Antioxidant and antifungal activities of marrubiin, extracts and essential oil from Marrubium vulgare L. against pathogenic dermatophyte strains.

OBJECTIVE: Medicinal plants extracts and plant-derived compounds are one of the natural sources for discovering new antifungal agents, the objectives of this work were to investigate for the first time the antidermatophytic, antipathogenic activities of methanol, acetone extracts, and essential oil of Marrubium vulgare L. grown in Tunisia and its active compound marrubiin on pathogenic for animals and humans, such as some dermatophytes and pathogenic for plants, and to evaluate antioxidant activities of different extracts with consideration to their chemical compositions. MATERIAL AND METHODS: Acetone and methanol extracts were evaluated by HPLC, the essential oil was also analyzed by GC/MS. PCL assay was used to determine the antioxidant activity. RESULTS: Results showed that methanol and acetone extracts exhibited a significant antioxidant activity (261.41 and 272.90µmol TE/g respectively), while the lowest one was observed in the case of marrubiin and essential oil. The antifungal activity of different extracts, marrubiin and essential oil at two concentrations (20 and 100µg/mL) were screened against the dermatophytes fungi Microsporum gypseum, Microsporum canis, Arthroderma cajetani, Trichophyton mentagrophytes, Trichophyton tonsurans, Epidermophyton floccosum and against two fungi strains (Botrytis cinerea, Pythium ultimum). Among tested extracts, marrubiin at 100µg/mL showed about 50% inhibition for T. mentagrophytes and E. floccosum. The anti-phytopathogenic activity was also carried out, only marrubiin had in activity against B. cinerea at the highest dose (32.40%), while methanol extract of M.vulgare and marrubiin are able to increase the mycelial growth of P. ultimum at the highest concentration (45.15 and 40.30% respectively). CONCLUSION: In our study, we conclude that M.vulgare and marrubiin can be used as natural antioxidants and antifungal agent for treatment of skin dermatophyte infections.

Changing Concepts and Current Definition of Majocchi's Granuloma.

Dermatophytic granuloma characterized by perifollicular granulomatous inflammation was first described by Domenico Majocchi and was later named after him, Majocchi's granuloma (MG). Although the initial description was related to a dermatophyte Trichophyton tonsurans, later reports linked MG to non-dermatophytes (Phoma, Aspergillus, Malbranchea), which led to a confusion of disease patterns caused by cutaneous pathogens and general opportunistic microorganisms. Furthermore, several causative agents of MG described in the literature were not confirmed as such. Our review addressed the following aspects: (1) significance of histopathological finding for MG diagnosis, (2) dermatophytes as exclusive agents of MG, (3) spectrum of etiological agents causing different types of invasive dermatophytic infections, and (4) treatment options.

Dermatophytosis in dogs and cats - an update. / Dermatophytose bei Hund und Katze ­ ein Update.

Dermatophytosis is a cutaneous infection, caused by several types of keratophilic fungi (dermatophytes). It represents a serious and common contagious skin disease in dogs and cats. The significance of this disease for pet owners is based on the zoonotic potential. The prevalence varies with climate and local dermatophyte infestation. The most common infection in dogs and cats are caused by the genera Microsporum (M.), Nannizzia (N.) or Trichophyton (T.). The aim of this article is to summarise novel taxonomy, diagnosis, and treatment recommendations as well as the recently revised recommendations of the World Association of Veterinary Dermatology.

Ocorrência de dermatófitos em tegumento de bovinos e ovinos hígidos / Occurrence of dermatophytes in healthy cattle and sheep tegument / Ocurrencia de dermatofitos en tegumento de bovinos y ovinos hígidos

