming a global health concern. Accurate identification of T. indotineae requires elaborate mycological investigations which is beyond the domain of routine microbiology testing. Extensive, non-inflammatory and atypical presentations are commonly seen with this novel species. T. indotineae shows an alarmingly high rate of mutations in the squalene epoxidase gene leading to lowered in vitro susceptibility to terbinafine. This has also translated into a lowered clinical response and requirement of a higher dose and much longer durations of treatment with the drug. Although the species remains largely susceptible to itraconazole, prolonged treatment durations are required to achieve cure with itraconazole. Fluconazole and griseofulvin do not have satisfactory in vitro or clinical activity. Apart from requirement of prolonged treatment durations, relapse postsuccessful treatment is a distressing and yet unexplained consequence of this "species-shift." Use of third generation azoles and combinations of systemic antifungals is unwarranted as both have not demonstrated clear superiority over itraconazole given alone, and the former is an important class of drugs for invasive mycoses.

7.
Mycoses ; 67(2): e13707, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38366126

RESUMO

BACKGROUND: Dermatophytosis is very common among all age groups throughout the world. The incidence of the same is increasing on a steady basis. AIM: Estimating the clinical prevalence of dermatophytes mycoses among the patients visiting the outpatient unit and assessing its distinct manifestations. METHODOLOGY: A prospective observational study was conducted with the patients attending the Skin and STD outpatient unit of a tertiary care teaching hospital in Salem. A total of 3068 outpatients attended the department, of which 420 patients were diagnosed with dermatophytic mycoses and were taken for investigating the prevalence. RESULTS: A total of 420 dermatophytosis patients were included giving a percentage prevalence of 13.69%. There were more female patients (n = 213, 50.71%) than males (n = 207, 49.29%). The most common afflicted age group was 31-40 years (n = 99, 50.71%). Most of the patients had an atypical lesion called tinea incognita (n = 265, 63.09%) where there was no typical classic appearance of dermatophytic infections. The most prevalent clinical manifestation was tinea corporis (n = 73, 17.38%) followed by tinea cruris (n = 69, 16.43%). There were more newly diagnosed dermatophytosis cases (n = 326) than the previously diagnosed cases (n = 94). CONCLUSION: This study concludes that dermatophytic mycoses were more prevalent among females than males and among the age groups of 31-40 years. The most common clinical presentation was tinea incognita followed by tinea corporis.


Assuntos
Tinha , Masculino , Humanos , Feminino , Adulto , Prevalência , Centros de Atenção Terciária , Tinha/epidemiologia , Tinha/diagnóstico , Índia/epidemiologia
8.
Med Mycol J ; 65(1): 1-5, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38417881

RESUMO

Microsporum canis is a type of dermatophyte that causes zoonotic dermatophytosis in cats and dogs. We report three cases of tinea corporis due to M. canis from a single household with a domestic cat as a pet. The cases included a woman in her thirties (mother), a girl in her teens (older sister), and a girl in her teens (younger sister). Following sudden hair loss in the domestic cat, annular erythema with pruritus and scales appeared on the face, neck, and limbs of the older sister, younger sister, and mother, sequentially; they subsequently visited our hospital. Potassium hydroxide direct microscopy revealed filamentous fungi on all three women. In addition, short-haired colonies with a white to yellowish-white color and extending in a radial manner were found in cultures using a flat plate agar medium. A slide culture with the same medium indicated pointed spindle-shaped macroconidia with 7-8 septa. Therefore, the cases were diagnosed as tinea corporis due to M. canis. Genetic analysis of the cells of the cat and the mother, older sister, and younger sister using multilocus microsatellite typing (MLMT) indicated that all cases were classified into the same genotype, suggesting that the transmission route of these cases was familial. Here, we show that MLMT is useful in identifying the infection route in cases of tinea corporis due to M. canis.


