Querión de Celso: a propósito de un caso

Divulgamos el caso de Queiron de Celso del cuero cabelludo en una niña de 6 años, procedente de área urbana con antecedente patológico de tiña capitis. La tiña de la cabeza, tinea capitis o dermatofitosis es una infección fúngica causada por hongos, denominados «dermatofitos». El querión es una manifestación grave de tinea capitis que resulta de una intensa respuesta inmune a la infección y caracteriza por el desarrollo de una placa inflamatoria con pústulas, costras gruesas y/o drenaje.

We report the case of Queiron de Celso of the scalp in a 6-year-old girl from an urban area with a pathologic history of tinea capitis. Tinea capitis or dermatophytosis is a fungal infection caused by fungi called "dermatophytes". Kerion is a severe manifestation of tinea capitis resulting from an intense immune response to infection and characterized by the development of an inflammatory plaque with pustules, thick crusts and/or drainage.

Dermatophytes and skin dermatophytoses in Southeast Asia-First epidemiological survey from Cambodia.

BACKGROUND: Dermatomycoses count to the most frequent dermatoses in Cambodia. OBJECTIVES: The aim of this survey was to investigate the occurrence of dermatophytes in this Southeast Asian country. METHODS: From June 2017 to July 2018, skin scrapings were taken from 67 patients with superficial dermatophytosis for mycological diagnostics. Identification of dermatophytes was confirmed by sequencing of the 'internal transcribed spacer'-(ITS) region of the rDNA, and the gene of the Translation Elongation Factor (TEF)-1α. RESULTS: Patients were suffering from tinea corporis and tinea inguinalis/cruris 42/67 (63%), tinea capitis/faciei 14/67 (21%), tinea corporis/capitis/faciei 6/67 (9%), tinea manuum/pedis 2/67 (3%), tinea pedis 2/67 (3%) and tinea manuum 1/67 (1%). Both, by culture and/or PCR, a dermatophyte was detected in 52 (78%) out of 67 samples. Culture positive were 42 (81%) of 52, PCR positive were 50 (96%). The following dermatophytes were found: Trichophyton (T.) rubrum, 36/52 strains (69%, 29 by culture), T. mentagrophytes/T. interdigitale (TM/TI) 9/52 (17%, six by culture) and Microsporum (M.) canis 5/52 strains (10%, by culture). One strain of Nannizzia (N.) incurvata 1/52 (2%) and N. nana 1/52 (2%) was isolated. Based on sequencing, we demonstrated that two T. mentagrophytes strains out of the nine TM/TI represented the new ITS genotype XXV Cambodia. We found one T. mentagrophytes strain genotype VIII (now, reclassified as T. indotineae). This isolate was terbinafine resistant, and it exhibited the amino acid substitution Phe397Leu in the squalene epoxidase. Three strains of T. interdigitale genotype II* were isolated. CONCLUSION: This is the first survey on epidemiology of dermatophytes in Cambodia. Currently, T. rubrum represents the most frequent species in Cambodia. One Indian strain genotype VIII T. mentagrophytes was found. A highlight was the first description of the new T. mentagrophytes genotype XXV Cambodia.

Antifungal activity of 3,3'-dimethoxycurcumin (DMC) against dermatophytes and Candida species.

Dermatomycosis is an infection with global impacts caused especially by dermatophytes and Candida species. Current antifungal therapies involve drugs that face fungal resistance barriers. This clinical context emphasizes the need to discover new antifungal agents. Herein, the antifungal potential of 10 curcumin analogs was evaluated against four Candida and four dermatophyte species. The most active compound, 3,3'-dimethoxycurcumin, exhibited minimum inhibitory concentration values ranging from 1.9‒62.5 to 15.6‒62.5 µg ml-1 against dermatophytes and Candida species, respectively. According to the checkerboard method, the association between DMC and terbinafine demonstrated a synergistic effect against Trichophyton mentagrophytes and Epidermophyton floccosum. Ergosterol binding test indicated DMC forms a complex with ergosterol of Candida albicans, C. krusei, and C. tropicalis. However, results from the sorbitol protection assay indicated that DMC had no effect on the cell walls of Candida species. The in vivo toxicity, using Galleria mellonella larvae, indicated no toxic effect of DMC. Altogether, curcumin analog DMC was a promising antifungal agent with a promising ability to act against Candida and dermatophyte species.

