Treatment recalcitrant cases of tinea corporis/cruris caused by T. mentagrophytes - interdigitale complex with mutations in ERG11 ERG 3, ERG4, MDR1 MFS genes & SQLE and their potential implications.

BACKGROUND: Recalcitrant dermatophyte infections are being reported from various parts of the world due to varied causes including strain variation, steroid misuse, SQLE mutations, and variable quality of itraconazole pellet formulations. The oral drug preferred in endemic areas is itraconazole, to which MIC levels remain low, and clinical failures to itraconazole reported defy a sound scientific explanation. OBJECTIVES: The objective of the study was to conduct a proteomic and genomic analysis on isolates from therapeutically recalcitrant case with isolation of gene mutations and enzymatic abnormalities to explain azole failures. METHODS: Trichophyton mentagrophyte interdigitale complex strains were isolated from seven clinically non-responding tinea corporis/cruris patients, who had failed a sequential course of 6 weeks of terbinafine 250 mg QD and itraconazole 100 mg BID. After AFST 1 strain, KA01 with high MIC to most drugs was characterized using whole genome sequencing, comparative proteomic profiling, and total sterol quantification. RESULTS: Sterol quantification showed that the standard strain of Trichophyton mentagrophytes (MTCC-7687) had half the ergosterol content than the resistant KA01 strain. Genomic analysis revealed mutations in SQLE, ERG4, ERG11, MDR1, MFS genes, and a novel ERG3 mutation. Proteomic analysis established the aberrant expression of acetyl Co-A transferase in the resistant strain and upregulation of thioredoxin reductase and peroxiredoxin. CONCLUSION: Our findings demonstrate possible reasons for multidrug resistance in the prevalent strain with mutations in genes that predict terbinafine (SQLE) and azole actions (ERG4, ERG11, ERG3) apart from efflux pumps (MDR1, MFS) that can explain multidrug clinical failures.

Skin disease in goats (Capra aegagrus hircus): a retrospective study of 358 cases at a university veterinary teaching hospital (1988-2020).

BACKGROUND: Goats are important worldwide as a source of milk, meat, fibre and hide, and as show animals and pets. HYPOTHESIS/OBJECTIVES: To document the type, signalment associations and prevalence of skin disease in a referral hospital population. ANIMALS: Case population at a university veterinary teaching hospital. METHODS AND MATERIALS: Retrospective study by searching computerised medical records of goats seen between 1 January 1988 and 1 January 2021. Key words employed were "alopecia, caseous lymphadenitis, Chorioptes, dermatitis, dermatophyte, dermatophytosis, goat, lice, louse, mange, mite, pemphigus foliaceus, Psoroptes, ringworm, seborrhea, skin" RESULTS: Of 1,488 records reviewed, 358 (24%) goats had skin disease recorded. Seventy-nine (22.1%) of 358 goats presented primarily for skin disease. The Nigerian Dwarf goat breed was at higher risk of developing skin disease (P < 0.0002). As goats aged, the odds for developing skin disease was higher [odds ratio (OR) = 1.07 per year, 95% confidence interval (1.04, 1.12)] as was the predilection for malignant skin tumours (P < 0.001). Sex was not associated with skin disease (P = 0.98). The most common clinical sign was exfoliative dermatitis, noted in 94 (26.4%) of 358 goats. The most common diagnoses were pediculosis, bacterial skin disease and squamous cell carcinoma. Less frequent diagnoses were Chorioptes spp. infestation, contagious ecthyma (orf), coronitis/interdigital dermatitis, demodicosis, dermatophytosis, Psoroptes spp. infestation, dermatophilosis and pemphigus foliaceus. CONCLUSIONS AND CLINICAL IMPORTANCE: Skin diseases are common in goats. Nigerian Dwarf goats and older goats are at greater risk of developing skin disease; Nigerian Dwarf goats had a predilection for malignant skin tumours. Clinicians should include a dermatological examination in goats regardless of the reason for presentation.

