RESUMEN
Context: Risk factors for the persistence of superficial skin infestations are prevalent in humid tropical environments, which are favorable for breeding of the causative vector mite Sarcoptes scabiei (ectoparasite) and dermatophyte fungi. Aim: This study aimed at assessing the awareness and knowledge of childhood scabies and ringworm infestations among parents in Calabar, a highly humid rainforest tropical environment. Settings and Design: Cross-sectional study design and systematic random sampling were used to recruit school-age children in selected primary schools in Calabar. Materials and Methods: Researcher-driven administration of a structured questionnaire was conducted to obtain quantitative data from parents of recruited children. Statistical Analysis Used: : Chi-square was used to assess factors associated with ever hearing or seeing scabies and ringworm infestations. Statistical significance was set at P < 0.05. Results: One hundred and eighty-two (56.7%) and 218 (67.9%) of the respondents had heard of or seen scabies and ringworm infestation. Among respondents that were aware of scabies, 53.3% knew of the cause, 50.5% were aware of the risk factors while 68.1% and 78.0% knew their treatment and prevention, respectively; 98.6%, 60.6%, 76.6%, and 80.7% of respondents knew the cause, risk factors, treatment, and prevention of ringworm infestation, respectively. Fathers with at least secondary school literacy level and sharing beds were significantly associated with awareness of scabies. Conclusion: There is a suboptimal level of awareness and knowledge of two of the most common superficial skin infestations among parents of primary school children in the study setting. There is a need to redouble our effort at sensitization of parents toward improved awareness of these common infestations.
Résumé Contexte: Les facteurs de risque de persistance des infestations cutanées superficielles sont prévalents dans les environnements tropicaux humides, favorables à la reproduction du vecteur responsable, la gale Sarcoptes scabiei (ectoparasite), et des champignons dermatophytes. Objectif : Cette étude visait à évaluer la sensibilisation et les connaissances des parents de Calabar, un environnement tropical de forêt équatoriale très humide, concernant la gale et les infestations à la teigne chez les enfants. Cadre et conception : Une étude transversale et un échantillonnage systématique ont été utilisés pour recruter des enfants d'âge scolaire dans des écoles primaires sélectionnées à Calabar. Méthodes et matériel: Une administration dirigée par le chercheur d'un questionnaire structuré a été réalisée pour obtenir des données quantitatives auprès des parents des enfants recrutés. Analyse statistique utilisée: Le test du chi carré a été utilisé pour évaluer les facteurs associés à la connaissance de la gale et des infestations à la teigne. La signification statistique a été fixée à P < 0,05. Résultats: Cent quatre-vingt-deux (56,7 %) et 218 (67,9 %) des répondants avaient entendu parler ou vu une infestation de gale et de teigne. Parmi les répondants qui étaient au courant de la gale, 53,3 % connaissaient la cause, 50,5 % étaient conscients des facteurs de risque, tandis que 68,1 % et 78,0 % connaissaient respectivement leur traitement et leur prévention. De même, 98,6 %, 60,6 %, 76,6 % et 80,7 % des répondants connaissaient respectivement la cause, les facteurs de risque, le traitement et la prévention de l'infestation à la teigne. Les pères ayant au moins un niveau d'alphabétisation au niveau secondaire et partageant des lits étaient significativement associés à la connaissance de la gale. Conclusion: Il existe un niveau sous-optimal de sensibilisation et de connaissance de deux des infestations cutanées superficielles les plus courantes parmi les parents d'enfants d'école primaire dans le cadre de l'étude. Il est nécessaire de redoubler d'efforts pour sensibiliser les parents afin d'améliorer la connaissance de ces infestations courantes. Mots-clés: Infestations cutanées, gale, teigne, connaissance, parents, enfants d'âge scolaire, Nigeria.
Asunto(s)
Escabiosis , Tiña , Niño , Humanos , Escabiosis/epidemiología , Escabiosis/prevención & control , Estudios Transversales , Nigeria/epidemiología , Tiña/complicaciones , PadresRESUMEN
Trichophyton rubrum is a common fungal pathogen that usually causes superficial infection limited to epidermis only, so called dermatophytosis. However in immunocompromised patients, dermatophytosis can be exceptionally more invasive with extensive lesions involving deep tissues and generating sometimes systemic course. We report the case of a 43-year-old heart transplanted man, who presented with multiple deep-seated nodules and papules in the inguinal areas and in the buttocks. Involvement of Trichophyton rubrum was confirmed by culture, DNA sequencing and histological examination that showed granulomatous inflammatory infiltrates with the presence of hyphae in the dermis. Antifungal therapy with oral terbinafine for four weeks was successful; in spite of initial remnant atrophic scars, the lesions were completely cleared after four month evolution. Deep-seated invasive dermatophytosis is rare, but should be considered with immunocompromised conditions, especially when history of previous superficial dermatophytosis is present.
