Comparing the diagnostic accuracy of PCR-reverse blot hybridization assay and conventional fungus study in superficial fungal infection of the skin: A systematic review.

BACKGROUND: In superficial fungal infections, prompt diagnosis and treatment are essential to prevent the spread of infection and minimise the impact on patients' quality of life. Traditional diagnostic methods, such as KOH smear and fungal culture, have limitations in terms of sensitivity and turnaround time. Recently, the PCR-reverse blot hybridization assay (PCR-REBA) has been developed for the direct detection of dermatophyte DNA. However, there is a lack of information assessing the diagnostic accuracy of PCR-REBA. OBJECTIVES: This systematic review aimed to evaluate the diagnostic accuracy of PCR-REBA in superficial fungal infections compared to conventional and molecular methods. METHODS: The comprehensive search containing Ovid MEDLINE and Embase databases was conducted on 7 August 2022. Two reviewers independently reviewed the included articles. Quality assessment was performed using the Newcastle-Ottawa Scale tool. RESULTS: The included studies were conducted in Korea (five studies) and the Netherlands (two studies), all of which were conducted in a single institution. The quality assessment of these studies indicated low risk of bias. When compared to the potassium hydroxide (KOH) smear and fungus culture, the sensitivity of PCR-REBA ranged from 85% to 100%, and the positive predictive values ranged from 58.9% to 100%. When compared to the RT-PCR, the sensitivity of PCR-REBA ranged from 93.3% to 100%, and the positive and negative predictive values were 91.6%-99.6% and 81.0%-89.1%, respectively. CONCLUSIONS: The PCR-REBA shows promise as a valuable diagnostic tool for dermatophytosis, offering practical and cost-effective benefits.

Nanoformulations Insights: A Novel Paradigm for Antifungal Therapies and Future Perspectives.

Currently, fungal infections are becoming more prevalent worldwide. Subsequently, many antifungal agents are available to cure diseases like pemphigus, athlete's foot, acne, psoriasis, hyperpigmentation, albinism, and skin cancer. Still, they fall short due to pitfalls in physiochemical properties. Conventional medications like lotion, creams, ointments, poultices, and gels are available for antifungal therapy but present many shortcomings. They are associated with drug retention and poor penetration problems, resulting in drug resistance, hypersensitivity, and diminished efficacy. On the contrary, nanoformulations have gained tremendous potential in overcoming the drawbacks of conventional delivery. Furthermore, the potential breakthroughs of nanoformulations are site-specific targeting. It has improved bioavailability, patient-tailored approach, reduced drug retention and hypersensitivity, and improved skin penetration. Nowadays, nanoformulations are gaining popularity for antifungal therapy against superficial skin infections. Nanoformulations-based liposomes, niosomes, nanosponges, solid lipid nanoparticles, and potential applications have been explored for antifungal therapy due to enhanced activity and reduced toxicity. Researchers are now more focused on developing patient-oriented target-based nano delivery to cover the lacunas of conventional treatment with higher immune stimulatory effects. Future direction involves the construction of novel nanotherapeutic devices, nanorobotics, and robust methods. In addition, for the preparations of nanoformulations for clinical studies, animal modeling solves the problems of antifungal therapy. This review describes insights into various superficial fungal skin infections and their potential applications, nanocarrier-based drug delivery, and mechanism of action. In addition, it focuses on regulatory considerations, pharmacokinetic and pharmacodynamic studies, clinical trials, patents, challenges, and future inputs for researchers to improve antifungal therapy.

Developing diagnostic criteria to differentiate fungal foot infections caused by Neoscytalidium dimidiatum and dermatophytes.