Terbinafine resistance in Trichophyton mentagrophytes and Trichophyton rubrum in the Czech Republic: A prospective multicentric study.

BACKGROUND: Terbinafine, an allylamine antifungal, is crucial for treating dermatophytosis by inhibiting squalene epoxidase (SQLE) in the ergosterol biosynthetic pathway. However, resistance is emerging, particularly in India and Southeast Asia, but reports of resistance spread worldwide. Despite this, comprehensive studies on terbinafine resistance in Trichophyton are still limited. OBJECTIVES: This research aimed to determine the prevalence of terbinafine resistance in the Czech Republic, with a focus on Trichophyton rubrum and Trichophyton mentagrophytes, and investigate the underlying molecular mechanisms. PATIENTS/METHODS: A total of 514 clinical strains of T. rubrum and 240 T. mentagrophytes collected from four Czech clinical institutions were screened for terbinafine resistance. Molecular investigations included DNA sequencing, specifically the ITS rDNA region and SQLE gene, as well as antifungal susceptibility testing following EUCAST guidelines. RESULTS: While no resistance was observed in T. rubrum, 2.5% of T. mentagrophytes strains exhibited resistance, marked by the F397L mutation in SQLE. Notably, resistance surged from 1.2% in 2019 to 9.3% in 2020 but reverted to 0% in 2021. All resistant strains were identified as T. mentagrophytes var. indotineae. Resistant strains exhibited high MICs for terbinafine (≥4 mg L-1 ) but low MICs to the other seven antifungals tested except for fluconazole. CONCLUSIONS: This study highlights the emergence of terbinafine-resistant T. mentagrophytes strains in the Czech Republic, with the F397L mutation being pivotal. Due to the relatively low resistance level, the current guidelines for dermatomycosis treatment in the Czech Republic remain effective, but ongoing surveillance is essential for timely adaptations if resistance patterns change.

A Novel Report of mycetoma with Spinal Spread due to Madurella fahalli from India.

Eumycetoma caused by Madurella fahalii, a drug-resistant fungus, has never been reported in India. Here, we describe a fatal case of eumycetoma with spinal involvement due to M. fahalii for the first time in India.

Clinical study on antifungal drug resistance among cases of dermatophytosis in patients reporting to multiple tertiary care hospitals.

Background: In a tropical country like India, the warm and humid climate plays an important role in the increased incidence of superficial fungal infections. This is a study to identify the causative fungi of dermatophytosis and their in vitro antifungal susceptibility pattern among patients reporting to multiple tertiary care hospitals. Methods: Skin scrapping, nail clipping, and hair follicles were processed for microscopy, culture, and antifungal susceptibility testing as per standard guidelines. Antifungal susceptibility was performed as per published by Clinical Laboratory Standards Institute for yeasts (M27-A3) and filamentous fungi (M38-A2). Result: The study sample had a predominantly male population with the commonest age group being 21-30 years (39.57%) followed by 31-40 years (31.46%). Tinea corporis (57.30%) was the most common clinical presentation followed by tinea cruris (20.85%) and onychomycosis (14.73%). Microscopy positivity was 43.19%, while culture positivity was 23.97%. Dermatophytes accounted for the majority of isolates. All fungal isolates had high minimum inhibitory concentration (MIC) to fluconazole, suggesting that dermatophytes are possibly resistant to this drug. Conclusion: Trichophyton mentagrophytes is confirmed as the dominant pathogen of dermatophytosis in all three tertiary care hospitals.

Survey of Sensitization to Common Fungi in an Allergic Dog Population: The Need for Further Focus on Sensitization and Allergy to Fungi in Veterinary Medicine.