Asunto(s)
Arthrodermataceae , Distrofia Muscular de Duchenne , Tiña , Masculino , Humanos , Adulto , Antifúngicos/uso terapéutico , Tiña/complicaciones , Tiña/diagnóstico , Tiña/tratamiento farmacológico , Distrofia Muscular de Duchenne/tratamiento farmacológico , Trichophyton/genéticaRESUMEN
BACKGROUND: Dermatophytes are the most common causative pathogens of mycoses worldwide and usually cause superficial infections. However, they can enter deep into the dermis lead to invasive dermatophytosis such as deeper dermal dermatophytosis on rare occasions. Erythroderma is a severe dermatological manifestation of various diseases resulting in generalized skin redness, but erythroderma due to fungi infections is barely reported. In this article, we reported the first case of erythroderma combined with deeper dermal dermatophytosis due to Trichophyton rubrum (T. rubrum) in a patient with myasthenia gravis. CASE PRESENTATION: A 48-year-old man was hospitalized because of erythema with scaling and nodules covering his body for a month. The patient had a history of myasthenia gravis controlled by regularly taking prednisolone for > 10 years and accompanied by onychomycosis and tinea pedis lasting > 8 years. Based on histopathological examinations, fungal cultures, and DNA sequencing results, the patient was finally diagnosed with dermatophyte-induced erythroderma combined with deeper dermal dermatophytosis caused by T. rubrum. After 2 weeks of antifungal treatment, the patient had recovered well. CONCLUSIONS: This case report shows that immunosuppressed patients with long histories of superficial mycoses tend to have a higher risk of developing invasive dermatophytic infections or disseminated fungal infections. Dermatologists should be alert to this condition and promptly treat the superficial dermatophytosis.
Asunto(s)
Arthrodermataceae , Dermatitis Exfoliativa , Miastenia Gravis , Tiña , Masculino , Humanos , Persona de Mediana Edad , Tiña/complicaciones , Tiña/diagnóstico , Tiña/tratamiento farmacológico , Dermatitis Exfoliativa/complicaciones , Trichophyton/genéticaAsunto(s)
Artritis Psoriásica , Psoriasis , Tiña , Humanos , Artritis Psoriásica/tratamiento farmacológico , Artritis Psoriásica/complicaciones , Psoriasis/tratamiento farmacológico , Psoriasis/complicaciones , Anticuerpos Monoclonales Humanizados/efectos adversos , Tiña/diagnóstico , Tiña/tratamiento farmacológico , Tiña/complicaciones , Resultado del TratamientoRESUMEN
BACKGROUND Pityriasis rubra pilaris (PRP) is a rare chronic inflammatory skin condition characterized by follicular, papulosquamous, reddish-orange scaling, palmoplantar keratoderma, and erythema with islands of sparing. Its heterogeneous clinical presentation makes the diagnosis of PRP quite challenging, especially at the initial presentation, as it can mimic common skin conditions. CASE REPORT We present a case with an early presentation of PRP in a 61-year-old Malay woman with underlying uncontrolled diabetes, and discuss evolving clinical course of her disease. She presented to a primary care clinic with a 3-week history of itchy, ring-like skin lesions that started on her neck and chest but subsequently spread widely on her chest, back, and upper extremities. She was first treated as having extensive tinea corporis but responded poorly to multiple courses of antifungal treatment. An initial skin biopsy that was taken at the dermatology clinic revealed features suggestive of erythema annulare centrifugum. However, despite topical steroid treatment, her skin condition evolved further and she developed generalized erythroderma along with follicular hyperkeratosis and palmoplantar keratoderma. A repeat biopsy finally confirmed the diagnosis of PRP. CONCLUSIONS Making the diagnosis of PRP is challenging for clinicians. However, clinicians should approach any common skin problem that does not respond to treatment appropriately, with consideration of other uncommon skin disorders. A repeat skin biopsy may be considered if there are any doubts about the diagnosis. A clinical and histopathological correlation is important to aid in the diagnosis of PRP.
