[Renaissance of mouse favus : Retrospective analysis of Trichophyton quinckeanum infections at Jena University Hospital in the period 2015-2020]. / Renaissance des Mäusefavus : Retrospektive Analyse der Trichophyton-quinckeanum-Infektionen am Universitätsklinikum Jena im Zeitraum 2015 bis 2020.

The number of Trichophyton quinckeanum infections has increased significantly in recent years. In 2020 in particular, the number of cases increased fivefold compared to 2015. Infections multiplied, especially in the second half of the year, which correlated with the upsurge in field mouse populations. Typical vectors are mice and rats as well as dogs and cats, which hunt the rodents. The animals are usually asymptomatic. In humans, on the other hand, the course is usually more inflammatory corresponding to other zoophilic mycoses. Typical clinical manifestations of the infections are tinea corporis and tinea capitis. Treatment of T. quinckeanum infections is similar to other dermatophyte infections, depending on the severity, location and age of the patient as well as the immune status, previous illnesses and medication. The duration of local therapy should be at least 4 weeks and continued for up to 14 days after the normalization of the skin presentation. Systemic treatment should take place with terbinafine 250 mg once a day orally (in adults). Alternatives are itraconazole, fluconazole and griseofulvin. Only the preparation griseofulvin, which is no longer available in Germany, is approved for children. Alternatively, terbinafine, itraconazole or fluconazole can also be used in children as an "off-label" treatment in an individual healing attempt.

Favus of Scrotum Due to Trichophyton rubrum in Immunocompetent Patients: A Clinical, Mycological and Ultrastructural Study.

PURPOSE: To characterize the clinical and mycological features of favus of scrotum due to Trichophyton rubrum. METHODS: A single-site prospective study was carried out in an outpatient dermatology clinic. Microscopic examination and fungal culture were done using skin scrapings. Scales on the scrotum were stained with PAS and visualized by microscopy, including in vivo reflectance confocal microscopy (RCM). Two strains were analyzed by RAPD typing. Scutular lesions were fixed for scanning electron microscopy (SEM) and transmission electron microscopy (TEM). RESULTS: Cultures of the scale from the scrotum and/or groin in all patients showed a growth of T. rubrum. T. rubrum strains from scrotum and groins in one patient were demonstrated as the same strain by RAPD typing. The average age of patients was 34.1 ± 12.78 years. The mean course was 8.2 ± 5.07 days. All the patients received only topical treatment for 2 weeks without recurrence. Direct smear, calcofluor-white staining and in vivo RCM study of the scrotal favus in patients showed a massive number of septate branching hyphae, while fewer septate hyphae in scales in the groin. Abundant hyphae were found only in the outer layer of the stratum corneum of the scrotum under SEM and TEM with intact bilateral cell walls, and normal nucleus, liposomes and reticulum. Few distorted hyphae structures, cell wall degeneration, degenerated cytoplasm and the autophagy phenomenon could be seen in scales from groin under TEM. CONCLUSIONS: Scrotal favus due to T. rubrum is still a true infection, which most often occurred in immunocompetent patients.

[A recurrent case of adult favus successfully treated with terbinafine]. / Terbinafi n ile basarili olarak tedavi edilen bir eriskin nüks favus olgusu.

Favus or tinea capitis favosa, is a chronic inflammatory dermatophytosis of the scalp. The disease is particularly common in children aged 6 to 10 years, more often in boys, and it also occurs in adults. Human-to-human transmission is therefore possible. Anthropophilic Trichophyton schöenleinii is responsible for over 95% of favus cases. In addition, there are rare cases of anthropophilic T.violaceum, zoophilic (T.verrucosum, T.quinckeanum, and Microsporum canis) and geophilic M.gypseum species recorded as agents of favus. It is also reported in mice (T.quinckeanum), poultry (M.gallinae), and cats (M.incurvatum). Favus is common in Iran, Nigeria, and China, however it has been reported rarely in the last two decades in Turkey. Although Turkish records are not sufficient to indicate an accurate incidence rate, favus is still present in Turkey. In this report, a 20-year-old female with favus was presented. She had squames and areas of alopecia on the right frontoparietal area of her scalp. Scalp biopsy and hair follicle samples were taken for histopathological examination and fungal culture. According to the conventional identification by mycological methods and internal transcribed spacer (ITS) sequencing analysis, the pathogen was identified as T.schöenleinii. The patient was treated with oral terbinafine (250 mg/day) for 4 weeks and topical isoconazole and ketoconazole for 6 weeks. Clinical recovery was observed after 6 weeks, however, fungal culture could not be repeated. Six months after the initial presentation, the patient's symptoms recurred due to the poor adherence and T.schöenleinii was repeatedly grown in culture. Antifungal treatment was administered with the same drugs for the same period. There was a clinical and mycological recovery 8 months after initial presentation. Favus, which is not frequently observed in adults, is an uncommon disease. Confusion arises in its diagnosis because other diseases have similar clinical appearances, and asymptomatic carriage have also been reported. For these reasons, and because of improvements in health conditions, treatment might be delayed. With accurate assessment of the patient's medical history, the clinical characteristics of the disease, and results of laboratory analyses, coupled with effective mycologist-clinician collaboration, it is possible for the patient to continue a healthy social life. Consequently, favus is still an important health problem encountered in Turkey.

Tinea favosa: psoriasiform favus in bindi area of an adult.