O objetivo desta pesquisa foi verificar a prevalência de dermatófitos em tegumento de bovinos e ovinos hígidos e a sua capacidade de transmissão e desenvolvimento da doença. Para isso, foram coletadas amostras de pelo e descamações de 90 bovinos e 90 ovinos hígidos. Essas amostras foram semeadas em meio DTM e ágar Sabouraud Dextrose enriquecido com extrato de levedura, tiamina, antibióticos (estreptomicina e cloranfenicol) e suplementado de cicloheximida, sendo essas incubadas a 35 oC por 10 dias. As culturas positivas foram avaliadas macro e microscopicamente e, os fungos foram identificados por métodos bioquímicos. Verificou-se que as espécies isoladas com maior frequência, nos bovinos, foram T. mentagrophytes e M. gypseum. Nos ovinos, foi constatada maior ocorrência do agente T. verrucosum, seguido por T. mentagrophytes e M. gypseum. Houve também isolamento de M. canis, porém, em um número reduzido de amostras. Assim, concluiu-se que o tegumento de bovinos e de ovinos hígidos apresentou incidência elevada de dermatófitos de diferentes espécies, em amostras coletadas durante o período chuvoso do ano. Por isso, em animais jovens ou naqueles submetidos a elevados níveis de estresse e, consequente queda da resposta imunológica, o risco de desenvolvimento da dermatofitose e da transmissão dos dermatófitos neste período são eminentes.(AU)

The purpose of this study was to determine the prevalence of dermatophytes in healthy cattle and sheep teguments, and their ability to transmit and develop diseases. Samples of fur and flaking from 90 healthy cattle and 90 healthy sheep were collected. These samples were plated on DTM medium and Sabouraud Dextrose agar supplemented with yeast extract, thiamine, antibiotics (streptomycin and chloramphenicol) enhanced with cycloheximide. They were then incubated at 35 °C for 10 days. Positive cultures were macroscopically and microscopically evaluated, and fungi were identified by biochemical methods. It was found that the most frequent species isolated in cattle were T. mentagrophytes and M. gypseum. In sheep, a higher occurrence of the agent T. verrucosum could be observed, followed by T. mentagrophytes and M. gypseum. There was also the isolation of M. canis, but in a small number of samples. Thus, it could be concluded that the tegument of healthy cattle and sheep showed high incidence of dermatophytes from different species in samples collected during the rainy season of the year. Therefore, in young animals, in those subjected to high levels of stress and consequent drop in immune response, there is eminent risk of developing dermatophytosis and transmission of dermatophytes in this period.(AU)

El objetivo de esta investigación ha sido verificar la prevalencia de dermatofitos en tegumento de bovinos y ovinos hígidos y su capacidad de transmisión y desarrollo de la enfermedad. Para ello, se recolectó muestras de pelo y descamaciones de 90 bovinos y 90 ovinos hígidos. Esas muestras fueron sembradas en medio DTM y agar Sabouraud Dextrosis enriquecida con extracto de levadura, tiamina, antibióticos (estreptomicina y cloranfenicol) y suplementado de cicloheximida, siendo esas incubadas a 35ºC durante 10 días. Los cultivos positivos fueron evaluados macro y microscópicamente y los hongos fueron identificados por métodos bioquímicos. Se verificó que las especies aisladas con mayor frecuencia, en los bovinos, fueron T. mentagrophytes y M. gypseum. En los ovinos, se constató mayor ocurrencia del agente T. verrucosum, seguido por T. mentagrophytes y M. gypseum. También hubo aislamiento de M. canis, sin embargo, en un número reducido de muestras. Así, se concluyó que el tegumento de bovinos y de ovinos hígidos presentó una elevada incidencia de dermatofitos de diferentes especies, en muestras recogidas durante el período lluvioso del año. Por lo tanto, en animales jóvenes o en aquellos sometidos a altos niveles de estrés y, consecuente caída de la respuesta inmunológica, el riesgo de desarrollo de la dermatofitosis y de la transmisión de los dermatofitos en este período son eminentes.(AU)

HapX Mediates Iron Homeostasis in the Pathogenic Dermatophyte Arthroderma benhamiae but Is Dispensable for Virulence.