Dermatomicosis superficiales: cuando el diagnóstico lo entrega la histología / Superficial dermatomycosis: when the diagnosis is provided by histology

Superficial dermatomycosis are prevalent pathologies in the medical field and their diagnosis is fundamentally clinical. Histopathology is not considered part of his study, however, the diagnosis is exceptionally obtained by biopsy, when dermatomycosis was not suspected. Unpublished retrospective work is carried out on patients who had the histopathological diagnosis of superficial dermatomycosis between the years 2000-2019 at the HCUCH, based on selection criteria, obtaining 19 patients, in which the following were analyzed: age, gender, clinical characteristics, location, presumptive diagnosis and mycological and histological examinations. He stressed, as was our hypothesis, that dermatomycosis was not clinically suspected, since the presumptive diagnoses were various dermatoses. The most suspected dermatosis was psoriasis, as a result that 57.8% of the dermatoses studied had erythematous scaly plaques on examination. Another relevant fact is that only 21% of the cases underwent a direct mycological prior to the biopsy, which was negative ('' false negative''). It is concluded, then, that superficial dermatomycosis should be considered clinical simulators of other dermatoses, so clinical suspicion and support of mycological examination and fungal culture is essential. (AU)

Occurrence of dermatophytoses in patients from the Sistema Único de Saúde.

BACKGROUND: Dermatophytosis is a cutaneous disease caused by filamentous keratinophilic fungi belonging to the genera Trichophyton, Microsporum and Epidermophyton, which present a high prevalence in the general population, being among the most common mycoses affecting about 20% of the world's population. OBJECTIVE: To carry out the epidemiological survey of cases of dermatophytosis in patients from the Sistema Único de Saúde in a regional Laboratory in the period of 5 years (2009 to 2013). METHODS: A retrospective study (January 2009 to December 2013) was carried out with a qualitative and quantitative design, through the registry book of the laboratory, Mycology Sector, where cases of patients with suspected dermatomycosis were analyzed. RESULTS: In a 5-year period, a total of 4467 cases were suspected of having a fungal infection. Of these, 68.74% (3071) cases were of dermatomycosis. In relation to cultures with fungal growth, 12.54% (385 cases) were dermatophyte fungi and 7.97% (245 cases) non-dermatophyte fungi were isolated. Among the species identified, there was a higher prevalence of T. rubrum complex (75%), T. mentagrophytes complex (11.68%) and M. canis (7.01%). Regarding the sites analyzed, nail involvement was the most frequent in 75% of the cases. STUDY LIMITATIONS: This work is representative in the studied region. CONCLUSIONS: Dermatomycosis samples are the most frequent among all samples of fungal infections from these patients, with the nail being the most affected area and the fungi T. rubrum complex and T. mentagrophytes complex the most frequent.

Brote de tiña por Trichophyton tonsurans en una escuela básica de Valparaíso, Chile / Ringworm of Trichophyton tonsurans outbreak in a basic school in Valparaíso, Chile

Resumen Introducción: Las tiñas son infecciones que afectan la piel y anexos. Trichophyton tonsurans es un hongo antropofílico emergente que puede provocar brotes. Objetivo: Describir un brote de tiña por T. tonsurans en una escuela de Valparaíso. Materiales y Método: Estudio descriptivo realizado entre junio-agosto de 2018. Se consideró caso a todo alumno de la escuela y a familiares directos en contacto con ellos, con diagnóstico clínico de tiña. El estudio micológico de las muestras tomadas se realizó a través de pruebas morfo-fisiológicas. Los datos se expresaron en números y porcentajes. Resultados: Hubo 18 casos, 16 niños (15 del kindergarten) y dos adultos. Tasa de ataque en kindergarten fue de 68%. Nueve casos fueron varones con promedio de edad de 6 años. Catorce de nacionalidad chilena y una haitiana. El caso índice fue un niño chileno y el primario el niño haitiano. La localización más frecuente fue en el rostro. Diez casos tuvieron cultivo con desarrollo de T. tonsurans. La mayoría requirió tratamiento con terbinafina por fracaso terapéutico con clotrimazol. Conclusiones: El brote por T. tonsurans ocurrió principalmente en varones del kindergarten. La principal localización fue en el rostro. La mayoría de los casos requirió terbinafina como tratamiento por fracaso terapéutico con clotrimazol.