Background: The predisposing factors and clinical presentations of fungal foot infections caused by non-dermatophytes and dermatophytes are challenging to differentiate. Definite diagnoses of non-dermatophyte infections at first visits facilitate their treatment. Objectives: This study aimed to develop diagnostic criteria to differentiate fungal foot infections caused by Neoscytalidium dimidiatum and dermatophytes. Methods: Diagnostic prediction research based on a retrospective, observational, cross-sectional study. The reviewed patients were aged ≥18 and underwent a mycological examination for fungal foot infections. A fungal culture at the initial visit was the gold standard for determining causative organisms. Results: Analyses were carried out on the data from 371 patients. N. dimidiatum accounted for 184 (49.6%) infections, and dermatophytes caused the remaining 187 (50.4%) cases. Five significant predefined predictors were used to develop the diagnostic criteria and score. They were immunocompetence status, no family history of fungal infections, the absence of pruritus, the absence of other concurrent fungal skin infections, and agricultural work. The lower score cutoff was <8 (sensitivity 97.8% and specificity 25.7%). The higher cutoff was >11 (sensitivity 83.7% and specificity 57.8%). The score showed an area under the receiver operating characteristic curve of 0.755 and was well calibrated. Conclusions: The criteria and score show promise for clinical use, with acceptable discriminative performance and good calibration. They will help physicians differentiate the causative organisms in patients with fungal foot infections at the first visit, enabling the determination of appropriate antifungal treatment.

Dermoscopic Features seen in Tinea Capitis, Tinea Corporis and Tinea Cruris.

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.

Dermatophyte Infections Worldwide: Increase in Incidence and Associated Antifungal Resistance.

The increase in incidence of superficial fungal infections combined with the emergence of antifungal resistance represents both a global health challenge and a considerable economic burden. Recently, dermatophytes, the main culprit causing superficial fungal infections, have started to exhibit antifungal resistance. This can be observed in some of the most common species such as Trichophyton rubrum and Trichophyton mentagrophytes. Importantly, the new subspecies, known as Trichophyton indotineae, has been reported to show high resistance to terbinafine, a first-line treatment for dermatophyte infections. Compounding these issues is the realization that diagnosing the causative infectious agents requires using molecular analysis that goes beyond the conventional macroscopic and microscopic methods. These findings emphasize the importance of conducting antifungal susceptibility testing to select the appropriate antifungal necessary for successful treatment. Implementing these changes may improve clinical practices that combat resistant dermatophyte infections.

Investigation and analysis of superficial fungal infection and drug use among naval trainees / 药学实践杂志

Objective To investigate the pathogenesis of superficial mycosis among naval trainees, and observe the efficacy of a novel antifungal drug. Methods A questionnaire survey was conducted on the onset, medication and recurrence of superficial fungal infection among the trainees from January, 2020 to July, 2020. At the same time, the new antifungal drug sulconazole nitrate spray was provided for treatment and the drug efficacy was observed. Results The participants generally lacked understanding and attention to superficial fungal infections. The incidence rate of superficial fungal infection was 52%, of which 76.2% of patients had recurrence of superficial fungal infection. The sulconazole nitrate spray showed great effect against these infections. Conclusion The trainees should understand the causes of superficial fungal infection through health education and seek medical treatment and medication in time. The cure rate of superficial fungal infections could only be improved through the collaborative management of the school, hospital, and trainees to reduce the impact of these infections on naval trainees’ work and life.

Clinicomycological Profile of Pediatric Dermatophytoses: An Observational Study.

Background/Objectives: There has been a recent explosion in the incidence of dermatophytic infections globally, especially in tropical countries including India. This increase is associated with a change in the clinical pattern and mycological profile with poor response to treatment, in adults and children. Limited studies in India have focused on pediatric dermatophytoses. Our study's primary objective was to assess the clinicomycological profile of pediatric dermatophytosis in our region and secondarily to understand the association of lifestyle factors with poor response to treatment. Methods: This was an observational study including children ≤16 years of age, clinically diagnosed with tinea. Clinical and lifestyle data regarding site, affected surface area, duration of infection, previous treatment, possible sources of infection, overcrowding, and bathing practices were collected. Samples were collected for potassium hydroxide mount and fungal culture. Results: A total of 183 children participated in our study. The most common diagnosis was tinea corporis. Tinea cruris was more frequent in preadolescents, where males were more affected. Positive associations were seen between increased duration of infection, increased household infection, infection among playmates, irregular bathing, and use of steroid creams. The most common organism isolated was Trichophyton mentagrophytes/interdigitale (55.19%) followed by Trichophyton rubrum (14.75%). Conclusions: There is a change in the mycological profile of pediatric dermatophytosis with an increase in Trichophyton mentagrophytes/interdigitale infection. Important sources of infection in children must be identified in chronic and recurrent cases. Misinformed and ignorant use of steroid creams is an important reason for recurrent infection.