For many pathogenic fungi, siderophore-mediated iron acquisition is essential for virulence. The process of siderophore production and further mechanisms to adapt to iron limitation are strictly controlled in fungi to maintain iron homeostasis. Here we demonstrate that the human pathogenic dermatophyte Arthroderma benhamiae produces the hydroxamate siderophores ferricrocin and ferrichrome C. Additionally, we show that the iron regulator HapX is crucial for the adaptation to iron starvation and iron excess, but is dispensable for virulence of A. benhamiae. Deletion of hapX caused downregulation of siderophore biosynthesis genes leading to a decreased production of siderophores during iron starvation. Furthermore, HapX was required for transcriptional repression of genes involved in iron-dependent pathways during iron-depleted conditions. Additionally, the ΔhapX mutant of A. benhamiae was sensitive to high-iron concentrations indicating that HapX also contributes to iron detoxification. In contrast to other pathogenic fungi, HapX of A. benhamiae was redundant for virulence and a ΔhapX mutant was still able to infect keratinized host tissues in vitro. Our findings underline the highly conserved role of the transcription factor HapX for maintaining iron homeostasis in ascomycetous fungi but, unlike in many other human and plant pathogenic fungi, HapX of A. benhamiae is not a virulence determinant.

Dermatophytes activate skin keratinocytes via mitogen-activated protein kinase signaling and induce immune responses.

Dermatophytes cause superficial and cutaneous fungal infections in immunocompetent hosts and invasive disease in immunocompromised hosts. However, the host mechanisms that regulate innate immune responses against these fungi are largely unknown. Here, we utilized commercially available epidermal tissues and primary keratinocytes to assess (i) damage induction by anthropophilic, geophilic, and zoophilic dermatophyte strains and (ii) the keratinocyte signaling pathways, transcription factors, and proinflammatory responses induced by a representative dermatophyte, Trichophyton equinum. Initially, five dermatophyte species were tested for their ability to invade, cause tissue damage, and induce cytokines, with Microsporum gypseum inducing the greatest level of damage and cytokine release. Using T. equinum as a representative dermatophyte, we found that the mitogen-activated protein kinase (MAPK) pathways were predominantly affected, with increased levels of phospho-p38 and phospho-Jun N-terminal protein kinase (JNK) but decreased levels of phospho-extracellular signal-regulated kinases 1 and 2 (ERK1/2). Notably, the NF-κB and PI3K pathways were largely unaffected. T. equinum also significantly increased expression of the AP-1-associated transcription factor, c-Fos, and the MAPK regulatory phosphatase, MKP1. Importantly, the ability of T. equinum to invade, cause tissue damage, activate signaling and transcription factors, and induce proinflammatory responses correlated with germination, indicating that germination may be important for dermatophyte virulence and host immune activation.

The Arthroderma benhamiae hydrophobin HypA mediates hydrophobicity and influences recognition by human immune effector cells.

Dermatophytes are the most common cause of superficial mycoses in humans and animals. They can coexist with their hosts for many years without causing significant symptoms but also cause highly inflammatory diseases. To identify mechanisms involved in the modulation of the host response during infection caused by the zoophilic dermatophyte Arthroderma benhamiae, cell wall-associated surface proteins were studied. By two-dimensional gel electrophoresis, we found that a hydrophobin protein designated HypA was the dominant cell surface protein. HypA was also detected in the supernatant during the growth and conidiation of the fungus. The A. benhamiae genome harbors only a single hydrophobin gene, designated hypA. A hypA deletion mutant was generated, as was a complemented hypA mutant strain (hypA(C)). In contrast to the wild type and the complemented strain, the hypA deletion mutant exhibited "easily wettable" mycelia and conidia, indicating the loss of surface hydrophobicity of both morphotypes. Compared with the wild type, the hypA deletion mutant triggered an increased activation of human neutrophil granulocytes and dendritic cells, characterized by an increased release of the immune mediators interleukin-6 (IL-6), IL-8, IL-10, and tumor necrosis factor alpha (TNF-α). For the first time, we observed the formation of neutrophil extracellular traps against dermatophytes, whose level of formation was increased by the ΔhypA mutant compared with the wild type. Furthermore, conidia of the ΔhypA strain were killed more effectively by neutrophils. Our data suggest that the recognition of A. benhamiae by the cellular immune defense system is notably influenced by the presence of the surface rodlet layer formed by the hydrophobin HypA.