Background: Ringworm are skin and its annexes infections. Trichophyton tonsurans is an emergent anthropophilic fungus that might cause outbreaks. Aim: To describe a ringworm outbreak by T tonsurans in an elementary school in Valparaíso, Chile. Methods: A descriptive study was run between June and August, 2018. Students and his closest relatives in contact with them who were clinically diagnosed with ringworm have been considered a case. Mycological studies of samples had been carried out through morphophysiology tests. Data are shown in numbers and percentages. Results: There were 18 cases, 16 kids (15 from kindergarten) and 2 adults. Attack rate was 68% in kindergarten. Nine cases were boys with average age of 6 years old. For 14 cases their nationality was Chilean and in 1 case Haitian. First case was a Chilean boy, and primary case was a Haitian boy. The most frequent location was face. Ten cases yielded positive cultures for T tonsurans. Most of the patients needed terbinafine treatment after a therapeutic failure performed with clotrimazole. Conclusion: T. tonsurans outbreak ocurred mainly in kindergarten male. The most frequent location was face. Most of the patients needed terbinafine treatment after a therapeutic failure with clotrimazole.

Occurrence of dermatophytoses in patients from the Sistema Único de Saúde

Abstract: Background: Dermatophytosis is a cutaneous disease caused by filamentous keratinophilic fungi belonging to the genera Trichophyton, Microsporum and Epidermophyton, which present a high prevalence in the general population, being among the most common mycoses affecting about 20% of the world's population. Objective: To carry out the epidemiological survey of cases of dermatophytosis in patients from the Sistema Único de Saúde in a regional Laboratory in the period of 5 years (2009 to 2013). Methods: A retrospective study (January 2009 to December 2013) was carried out with a qualitative and quantitative design, through the registry book of the laboratory, Mycology Sector, where cases of patients with suspected dermatomycosis were analyzed. Results: In a 5-year period, a total of 4467 cases were suspected of having a fungal infection. Of these, 68.74% (3071) cases were of dermatomycosis. In relation to cultures with fungal growth, 12.54% (385 cases) were dermatophyte fungi and 7.97% (245 cases) non-dermatophyte fungi were isolated. Among the species identified, there was a higher prevalence of T. rubrum complex (75%), T. mentagrophytes complex (11.68%) and M. canis (7.01%). Regarding the sites analyzed, nail involvement was the most frequent in 75% of the cases. Study Limitations: This work is representative in the studied region. Conclusions: Dermatomycosis samples are the most frequent among all samples of fungal infections from these patients, with the nail being the most affected area and the fungi T. rubrum complex and T. mentagrophytes complex the most frequent.

Severe dermatophytosis in solid organ transplant recipients: A French retrospective series and literature review.

OBJECTIVE: Severe dermatophytosis is described in immunocompromised patients with defective cellular immunity. We report here a large series and a literature review of severe dermatophytosis in solid-organ transplant (SOT) recipients. METHOD: The data main source was a national French retrospective study of severe dermatophytosis in SOT recipients between 2010 and 2016. Inclusion criteria were the presence of dermatophytes in skin culture and 1 severity criteria: dermal invasion by dermatophytes (invasive dermatophytosis) or involvement of at least two body sites or >10% of body surface area (extensive dermatophytosis). RESULTS: A total of 12 patients were included (8 men, median age of 56 years [range: 33-71]). Of the 12 patients, 10 underwent kidney transplantation. The median time from transplantation to severe dermatophytosis diagnosis was 16 months [range: 2-94]. Clinical signs of superficial dermatophytosis were present in 8/12 patients before the emergence of severe dermatophytosis. Nine patients had invasive forms and three extensive ones, and nodules of the lower extremities were found in eight. Trichophyton rubrum was isolated in 11 cases. First-line treatment was terbinafine (7/12), posaconazole (3/12), or topical treatment alone (2/12). Immunosuppressive therapy was reduced in 3 patients because of associated infections. Complete response was obtained for 3/3 and 5/9 patients with extensive or invasive forms, respectively, after a median treatment's duration of 2.5 [range: 1.5-5] months and 7.5 months [range: 4-12]. Unrelated deaths (n = 2) and graft function impairment (n = 3) occurred. CONCLUSION: Severe dermatophytosis is a late complication in SOT recipients presenting with lower limb nodules, which might be prevented by prompt treatment of superficial dermatophytosis.