Most fungal species are commensals and non-pathogenic to plants, humans, or animals. However, several species of the Alternaria, Aspergillus, Trichophyton, and Microsporum genera are common causes of disease, even for immunocompetent individuals. Besides mucosal damage, fungi may contribute to a skin barrier impairment, favoring sensitization and allergy development. A total of 68 allergic dogs were selected from a veterinary dermatology and allergy outpatient consultation for conditions related to both Malassezia overgrowth and other fungal complications. The allergy diagnosis was made through anamnesis and current clinical criteria, with the involved allergenic species being identified by intradermal tests (IDTs) and allergen-specific immunoglobulin E (sIgE) determination in serum. Dermatophagoides farinae, Dactylis glomerata, and Malassezia pachydermatis showed as the higher sensitization species from house dust mites, grass pollen, and fungi, respectively. Significant correlations at p < 0.05 were found between sensitization to Dactylis glomerata and Phleum pratense grass pollens, Dermatophagoides farinae and Dermatophagoides pteronyssinus, Acarus siro, Tyrophagus putrescentiae, and Lepidoglyphus destructor dust/storage mites, and between fungi like Aspergillus mix and Penicillium or Alternaria alternata. A significant correlation was also found between sensitization to the Aspergillus mix and D. farinae, D. pteronyssinus, or A. siro. Rather severe dermatitis was observed when a positive IDT to Malassezia pachydermatis was found, regardless of the detection of circulating sIgE, allowing us to consider the usefulness of both the IDT and the sIgE for a systematic diagnosis of allergy to fungi.

[2021 Epidemiological Survey of Dermatomycoses in Japan].

This is a report of the results of the epidemiological survey on dermatomycoses conducted in 2021. A total of 9,442 patients with dermatomycosis were reported for one year. They include 8,151 (86.3%) with dermatophytosis, 796 (8.4%) with candidiasis, 484 (5.1%) with Malassezia infection, and 11 (0.1%) with deep cutaneous mycosis. In order, the most common types of dermatophytoses were tinea pedis (4,195 cases, 2,341 males and 1,854 females), tinea unguium (2,711 cases, 1,509 males and 1,202 females), tinea corporis (674 cases, 445 males and 229 females), tinea cruris (399 cases, 305 males and 94 females), tinea manus (125 cases, 78 males and 47 females), and tinea capitis (47 cases, 25 males and 22 females). The number of cases of tinea pedis and tinea unguium increased during the summer. A higher percentage of patients were aged 80 or older than in previous surveys. These findings may reflect the increasing percentage of elderly patients seen and the superannuation of the population. As in previous surveys, Trichophyton rubrum and Trichophyton interdigitale were the two most frequently isolated species of fungi causing dermatophytoses. Microsporum canis and Trichophyton tonsurans were the two species most often causing tinea capitis.Regarding cutaneous candidiasis, while candidal intertrigo was the most common in previous surveys, diaper candidiasis in the elderly was the most common in this survey. A background check revealed that this was because a facility included a semi-prophylactic approach to address diaper candidiasis occurring within the ward.Malassezia infections by Malassezia folliculitis clearly increased with each survey. The tendency of certain facilities with many reports of Malassezia folliculitis suggests that it is greatly affected by the presence of physicians familiar with the disease.

Successful Treatment of Cutaneous Scedosporium prolificans: An Emerging and Treatment-Resistant Fungal Pathogen.

Scedosporium prolificans (S. prolificans) is an increasingly prevalent and treatment-resistant opportunistic fungus. The pathogen is known to cause a variety of clinical manifestations ranging from localized cutaneous disease to disseminated systemic infection. Herein we present an otherwise healthy 41-year-old male with biopsy-proven S. prolificans cutaneous infection. The patient experienced drastic clinical improvement on two months of a combination of oral itraconazole and oral minocycline. S. prolificans exhibits resistance to many antifungal agents, thus, single-agent antifungal therapy has a high failure rate and often results in the need for surgical excision or debridement. Recent accounts suggest that minocycline in combination with azole antifungals has a synergistic effect in treating S. prolificans. This case highlights the excellent response to combination oral therapies with minocycline and itraconazole. Prompt and efficacious treatment reduces the risk of destructive or disseminated disease and may avoid the need for surgical intervention.