Micosis superficiales en atletas de la Facultad de Ciencias de la Educación, Universidad de Carabobo / Surface mycosis in athletes from the School of Education, University of Carabobo

Las dermatofitosis constituyen uno de los problemas de salud más frecuente a nivel mundial, con mayor incidencia en países tropicales y subtropicales, más frecuentemente en el sexo masculino. Los atletas están en constante predisposición a sufrir de infecciones micóticas por la variabilidad de las condiciones individuales así como ambientales. El objetivo fue determinar la prevalencia de los agentes etiológicos causantes de micosis superficiales en los atletas de la Facultad de Ciencias de la Educación de la Universidad de Carabobo. La muestra estuvo representada por 71 atletas de diferentes disciplinas que presentaban lesiones sospechosas de micosis superficiales en piel y uñas, realizándoles un examen directo con KOH, Cinta adhesiva, cultivo en Agar Lactrimel. Los aislados obtenidos se les practicó un examen directo con azul de lactofenol y microcultivo para identificar el agente etiológico. Se encontró en los atletas 63,4% de lesiones por dermatofitos identificando las especies T. rubrum (23,9%), T. mentagrophytes (19,7%) y E. floccosum (19,7%) y 36,6% de lesiones por levaduras identificando Malassezia furfur (29,6%) y Malassezia ovalis(7,1%) siendo el sexo masculino el más afectado. Estos hallazgos son relevantes debido a que estos agentes se aprovechan de condiciones desfavorables para colonizar y ocasionar lesiones que pudiesen disminuir el rendimiento deportivo del atleta.

Dermatophytosis is one of the most common health problems worldwide, with greater incidence in tropical and subtropical countries, most often in males. Athletes are constantly predisposed to suffering from fungal infections due to the variability of individual and environmental conditions. The objective was to determine the prevalence of etiological agents causing superficial mycosis in athletes from the School of Educational Sciences at the University of Carabobo. The sample was represented by 71 athletes from different disciplines that had lesions suspected of being surface mycosis on skin and nails; a direct examination was made with KOH, adhesive tape and cultivation on Lactrimel agar. The obtained isolates were examined directly with lactophenol blue and microculture to identify the etiologic agent. It was found that 63.4% of the athletes had lesions by dermatophytes, identifying the species T. rubrum (23.9%), T. mentagrophytes (19.7%) and E. floccosum (19.7%); in 36.6% of lesions, the yeast Malassezia furfur (29.6%) and Malassezia ovalis (7.1%) were identified; males were the most affected. The findings are relevant because these agents take advantage of adverse conditions to colonize and cause lesions that could decrease athletic performance.

Dermatomicosis en ancianos institucionalizados y estudios de sensibilidad in vitro a los antifúngicos sistémicos / Dermatomycosis in institutionalized elderly patients and in vitro sensitivity study to systemic antifungus

Se determinó la prevalencia de dermatomicosis en ancianos institucionalizados de Ciudad Bilívar, Estado Bolívar, Venezuela, y se evaluó la sensibilidad in vitro de los aislamientos clínicos a los antifúngicos itraconazol, fluconazol y terbinafina mediante el método de microdilución en medio líquido, recomendado por el Comité Internacional de Laboratorios Clínicos (M38-P), con algunas modificicaciones. Los hongos fueron identificados mediante métodos tradicionales. Las levaduras se identificaron mediante pruebas bioquímicas, sistema Api 20 C AUX (Biomérieux SA®, France) y crecimiento en medio de Staib. Se estudiaron 74 ancianos, todos recluidos en el Asilo "San Vicente de Paúl" y el Geriátrico "Carlos Fragachán" quienes dieron consentimiento por escrito para participar en el estudio. La edad de los pacientes estuvo comprendida entre 63 y 98 años (80 ± 8,4 años), la mayoría eran hombres (73%). Todos los pacientes tenían lesiones sugestivas de onicomicosis en los pies. El único dermatofito aislado fue Trichophyton rubrum (n=2) el cual resultó sensible al Itraconazol, terbinafina y sensibilidad variable a flucozazol. Asimismo se logró aislar Aspergillus niger (n=5; 6,7%) demostrándose sensible a terbinafina y fluconazol con sensibilidad variable a itraconazol. Candida albicans (n=3; 4,1%) fue sensible a fluconazol, resistentes a itraconazol y variable a la terbinafina. Aspergillus flavus fue aislado en dos casos (2,7%). Además de Geomyces sp, Fusarium oxysporum y Pseudeurotium ovale. Se concluye que existe una prevalencia baja de dermatomicosis en los ancianos institucionalizados de Ciudad Bolívar y que las lesiones clinicamente observadas son debidas a los cambios degenerativos propios de la edad.