Frecuencia de Epidermophyton floccosum en dermatofitos aislados en un laboratorio de la Región de Valparaíso, Chile. Período 1980-2010 / Frequency of Epidermophyton floccosum in isolated dermatophytea laboratory from the Region of Valparaiso, Chile. Time frame: 1990-2010

Resumen Introducción: Las dermatofitosis son infecciones comunes en humanos, provocadas por hongos de los géneros Trichophyton, Microsporum y Epidermophyton. Objetivo: Determinar la frecuencia de E. floccosum en dermatofitos aislados en un laboratorio de la Región de Valparaíso durante las últimas tres décadas. Conocer las localizaciones más frecuentes, los grupos etarios y sexo de los pacientes afectados por este agente. Materiales y Método: Se revisaron los informes de cultivos superficiales con desarrollo de E. floccosum, Microsporum spp y Trichophyton spp de las tres últimas décadas del laboratorio de Micología de la Universidad de Valparaíso. Se registró en una planilla Excel el resultado del cultivo, edad, sexo y ubicación de la lesión de los pacientes. Resultados: El total de dermatofitosis con agente identificado fue de 6.780. En 26 casos hubo desarrollo de E. floccosum, de éstos, 73% (19/26) fueron en hombres y con una edad promedio de 37 años. La frecuencia disminuyó progresivamente desde la década de los ochenta hasta la del 2000. El grupo etario más afectados fue el de 36-60 años. Las localizaciones más frecuentemente afectadas fueron la planta y uñas de los pies. Conclusiones: Existe una disminución progresiva de la frecuencia de aislamiento de E. floccosum en el período estudiado. El sexo masculino y el grupo etario de 36-60 años fueron los más afectados. Las localizaciones más frecuentes fueron la planta y uñas de los pies.

Background: Dermatophytoses are frequent infections in human, which are produced by fungus genera Trichophyton, Microsporum and Epidermophyton. Aim: To determine frequency of E. floccosum in isolated dermatophyte in a laboratory from Valparaíso during the last three decades, in addition to knowing the most frequent localization, age and gender of patients affected by this agent. Method: All superficial culture reports, issued by the Universidad de Valparaíso's mycology laboratory in the last three decades, with E. floccosum, Microsporum spp and Trichophyton spp development, has been reviewed. Patients age, gender, location of the injury and culture report has been registered in an excel spreadsheet. Results: The total number of reports with dermatophyte development in the culture was 6,780. Only 26 cases show E. floccosum development, 73% of this (19/26) were present on men with and average age of 37 years. Frequency did progressively fall since eighty's until 2000 decade. The age group most affected by this etiological agent was 30-36 years. The most frequently localization in both man and woman were foot plant and nails. Conclusions: Frequency of isolation did decrease progressively in dermatophytose by E. floccosum for the study period. Masculine gender and 36-60 age group were the most affected. The most frequently localization were foot plant and nails.

A Unique Clinicopathological Manifestation of Fungal Infection: A Case Series of Deep Dermatophytosis in Immunosuppressed Patients.