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Queratodermia Palmoplantar , Pitiriasis Rubra Pilaris , Tiña , Eritema , Femenino , Humanos , Queratodermia Palmoplantar/complicaciones , Queratodermia Palmoplantar/patología , Persona de Mediana Edad , Pitiriasis Rubra Pilaris/diagnóstico , Pitiriasis Rubra Pilaris/tratamiento farmacológico , Pitiriasis Rubra Pilaris/patología , Enfermedades Raras , Piel/patología , Tiña/complicaciones , Tiña/diagnóstico , Tiña/patologíaAsunto(s)
Eritema Multiforme , Tiña , Humanos , Tiña/complicaciones , Tiña/diagnóstico , Trichophyton , Eritema Multiforme/diagnósticoAsunto(s)
Arthrodermataceae , Tiña , Humanos , Masculino , Microsporum , Escroto , Tiña/complicaciones , Tiña/diagnósticoRESUMEN
BACKGROUND: Relapsed childhood polymicrobial osteomyelitis associated with dermatophytosis has not been reported in the literature. CASE PRESENTATION: Here we report on a case of a 45-year-old man who had left tibial osteomyelitis for 29 years, accompanied by skin fungal infection of the ipsilateral heel for 20 years, and underwent a second operation due to recurrence of polymicrobial infection 6 years ago. The patient had a history of injury from a rusty object, which penetrated the anterior skin of the left tibia middle segment causing subsequent bone infection, but was asymptomatic after receiving treatments in 1983. The patient was physically normal until dermatophytosis occurred on the ipsilateral heel skin in 1998. The patient complained that the dermatophytosis was gradually getting worse, and the tibial wound site became itchy, red, and swollen. The left tibial infection resurged in May 2012, leading to the patient receiving debridement and antibiotic treatment. H&E and Gram-stained histology was performed on biopsy specimens of sequestrum and surrounding inflammatory tissue. Tissue culture and microbiology examination confirmed polymicrobial infection with Staphylococcus aureus (S. aureus) and Corynebacterium and a fungus. Additionally, the patient also received potassium permanganate for dermatophytosis when he was admitted into the hospital. CONCLUSIONS: Together with longitudinal follow-up of medical history, surgical findings, histopathological and microbiology culture evidence, we conclude that boyhood tibia polymicrobial osteomyelitis with S. aureus and Corynebacterium occurred in this patient, and the fungal activation of dermatophytosis may have led to osteomyelitis relapse.
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Coinfección , Osteomielitis , Infecciones Estafilocócicas , Tiña , Antibacterianos , Niño , Coinfección/complicaciones , Coinfección/diagnóstico , Desbridamiento , Humanos , Masculino , Persona de Mediana Edad , Osteomielitis/complicaciones , Osteomielitis/diagnóstico , Infecciones Estafilocócicas/complicaciones , Staphylococcus aureus , Tibia/cirugía , Tiña/complicacionesRESUMEN
Pruritus is the sensation of itching; it can be caused by dermatologic and systemic conditions. An exposure history may reveal symptom triggers. A thorough skin examination, including visualization of the finger webs, anogenital region, nails, and scalp, is essential. Primary skin lesions indicate diseased skin, and secondary lesions are reactive and result from skin manipulation, such as scratching. An initial evaluation for systemic causes may include a complete blood count with differential, creatinine and blood urea nitrogen levels, liver function tests, iron studies, fasting glucose or A1C level, and a thyroid-stimulating hormone test. Additional testing, including erythrocyte sedimentation rate, HIV screening, hepatitis serologies, and chest radiography, may also be appropriate based on the history and physical examination. In the absence of primary skin lesions, physicians should consider evaluation for malignancy in older patients with chronic generalized pruritus. General management includes trigger avoidance, liberal emollient use, limiting water exposure, and administration of oral antihistamines and topical corticosteroids. If the evaluation for multiple etiologies of pruritus is ambiguous, clinicians may consider psychogenic etiologies and consultation with a specialist.
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Prurito/diagnóstico , Prurito/terapia , Administración Tópica , Corticoesteroides/administración & dosificación , Anciano , Recuento de Células Sanguíneas/métodos , Sedimentación Sanguínea , Nitrógeno de la Urea Sanguínea , Creatinina/sangre , Dermatitis Atópica/complicaciones , Emolientes/administración & dosificación , Antagonistas de los Receptores Histamínicos/administración & dosificación , Humanos , Examen Físico/métodos , Prurito/etiología , Radiografía/métodos , Derivación y Consulta , Cuero Cabelludo/patología , Piel/patología , Enfermedades de la Piel/diagnóstico , Tiña/complicacionesAsunto(s)
Prurito/etiología , Prurito/terapia , Administración Tópica , Anciano , Dermatitis Atópica/complicaciones , Eccema/complicaciones , Emolientes/uso terapéutico , Femenino , Humanos , Mordeduras y Picaduras de Insectos/complicaciones , Masculino , Pomadas/uso terapéutico , Examen Físico/métodos , Embarazo , Prurito/diagnóstico , Piel/patología , Tiña/complicaciones , AguaAsunto(s)
Vesícula/diagnóstico , Eritema Multiforme/diagnóstico , Herpes Simple/diagnóstico , Tiña/diagnóstico , Antifúngicos , Antivirales/administración & dosificación , Vesícula/tratamiento farmacológico , Vesícula/virología , Nalgas , Diagnóstico Diferencial , Eritema Multiforme/tratamiento farmacológico , Eritema Multiforme/virología , Femenino , Herpes Simple/complicaciones , Herpes Simple/tratamiento farmacológico , Herpes Simple/virología , Humanos , Pierna , Neumonía por Mycoplasma/diagnóstico , Recurrencia , Síndrome de Stevens-Johnson/diagnóstico , Tiña/complicaciones , Tiña/tratamiento farmacológico , Resultado del Tratamiento , Adulto JovenRESUMEN
We present a 76-year-old Japanese male with tinea faciei, tinea corporis, and tinea unguium with dermatophytoma. We performed fungal culture and confirmed the causative fungus to be Trichophyton rubrum. We treated the patient using oral fosravuconazole l-lysine ethanolate (F-RVCZ). More than one year has passed since the end of treatment, but there has been no recurrence. This case suggests that F-RVCZ is effective for tinea other than tinea unguium.