Assuntos
Dermatomicoses , Tinha , Humanos , Adolescente , Feminino , Animais , Cães , Gatos , Tinha/diagnóstico , Tinha/veterinária , Microsporum/genética , Mães , Repetições de Microssatélites/genética , Dermatomicoses/diagnóstico , Dermatomicoses/microbiologia
9.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1559119

RESUMO

ABSTRACT Microsporum canis, one of the most widespread dermatophytes worldwide, is a zoonotic microorganism that transmits infection from reservoirs such as cats and dogs to humans. This microorganism is associated with Tinea corporis and other clinical manifestations; however, few studies have used genetic surveillance to determine and characterize the process of zoonotic transmission. In this study, we show a clear example of zoonotic transmission from a cat to an intrafamilial environment, where it caused Tinea corporis by infection with M. canis. Molecular characterization using the b-tubulin gene and Random Amplified Polymorphic DNA analysis made it possible to determine that the six isolates of M. canis obtained in this study belonged to the same genetic variant or clone responsible for reservoir-reservoir or reservoir-human transmission.

10.
Indian J Dermatol ; 68(5): 525-540, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38099117

RESUMO

The emergence and spread of Trichophyton indotineae (T. indotineae) has led to a sea change in the prescription practices of clinicians regarding the management of dermatophytic skin infections. An infection easily managed with a few weeks of antifungals, tinea corporis or cruris, is now often chronic and recurrent and requires prolonged treatment. Rising resistance to terbinafine, with documented squalene epoxidase (SQLE) gene mutations, and slow clinical response to itraconazole leave clinicians with limited treatment choices. However, in these testing times, it is essential that the tenets of antifungal stewardship be followed in making therapeutic decisions, and that the existing armamentarium of antifungals be used in rationale ways to counter this extremely common cutaneous infection, while keeping the growing drug resistance among dermatophytes in check. This review provides updated evidence on the use of various systemic antifungals for dermatophytic infection of the glabrous skin, especially with respect to the emerging T. indotineae species, which is gradually becoming a worldwide concern.

11.
J Fungi (Basel) ; 9(11)2023 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-37998927

RESUMO

BACKGROUND: Trichophyton benhamiae, an anthropophilic dermatophyte, can cause dermatophytosis in humans and animals with rising zoonotic infections through pets, primarily in Europe. Dermatophytosis from T. benhamiae is often misdiagnosed due to its inflammatory symptoms. We report a case of tinea corporis from T. benhamiae var. luteum in a Japanese woman, contracted from pet Czech degus. CASE: The 40-year-old patient developed neck papules resembling acne. Initial treatment with topical antibiotics and steroids exacerbated the rash. Fungal elements were not detected by direct potassium hydroxide examination. Skin biopsy confirmed fungal elements in the stratum corneum and hair follicles, and tinea corporis was diagnosed. Oral terbinafine 125 mg was initiated without topical agents. Erythematous papules appeared on her limbs, determined as a trichophytid reaction. After two months, her skin improved significantly. Fungal culture identified T. benhamiae var. luteum colonies with a yellowish hue. Mating tests classified the strain as Americano-European race (-) with MAT1-1 genotype. This was diagnosed as tinea corporis from T. benhamiae var. luteum, likely transmitted from pet Czech degus. CONCLUSIONS: The incidence rate of pet-transmitted cutaneous fungal infections may increase in Japan with the trend to keep exotic pets. Dermatologists must recognize dermatophytosis clinical features from anthropophilic dermatophytes to prevent misdiagnosis and understand evolving nomenclature and pathogenesis.