A study determine prevalence of dermatomycosis in 74 institutionalized elderly patients was conductted in Ciudad Bolivar, state of Bolivar, Venezuela. Clinical isolates were assayed for in vitro sensitivity to itraconazole, fluconazole, and terbinafine using a slightly modified version of the microdilution method in liquid medium recommended by the International Committee of Clinical Laboratory (M38-P). Traditional methods were used to identify the fungi. The yeasts were identified by Api 20C AUX biochemical testing (bioMérieux SA®, France) and growth on Staib media. The elders, mostly men (73%), from the "San Vicente de Paúl" Nursing Home and the "Carlos Fragachan" Geriatric Hospital, were aged between 63 and 98 (80 ± 8.4 years). All the patients, whose written consent was secured, had lesions suggestive of onychomycosis. Trichophyton rubrum was the only isolated dermatophyte (n=2), which resulted sensitive to itraconazole and terbinafine, with variable sensitivity to fluconazole. Aspergillus niger (n=5;6.7%) was sensitive to terbinafine and fluconazole with variable itraconazole sensitivity. Candida albicans (n=3; 4.1%) was fluconazole sensitive, resistant to itraconazole, and variable to terbinafine. Aspergillus flavus was isolated in two cases 2.7%). Geomyces sp., Fusarium oxysporum, and Pseudeurotium ovale were also isolated. It is concluded that there is a low prevalence of dermatomycosis among institutionalized elders in Ciudad Bolivar, and that the lesions clinically observed were due to degenerative changes naturally occurring with aging.

Pathogenesis of tinea.

Dermatophytes are hyphomycetes that can degrade keratin. This puts them in a position to cause infections of the keratin-containing superficial skin. The resulting clinical picture is called tinea. The pathogenesis and course of tinea is decisively determined by pathogen-related factors and by the defense mechanisms of the host. An infection starts with an adherence of fungal propagules, followed by the formation of hyphae that can spread within the tissue. This process is accompanied by a release of fungal enzymes and other pathogenic factors. Next keratinocytes are activated, the epidermal barrier is destroyed, epidermal proliferation is enhanced and defensins are expressed within the epidermis. In addition, innate and specific immune responses are initiated, involving neutrophilic granulocytes, macrophages, antibodies and T cells. The cellular mechanisms are thought to be crucial for healing. Special conditions apply to nail infections, because within nail plates the fungi are not accessible to effective defense mechanisms, as well as to infections of hair follicles that contain specific concentrations of steroid hormones. Dermatophytes that penetrate into the dermis can cause granulomatous inflammatory reactions and systemic immune reactions are supposed to be a trigger of so-called id reactions.

Arthroderma gypseum y su anamorfo en el jardín central de la Universidad Nacional de Tucumán, Argentina / Artroderma gypseum and its anamorph from the central garden of the Universidad Nacional de Tucuman, Argentina

