Tinea nigra: rare and almost never remembered superficial mycosis

Tinea nigra is a chronic fungal infection of the stratum corneum caused by the fungus Hortaea werneckii, clinically manifested by asymptomatic and hyperchromic macules ranging in color from light brown to black and affecting mainly the palmar and plantar areas. must be differentiated mainly from acral melanoma. It occurs mainly in South America (Brazil, Colombia, Venezuela), Central America and the Caribbean (Panama, Cuba), Asia (India, Japan, Sri Lanka) and the coastal regions of Africa and is uncommon in Europe, correlated with travel and immigration intercontinental. In relation to Brazil in the period 1916-2020, 203 cases were reported. We present a case of palmar tinea nigra in an adult patient with 3 months of evolution, diagnosed through clinical examination, direct mycological examination, Sabouraud agar culture, and dermatoscopy of the lesion was also performed. who fully responded to topical therapy with miconazole.

Incidence of Hortaea werneckii in a tertiary care centre in Maharashtra

Background: Hortaea werneckii, a melanized yeast-like fungus is the cause of Tinea nigra, a superficial dermatomycosis. The lesions are differential diagnosis of melanocytic lesions. Tinea nigra mainly affects people in the temperate or subtropical climates with well-demarcated, expanding, hyperchromic plaques on the palms or soles. Methods: Skin scrapings from various lesions with suspected fungal aetiology were received after clinical assessment and were subjected to laboratory procedures, including direct KOH (10%) analysis, culture on Sabouraud dextrose agar (SDA), and incubation at 25°C and 37°C for 28 days which was further confirmed by lactophenol cotton blue preparation and slide culture. Results: Out of 295 samples examined, a total number of 15 samples were positive for Hortaea werneckii in the time period of 1st January 2023 to 31st December 2023. 7 patients had lesions on both palmar as well as plantar region (46.66%), 3 on palmar and plantar region each (20%), 1 (6.66%) on scalp and 1 (6.66%) on face and scalp. The skin scrapings were taken and examined in 10% KOH wet mount which showed positivity of 11 (73.33%) samples. The primary isolation of the fungus was done on SDA. Conclusions: Hortaea werneckii is the most common cause of Tinea nigra. Pigmented patches of Tinea nigra may be confused with other inflammatory or neoplastic aetiology. For Tinea nigra, skin scrapings are sufficient for diagnosis by KOH mount and culture on SDA. Generally, the lesions resolve within 2 weeks of adequate treatment. To conclude, a high suspicion should be maintained to timely diagnose the disease, avoid unnecessary invasive investigation and early administration of treatment.

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.

Drug utilization pattern evaluation and cost variation analysis of anti-fungal agents in tinea infected patients in dermatology department of a tertiary care teaching hospital

Background: Tinea infections are chronic superficial fungal infections, highly prevalent in tropical countries like India. Therefore, long-term therapy is needed and this can inflict a financial burden on the patients. Aim of the study was to assess drug utilization patterns in patients diagnosed with tinea infection and to evaluate the cost variability of anti-fungal agents. Methods: A cross-sectional observational study was conducted in patients for 3 months after taking permission from IEC. All adult patients already diagnosed with tinea infection were enrolled. Evaluation of drug utilization pattern was carried out using WHO core drug prescribing indicators and percentage of cost variability was calculated between different brands of anti-fungal agents. Results: A total of 252 patients were enrolled. Tinea corporis and cruris were the most commonly diagnosed tinea infection. Pruritus was the most common presenting symptom. Past history of similar illness was seen in 74 (29.4%) patients mean of 3.83±0.87 drugs were prescribed per patient. Drugs prescribed from NLEM was only 42.1%. Most commonly prescribed drugs were oral itraconazole and topical miconazole. Percentage of cost variability was seen maximum with capsule itraconazole 200 mg (237.5%) by oral route and luliconazole 30 gm (175.6%) by topical route. Conclusions: Prescribing practices of drugs can be improved by promoting generic drug and prescribing drugs from NLEM. Wide range of cost variation can lead to high economic burden in tinea infected patients.