12.
J Fungi (Basel) ; 9(9)2023 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-37754973

RESUMO

Trichophyton indotineae is an emerging dermatophyte species that plays a relevant role in human healthcare. It has been associated with severe chronic skin infections and a high level of terbinafine resistance. T. indotineae is endemic to India, Iran, and Iraq but several cases have been reported in Europe, recently. In this manuscript, the authors report the first clinical description of a tinea corporis and onychomycosis due to T. indotineae. The patient was a 42-year-old female from India that has lived in Umbria (Central Italy) for the last two years. Firstly, a dermatological examination suggested dermatophytosis: mycology isolation from cultures and macro- and microscopical features identified the colonies as belonging to the T. mentagrophytes/T. interdigitale species complex. Subsequently, ITS1/ITS4 end-point PCR and Sanger sequencing identified the strain as T. indotineae. Lastly, a DermaGenius® Resistance Multiplex real-time PCR assay was carried out, targeting the mutations in the SQLE gene to establish terbinafine resistance or susceptibility of the strain. The melting curve observed was compatible with wild-type positive control, identifying the strain as T. indotineae terbinafine-sensitive. An oral terbinafine treatment was associated with a topical ciclopirox nail solution, resulting in remission in its clinical manifestation. On 3 July 2023, the local Prevention Service notified the case to the Ministry of Health that then reported the information at national and international levels.

13.
Expert Rev Anti Infect Ther ; 21(9): 977-991, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37606343

RESUMO

INTRODUCTION: There is an epidemic emergence of increased resistance in dermatophytes with to antifungal drugs with ergosterol1 (Erg1) and Erg11 mutations to terbinafine and azoles. Apart from mutations, mechanisms that predict clinical failure include efflux pumps, cellular kinases, heat shock proteins (Hsp), and biofilms. Apart from itraconazole and SUBATM (Super-Bioavailable) itraconazole, measures that can be used in terbinafine failure include efflux-pump inhibitors, Hsp inhibitors and judicious use of antifungal drugs (topical + systemic) combinations. AREAS COVERED: A PubMed search was done for the relevant studies and reviews published in the last 22 years using keywords dermatophytes OR Trichophyton, anti-fungal, resistance, mechanism and fungal AND resistance mechanisms. Our aim was to look for literature on prevalent species and we specifically researched studies on Trichophyton genus. We have analyzed varied antifungal drug mechanisms and detailed varied experimental and approved drugs to treat recalcitrant dermatophytosis. EXPERT OPINION: Apart from administering drugs with low minimum inhibitory concentration, combinations of oral and topical antifungals (based on synergy data) and new formulations of existing drugs are useful in recalcitrant cases. There is a need for research into resistance mechanism of the existent Trichophyton strains in therapeutic failures in tinea corporis & cruris instead of data derived from laboratory strains which may not mirror clinical failures.


Assuntos
Arthrodermataceae , Tinha , Humanos , Antifúngicos , Terbinafina/farmacologia , Terbinafina/uso terapêutico , Trichophyton/genética , Itraconazol/farmacologia , Itraconazol/uso terapêutico , Tinha/tratamento farmacológico , Tinha/microbiologia , Testes de Sensibilidade Microbiana
14.
J Fungi (Basel) ; 9(7)2023 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-37504722

RESUMO

Trichophyton indotineae causes resistant dermatophytosis to terbinafine. The global spread of terbinafine-resistant Trichophyton indotineae strains with mutations in the squalene epoxidase gene is a major issue. This emerging species is now more frequently isolated in Europe and we report here two cases of T. indotineae tinea corporis in Switzerland, one with in vitro resistance to terbinafine and a second with in vitro susceptibility but a clinical resistance. Mycology isolation from cultures and sequencing ITS gene were used to confirm T. indotineae infection. In vitro antifungal susceptibility was tested in a microplate with a colorimetric detection of fungal viability for the determination of the minimal inhibitory concentration (MIC). Facing these emerging resistances and since there are a limited number of antifungal agents available to treat dermatophytosis, the early detection of terbinafine resistance should be a prerequisite in the management of T. indotineae infections.

15.
Dermatologie (Heidelb) ; 74(9): 707-710, 2023 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-37280370

RESUMO

The horse is the most common reservoir of Trichophyton (T.) equinum. However, this zoophilic dermatophyte only rarely causes infections in humans. The following case report describes such a case. In addition to epidemiology, treatment is described and the morphological and physiological characteristics of T. equinum are illustrated. Because of its formation of spiral hyphae and nodal organs, which has not been previously documented for this species, the isolated strain was deposited in the German Collection of Microorganisms and Cell Cultures (DSM No. 114196).


