Factors influencing epidemiology of dermatomycoses at Gdansk, Poland and Grodno, Belarus.

Introduction: An increase in numbers of cutaneous fungal infections is being observed around the world. Dermatomycoses occur in every age group and can significantly decrease quality of life. Examining the prevalence and epidemiological trends of cutaneous fungal infections is necessary for developing new effective preventive, diagnostic and therapeutic methods. Many factors can influence the growth and patterns of global spread of the different species of fungi. Aim: To investigate the differences between the prevalence of dermatophytes and cutaneous fungal infections observed at two mycological laboratories and their plausible causes. Material and methods: Mycological examination was performed in 7324 patients in Gdansk, Poland and in 4729 patients in Grodno, Belarus who exhibited clinical signs and symptoms of cutaneous fungal infections. Direct preparations was made in 20% KOH with 40% DMSO. Additionally cultures were prepared on modified Sabouraud dextrose agar. Results: Dermatophytes were cultured in 642 (53.58%) cases in Gdansk. The most common species of dermatophytes were Trichophyton rubrum (306 cases), Trichophyton mentagrophytes var. granulosum (193 cases) and Microsporum canis (127 cases). Yeasts were isolated in 531 (44.40%) cases out of which Candida albicans was the most frequently identified in 323 cases. Similarly, dermatophytes were the most common in 1158 (68.72%) cases in Grodno. Candida were isolated in 527 (31.28%) cases. Analysing the localization of dermatomycoses onychomycosis was observed in majority of the infected patients in Gdansk. In Grodno the most common location of superficial cutaneous infection was tinea corporis In the Gdansk region dermatomycoses were observed in 688 female patients and in 508 male patients. In Grodno the prevalence is inverted with the majority of cases observed in 921 males and 764 females. Conclusions: The prevalence of superficial fungal infections is higher in Grodno, Belarus when compared to Gdansk, Poland. Similarly, dermatophytes were most commonly observed in both Laboratories.

The prevalence and etiological factors of onychomycosis in psoriatic patients.

INTRODUCTION: The role of a number of inherited, acquired and environmental factors has been identified to increase the risk of onychomycosis. The literature data on psoriasis as a risk factor are contradictory. The potential relationship between these pathologies is very important as it influences the patient management. AIM: To evaluate the frequency of onychomycosis and etiological factors in patients with psoriasis compared to controls. MATERIAL AND METHODS: The studied group (n = 2427) included 2325 patients with nail abnormalities raising a clinical suspicion of nail onychomycosis (with no history of psoriasis) and 102 psoriatic inpatients. The control group included 100 patients with clinically normal nails. The assessment of psoriasis severity using Nail Psoriasis Severity Index (NAPSI) and Psoriasis Area and Severity Index (PASI) was performed in all psoriatic patients. The presence of fungi was confirmed in direct microscopy and culture. RESULTS: A significantly higher incidence of onychomycosis was observed in psoriatic patients as well as in non-psoriatic patients with clinically abnormal nails compared to controls. The prevalence of onychomycosis did not differ significantly between psoriatic patients and non-psoriatic patients with nail alterations. The characteristics of isolated fungi differed significantly between psoriatic and non-psoriatic patients. NAPSI ≥ 40 and receiving systemic treatment increased the risk of onychomycosis in psoriatic patients. CONCLUSIONS: The presented study showed a relatively high prevalence of onychomycosis in patients with psoriasis, what confirms the accuracy of performing screening mycological examination in this group. Further studies are warranted to evaluate the role of specific risk factors, explain the differences observed in previous studies and to determine optimal patient management.

Tinea incognito due to Trichophyton mentagrophytes.

Tinea incognito is a dermatophytosis of atypical clinical character, usually misdiagnosed and treated with corticosteroids. We report a case of tinea faciei modified by high potency topical corticosteroids in a 54-year-old woman. Deep, intense inflammatory plaque with boggy, pustular surface located on the right cheek was found. Direct microscopy and culture confirmed dermatophytosis and led to the identification of Trichophyton mentagrophytes var. mentagrophytes. Complete resolution occurred after treatment with oral terbinafine.

Real-time PCR approach in dermatophyte detection and Trichophyton rubrum identification.

Dermatophytes are keratinophilic molds that infect human hair, nails and skin. Diagnosis of dermatophytosis is based on morphological, serological and biochemical features. However, identification is difficult and laborious due to similarities between microorganisms. Thus, there is considerable interest to develop mycological diagnostic procedures based on molecular biology methods. In this study, fast, two-step DNA extraction method and real-time PCR was used for detection of dermatophytes DNA using pan-dermatophyte primers and identification of Trichophyton rubrum from pure cultures. The applied method allowed correct detection of all dermatophytes and correct identification of Trichophyton rubrum in less than 2 hours.