Progress in the diagnosis and treatment of superficial cutaneous fungal infections in children / 中华实用儿科临床杂志

Superficial cutaneous fungal infections are caused by fungi infections that only invade fully keratinized tissues, such as the stratum corneum, hair, and nails.In clinical practice, tinea capitis is the most prevalent superficial cutaneous fungal infections in children, whereas the incidence of tinea corporis/cruris, tinea manuum/pedis, onychomycosis, and pityriasis versicolor is relatively low.This article aims to comprehensively discuss the clinical manifestations, diagnosis, and advancements in the treatment of superficial cutaneous fungal infections in children, focusing on each specific infection individually.

Tinea corporis intrafamilial infection in pets due to Microsporum canis

ABSTRACT Microsporum canis, one of the most widespread dermatophytes worldwide, is a zoonotic microorganism that transmits infection from reservoirs such as cats and dogs to humans. This microorganism is associated with Tinea corporis and other clinical manifestations; however, few studies have used genetic surveillance to determine and characterize the process of zoonotic transmission. In this study, we show a clear example of zoonotic transmission from a cat to an intrafamilial environment, where it caused Tinea corporis by infection with M. canis. Molecular characterization using the b-tubulin gene and Random Amplified Polymorphic DNA analysis made it possible to determine that the six isolates of M. canis obtained in this study belonged to the same genetic variant or clone responsible for reservoir-reservoir or reservoir-human transmission.

Efficacy and safety of SilverNovaTM skin cream as adjuvant to oral and topical antifungals in treatment of fungal skin infections

Background: To evaluate the efficacy and safety of SilverNovaTM skin cream, composed of SilverSol® (a patented colloidal nano silver technology from American Biotech Labs, USA) with other skin rejuvenators (coconut oil, vitamin E, and hyaluronic acid), as an adjuvant to topical and oral antifungals in the treatment of fungal skin infections like tinea and intertrigo. Methods: This prospective clinical study enrolled 80 patients with tinea corporis, tinea cruris, tinea manus, tinea pedis infections, and intertrigo. The patients were randomized to receive either SilverNovaTM skin cream and clotrimazole cream (n=40) or clotrimazole cream (n=40) alone applied topically as an adjuvant to oral antifungal therapy for 14 days. The primary endpoints were the reduction of clinical signs and symptoms of the infection at the end of the treatment and the proportion of patients with therapeutic cures. Results: SilverNovaTM skin cream exhibited better efficacy and safety than clotrimazole cream, though without reaching clinical significance at the end of the treatment. On the 14th day, there was an improvement in clinical signs and symptoms of fissuring/cracking, erythema, maceration, scaling, pruritus, and burning/stinging from baseline in patients with tinea infections, and intertrigo in both the treatment groups. A higher proportion of patients reported therapeutic cures at the end of the treatment, numerically better with SilverNovaTM skin cream group. No drug-related adverse events occurred. Conclusions: SilverNovaTM skin cream is effective and well tolerated as an adjuvant to topical and oral antifungals for the treatment of fungal skin infections like tinea and intertrigo.

KAP survey in patients of dermatophytosis in a tertiary care hospital: a cross-sectional study

Background: Dermatophytes are a group of fungi with the capacity to invade keratinized tissue. Along with etiological factors, the clinical and epidemiological patterns has shown changing trend, leading to epidemic state of dermatophytosis. This could be attributed to inadequate knowledge and substandard practices followed by patients of dermatophytosis. Methods: A cross-sectional observational survey of patients with dermatophytosis who visited the outpatient department of dermatology at a tertiary healthcare facility over a period of two months to assess knowledge, attitude and practices regarding dermatophytosis management was performed. Results: A total of two hundred and twenty-seven (227) patients were recruited in during 2-month study period. The male:female ratio was 0.82:1. Fifty two percent respondents were from a rural background. Fifteen percent of respondents had cattles as pets. Majority of the respondents preferred wearing loose clothes (79%), 89% wore cotton as the material of cloth and 35% preferred wearing closed footwear. Seventy two percent were unaware of the infective nature of disease and 84% of the treatment of this condition 11.45% were hesitant to take oral treatment for the same. More than half of the patients gave a history of self-medication, and 27% of the patients gave a history of receiving steroid injections. Conclusions: This study concluded that there is an extensive knowledge gap in this subset of the population, which lead to faulty and substandard practices, such as self-treating, steroid abuse and visiting quacks before considering registered dermatologists for treatment purposes.