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Onicomicosis/tratamiento farmacológico , Onicomicosis/microbiología , Tiña/tratamiento farmacológico , Tiña/microbiología , Triazoles/administración & dosificación , Administración Oral , Anciano , Arthrodermataceae/aislamiento & purificación , Arthrodermataceae/patogenicidad , Humanos , Masculino , Onicomicosis/complicaciones , Onicomicosis/patología , Tiña/complicaciones , Tiña/patología , Resultado del TratamientoRESUMEN
BACKGROUND: Until 1960, hundreds of thousands of children worldwide had been treated for scalp ringworm by epilation via irradiation. The discovery of late health effects in adulthood prompted investigation of the medical aspects of irradiation in childhood and led to the establishment of strict protocols for the use of X-ray irradiation. These studies ignored alopecia, which affects some individuals who underwent irradiation for scalp ringworm as children. This study examined the impact of alopecia due to irradiation for scalp ringworm on the health and psychosocial status of affected women. METHODS: We analysed a random sample of 130 medical files of women recognised by Israel's state committees as suffering from permanent hair loss as a result of scalp ringworm irradiation in childhood. The coded medical data included demographic variables, self-reported mental health conditions, self-reported physical health conditions, self-reported social conditions, and spousal relationship. RESULTS: Compared with the general population of women in Israel, research participants reported significantly higher rates of depression, anti-depressant and/or anti-anxiety drug use, psychotherapy or psychiatric hospitalisation, attempted suicide, migraines, cancer, and divorce. Many described humiliating social experiences due to their appearance, both in childhood and adulthood, that led them to curtail their social interactions. The participants also reported that alopecia negatively affected their spousal relationships. CONCLUSIONS: Life with hair loss from scalp ringworm irradiation in childhood has a negative impact on women's health status and psychosocial state. Health policy-makers must broaden their approach to women who underwent scalp ringworm irradiation by addressing the effects of their hair loss in addition to the effects of the radiation treatment per se. This may be achieved by guiding physicians who provide medical services to these women to take into account the psychosocial and health risks related to hair loss in their diagnosis and treatment as well as by creating a cadre of specially trained mental health professionals who can address their unique psychosocial needs. They must also consider including the specialized mental health services tailored for these women's unique needs in the Healthcare Basket.
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Alopecia/etiología , Efectos de la Radiación , Tiña/complicaciones , Tiña/terapia , Adulto , Anciano , Anciano de 80 o más Años , Alopecia/fisiopatología , Femenino , Humanos , Israel , Persona de Mediana Edad , Conducta Sexual/psicología , Tiña/fisiopatologíaRESUMEN
Tinea incognita is an atypical presentation of fungal infection of the skin, the clinical presentation of which has been modified by misuse of topical corticosteroids or calcineurin inhibitors. Such dermatophyte infections often have an atypical clinical presentation and are difficult to diagnose, but with the rise of immunosuppressive drugs and self-prescribed topical therapies, they are becoming increasingly prevalent. Here we report the case of a 68-year-old male patient with a history of psoriasis, presenting with erythematous scaly lesions, that did not respond to conventional treatment for psoriasis, as would be expected. A diagnosis of tinea incognita was made with histopathological examination with periodic acid-Schiff stain of a skin biopsy sample. This case highlights the fact that dermatophyte infections are widespread but sometimes neglected and can occur concomitantly with other dermatoses.
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Tiña , Anciano , Humanos , Masculino , Psoriasis/complicaciones , Tiña/complicaciones , Tiña/patologíaRESUMEN
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