BACKGROUND: Dermatophytes are the most common cause of superficial fungal infections in humans. Deep dermatophytosis, however, is rare, described to date only in isolated case reports, usually in the setting of systemic immunosuppression. OBJECTIVE: To present the 15-year experience of a tertiary dermato-mycology clinic with the diagnosis and treatment of deep dermatophytosis. METHODS: Patients were identified by database search. Clinical, mycological, histological, and treatment data were collected from the medical files. RESULTS: Ten patients were identified: nine after solid-organ transplantation and one undergoing chemotherapy, all diagnosed within 3 years after beginning immunosuppression (average 7.5 months). The infective agent in nine cases was Trichophyton rubrum. All patients presented with concurrent superficial fungal infections. Complete resolution was noted in response to systemic antifungal agents. There was no histological evidence of hair-follicle involvement. LIMITATIONS: The limitations of the study were the retrospective design and the small cohort size. CONCLUSION: This case-series study suggests that deep dermatophytosis is a separate entity, distinct from Majocchi's granuloma. It occurs only in immunocompromised patients and is characterized by discrete nodules, an indolent course, the absence of follicular invasion, and proximity to a superficial dermatophyte infection. Systemic antifungal treatment leads to complete resolution. The urgent need for the treatment of superficial fungal infections in immunocompromised patients is emphasized.

[Etiology of intertrigo in adults: A prospective study of 103 cases]. / Les étiologies des intertrigos chez l'adulte : étude prospective de 103 cas.

INTRODUCTION: The etiologies of intertrigo in adults are numerous and different. The objective of our work was to study the epidemiological, clinical and the risk factors of intertrigo in adults. METHODS: We conducted a prospective study for a period of seven months in two Dermatology Units in Dakar (Senegal). All adults patient with intertrigo seen during this period who gave consent were included. RESULTS: One hundred and three patients with intertrigo were diagnosed with a hospital prevalence of 2.54%. The sex -ratio was 0.63 and the average age was 41. The study of habits and lifestyles of the patients found a history of intensive skin lightening, sport, wearing synthetic clothes and smoking in 26, 22, 20 and 22 cases, respectively. Infectious complications mainly bacterial (3.88%) and viral (1.94%) were reported in nine cases (8.7%). A dry erythroderma was noted in 3 cases (2.9%). It was found that the intertigo was commonly caused by fungal infections with a prevalence of 48.5% followed by immuno-allergic reactions with a prevalence of 34.9%, suppurative hidradenitis and inverse psoriasis with the same prevalence of 2.9%. Fifty-eight percent of cases with tinea and 63% of cases with candidiasis were women. Thirty-five percent of tinea cases and 45% of candidiasis cases were found to have a history of intensive skin lightening. CONCLUSION: The cause of intertrigo in adults are mainly infectious, particularly fungi, infections and immuno-allergic diseases. There are predisposing factors and some professions are more at risk.

Dermatofitos: casuística en la Sección de Micología del Laboratorio Central de Salud Pública, Asunción - Paraguay (2000 - 2016) / Dermatophytes: casuistry in the Mycology Section of the Central Public Health Laboratory, Asunción - Paraguay (2000 - 2016)

Introducción: los dermatofitos son las principales causas de micosis superficial. Su epidemiología es poco conocida en Paraguay. Objetivos: describir las especies prevalentes, tipos de tiñas y características según sexo y edad de pacientes que acudieron al Laboratorio Central de Salud Pública, Asunción- Paraguay,en el período 2000-2016. Materiales y Métodos: se estudiaron pacientes de todas las edades con diagnóstico de micosis superficiales. Las muestras procesadas fueron uñas, pelos y escamas epidérmicas Se realizaron exámenes directos con KOH y cultivos. La identificación fue por macro y microscopía de las colonias. Resultados: de 6.652 pacientes con sospecha de micosis superficiales, 803 (12%) fueron positivas para dermatofitos. Los aislamientos fueron Microsporumcanis (33,9%), Trichophytonrubrum (23,8%), Trichophytonmentagrophytes (22%), Trichophytontonsurans (12,6%), Microsporumgypseum (6,2%), Trichophytonverrucosum (1,4%), un aislamiento para Microsporummanuumy Epidermophytonfloccosum respectivamente. Los tipos de tiñas fueron: capitis (54,3%), corporis (27,1%) yunguium (9,8%), pedís (3,8%), cruris (3%) y manuum (2%). Conclusión: el hongo prevalente fue Microsporumcanis (33,9%) y la tiña más frecuente fue capitis.