Imunoterapia de dessensibilização para Malassezia spp. - Relato de caso experimental / Desensitization immunotherapy for Malassezia spp: experimental case report

A pitiríase versicolor (PV) consiste em uma infecção fúngica ocasionada por leveduras de Malassezia spp., que apesar de manejo simples, é uma doença com elevadas chances de recidiva e cronificação, além da pouca variedade de terapias efetivas para tratar cepas resistentes. Existem relatos na literatura sobre utilização de dessensibilização para Malassezia spp., mas para o tratamento de dermatite atópica e não PV, conferindo caráter inovador ao relato em questão. O caso apresentado consiste em um paciente de 28 anos, do sexo masculino, com manifestações típicas de PV em região de face, cervical, dorsal e axilar, há 4 anos, com resistência aos esquemas terapêuticos tópicos e sistêmicos. Uma vez identificada a ineficácia das terapias tradicionais, foi iniciado o tratamento com dessensiblização para Malassezia spp., em aplicações semanais, com aumento progressivo da dosagem e posterior aumento no intervalo das aplicações. Após onze meses de realização do novo tratamento, o paciente evoluiu com melhora completa das lesões. Conclui-se que a utilização de técnicas imunoterápicas para o tratamento de PV foi considerado eficaz no caso relatado, apesar de ainda não haver evidências que amparem sua utilização em maior escala.

Pityriasis versicolor is a infection caused by Malassezia yeast species, which, despite simple management, involves a high risk of recurrence and chronicity, and there are few effective therapies for resistant strains. Desensitization for Malassezia spp. has been reported in the literature, but for atopic dermatitis, rather than pityriasis versicolor, making this an innovative report. The case presented herein is of a 28-year-old man who had typical manifestations of pityriasis versicolor in the face, cervical, dorsal, and axillary region for 4 years that were resistant to topical and systemic therapies. Once the ineffectiveness of traditional therapies had been determined, weekly Malassezia desensitization sessions were begun, progressively increasing first in dosage and then in frequency. After 11 months, the lesions had improved completely. In this case, immunotherapeutic techniques effectively treated pityriasis versicolor, although the evidence is as yet insufficient to support large-scale use.

Querión Celso, dermatofitosis del cuero cabelludo infantil / Kerion Celsi, dermatophytosis of the scalp in young boy

Resumen Querión Celso es una micosis ocasionada por hongos dermatofitos que daña el cuero cabelludo principalmente a niños y en raras ocasiones a adultos. La forma de infección para los humanos proviene de los animales y del suelo y se relaciona con mala higiene personal, hacinamiento en las viviendas, condiciones de subdesarrollo y pobreza. Se presenta un caso de un niño de 9 años con una úlcera de 7 cm de diámetro en el cuero cabelludo y en forma de placa circular que presentaba material purulento, pelo quebradizo y un área alopécica. Al inicio, se abordó de manera terapéutica como una infección bacteriana; posteriormente, se solicitó estudio micológico que evidenció una coinfección por el microorganismo Microsporum gypseum. Se le confirmó el diagnóstico de tiña capitis con afección inflamatoria y se le prescribió griseofulvina, lo que resultó en una curación completa.

Abstract Kerion Celsi is a mycosis caused by dermatophyte fungi that mostly affects children and rarely adults, causing damage to the scalp. The form of infection for humans comes from animals and the soil. The infection is related to poor personal hygiene, overcrowded homes, underdeveloped conditions, and poverty. A case of a 9-year-old boy with a 7cm diameter ulcer on the scalp and in the form of a circular plaque that presented purulent material, brittle hair and an alopecic area is presented. Initially it was therapeutically addressed as a bacterial infection, a mycological study was requested, which showed coinfection by the microorganism Microsporum gypseum, the diagnosis of tinea capitis with inflammatory condition was confirmed, and Griseofulvin was prescribed, resulting in complete cure.