Photodynamic therapy treatment of superficial fungal infections: A systematic review.

BACKGROUND: Fungal infections in skin, hair and nails affect up to 25 % of the global population. Conventional antifungal treatment is effective but due to resistance, treatment failure, drug interactions, and treatment related toxicity, there is a need for alternative treatments. Photodynamic therapy (PDT) has shown antimicrobial properties and is used increasingly for fungal infections. This review investigates the reported efficacy and side effects of PDT of superficial mycoses. METHODS: Pubmed and Embase were searched 26-01-2020 for "superficial fungal infections" and "photodynamic therapy" in "Human subjects" using a predefined search string. Criteria for inclusion were: clinical trials and cases involving PDT-treated patients with primary fungal infections in skin, hair and nails. Criteria for exclusion were: languages other than English, animal models, in vitro trials, secondary fungal infections, reviews and guidelines. RESULTS: 541 records were identified and 34 papers fulfilled the criteria. PDT of onychomycosis (n = 380 patients) found treatment with methylene blue (MB) photosensitizer (PS) more efficacious with complete cure rates of 70 %-80 % than 5-aminolevulinic acid (ALA)-PDT (mycological cure rates of 17 %-57 %) and methyl aminolevulinate (MAL)-PDT (mycological cure rate of 32 %). Other PDT-treated fungal diseases included (n = 55): foot infections (n = 19), tinea cruris (n = 10), scalp infections (n = 2), Malassezia infections (n = 9) and subcutaneous fungal infections (n = 15) achieved promising effect. CONCLUSION: PDT-treatment of superficial mycoses can be efficacious as salvage therapy. In the light of increasing resistance and few licensed treatment alternatives, larger randomized controlled trials investigations and optimization of the PDT-treatment protocol are warranted to evaluate PDT's potential as a future antifungal treatment.

Modified ulcer debridement in the treatment of the superficial fungal infection of the cornea.

AIM: To evaluate the efficacy of modified corneal ulcer debridement in superficial fungal keratitis unresponsive to medications. METHODS: A total of 209 patients (209 eyes) with fungal keratitis, involving no more than 50% of the stromal depth and not responding to antifungal agents for 2wk, were recruited in this retrospective, noncomparative study. The patients were treated with modified corneal ulcer debridement. All visible corneal infiltrates were removed under an operating microscope to obtain a clean stromal bed and smooth incised edges. Antifungal drugs were used immediately after surgery. Healing time of the ulcers was recorded. Fungal recurrence, visual acuity, corneal thickness and risk factors for treatment failure were monitored. RESULTS: The follow-up was 13.6±5.8mo. The corneal ulcers healed in 195 of 209 eyes (93.3%), with a mean healing time of 8.4±6.8d. The other 14 eyes were further treated by penetrating keratoplasty (PK) (1 eye), anterior lamellar keratoplasty (LK) (7 eyes), conjunctival flap covering (4 eyes) or amniotic membrane transplantation (2 eyes). The best corrected visual acuity (BCVA) was ≥20/70 in 80.3% of the eyes, ≥20/40 in 56.9% of the eyes, and ≥20/25 in 27.3% of the eyes. The corneas at the lesions became thinner, but all in the safe range. No fungal recurrence or corneal ectasis developed during the follow-up. The risk of treatment failure was higher in patients with preoperative hypopyon (P=0.036) and ever using steroid (P=0.025). CONCLUSION: Modified surgical debridement is a simple and effective method for the treatment of superficial fungal infection of the cornea, with improved visual acuity and no recurrence. Such an intervention in time can rapidly control fungal infection and largely shorten corneal ulcer healing time.