Favus is an uncommon chronic inflammatory dermatophyte infection of the scalp. Predominantly, a disease of childhood, uncommon reports of adult cases are described. For the most part, this infection is characterised by invasion of hair shaft clinically presenting as yellowish scaly plaques, alopecia and/or inflammatory lesions. We hereby present an immunocompetent adult presenting with a psoriasiform plaque over glabella, culturally referred to as 'bindi' area. No involvement of the scalp or other hair-borne areas was seen. As she did not agree to undergo a skin biopsy, a last resort of simple stains like potassium hydroxide was done confirming favus. Systemic itraconazole was initiated and complete clinical and mycological resolution was seen with no relapse. Such atypical presentations in adults can cause a diagnostic dilemma and simple stains still hold their ground in making a diagnosis in resource-poor settings.

Pitfall scarring alopecia: favus closely mimicking lichen planus.

We describe a woman presenting primarily with slowly progressing scarring alopecia. Course, symptoms, and clinical picture were highly suggestive for lichen planus. But mycological investigations revealed that cicatricial alopecia was caused by a specific infection with Trichophyton schoenleinii running a chronic course with minimal skin inflammation.

Revival of favus in Japan caused by Trichophyton schoenleinii.

Favus is a type of dermatophytosis known to produce yellow scutula around hair follicles. Most cases of this disease worldwide are infections of Trichophyton schoenleinii. Favus has rarely been reported in Japan throughout the last four decades, and T. schoenleinii has not been clinically isolated in any case during the period. Here, we report a case of favus of vellus hair observed in a 63-year-old Japanese woman. Fungal culture showed negative; however, we detected fungal elements in the crust and hair bulbs by Grocott staining. Pathogenic fungi were identified as T. schoenleinii by polymerase chain reaction-based DNA sequencing, targeting the internal transcribed spacer regions of the rRNA gene using the formalin-fixed, paraffin-embedded tissue sample. She was successfully treated with p.o. administration of terbinafine and topical application of luliconazole cream.

Trichophyton tonsurans associated tinea corporis infection with the development of Majocchi's granuloma in a renal transplant patient.

Trichophyton tonsurans is an uncommon cause of tinea corporis, and an even more uncommon cause of Majocchi's granuloma. We report a patient who developed tinea corporis with Majocchi's granuloma from T. tonsurans infection. Immunocompromised hosts are predisposed to develop cutaneous fungal infections, as was the case with this patient. Majocchi's granuloma is a rare complication with immunosuppression, but is significant to consider when a fungal infection is suspected because it may require more aggressive therapy.

[Tinea favosa. Report of a familial occurrence in Itapecerica da Serra (municipality of Greater São Paulo)]. / Tinha favosa. Relato de ocorrência familiar em Itapecerica da Serra (município da grande São Paulo).

Four cases of Tinea favosa occurred in the same family are reported in a small city of Brazil (Itapecerica da Serra--State of São Paulo). Trichophyton schoenleinii was isolated from all four cases. Treatment consisted of oral griseofulvin (10 mg/kg/day) for at least three months.

[Treatment of 2 cases of kerions with griseofulvin and oral steroids]. / Traitement de 2 cas de kérions par griséofulvine et corticoïdes oraux.

We report on 2 cases of kerions in children: one of them was located on the pubis, an exceptional location; the second one was located on the scalp and presented like multiple abscess of the scalp, for which surgical drainage was performed. In both cases, Trichophyton mentagrophytes was involved. This dermatophyte is zoophilic, contrary to the dermatophytes usually involved in tinea capitis, which could explain the poor adaptation of the dermatophyte to the human host, who would therefore react by generating a severe inflammatory reaction. Antifungal drugs are recommended for the treatment of kerions, especially griseofuline for 6 to 8 weeks. The value of oral steroids and surgery continues to be debated.

An experience from an outbreak of tinea capitis gladiatorum due to Trichophyton tonsurans.

'Tinea corporis gladiatorum' describes a dermatophytosis transmitted mainly from close skin contact among wrestlers. Although tinea corporis is well recognized, no data are available for tinea capitis infections in wrestlers. After finding tinea capitis infection in a student wrestler, we aimed to search for possible ringworm infections among wrestlers in a wrestling boarding-school. Of the 32 wrestlers, 29, aged 12-18 years, were affected, of whom 22 had scalp involvement. Trichophyton tonsurans was isolated from 20 of the patients, and T. mentagrophytes from the remaining two. Isolated strains of dermatophytes were susceptible to terbinafine and itraconazole. The patients with tinea capitis received oral terbinafine for 4 weeks, and patients with more than two lesions but without scalp involvement received oral terbinafine for 2 weeks. Overall clinical and mycological cure rate was 72.4% and 70%, respectively, at assessment at week 6. The asymptomatic dermatophyte carrier rate was negative 1 year after control of the epidemic. Terbinafine seems to be an alternative drug for the treatment of tinea capitis caused by T. tonsurans; however, control of an outbreak may be very difficult and effective preventive measures should be considered.

Favus due to Trichophyton mentagrophytes var. quinckeanum.

We report a case of favus affecting the temporal region of the scalp in a 22-month-old boy. Mycological study of hairs and crusts identified Trichophyton mentagrophytes var. quinckeanum (T. quinckeanum), the causative agent of mouse favus. Treatment with oral griseofulvin led to healing.