Clinical types and fungal pathogens of children′s tinea capitis analysis of 542 cases in a tertiary first-class hospital of Wuhan / 中国热带医学

@#Abstract: Objective To investigate the clinical types of children's tinea capitis and the distribution of fungal pathogens in Wuhan from 2011 to 2020, and to provide scientific basis for the prevention, diagnosis and treatment of children's tinea capitis. Methods Laboratory data of children with tinea capitis in outpatient and inpatient department of dermatology in Wuhan No.1 Hospital from January 2011 to December 2020 were collected. A total of 542 cases of pediatric tinea capitis were included, with 239 male cases and 303 female cases. Microscopic examination of fungi and culture identification were performed on the affected skin lesions of the children. Chi-square test was used to analyze the differences in pathogen spectrum of children with different age groups and clinical type. Results Among the pediatric tinea capitis patients, the age group with the highest prevalence was preschool children（3 to <7 years old), accounting for 48.52%（263/542). The top three pathogenic fungi were Trichophytes violaceum（49.26%, 267/542), Microsporum canis（31.55%, 171/542) and Trichophyton mentagrophytes （9.96%, 54/542). Trichophyton violaceum was the main pathogen in all ages, followed by Microsporum canis. The infection rate of Microsporum canis in children over 7 years old was lower than that in children under 7 years old, and the infection rate of Trichophyton rubrum in infants was higher than that in other ages. The distribution of Trichophytes violaceum, Trichophyton mentagrophytes, Nannizzia gypseum and Microsporum ferrugineum was uniform in all age groups. Trichophytes violaceum and Trichophyton tousurans mainly caused black-dot ringworm, Microsporum canis mainly caused tinea alba, Trichophyton mentagrophytes,Nannizzia gypseum and Trichophytonrubrum mainly caused kerion. Except for Microsporum ferrugineum, the composition ratios of other fungi species showed statistically significant differences among different clinical types of tinea capitis（P<0.05). Conclusions Preschool children are the most commonly affected age group by pediatric tinea capitis, and black-dot ringworm caused by Trichophytes violaceum is the main clinical type. Analysis of the high-riskage group, pathogenic fungi and clinical types of tinea capitis in children can enhance the understanding of its epidemiological characteristics, which is helpful for early diagnosis and targeted standardized treatment of pediatric tinea capitis.

Comparison of oral terbinafine versus itraconazole in the treatment of tinea capitis in children / 中华皮肤科杂志

Objective:To compare the efficacy and safety of oral terbinafine versus itraconazole in the treatment of pediatric tinea capitis.Methods:From January 2021 to December 2021, a randomized clinical trial was conducted among 53 children with tinea capitis in Beijing Children′s Hospital. These patients were randomly divided into 2 groups by using a random number table: terbinafine group treated with oral terbinafine at different doses (weight <20 kg, dose: 62.5 mg/d; weight 20 - 40 kg, dose: 125 mg/d; weight >40 kg, dose: 250 mg/d), while itraconazole group treated with oral itraconazole at doses of 3 - 5 mg·kg -1·d -1. Statistical analysis was performed using the SPSS 23.0 software, and enumeration data were compared between groups by using chi-square test or Fisher′s exact test. Results:Totally, 27 patients were treated with oral terbinafine, including 17 with tinea alba and 10 with kerion; 26 were treated with oral itraconazole, including 17 with tinea alba and 9 with kerion. After treatment, 14 (51.85%) patients were cured in the terbinafine group, including 5 with tinea alba and 9 with kerion, while 25 (96.15%) were cured in the itraconazole group, including 16 with tinea alba and 9 with kerion. The response rate was significantly higher in the itraconazole group than in the terbinafine group ( χ2 = 13.37, P < 0.001) . Conclusion:The efficacy of itraconazole was superior to that of terbinafine in the treatment of pediatric tinea alba, but their efficacy was equivalent in the treatment of pediatric kerion.