Topical antifungal-corticosteroid combination therapy for the treatment of superficial mycoses: conclusions of an expert panel meeting.

Superficial fungal infections affect 20-25% of people worldwide and can cause considerable morbidity, particularly if an inflammatory component is present. As superficial fungal infections can be diverse, the treatment should be tailored to the individual needs of the patient and several factors should be taken into account when deciding on the most appropriate treatment option. These include the type, location and surface area of the infection, patient age, degree of inflammation and underlying comorbidities. Although several meta-analyses have shown that there are no significant differences between the numerous available topical antifungal agents with regard to mycological cure, agents differ in their specific intrinsic properties, which can affect their clinical use. The addition of a corticosteroid to an antifungal agent at the initiation of treatment can attenuate the inflammatory symptoms of the infection and is thought to increase patient compliance, reduce the risk of bacterial superinfection and enhance the efficacy of the antifungal agent. However, incorrect use of antifungal-corticosteroid therapy may be associated with treatment failure and adverse effects. This review summarises available treatment options for superficial fungal infections and provides general treatment recommendations based on the consensus outcomes of an Expert Panel meeting on the topical treatment of superficial mycoses.

Superficial Fungal Infections.

Superficial fungal infections grow in dark and moist areas and invade various parts of the body. These infections are easily treatable in immunocompetent individuals. In immunosuppressed individuals, the presentation can be quite severe, requiring use of more potent antifungal agents. The treatment for these conditions consists of topical antifungal agents, creams, and oral systemic medications. The use of prednisone can alter the appearance of superficial fungal infections, making them difficult to diagnose. It is important for primary care providers to become adept at understanding the epidemiology, transmission, clinical presentation, diagnosis techniques, and treatment options available.

Distinct characteristics of Scytalidium dimidiatum and non-dermatophyte onychomycosis as compared with dermatophyte onychomycosis.

Studies of demographic data, predisposing factors and clinical manifestations of non-dermatophyte mold (NDM) infection particularly in Scytalidium spp. have been limited. This study aimed to compare these data between dermatophytes (DMP) and NDM onychomycosis with statistical analysis. This was a retrospective chart review of outpatients with onychomycosis in the Nail Clinic of Department of Dermatology between January 2011 and December 2013. A total of 237 patients who had presented with onychomycosis were included. One hundred and eighty patients (75.9%) were infected with DMP: Trichophyton mentagrophytes, 46.8%; and Trichophyton rubrum, 28.3%. Of patients who had NDM onychomycosis, 17.3% were Scytalidium dimidiatum and 6.8% were Fusarium spp. Comparing the DMP and NDM groups, family history of superficial fungal infection was significantly demonstrated in the DMP group. Approximately 50% of patients in both groups had feet infections. However, no patients with NDM onychomycosis had fungal glabrous skin infection at other sites beyond the feet that was statistically different from cases with DMP onychomycosis. In conclusion, The distinct characteristic of patients with NDM onychomycosis was absence of fungal glabrous skin infection in areas other than the feet. This was statistically different from DMP.

Investigation of preparation and quality control for butenafine hydrochloride plastics / 中国生化药物杂志

Objective To prepare butenafine hydrochloride plastics,investigate the prescription composition and make a quality control standard for the preparation.Methods Film-forming time and appearance quality as the evaluation index,the quality control standard of butenafine hydrochloride according to the Chinese pharmacopoeia two section ( 2010 edition ) was made.ResuIts The prescription of butenafine hydrochloride plastics was identified as:1%butenafine hydrochloride(w/w),10%glycerol(w/w),3%carbomer 971PNF(w/w),0.1% ethyl p-hydroxybenzoate(w/w),moderate anhydrous sodium sulfite(pH adjusting agent) and 95% ethanol (solution).The preparation was colorless,transparent and viscous semi-solid with pH4.5.A content determination method of butenafine hydrochloride with HPLC was established and the result was stable and reliable .ConcIusion The butenafine hydrochloride has several advantages such as preparation simply , stable property,application convenience and quality control.It is a potential preparation to develop.