Assuntos
Arthrodermataceae , Tinha , Humanos , Animais , Cavalos , Tinha/diagnóstico , Trichophyton , Técnicas de Cultura de Células
16.
West Afr J Med ; 40(5): 463-468, 2023 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-37245212

RESUMO

BACKGROUND: Superficial fungal infections (SFIs) are infections affecting the keratinized layer of the skin, nail and hair that are mainly caused by dermatophytes. Although diagnosis is routinely done clinically and confirmed by direct potassium hydroxide (KOH) microscopy, fungal culture remains the gold standard for diagnosis and speciation of aetiological agents. Dermoscopy is a recent non-invasive diagnostic tool used to identify features of tinea infections. This study is aimed primarily at identifying specific dermoscopic features seen in tinea capitis, tinea corporis and tinea cruris, and secondarily, to compare dermoscopic features between the three diseases. METHODOLOGY: This is a cross sectional study of 160 patients with suspected superficial fungal infection using a handheld dermoscope. Skin scrapping with 20% KOH microscopy was done, fungal culture was grown on Sabouraud dextrose agar (SDA) and species identified further. RESULTS: There were 20 different dermoscopic features observed in tinea capitis, thirteen in tinea corporis, and twelve in tinea cruris. The commonest dermoscopic feature in tinea capitis was corkscrew hairs, observed in 49 of the 110 patients. This was followed by black dots and comma hairs. There were similar dermoscopic features in tinea corporis and tinea cruris with interrupted hairs and white hairs being the most common features seen respectively. The presence of scales was the dominant feature observed across these three tinea infections. CONCLUSION: Dermoscopy is being used constantly in dermatology practice to improve clinical diagnosis of skin disorders. It has been shown to improve the clinical diagnosis of tinea capitis. We have described the dermoscopic features of tinea corporis and cruris and compared them with that of tinea capitis.


CONTEXTE: Les infections fongiques superficielles (IFS) sont des infections affectant la couche kératinisée de la peau, des ongles et des cheveux, principalement causées par des dermatophytes. Bien que le diagnostic soit systématiquement effectué cliniquement et confirmé par microscopie directe au KOH, la culture fongique reste l'étalon-or pour le diagnostic et la spéciation des agents étiologiques. La dermoscopie est un outil de diagnostic non invasif récent utilisé pour identifier les caractéristiques des infections à tinea. Cette étude vise à identifier les caractéristiques dermoscopiques spécifiques observées dans la tinea capitis, la tinea corporis et la tinea cruris. Ensuite, elle compare les caractéristiques dermoscopiques de ces trois maladies. MÉTHODOLOGIE: Il s'agit d'une étude transversale portant sur 160 patients soupçonnés d'être atteints d'une infection fongique superficielle, réalisée à l'aide d'un dermoscope portatif. Un grattage de la peau avec un microscope à 20 % de KOH a été effectué, une culture fongique a été réalisée sur une gélose dextrose de Sabouraud (SDA) et les espèces ont été identifiées. RÉSULTATS: Vingt caractéristiques dermoscopiques différentes ont été observées dans la tinea capitis, treize dans la tinea corporis et douze dans la tinea cruris. La caractéristique dermoscopique la plus courante dans la tinea capitis était les poils en tire-bouchon, qui ont été observés chez 49 des 110 patients. Viennent ensuite les points noirs et les poils en virgule. La tinea corporis et la tinea cruris présentaient des caractéristiques dermoscopiques similaires, les poils interrompus et les poils blancs étant respectivement les caractéristiques les plus courantes. La présence de squames était la caractéristique dominante observée dans ces trois infections à tinea. CONCLUSION: La dermoscopie est constamment utilisée dans la pratique dermatologique pour améliorer le diagnostic clinique des troubles cutanés. Il a été démontré qu'elle améliorait le diagnostic clinique de la tinea capitis. Nous avons décrit les caractéristiques dermoscopiques des tinea corporis et cruris et les avons comparées à celles de la tinea capitis. Mots clés: Dermoscopiques, Superficielle, Infection fongique, Tinea capitis, Tinea corporis, Tinea cruris.