Recalcitrant cutaneous fungal infections-A growing problem.

The incidence and prevalence of recalcitrant cutaneous fungal infections is on the rise. Terbinafine-resistant Trichophyton has not only been widespread in India, but has also been reported in countries spread throughout the globe. Strains of yeasts such as Malassezia and Candida, which exist both as commensals and as pathogens to the human skin, have also been found to develop resistance to antifungals. Non-dermatophyte moulds which can colonize and infect damaged nails are especially difficult to treat, not only due to resistance, but also because of poor drug penetration of hard keratin. Psychosocial factors such as the indiscriminate broad-spectrum antifungal use in agriculture and in medicine, and poor adherence to hygienic measures to break the chain of infection contribute to the development of antifungal resistance. Such environments encourage fungi to develop various resistance mechanisms to withstand antifungal treatment. These include: (a) alteration of the drug target, (b) increasing efflux of drug/metabolites, (c) inactivation of drug, (d) bypass mechanisms or substitution of the pathway affected by the drug, (e) stress adaptation mechanisms and (f) biofilm formation. Understanding of such mechanisms and how they arise are crucial for development of new ways to prevent or overcome resistance. Novel antifungal treatments have recently been approved in the United States of America for treatment of vulvovaginal candidiasis. Ibrexafungerp (enfumafungin derivative) and oteseconazole (tetrazole) differ from their respective related drug classes of echinocandins and triazoles by having different structures, which lend these medicines advantage compared to traditional treatment by having a different binding site and more selectivity for fungi respectively. Other drugs designed to circumvent the known mechanisms of antifungal resistance are also at various phases of development. Concurrent measures at an institutional and individual level to address and limit inappropriate antifungal use to reduce development of antifungal resistance should be undertaken in a concerted effort to address this epidemic.

First record of Trichophyton benhamiae isolated from domestic cats in Russia.

We report a first case of Trichophyton benhamiae isolation from domestic cats in Russia. Genetically affiliated to European strains T. benhamiae were deposited in NCBI. T. benhamiae strains formed zonal cream-colored colonies, with reversum pigmentation ranging from intensive yellow to orange-brown in one and orange-brown to chocolate in the second strain. Mycelium is colorless, hyphae are septated, rapidly aging with the formation of arthrospores and microconidia. The formation of macroconidia was recorded after 48 hours. A favorable outcome of treatment was recorded after two weeks.

The need for fast and accurate detection of dermatomycosis.

Dermatomycosis of the hair, skin, or nails is one of the most common fungal infections worldwide. Beyond permanent damage to the affected area, the risk of severe dermatomycosis in immunocompromised people can be life-threatening. The potential risk of delayed or improper treatment highlights the need for a rapid and accurate diagnosis. However, with traditional methods of fungal diagnostics such as culture, a diagnosis can take several weeks. Alternative diagnostic technologies have been developed which allow for an appropriate and timely selection of an antifungal treatment, preventing nonspecific over-the-counter self-medication. Such techniques include molecular methods, such as polymerase chain reaction (PCR), real-time PCR, DNA microarray, next-generation sequencing, in addition to matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry. Molecular methods can help close the 'diagnostic gap' observed with traditional cultures and microscopy and allow for a rapid detection of dermatomycosis with increased sensitivity and specificity. In this review, advantages and disadvantages of traditional and molecular techniques are discussed, in addition to the importance of species-specific dermatophyte determination. Finally, we highlight the need for clinicians to adapt molecular techniques for the rapid and reliable detection of dermatomycosis infections and to reduce adverse events.

Dermatomycosis is one of the most common fungal infections worldwide. Traditional fungal diagnostics are limited and can take several weeks. Molecular techniques can detect dermatomycosis pathogens quickly and allow for species-specific identification which is important for treatment.