Con el objeto de contribuir al conocimiento de la micobiota en áreas públicas, en especial en la búsqueda de propágulos infectivos para el hombre y los animales de dermatofitos geofílicos desde sus fuentes saprofíticas, se estudiaron en el lapso de 2 años, 8 muestras superficiales de suelo (una cada 3 meses) desde los jardines centrales de la Universidad Nacional de Tucumán mediante la Técnica de Vanbreuseghem, usando pelos de niños como anzuelo queratínico. Las 8 muestras sembradas en 24 placas de Petri, presentaron todas al cabo de 25-30 días la presencia de Arthroderma gypseum y su anamorfo Microsporum gypseum como único dermatofito presente. Los cultivos en Sabouraud glucosado y en Sabouraud al 10 por ciento (medio deTakashio), permitieron identificar las cepas típicas del anamorfo. La presencia y prevalencia en el tiempo de este agente en las muestras colectadas en dependencias universitarias rodeadas de aulas, laboratorios y oficinas, posee un impacto en salud pública y ambiental por su conocido oportunismo en pacientes inmunocompetentes e inmunocomprometidos.

With the purpose of knowing the presence of mycobiota in public areas, mainly in the search of propagules of geophilic dermatophytes which are infective for man and animals from their saprophytic sources, 8 superficial samples of soil (every 3 month), collected from the central gardens of the Universidad Nacional de Tucumán were studied during a 2-year period, by using the Vanbreuseghem Technique which employs children hair as a keratinic bait. The overall 8 samples sowed on 24 Petri plates revealed after 25-30 days the presence of Arthroderma gypseum and its anamorph Microsporum gypseum as the only dermatophyte present. Cultures in glucose Sabouraud and in 10 percent Sabouraud (Takashio medium), allowed the identification of the typical strains of the anamorph. Presence and prevalence in time of this agent in samples collected from university buildings surrounded by classrooms, laboratories and offices means an impact on public and environmental health due to its well known opportunism in immunocompetent and immunocompromised patients.

Frecuencia de gérmenes causantes de Micosis superficiales / Frequency of germs causes of superficial Mycoses

Las micosis superficiales representan un grupo heterogéneo de infecciones muy frecuentes a nivel mundial. Con objeto de conocer la frecuencia de hongos productores de micosis superficiales y conformar indicadores epidemiológicos que no aproximen a la realidad local es que, en el laboratorio de bacteriología del Hospital Obrero, se realizó un estudio retrospectivo de muestras de pacientes ambulatorios e internos de ambos sexos con diagnóstico presuntivo de dermatomicosis.

Micetomas en cuero cabelludo por Microsporum canis en huésped inmunocompetente / Scalp mycetomas due to Mycosporum canis in a immunocompetent host

Se presenta una paciente de 15 años de edad con lesiones tumorales en el cuero cabelludo acompañadas de descamaciones. Se observaron además otras formaciones de aspecto verrugoso en cara anterior de piernas, manos, cola de ceja izquierda y otra en la úvula. Los estudios histopatológicos determinaron que las lesiones de piel eran verrugas vulgares; la lesión de la úvula fue un condiloma acuminado, y las del cuero cabelludo correspondieron a un micetoma con granos de un Eumycote. Por tal motivo se extirpó quirúrgicamente la lesión biopsiada del cuero cabelludo y se la cultivó en medio de Sabouraud y Lactrimel, obteniéndose el desarrollo de un Microsporum canis. También se cultivaron pelos y escamas, aislándose el mismo microorganismo. El examen físico así como los exámenes de laboratorio, no pusieron en evidencia alteraciones significativas. Con el diagnóstico de micetoma por Microsporum canis se le instituyó un tratamiento con griseofulvina a razón de 15 mg/kg/día, durante seis meses. Las lesiones cicatrizaron, las verrugas remitieron espontáneamente y el condiloma acuminado fue extirpado quirúrgicamente

The AIDS epidemic.

The nature of the clinical presentation of HIV infection continues to evolve over time. New cutaneous (e.g., seborrheic dermatitis, onychomycosis, and tinea pedis) and systemic (e.g., Aspergillus fumigatus and Penicillium marneffei) opportunistic fungal infections can now be added to the classic clinical markers for progressive HIV infection, such as Kaposi's sarcoma, Pneumocystis carinii pneumonia, Mycobacterium avium intercellulare infections, and cryptococcal meningitis. The fact that the appearance of many of these fungal diseases is directly correlated with the patient's CD4 cell count is a valuable tool for ongoing clinical evaluation. Although systemic manifestations characterize a progression from asymptomatic HIV infection to AIDS, many of the signs of disease progression are cutaneous. Prophylaxis against many of the potentially life-threatening systemic opportunistic infections associated with HIV positivity has had a positive impact on the life expectancy of patients with AIDS.