Analysis of pathogenic fungi causing tinea capitis: a single-center retrospective study / 中华皮肤科杂志

Objective:To investigate the distribution of pathogenic fungi in patients with tinea capitis diagnosed in Xijing Hospital, Air Force Medical University in the past 10 years.Methods:A total of 871 outpatients or inpatients with tinea capitis were collected from the Department of Dermatology, Xijing Hospital from January 2011 to December 2020, and their clinical data and pathogen distribution were retrospectively analyzed. Pearson chi-square test was used to analyze differences in the pathogen distribution between children and adult patients with tinea capitis.Results:Of 871 patients with tinea capitis, 588 (67.5%) were males and 283 (33.5%) were females; 21 (2.40%) were aged less than 1 year, 266 (30.50%) aged 1 - 3 years, 352 (40.40%) aged 4 - 6 years, 187 (21.50%) aged 7 - 12 years, 4 (0.50%) aged 12 - 18 years, and 41 (4.70%) were aged 18 - 74 years. A total of 705 pathogenic strains were isolated from these patients, including 599 strains of Microsporum canis (85.0%) , 52 strains of Trichophyton mentagrophytes complex (7.4%) , 27 strains of Trichophyton tonsurans (3.8%) , and 18 strains of Trichophyton violaceum (2.6%) . Among the pathogenic fungi of tinea capitis, the proportion of Trichophyton violaceum was significantly higher in adults (8.8%) than in children (2.2%, P = 0.048) . Conclusions:In the past 10 years, the patients with tinea capitis in the Department of Dermatology, Xijing Hospital were mainly children aged 1 - 6 yearswhile adults, and adult patients with tinea capitis were uncommon. The main pathogen of tinea capitis was Microsporum canis, followed by Trichophyton mentagrophytes complex.

Uso da Curcuma longa associada à terapia fotodinâmica para o tratamento do Kerion Celsi / Photodynamic therapy with Curcuma longa for the treatment of Kerion celsi

O Kerion Celsi é uma forma inflamatória da tinea capitis, cujo principal agente etiológico é o Microsporum canis. O tratamento padrão-ouro é a griseofulvina, porém seu uso é aprovado pela Food and Drug Administration (FDA) em crianças a partir dos dois anos de idade. Apesar de rara em crianças com menos de três anos, a tinea capitis pode ocorrer, como é o caso desta criança de um ano de idade que foi submetida, com sucesso, à terapia fotodinâmica com curcumina e houve a remissão completa do quadro

Kerion Celsi is an inflammatory variant of tinea capitis and is usually caused by Microsporum canis. Griseofulvin is the gold standard treatment, but FDA approves its use only for children up to two years. Even though it is rare in children younger than three years, tinea capitis can still occur, as in the case of the one-year-old child who was successfully treated with photodynamic therapy combined with curcumin, resulting in total remission.

Brote de tinea capitis y otras micosis superficiales en una comunidad urbana de Medellín / Tinea capitis outbreak and other superficial mycosis in an urban community of Medellín

Introducción. Las dermatofitosis son infecciones fúngicas superficiales de epitelios queratinizados. La tinea capitis es una de ellas y afecta a poblaciones escolares vulnerables. Carpinelo es un barrio del área periférica de Medellín con precarias condiciones socioeconómicas. Ante la sospecha de un brote de dermatofitosis, los afectados fueron evaluados. Objetivo. Evaluar clínica y microbiológicamente pacientes del barrio Carpinelo con sospecha de micosis cutáneas para determinar la presencia de un brote por dermatofitos. Materiales y métodos. Se llevó a cabo un estudio descriptivo, de corte longitudinal, con muestreo a conveniencia. Se hizo una búsqueda activa de casos en el Jardín Educativo Buen Comienzo de Carpinelo en niños de la institución y sus familiares. Se evaluaron clínicamente y se tomaron muestras de escamas y cabellos para exámenes directos y cultivos microbiológicos. Se analizó el perfil demográfico, clínico y micológico, con el programa estadístico SPSS™, versión 25. Resultados. Se estudiaron 57 pacientes, 47 eran menores de edad con una media de edad de seis años; se observó una proporción de hombres y mujeres de 2:1. Los pacientes con resultados positivos se diagnosticaron con tinea capitis (78,95 %), tinea faciei (15,79 %) y tinea corporis (10,52 %). El 75,43 % de los pacientes recibió tratamiento previo y de estos el 69,73 % fue con esteroides. El examen directo fue positivo en el 53,84 % y los cultivos en el 46,5 % de los casos. Los agentes aislados fueron: Microsporum canis (77,77 %), Trichophyton spp. (11,11 %), Trichophyton rubrum (5,55 %) y Malassezia spp. (5,55 %). Conclusión. Tinea capitis fue la presentación clínica más común y M. canis el dermatofito más frecuentemente aislado. Llamó la atención el uso de esteroides como primera y única opción del tratamiento empírico' lo cual resalta la importancia del diagnóstico microbiológico para proporcionar la terapia apropiada.