Miconazole nitrate bearing ultraflexible liposomes for the treatment of fungal infection.

Miconazole nitrate is a widely used antifungal agent, but its use in topical formulations is not efficacious because deep seated fungal infections are difficult to treat with conventional topical formulation. Miconazole nitrate loaded ultraflexible liposomes have been prepared and their topical performance has been compared with conventional liposomes containing miconazole nitrate. Various ultraflexible liposomal formulations were prepared and extensively characterized for vesicular shape, size, entrapment efficiency, degree of deformability and in-vitro skin permeation through rat skin. Higher rate of drug transfer across the skin with ultraflexible liposomal formulations of miconazole nitrate suggests that the drug in its lipo-solubilized state might have gained facilitated entry into the tough barrier consisting of subcutaneous. In-vivo study showed better antifungal activity as compared to traditional liposomes and plain drug solution. This was confirmed through fluoroscence microscopy. It is concluded that prepared ultraflexible liposomes can facilitate improved and localized drug action in the skin, thus providing a better option to deal with deep seated skin problems.

Superficial Fungal Infection in Patients with Atopic Dermatitis / 대한피부과학회지

BACKGROUND: It is well known that patients with atopic dermatitis are prone to cutaneous infections, and especially superficial fungal infection. However, a study on the relationship of superficial fungal infection in atopic dermatitis patients has not yet been performed in Korea. OBJECTIVE: The purpose of this study is to evaluate the relationship of atopic dermatitis to superficial fungal infection in Koreans. METHODS: We examined for evidence of superficial fungal disease in 2,153 atopic dermatitis patients and we compared the findings to those of 126,777 non-atopic dermatitis patients who visited the Department of Dermatology of Chung-Ang University from January 2003 to December 2007. RESULTS: Superficial fungal infections were more common in the atopic dermatitis patients (6%) than in the controls (2.5%) (p<0.05) and especially in the age group of the 1st and 2nd decades (p<0.05). The seasonal prevalence of superficial fungal infection was high during summer for both groups (38% vs 44%, respectively). The most common site of fungal distribution was feet (Tinea pedis) for both groups (42.5% vs 28.1%, respectively). The prevalence of coexisting superficial fungal infection was not significantly different in both groups (38.3% vs 39.9%, respectively). The most common isolated organism was Trichophyton rubrum in both groups (52.7% vs 38%, respectively). CONCLUSION: The study shows that the prevalence of superficial fungal infection in atopic dermatitis patients is higher than that in controls. Therefore, we should consider the presence of combined superficial fungal infection in recalcitrant atopic dermatitis patients and use antifungal agents for treatment.

Antifungal Agents for Dermatomycoses / 한양의대학술지

The development of selective and safe antifungal agents are relatively delayed, compared to that of other antibiotics. The reasons are the relatively lesser interest of pharmaceutical companies because of the fewer occurrence of fungal disease and the apparent lack of a highly selective fungal target, not present in other eukaryotic (including mammalian) cells. Until the 1940s, fungal skin infection was treated by keratinolytics, antiseptics, and antibacterial chemicals. The first selective antifungal agent was polylene compounds in the early 1950s, which were topical nystatin and fungizone (amphotericin-B). In 1958, the first oral fungal agents, 'griseofulvin', as developed and have been used effectively to tinea capitis and other dermatophytes. Between the late 1960s and early 1970s, the azole compound, 'the real broad spectrum antifungal agents' was introduced, and clotrimazole was the first topical azole compound followed, by miconazole and econazole. Ketoconazole was released in early 1980s and it was the first real oral antifungal agent for systemic and superficial fungal infections. However, because of serious side effects of symptomatic hepatic injury, its use was replaced by triazole antifungal agents such as itraconazole and fluconazole. Triazole was more safe and effective, and caused advancement in the treatment of onychomycosis. In addition, terbinafine 'belonging to the allylamine compounds and developed in 1984', has been approved as a very potent antifungal agent for dermatophytes and also is being used widely to cutaneous infection by candidia species and some molds.