Introduction: dermatophytes are the main causes of superficial mycosis. Its epidemiology is less known in Paraguay. Objectives: to describe the prevalent species, types of tinea and features according to sex and age of patients who attended the Central Laboratory of Public Health, Asunción-Paraguay, in the period 2000-2016. Materials and Methods: patients of all ages with a diagnosis of superficial mycosis were studied. The samples processed were nails, hairs and epidermal scales. Direct tests were carried out with KOH and cultures. The identification was by macro scopy and microscopy of the colonies. Results: of 6,652 patients with suspected superficial mycoses, 803 (12%) were positive for dermatophytes. The isolates were Microsporum canis (33.9%), Trichophyton rubrum (23.8%), Trichophyton mentagrophytes (22%), Trichophyton tonsurans (12.6%), Microsporum gypseum (6.2%), Trichophyton verrucosum (1,4%), isolation for Microsporum manuum and Epidermophyton floccosum respectively. The types of tinea were: capitis (54.3%), corporis (27.1%) and unguium (9.8%), pedis (3.8%), cruris (3%) and manuum (2%). Conclusion: The prevalent fungus was Microsporum canis (33.9%) and the most frequent tinea was capitis.

Dermatofitoses: agentes etiológicos, formas clínicas, terapêutica e novas perspectivas de tratamento / Dermatophytoses: etiologic agents, clinical forms, therapy and new perspectives of treatment

As dermatofitoses têm ocorrência mundial, sendo mais prevalentes em países de clima tropical e subtropical. Dados epidemiológicos indicam que essas micoses estão entre as infecções fúngicas de maior ocorrência. O quadro clínico mais comum de dermatofitose inclui despigmentação, placas anulares, prurido e perda de cabelo, com lesões tipicamente conhecidas como tineas, ocasionadas por fungos filamentosos dermatofíticos de três gêneros anamórficos: Microsporum, Trichophyton e Epidermophyton. O tratamento das dermatofitoses, em geral, está relacionado ao uso de antifúngicos tópicos e/ou sistêmicos, apresentando como problemática o surgimento de espécies multirresistentes. Esta revisão aborda as dermatofitoses e seus agentes etiológicos de forma aprofundada em aspectos epidemiológicos, apresentando a importância clínica do tema, com ênfase na causa, prevenção, tratamento e prognóstico dessa micose cutânea (AU)

Dermatophytoses have worldwide occurrence with higher prevalence in tropical and subtropical countries. Epidemiological data show that these mycoses are among the most frequent fungal infections. The most common symptoms of dermatophytoses include depigmentation, annular plaques, itching and hair loss, with lesions such as tinea, caused by dermatophytic filamentous fungi of three anamorphic genera: Microsporum, Trichophyton and Epidermophyton. Topical and/or systemic antifungalmedications are used in the treatment of dermatophytoses in general, resulting in problems such as the emergence of multidrug-resistant species. This review discusses dermatophytoses and their etiological agents with a focus on epidemiological aspects, presenting the clinical importance of the issue, with emphasis on cause, prevention, treatment and prognosis of this skin mycosis (AU)

Micosis superficiales en pacientes del estado Anzoátegui, Venezuela, periodo 2002-2012 / Superficial mycoses in patients from Anzoátegui state, Venezuela, period 2002-2012