Introduction. Dermatophytoses are superficial fungal infections of the keratinized epithelium like tinea capitis. The latte mainly affects school-vulnerable populations. Carpinelo is a peripheral neighborhood in Medellín with poor socioeconomic conditions and where a suspected tinea capitis outbreak took place. Objective. To study and characterize, clinically and microbiologically, patients with suspected dermatophytosis in Carpinelo. Materials and methods. We carried out a descriptive and longitudinal study with an active case search of tinea capitis in children and their relatives from the Jardín Educativo Buen Comienzo community in Carpinelo. Patients were clinically evaluated, and samples of scales and hair were taken to perform mycological studies with a 10 % potassium hydroxide and culture in Sabouraud and Mycosel agar. We analyzed the data with the statistical program SPSS™. 25 version. Results. Fifty-seven individuals were studied: 47 were children with a mean age of six years and a ratio of 2:1 male to female. Patients with confirmed diagnosis presented the following clinical forms: tinea capitis (78.95%), tinea faciei (15.79%) or tinea corporis (10.52%). Out of the total, 69.76% of the patients had previous treatment with steroids. The direct test was positive in 53.84% of the samples, and 46.15% had positive cultures. The isolated species were: Microsporum canis (77.77%), Trichophyton spp. (11.11%), Trichophyton rubrum (5.55%), and Malassezia spp. (5.55 %). Conclusion.Tinea capitis was the most common clinical form, and M. canis was the most frequently isolated species. The use of steroids as the first and only option for empiric treatment was worth of notice. The findings of this study point out the importance of microbiological diagnosis in choosing the best treatment for the patients.

Brote de tinea capitis tricofítica en un grupo de niños escolares en un área rural del departamento del Cauca, Colombia / An outbreak of trichophytic tinea capitis in a group of schoolchildren in a rural area of the department of Cauca, Colombia

Introducción. La tiña de la cabeza es una micosis que se presenta en el tejido queratinizado, afecta al cuero cabelludo y puede causar alopecia, prurito y descamación. Este tipo de micosis es más frecuente en niños de edad escolar, por lo que puede desencadenar un problema de salud pública. En Colombia, los principales agentes etiológicos reportados son los dermatofitos zoofílicos. Objetivo. En el presente estudio se buscó caracterizar un brote de tinea capitis en 32 niños de un colegio de la zona rural del departamento del Cauca. Materiales y métodos. Se llevó a cabo una investigación epidemiológica de campo en la que se aplicó una encuesta estructurada para caracterizar aspectos sociodemográficos y factores predisponentes para su ocurrencia. Se recolectaron muestras de escamas de cuero cabelludo y cabellos afectados para estudios micológicos. Finalmente, por medio de la Secretaría Departamental del Cauca y del hospital local, se manejó el brote de tinea capitis y se hicieron recomendaciones a los niños, los padres de familia y la población en general para prevenir estas micosis. Este estudio contó con el consentimiento informado verbal por parte de los padres de familia y los niños. Resultados. El agente etiológico aislado en el 63 % de las muestras recolectadas fue Trichophyton tonsurans y el principal factor predisponente para esta micosis fue compartir máquinas rasuradoras (87,5 %). El agente etiológico de este brote de tinea capitis no inflamatoria fue un dermatofito antropofílico. Conclusión. Idealmente, se deben practicar los estudios micológicos con el fin de establecer el agente etiológico y, así, plantear las terapéuticas y recomendaciones según las guías de manejo. Además, se debe realizar un trabajo multidisciplinario para el control del brote y la educación de la población respecto a esta micosis.