Dermatomycosis Caused by Paranannizziopsis australasiensis in Nonnative Panther Chameleons (Furcifer pardalis) Captured in Central Florida, USA.

Emergent fungal pathogens in herpetofauna are a concern in both wild and captive populations. We diagnosed dermatomycosis by Paranannizziopsis australasiensis in two panther chameleons (Furcifer pardalis) and suspected it in eight others captured from an established free-living nonnative population in Florida, USA. Chameleons developed skin lesions following recent exposure to cold weather conditions while housed in captivity, approximately 10 mo after capture and 12 wk after being placed in outdoor enclosures. Affected animals were treated with oral voriconazole and terbinafine until most cases resolved; however, medications were ultimately discontinued. Paranannizziopsis australasiensis has not previously been described in chameleons, nor in animals originating from a free-ranging population in the USA. Although the source of P. australasiensis infection is uncertain, we discuss several scenarios related to the pet trade and unique situation of chameleon "ranching" present in the USA.

Development of a Clioquinol Nanocarrier as a New, Promising Option for the Treatment of Dermatomycosis.

Dermatomycosis is a common fungal infection, and its treatment is limited by few antifungal agents. Clioquinol (CQ) is an antiparasitic agent that has been studied for new uses, such as antifungal and antiviral applications. CQ was incorporated into a lipid-based nanocarrier as a new, promising option for dermatomycosis. This study aimed to develop a CQ-loaded lipid-based nanocarrier for cutaneous application and to evaluate its antifungal activity. CQ-loaded nanoformulation (LBN-CQ) was developed using the ultrasonication method, and the particle size, polydispersity index (PDI), pH, zeta potential, and drug content were monitored for 45 days. To evaluate antifungal activity, broth microdilution and a time-kill assay were performed. LBN-CQ presented a particle size of 91 ± 3 nm and PDI of 0.102 ± 0.009. The zeta potential and pH values were -9.7 ± 2.0 mV and 6.0 ± 0.1, respectively. The drug content was 96.4 ± 2.3%, and the encapsulation efficiency was 98.4%. LBN-CQ was able to reduce the minimum inhibitory concentration (MIC) in a 2-fold or 4-fold manner in most of the tested strains. Additionally, LBN-CQ presented stable fungistatic action that was not concentration- or time-dependent. In conclusion, the developed CQ-loaded nanocarrier is a promising treatment for skin fungal infections and a promising candidate for future randomized clinical trials.

Deep dermatophytosis in an immunocompetent adult with no prior history of skin disease.

The clinical presentation of invasive dermatophytosis often mimics other more common skin diseases. We report a case of severe deep dermatophytosis caused by Trichophyton mentagrophytes initially interpreted as herpetiform rash. The diagnosis was established based on fungal culturing and molecular detection using RT-PCR in addition to response to treatment using oral terbinafine. Our case emphasizes the importance of fungal testing at an early point to accelerate diagnosis and initiation of correct treatment. 2012 Elsevier Ltd. All rights reserved.

Dermatology mycology diagnostics in Ireland: National deficits identified in 2022 that are relevant internationally.

BACKGROUND: Conventional testing methods for dermatophytes are time-consuming, and resource limitations in our institution have prompted curtailed access to these diagnostics. OBJECTIVES: Evaluation of our hospital's dermatological mycology diagnostic services and similar services nationally. METHODS: This was a retrospective observational study on skin, hair and nail mycology samples in our institution comparing twenty five-year periods (2011-2015 and 2016-2021), including analysis of dermatology clinic data and correspondence related to fungal infection. A survey of national public hospitals' laboratories was conducted to evaluate their mycology testing capabilities. RESULTS: The total 5 year test count prior to curtailment was 4851 specimens comprising 90% (n = 4344) from general practice and 6% (n = 290) from dermatology clinics. For the 5 years post curtailment, 64.5% (582/903) of specimens were from dermatology clinics. Dermatology clinic data demonstrated doubling of attendances (for all conditions) and of correspondence related to fungal infection. During this time also, national dermatological antifungal purchasing increased 11%. Ten of 28 Irish public hospital laboratories reported the provision of in-house dermatological mycology testing, and none had routine availability of susceptibility or molecular testing of dermatophytes. CONCLUSION: This study is the first to report an appraisal of dermatological fungal diagnostic services in Ireland. Insufficient testing capacity implies that patients are either being treated for fungal infection without appropriate diagnostic confirmation, or being left untreated because of the lack of access to diagnostics. The introduction of molecular detection methods and susceptibility systems would enhance testing capabilities and reduce the requirement for the external referral.