Terbinafina oral en tiña pedis: estudio clínico multicéntrico / Oral terbinafine in tinea pedis: multicentric clinical study

Se presenta la experiencia clínica multicéntrica Uruguay-Chile en el tratamiento de la tiña pedis con terbinafina oral administrada por 2 semanas, con períodos de observación postratamiento a las 4 y 8 semanas de inicio del estudio. Se incluyen 67 pacientes,39 mujeres y 28 hombres, con una edad promedio de 38,9 años, que presentaban el cuadro clínico de tiña pedis (forma interdigital y formas plantares difusas, ya sea uni o bilaterales), el que fue confirmado por la presencia de dermatofitos en el cultivo micológico inicial (79,1 por ciento de los casos trichophyton rubrum). Se evaluaron signos clínicos variados: eritema, descamación, vesiculización, presencia de pústulas, exudación, costras y síntoma prurito. La evaluación micológica se efectuó mediante examen directo y cultivo. Los signos y síntomas clínicos mejoraron durante todo el seguimiento, alcanzando entre 61,2 por ciento al 100 por ciento de mejoría total de estos parámetros a las 8 semanas de seguimiento. Los exámenes micológicos se fueron negativizando progresivamente, alcanzando en la evaluación final a las 8 semanas un 92 por ciento de exámenes directos y un 85 por ciento de cultivos negativos, respectivamente. Recaídas con cultivos micológicos positivos fueron observadas en 2 casos (4,3 por ciento). El medicamento fue, en general, bien tolerado, y los efectos adversos más frecuentes fueron gastrointestinales, presentes en 7 pacientes. No se registraron alteraciones de parámetros bioquímicos de significación. En conclusión, la terbinafina (LAMISIL) se presenta como una nueva medicación antimicótica sistémica de alta eficacia en cortos períodos de tratamiento en variadas formas de tiña pedis

Dermatofitos y candida en pacientes pediátricos con dermatitis atópica / Dermatophytes and C albicans in children whith atopic dermatitis

Estudio prospectivo para investigar la incidencia de dermatofitos y C. albicans en 30 pacientes en edad pediátrica con dermatitis atópica (DA), comparados con un número igual de pacientes con otras dermatosis sin asociación conocida a dermatofitos y/o C. albicans. En ambos grupos se investigó la presencia de dichos hongos, en ingles y pies, así como en piel enfermedad de DA. En el grupo de pacientes con dematitis atópica, se aislaron dermatofitos en tres y C. albicans en seis casos; en el grupo control se aisló C. albicans en cuatro casos y no se aislaron dermatofitos

Fisiopatogenia das dermatofitoses / Physiopathogeny of dermathophytosis

Os autores apresentam uma revisäo dos mecanismos fisiopatogênicos das dermatofitoses. Siao revisadas as características dos fungos envolvidos e os mecanismos de defesa do hospedeiro, com ênfase aos fatores inespecíficos e à imunidade humorale celular. Säo discutidas, também, as vias de penetraçiao e de desenvolvimento das infecçöes por dermatófitos no couro cabeludo, pele glabra e unhas

[Dermatomycoses as occupational diseases. The causative agents, sources of infection and the involved occupations]. / Dermatomykosen als Berufskrankheiten. Erreger, Infektionsquellen und betroffene Berufe.

Fungal diseases of the skin can be occupational dermatoses. This applies in particular to diseases due to microorganisms acquired from animals. A discussion of the relationship between occupation and disease, however, is not only pertinent in regards to dermatophytoses due to zoophilic fungi but also with those due to geophilic and--to a certain extent--even anthropophilic ones. The same is true of candidiasis. The present review deals with the various standpoints concerning the role of occupation in the development of cutaneous mycoses. In addition casuistic evidence for the various types disease, is compiled and discussed.