Introduction. Tinea capitis is a mycosis of keratinized tissue, which affects the scalp and may cause alopecia, pruritus, and desquamation. This type of mycosis is more frequent in school-age children, and it may represent a public health problem; the main etiological agents reported for Colombia are zoophilic dermatophytes. Objective. To characterize an outbreak of Tinea capitis in 32 children from a rural school in the department of Cauca. Materials and methods. We conducted an epidemiological field study using a structured survey to characterize sociodemographic aspects and predisposing factors for this mycosis. We collected samples of affected scalp scales and hair for mycological studies. The children and the general population received recommendations, about these mycoses' prevention, from Cauca's health authorities and the local hospital. The parents verbally approved the informed consent. Results. The etiological agent isolated in 63% of the collected samples was Trichophyton tonsurans, an anthropophilic dermatophyte, and the main predisposing factor was sharing razors (87.5%). Conclusions. Ideally, mycological studies define the etiological agent to propose therapeutics and recommendations in agreement with management guidelines. Implementation of multidisciplinary measures to control the outbreak and educate the population is required.

Tinea faciei por Trichophyton violaceum: primer caso alóctono reportado en Chile / Tinea faciei due to Trichophyton violaceum: first allochthonous case reported in Chile

Trichophyton violaceum es un dermatofito antropofílico endémico en África, Europa, Centroamérica y China. El incremento de los fenómenos de movilidad humana ha contribuido a su aparición en áreas no endémicas. Su principal manifestación clínica es la tinea capitis, seguida por la tinea corporis. En la población pediátrica afecta con mayor frecuencia el cuero cabelludo; y en adultos, la piel glabra. Presentamos el primer caso en Chile de tinea causada por T violaceum. Correspondió a una mujer chilena de 21 años que presentó placas faciales de un mes de evolución después de un viaje a Tanzania, África, sin respuesta a tratamientos médicos previos. Se sospechó una dermatofitosis alóctona y mediante cultivos especiales, se identificó una colonia de crecimiento lento, coloración violeta-negruzca, superficie cerosa y rugosa, con vellosidades aterciopeladas; compatible con T violaceum. Se confirmó mediante secuenciación de ADN ribosomal amplificando la región ITS. Se trató con terbinafina oral con respuesta clínica completa.

Trichophyton violaceum is an anthropophilic dermatophyte endemic in Africa, Europe, Central America and China. The increase in human mobility has recently contributed to the appearance in non-endemic areas. The main clinical manifestation is tinea capitis followed by tinea corporis. We present the first case in Chile of tinea caused by T violaceum. The case was a 21 year-old Chilean woman who presented asymptomatic facial plaques one month after arriving from Tanzania, Africa, with no clinical response to previous medical treatments. An allochthonous dermatophytosis was suspected and with special cultures, a slow-growing colony was identified with a violet-blackish color, waxy and rough surface, and velvety villi; all characteristics of T violaceum. The diagnosis was confirmed by ribosomal DNA sequencing amplifying the ITS region. She was treated with oral terbinafine obtaining a complete clinical response.

Kerion celsi caused by Trichophyton tonsurans in an adult

Abstract Tinea capitis is an uncommon infection in adults, and predominantly affects women and the elderly with hormonal disorders and immunosuppression. Clinical features are often polymorphic and atypical. A kerion celsi case in an elderly female patient with type 2 diabetes mellitus and menopause is presented. The diagnosis was established by direct examination and the isolation of Trichophyton tonsurans in culture and typified by microculture. Treatment with prednisone and itraconazol was very successful. Recognizing the presentation of tinea capitis in adults will help clinicians to avoid delay in the diagnosis, awareness of the risk factors and provide early treatment to minimize sequelae of the disease.