Las enfermedades fúngicas superficiales que afectan la piel y sus faneras son motivo de consultas en los servicios básicos de triaje y en dermatología. Se encuentran distribuidas en Venezuela con una incidencia de 92,9%. El objetivo del presente estudio fue conocer los géneros y especies que causan dermatomicosis en pacientes residentes del estado Anzoátegui, Venezuela, en el período 2002-2012. Se estudiaron 4257 pacientes con edades entre 7 meses y 79 años. La prevalencia general fue de 30,9%. Las más frecuentes fueron las dermatofitosis (44,7%). M. canis produjo 148 casos de tiña de la cabeza. Tres agentes dermatofiticos representaron el 95% de todos los casos, con predominio significativo de T. mentagrophytes representado por un 50%. La candidosis se presentó en 28,4%. C. albicans, y el complejo C. parapsilosis, fueron responsables del 80% de los casos. Otras especies identificadas fueron C. tropicalis (n = 41; 11,0%), C. glabrata (n = 10; 2,7%), C. guilliermondii (n = 6; 1,6%), C. krusei (n = 4; 1,1%). Pitiriasis versicolor se presentó en (22,4%), y en menor frecuencia la onicomicosis por mohos no dermatofitos, dominando Fusarium oxysporum (n = 34; 65,4%), Aspergillus terreus (n = 16; 30,8%) y Scytalidium dimidiatum (2; 3,8%). Raros casos de onicomicosis por Trichosporon (0,5%) y un caso de tinea negra. Estos resultados revelan una alta frecuencia de las micosis superficiales con predominio de las dermatofitosis indicando la existencia de un problema de salud pública.

Superficial fungal diseases that affect the skin and its appendages are frequently seen in basic triage and in dermatology services. These diseases are distributed in Venezuela with an incidence of 92.9%. The aim of this study was to determine the genera and species that cause dermatomycoses in residents of Anzoátegui state, Venezuela, during the period 2002-2012. A total of 4257 patients with a presumptive diagnosis of superficial mycoses were studied, with ages from 7 months to 79 years. The overall prevalence was 30.9%. The most frequent were dermatophytosis (44.7%). M. canis produced 148 cases of tinea capitis. Three dermatophytic agents represented 95% of all cases, with a significant predominance of T. mentagrophytes with 50%. Candidosis occurred in 28.4%. C. albicans, and the C. parapsilosis complex, were responsible for 80% of the cases. The other species identified were C. tropicalis (n = 41, 11.0%), C. glabrata (n = 10, 2.7%), C. guilliermondii (n = 6, 1.6%), C. krusei (n = 4, 1.1%). Pityriasis versicolor occurred in 22.4% of the cases studied, and less frequently were present onychomycosis produced by a non dermatophytic mold: Fusarium oxysporum (n = 34, 65.4%), Aspergillus terreus (n=16, 30.8%) and Scytalidium dimidiatum (n=2; 3.8%). Rare cases of Trichosporon onychomycosis (0.5%) and one case of black tinea were also found. Health education in the population is recommended to promote measures to prevent transmission of these fungi and prevent the spread of this silent public health problem.

Clinical, epidemiological, and therapeutic profile of dermatophytosis

BACKGROUND: The cutaneous mycoses, mainly caused by dermatophyte fungi, are among the most common fungal infections worldwide. It is estimated that 10% to 15% of the population will be infected by a dermatophyte at some point in their lives, thus making this a group of diseases with great public health importance. OBJECTIVE: To analyze the clinical, epidemiological, and therapeutic profile of dermatophytosis in patients enrolled at the Dermatology service of Universidade do Estado do Pará, Brazil, from July 2010 to September 2012. METHOD: A total of 145 medical records of patients diagnosed with dermatophytosis were surveyed. Data were collected and subsequently recorded according to a protocol developed by the researchers. This protocol consisted of information regarding epidemiological and clinical aspects of the disease and the therapy employed. RESULTS: The main clinical form of dermatophyte infection was onychomycosis, followed by tinea corporis, tinea pedis, and tinea capitis. Furthermore, the female population and the age group of 51 to 60 years were the most affected. Regarding therapy, there was a preference for treatments that combine topical and systemic drugs, and the most widely used drugs were fluconazole (systemic) and ciclopirox olamine (topical). CONCLUSION: This study showed the importance of recurrent analysis of the epidemiological profile of dermatophytosis to enable correct therapeutic and preventive management of these conditions, which have significant clinical consequences, with chronic, difficult-totreat lesions that can decrease patient quality of life and cause disfigurement. .