A Clinical and Mycological Study of Superficial Fungal Diseases (VIII) / 대한의진균학회지

BACKGROUND: Superficial fungal infections are common diseases in the dermatologic conditions. The prevalence of superficial fungal diseases is not static but change under the influence of various factors such as climate, migration of people, and development in prophylaxis and therapy. OBJECTIVE: The authors performed this study to investigate the present status of superficial dermatophytoses and some changes on the frequency of the diseases, sex distributions and varieties of the causative organisms. METHODS: The clinical and mycological study of superficial fungal diseases on 2,115 patients who had visited Department of Dermatology, University Hospital and Yongsan Hospital, College of Medicine, Chung Ang University between July 1992 and June 1994 were performed. RESULTS: 1) The incidence of superficial fungal diseases to total number of outpatients(8,048) was 26.3%(2,115 cases). 2) Superficial fungal diseases showed high incidence in fourth (22.3%), third(22.2%), and fifth decade(17.9%). 3) The ratio of male to female was 2.3:1(1,478:637). Especially in patients with tinea(T.) cruris, which was the most prominent disease showing male predominance, the sex ratio was 15.9:1. 4) The monthly prevalences of superficial fungal diseases were high in July(16.5%), June(13.1%), and August(12.3%), respectively 5) The incidence of each type of superficial fungal disease was the highest in T. pedis(21.4%), followed by T. cruris(17.6%), candidiasis(17.6%), T. corporis(13.5%), T. unguium(13.3%), T. versicolor(9.6%), T. manus(5.1%), and T. capitis(1.9%). 6) There were coexisting fungal infections in 426 patients(20.1%), and the case of T. pedis with T. unguium was the most common. 7) The positive rate of KOH scraping was 57.4% and the positive rate of culture on ordinary Sabouraud's dextrose agar media was 48.6%. 8) The most common cultured organism was Trichophyton(T.) rubrum(39.1%), followed by Candida species(34.6%), T. mentagrophytes(23.0%), Microsporum canis(2.0%), Epidermophyton floccosum(1.2%), and T. ferrugineum(0.2%). CONCLUSION: These results are not significantly different from those of previous studies. But the incidence of the superficial fungal diseases(26.3%) was higher than previous studies and showed a high incidence in young male patients and in warm season. The positive rate of KOH scraping(7.4%) was lower than previous studies. The most common causative organism was T. rubrum.

Superficial Mycoses in Patients with Diabetes Melitus / 대한피부과학회지

BACKGROUND: It has been well known that patients with diabetes mellitus are prone to cutaneous infections, but whether superficial mycoses are truly more prevalent in diabetic patients is still controversial. OBJECTIVE: The purpose of this study was to determine the true prevalence of superficial mycoses in diabetic patients as comparing with non-diabetic, non-immunocompromised individuals. METHODS: We examined for evidence of superficial fungal disease in 137 diabetic patients and compared it with 146 non-diabetic non-immunocompromised ones. Potassium hydroxide preparations and fungus cultures were performed from all suspected lesions. RESULTS: Superficial mycoses were more common in diabetic patients(50%) than controls(31%) (p=0.0004), especially in the age group of 4th and 5th decades9p=0.011). The duration of diabetes mallitus or blood sugar levels were not significantly correlated with the prevalence of superficial mycoses.The organism most commonly isolated was Trichophyton rubrum in both groups(53% vs 79%) and Candida albicans was more prevalent in diabetic patients(34% vs 7%). More than 2 kinds of superficial mycoses were mose common in diabetic patients than controls(38% vs 16%). CONCLUSION: This study shows that the prevalence rate of superficial mycoses in diabetic patients is higher than that in controls and the in controls and the duration of diabetes mellitus or blood sugar levels were not significantly correlated with it.