Trichophyton benhamiae, un dermatofito zoofílico emergente en Argentina con reservorio en cobayos: descripción de 7 casos en un hospital de la Ciudad Autónoma de Buenos Aires / Trichophyton benhamiae, an emergent zoonotic pathogen in Argentina associated with Guinea pigs: Description of 7 cases in Buenos Aires

Resumen Trichophyton benhamiae es un dermatofito zoofílico. Puede causar tinea corporis, tinea faciei y tinea capitis. Se caracteriza por producir lesiones inflamatorias, sobre todo en niños. El objetivo de esta publicación es describir 7 casos clínicos de pacientes pediátricos atendidos entre julio del 2019 y enero del 2020 en nuestra institución. A los pacientes se les solicitó estudio micológico convencional, con posterior confirmación con MALDI-TOF MS y secuencia-ción del ADN ribosomal. Se aisló e identificó T. benhamiae como agente etiológico; el nexo epidemiológico fue el contacto con cobayos. Estas son las primeras descripciones de infecciones causadas por T. benhamiae en Argentina. Al realizar estudios micológicos convencionales, este agente puede confundirse con otros dermatofitos, por lo tanto, se requieren herramientas como MALDI-TOF MS o la secuenciación para llegar a un diagnóstico definitivo. Es importante contar con datos epidemiológicos, como el contacto con mascotas no tradicionales, para una presunción diagnóstica adecuada.

Trichophyton benhamiae is a zoonotic dermatophyte that can cause tinea corporis, tinea faciei and tinea capitis, producing inflammatory lesions, especially in children. In this publication, we describe 7clinical cases of pediatric patients that occurred in our institution between July 2019 and January 2020. All patients underwent a conventional mycological study. The identification of fungi isolates was confirmed by MALDI-TOF MS and sequencing of the ribosomal DNA. T. benhamiae was identified as the etiological agent, whose epidemiological link in all cases was the contact with Guinea pigs. This is the first description of infections caused by T. benhamiae in Argentina. This dermatophyte can be misidentified as other more frequent dermatophytes when performing conventional studies. Molecular technology should be used to reach a definitive diagnosis. It is important to have epidemiological data from patients such as contact with non-traditional pets, especially Guinea pigs, for an adequate presumptive diagnosis of this dermatophytosis.

Tiña capitis por Trichophyton tonsurans en un paciente pediátrico / Tinea capitis by Trichophyton tonsurans in a pediatric patient

La tiña capitis (TC) es una micosis superficial del cuero cabelludo, considerada una de las infecciones más frecuentes por dermatofitos en niños. Hasta la actualidad, las especies descritas con mayor frecuencia en nuestro medio son el Microsporum y, en segundo término, Trichophyton, los cuales se contraen principalmente por contacto directo con animales o seres humanos infectados, respectivamente. Se presenta el caso de una paciente de 8 años con alopecia y lesiones inflamatorias de 2 años de evolución, en la que finalmente se llegó al diagnóstico de TC inflamatoria causada por T. tonsurans, un hongo antropofílico considerado poco frecuente en Argentina y emergente en la provincia de Buenos Aires. Este patógeno presenta alta transmisibilidad; son varios los países que han reportado brotes escolares y comunitarios. Se debe resaltar la importancia de su sospecha clínica temprana para un tratamiento adecuado.

Tinea capitis (TC) is a superficial mycosis of the scalp, considered one of the most common dermatophyte infections in children. Until now, the species mainly described in our environment are Microsporum and secondly Trichophyton, which are contracted mainly by direct contact with infected animals or humans, respectively. We present the case of an 8-year-old patient with alopecia and inflammatory lesions of 2 years of evolution, finally reaching the diagnosis of inflammatory tinea capitis caused by T. tonsurans, an anthropophilic fungus considered rare in Argentina and emerging in the province of Buenos Aires. This pathogen has high transmissibility; several countries have reported school and community outbreaks. The importance of its early clinical suspicion for adequate treatment should be emphasized.