Assuntos
Tinha do Couro Cabeludo , Tinea Cruris , Tinha , Humanos , Estudos Transversais , Tinha do Couro Cabeludo/diagnóstico , Tinha do Couro Cabeludo/epidemiologia , Tinha/diagnóstico , Tinha/epidemiologia , Cabelo
17.
Explore (NY) ; 19(5): 681-688, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36740535

RESUMO

OBJECTIVE: Tinea Corporis is the most frequent form of dermatophytosis reported as the commonest presentation. Majoon Ushba (MU) a polyherbal preparation in a semisolid oral dosage form and Marham Raal (MR) an ointment made up of herbal and animal drugs are used for skin disorders in Unai medicine. Considering the biologically active substances with antioxidant, antimicrobial, antifungal, anti-inflammatory, and wound-healing properties of their ingredients, this study aimed to evaluate the clinical and mycological efficacy and safety of MU and MR in tinea corporis. METHODS: This randomized open-labeled active-controlled clinical trial was conducted on 42 patients of tinea corporis. Patients were randomly assigned via a computer-generated list to the test group (n=21) receiving oral MU (6 gm) with topical MR and the control group (n=21) topical terbinafine hydrochloride (1%) for 40 days. The severity scores of clinical symptoms; erythema, scaling, itching, margins, and size were the primary outcome and the mycological cure (negative KOH microscopy), total score, and dermatology life quality index (DLQI) were the secondary outcomes were analyzed at baseline and at 40 days. RESULTS: A significant reduction was observed in clinical severity scores of erythema, scaling, and itching (P ≤ 0.05) in both groups except for margins, and size of the lesion (P ≥ 0.05). The mycological cure (P = .001) and the total score (P = 0.0002) and DLQI (P = 0.002) were statistically significant in both groups when analyzed from baseline to the end of the treatment within groups, however, the differences in these outcomes were statistically insignificant (P ≥ 0.05) on the inter-group comparison. All the safety parameters (clinical and laboratory) were in the normal range in both groups. CONCLUSION: The results demonstrated that traditional and conventional treatments were equally effective and MU and MR can be prescribed as alternative or complementary treatments for tinea corporis.


Assuntos
Antifúngicos , Tinha , Humanos , Antifúngicos/uso terapêutico , Tinha/tratamento farmacológico , Tinha/diagnóstico , Prurido/tratamento farmacológico , Eritema/tratamento farmacológico , Resultado do Tratamento
18.
Mycoses ; 66(5): 441-447, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36583603

RESUMO

BACKGROUND: Tinea capitis and tinea corporis are highly prevalent fungal skin infections, which globally are mainly caused by Microsporum canis and Trichophyton rubrum, respectively. While in the United States and Great Britain Trichophyton tonsurans is widely prevalent as a causative pathogen, it so far only plays a minor role in Germany. OBJECTIVES: Since the frequency of pathogenic species varies regionally and temporally, this study assesses the proportion of Trichophyton tonsurans infections in the dermatology department of a large university hospital in Germany from 2019 to 2022 and thoroughly characterises the affected patient population. PATIENTS/METHODS: This retrospective study at the Technical University of Munich analyses mycological culture results regarding the identified dermatophyte and infection site. Detailed patient and disease-related information on Trichophyton tonsurans positive patients was obtained. RESULTS: In 2022, 23 patients of 111 dermatophyte culture-positive patients tested positive for Trichophyton tonsurans. This accounted for 20.7% and represented a tenfold increase from 2.1% in 2019. Contact sports were only practiced by 21.7% of patients, and no common hotspot or other linkage could be identified between the cases. Additionally, 47.8% of the patients received a systemic treatment, with 30.4% visiting the clinic more than three times. In 2022, 21.7% were diagnosed with a simultaneous infection of the capillitium and body, whereas this was only observed in 7.1% of cases in 2019 to 2021. CONCLUSIONS: This study suggests an increase of Trichophyton tonsurans infections via several routes of transmission.