Comparison of samples of blister fluid and scales in the diagnosis of dermatomycosis.

BACKGROUND: The successful diagnosis of dermatomycosis depends on specimen collection. Dermatomycosis is sampled mainly for scales, but there is a lack of research on specimens of blister fluid. OBJECTIVES: To explore whether blister fluid can diagnose dermatomycosis and compare blister fluid and scale specimens for dermatomycosis diagnosis. METHODS: From April to July 2021, we prospectively gathered 34 patients who needed to meet all inclusion criteria simultaneously and collected their blister fluid and scales as specimens. The two samples were tested by fluorescent stain microscopy, fungal culture and PCR, and the diagnosis results were compared. RESULTS: The blister fluid sample's sensitivity, specificity and accuracy were 90%, 100% and 94.1%, respectively, whereas the scales sample were 60%, 100% and 76.5%, respectively. The positive likelihood ratios were >10 for both blister fluid and scales specimen, and the negative likelihood ratios were not <0.1. On the Youden's index, the blister fluid specimen was 90%, and the scales specimen was 60%. As for the diagnostic odds ratio, both of them were >1. By fungal culture, we detected 14 cases of fungi in blister fluid and eight in scales. On PCR, 22 cases of fungi in blister fluid and ten in scales were identified. CONCLUSIONS: This study demonstrated that a sample of blister fluid had better sensitivity, accuracy and Youden's index in diagnosing dermatomycosis with blister fluid. Collection of blister fluid might compensate for the inadequacy of collecting only scales specimens for mycological testing.

Altered skin fungal and bacterial community compositions in tinea capitis.

BACKGROUND: Tinea capitis is an infection of the scalp and hair shaft caused by dermatophytes that predominantly occurs in children. Skin fungal infections have been found to be associated with alterations in the overall bacterial and fungal communities. However, the scalp microbiome in tinea capitis have not been fully investigated. OBJECTIVES: To investigate and compare the scalp bacterial and fungal microbiomes between children with tinea capitis and healthy children and between children and adults. METHODS: Skin samples were collected from the scalp. Bacterial and fungal community compositions were analysed by amplification sequencing of the V3-V4 of 16S rDNA and ITS1-5F, respectively. RESULTS: The predominant fungi detected using amplicon sequencing were consistent with the culture- or real-time PCR-positive pathogens in most samples. Children with tinea capitis had lower fungal and higher bacterial Shannon diversity than healthy children. A higher relative abundance of pathogenic fungi and significant alterations in the bacterial community in the lesional sites of tinea capitis than healthy scalps. Compared with adults, healthy children were characterised by higher Shannon diversities with significantly lower relative abundances of Malassezia and Cutibacterium and higher relative abundances of Candida and Streptococcus. CONCLUSIONS: We demonstrated that tinea capitis was characterised by significant alterations in both fungal and bacterial communities and amplicon sequencing could be a complementary method for pathogen identification.

Epidemiology of dermatomycoses and onychomycoses in Ireland (2001-2020): A single-institution review.