Anti dermatophytic therapy: prospects for the discovery of new drugs from natural products

Millions of people and animals suffer from superficial infections caused by a group of highly specialized filamentous fungi, the dermatophytes, which only infect keratinized structures. With the appearance of AIDS, the incidence of dermatophytosis has increased. Current drug therapy used for these infections is often toxic, long-term, and expensive and has limited effectiveness; therefore, the discovery of new anti dermatophytic compounds is a necessity. Natural products have been the most productive source for new drug development. This paper provides a brief review of the current literature regarding the presence of dermatophytes in immunocompromised patients, drug resistance to conventional treatments and new anti dermatophytic treatments.

Dermatophytosis diagnosed at the Evandro Chagas Institute, Pará, Brazil

Dermatophytosis is caused by a dermatophyte fungus that affects the stratum corneum and keratinized tissue. Dermatophyte fungus has been reported worldwide as the causative agent of dermatophytosis, but the etio-epidemiological aspects of these mycoses in the state of Pará remain unknown. The purpose of this study was to describe the etio-epidemiological profile of dermatophytosis diagnosed in patients at the Evandro Chagas Institute from May 2005 to June 2006. A total of 494 patients were admitted, and their samples were collected, submitted for direct microscopic examination using 20% KOH and cultured in Sabouraud and Mycosel medium. The identification was based in macro and microscopic characteristics. Direct examinations were positive in 13% (66/494) of the patients, and agent isolation by cultivation of the biological sample was successful in 4% (20/494), with a high prevalence of T. mentagrophytes (40%; 8/20). Dermatophytosis was more frequent in women (58%; 38/66). Fifty-two percent (21/38) of the cases were children with an average age of 8 years. The most frequent clinical presentation was Tinea corporis (55%, 36/66). For the cases in which the dermatophyte agent was not isolated, we discuss the factors that may be interfering with isolation. Tinea corporis occurred more frequently observed when T. mentagrophytes and T. rubrum were the major etiologic agents.

Epidemiologia e etiologia das dermatofitoses em Pernambuco 2005-2010 / Epidemiology and etiology of the dermatophytosis in Pernambuco, 2005-2010

A presente pesquisa teve como objetivos detectar, isolar e identificar espéciesdermatófitos em amostras de pele, pêlos e unhas de 5.590 pacientes oriundos de hospitais públicos de Pernambuco. Os resultados apontaram o Trichophyton rubrum como a espécie de dermatófito mais incidente. O gênero masculino e faixa etária entre 0-20 anos prevaleceram...

Screening examination and treatment of Trichophyton tonsurans infection in judo athletes affiliated with the University Judo Federation of Tokyo.

In Japan, Trichophyton tonsurans infection has become an increasing problem among combat sports participants. We investigated the prevalence of T. tonsurans infection in athletes affiliated to judo clubs in the 21 First Division universities that were registered with the University Judo Federation of Tokyo in 2008. Study procedures performed by the subjects included (i) completion of a questionnaire concerning lifestyle, risk factors for tinea corporis and medical history; (ii) scrubbing the scalp with a circular hairbrush to obtain samples for fungal culture; (iii) anti-fungal treatment as recommended by a dermatologist, based on the number of fungal colonies isolated from the hairbrush; and (iv) repeat testing using the hairbrush method 3 months after treatment recommendations were received. Of 902 study subjects, 102 (11.3%) yielded positive hairbrush culture results. Of these, 14 individuals (13.7%) had tinea corporis; the remainder were asymptomatic. Conversion to negative fungal culture was observed in 85 of 96 culture-positive individuals who performed the second hairbrush culture test following treatment. Control of T. tonsurans infection among judo athletes could be achieved by educating athletes, trainers and coaches in judo clubs concerning detection, prevention, and treatment of T. tonsurans infection.