Assuntos
Arthrodermataceae , Tinha do Couro Cabeludo , Humanos , Trichophyton , Estudos Retrospectivos , Incidência , Tinha do Couro Cabeludo/epidemiologia , Tinha do Couro Cabeludo/microbiologia
19.
Front Ophthalmol (Lausanne) ; 3: 1174414, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38983055

RESUMO

A 40-year-old Asian Indian woman, diagnosed as having idiopathic panuveitis (elsewhere) 3 years earlier and being treated with oral steroids (20 mg/day) and methotrexate (25 mg/week), presented to us with worsening vision in both eyes. Her best corrected visual acuity (BCVA) was perception of light in her right eye and counting fingers close to face in her left eye. A slit lamp examination showed an anterior chamber (AC) reaction (1+) in both eyes with posterior synechia, a total cataract in her right eye, and pseudophakia in her left eye. The left fundus showed vitritis, vitreous membranes, chorioretinitis, multifocal areas of retinitis, and retinal vascular sheathing. A systemic examination showed extensive multifocal areas of tinea corporis on the hands and torso. Owing to the leukocytosis (22,000 cells/mm3), diagnostic vitrectomy was initially deferred and 100 mg of oral itraconazole was given twice a day for 3 months. The vitritis improved a little and her total white blood cell (WBC) count improved with treatment of the skin infection. Following a diagnostic vitrectomy later in her left eye, resolving areas of retinitis were seen. Complete resolution of eye inflammation was seen at the end of 6 weeks. At the 6-month follow-up, her BCVA was 6/18 in left eye and she was off oral steroids and methotrexate, with no recurrence of inflammation. We speculate a probable association between the ocular inflammation and extensive tinea corporis based on the therapeutic response to itraconazole.

20.
Cureus ; 14(11): e31728, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36569693

RESUMO

Background Dermatophytosis is a public health concern in tropical countries. In India, a scalable number of dermatophytosis cases from multiple states are reported. In the eastern part of India, very few studies were published assessing the clinicomycological profiles of patients. Hence, we conducted this study to ascertain the clinicomycological profile of patients suffering from dermatophytosis with special reference to associated socio-environmental factors. Materials and methods This cross-sectional observational study was conducted in a tertiary care hospital situated in Bihar state of India from January 2021 to December 2021. We included a total of 330 patients of all age groups who were clinically diagnosed with superficial mycosis from the Department of Dermatology and sent for investigations to the Department of Microbiology. The collected specimens from the lesions were prepared with wet potassium hydroxide and examined under the microscope. Then, the specimens were inoculated and incubated at 25°C for up to four weeks. Fungal isolates were identified by gross appearance and microscopy if growth was observed. Results Among the 330 patients, 186 (56.4%) were males and 144 (43.6%) were females. The majority of the patients (54.5%) were from the low socioeconomic group and living in overcrowded places. Direct microscopy was positive in 198 (60%) patients, and culture was positive in 68 (20.61%) patients. The majority of the patients who were found positive in direct microscopy were from the age group of 21-30 years (39.9%), followed by 1-10 years (25.25%). A total of 92 (46.4%) cases were of tinea capitis, followed by 68 (34.3%) patients of tinea corporis. Trichophyton was the predominant fungus isolated, and Trichophyton mentagrophytes was the most common species (52.6%). Conclusion Tinea capitis was the most common provisionally diagnosed dermatophytosis in our tertiary care hospital in Bihar, an Indian state in its eastern zone. Low socioeconomic status and poor personal hygiene were the factors associated with the high prevalence of dermatophyte infections in this region of India. A detailed analysis of all these epidemiological factors is needed to limit the prevalence of dermatophytosis in tropical regions.

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