BACKGROUND: Fungal skin infections are recognised as one of the most common health disorders globally, and dermatophyte infections of the skin, hair and nails are the most common fungal infections. Dermatophytes can be classified as anthropophilic, zoophilic or geophilic species based on their primary habitat association, and this classification makes epidemiological analysis useful for the prevention and control of these infections. The Irish contribution to the epidemiology of these infections has been scant, with just two papers (both reporting paediatric tinea capitis only) published in the last 20 years, and none in the last seven. OBJECTIVES: To perform a comprehensive retrospective epidemiological analysis of all dermatological mycology tests performed in University Hospital Limerick over a 20-year period. METHODS: All mycology laboratory test results were extracted from the Laboratory Information Management System (LIMS, iLab, DXC Technologies) from 2001 to 2020 inclusive for analysis. Specimen types were categorised according to the site of sampling. The data were analysed using Microsoft Excel. RESULTS: About 12,951 specimens of skin, hair and nails were studied. Median patient age was 42 years (IQR 26-57) with a slight female preponderance (57.2%). Two thirds of samples (67%, n = 8633) were nail, 32% were skin scrapings (n = 4118) and 200 hair samples (1.5%) were received. Zoophilic dermatophytes were more commonly present in females (38% F, 23% M, proportion of dermatophytes) and in those under 10 years of age or from 45 to 70 years (36% and 34% zoophiles, respectively, proportion of dermatophytes), although anthropophiles predominated every age and gender category. Anthropophiles had their highest prevalence in the 10-20 years age category (80% anthropophiles, proportion of dermatophytes), and yeast infections were more prevalent in older patients (29% of >60 year olds vs. 17% of <60 year olds, proportion of all fungal positives). Trichophyton rubrum was the most prevalent pathogen detected, accounting for 53% of all dermatophytes detected, 61% of those detected from nail samples and 34% from skin and hair samples. Trichophyton tonsurans was the most prevalent dermatophyte in tinea capitis, accounting for 37% of dermatophytes detected. Both of these organisms are anthropophilic, and this group showed consistently increased prevalence in proportion to all fungal isolates. The proportion of this dermatophyte class (anthropophiles) increased among both nail samples and skin/hair samples during the study period, from 55% of samples in the first 5 years of the study (2001-2005) to 88% (proportion of dermatophytes) in the final 5 years. Conversely, yeast detection decreased. CONCLUSIONS: This study provides a detailed overview of the epidemiology of the fungal cultures of skin, nail and hair samples in the Mid-West of Ireland over a 20-year period. Monitoring this changing landscape is important in identifying likely sources of infections, to identifying potential outbreaks, and may help guide empiric treatment. To the best of our knowledge, this study provides the first detailed analysis from Ireland of fungal detections from skin, hair and nail samples, and is the first epidemiological fungal report of any kind in over 7 years.

Epidemiology of dermatomycoses in children in Northern Mato Grosso 2015-2020.

OBJECTIVES: Dermatomycoses, fungal diseases that affect the superficial layers of skin, hair or nails, are a public health concern due to their high prevalence. In Brazil, dermatomycoses are not notifiable diseases, so only fragmented epidemiological studies have been reported in the national literature. To evaluate the epidemiological profile of dermatomycoses in preschoolers and school children in Sinop, Mato Grosso (MT), Brazil. METHODS: Classic methods were used to perform 782 mycological examinations to identify dermatophytosis, cutaneous candidosis and pityriasis versicolor in preschoolers and school children aged between 6 months and 12 years in 11 educational institutions in Sinop, MT. RESULTS: Among the evaluated clinical specimens, 5.2% tested positive for dermatophytosis, with 58.45% of these cases corresponding to tinea capitis, followed by skin (tinea corporis and tinea pedis) and toenail (tinea unguium) lesions; zoophilic fungi predominated. Microsporum canis and Trichophyton mentagrophytes complex were isolated in 53.66% and 24.39% of the cases, respectively. Regarding cutaneous candidosis, 9.1% of the specimens tested positive for this disease, with 59.16% and 12.7% of the cases corresponding to toenails and interdigitoplantar lesions, respectively. Candida albicans caused 70.43% of the lesions. The remaining specimens (85.7%) tested positive for pityriasis versicolor; children aged between 6 and 12 were the most affected (71.79%). CONCLUSION: Our results agree with most epidemiological studies carried out in Brazil and demonstrate the high frequency of mycoses in preschoolers and school children, a result of poor personal hygiene and favourable weather conditions in Northern Mato Grosso, Brazil.