Tinea faciei clinical characteristics, causative agents, treatments and outcomes; a retrospective study in Thailand.

BACKGROUND: Tinea faciei is a relatively uncommon dermatophyte infection. The studies, which included clinical forms, and isolated species of dermatophytes, are limited. MATERIALS AND METHODS: This retrospective study aims to determine the causative organism, clinical characteristics, treatments and outcomes of patients with tinea faciei attending the dermatologic clinic, Siriraj Hospital, from 1 January 2017 to 30 September 2021. Demographic data, clinical presentations, isolated dermatophyte species, treatments and outcomes were collected and analysed. RESULTS: A total of 151 tinea faciei cases were observed. Trichophyton rubrum (48.6%), Trichophyton mentagrophytes complex (22.2%) and Microsporum canis (18.1%) were common causative agents. Tinea faciei was commonly detected in females (64.9%) with a history of pets (54.6%). Clinical presentations often involved plaques and scales on the cheeks. Among patients with lesions on the cheek, mycological cure was observed significantly less often compared to those without cheek lesions. Patients with other concurrent skin or nail infections, a history of topical steroids and a history of previous fungal infection had a slightly longer duration of mycological cure than those without factors. Recurrent infection was found in 33.3%. Male, history of previous fungal infection, and lesions on the cheeks were significantly associated with recurrent infection. CONCLUSIONS: Fungal infection of the face was commonly found in women and patients with pets. The most common pathogen that caused tinea faciei was T. rubrum. Topical antifungal treatments could be used with favourable outcomes. The history of past infection and lesion on the cheeks should be carefully assessed to be vigilant for recurrent infection.

Prevalence and characteristics of Epidermophyton floccosum skin infections: A 12-year retrospective study.

BACKGROUND: Epidermophyton floccosum (E. floccosum), an anthropophilic dermatophyte, is the primary causative agent of skin conditions such as tinea cruris, tinea pedis and tinea corporis. OBJECTIVES: This study aimed to determine the prevalence and characteristics of E. floccosum-induced dermatophytosis, with particular emphasis on the types of infections and demographic profiles. METHODS: In this retrospective study, patient records from the dermatology outpatient clinic were scrutinized, covering the timeframe from January 2009 to December 2020. Eligibility for the study required a dermatophytosis diagnosis verified by microscopic examination and fungal culture. RESULTS: Of the 4669 confirmed dermatophytosis cases, 82 (1.8%) were attributable to E. floccosum infection. The proportions of male and female patients with E. floccosum infections were 50.0% each. The most common presentation was tinea pedis (39.0%), followed by tinea cruris (37.8%) and tinea corporis (26.8%). The mean age at disease onset for tinea cruris was 38.7 ± 18.7 years, which was lower than that for tinea pedis (50.6 ± 14.2 years) and tinea corporis (53.5 ± 16.4 years). However, these age differences were not statistically significant. A continuous decrease in E. floccosum isolation was observed over the study period. CONCLUSIONS: There was a steady decline in the prevalence of E. floccosum dermatophytosis over the 12-year study period. Despite the decreasing trend, tinea cruris, tinea corporis and tinea pedis remained the predominant clinical manifestations of E. floccosum infection.

A resurgence of tinea cruris caused by Epidermophyton floccosum: An outbreak among Thai naval cadets.

BACKGROUND: A decreasing trend in tinea cruris caused by Epidermophyton floccosum, an anthropophilic dermatophyte, has been observed. METHODS: This retrospective study involved Thai naval cadets aged 18 years or older with suspected groin lesions. Both clinical evaluations and laboratory investigations were conducted. RESULTS: In total, 86 male participants with a median age of 19 years who presented with groin rash were enrolled in the study. Branching septate hyphae from KOH examination were found in 55 patients (64.0 %). Fungal identifications were Epidermophyton floccosum (42 cases; 76.4 %), Trichophyton mentagrophytes complex (3 cases; 5.5 %), and no growth (10 cases; 18.2 %). An E. floccosum outbreak was identified, with a prevalence of 76.4 %. Most lesions exhibited admixed erythema and hyperpigmentation. Approximately two-thirds displayed prominent, easily visible scaling. Scrotal involvement was absent in 95.2 % of lesions, with 87.2 % presenting bilaterally. A gradual symptom onset lasting up to 2 months was observed in 78.9 % of cases. Lesion morphologies included annular (73.8 %), patchy (14.3 %), and polycyclic (9.5 %). Severe itching disrupting daily activities was reported by only 7.1 % of participants. Approximately two-thirds used over-the-counter (OTC) topical medications without consulting a physician. Risk factors related to clothing included sharing clothes (59.5 %), wearing sweaty clothes (100 %), and reusing unwashed clothes (81.0 %). CONCLUSIONS: The E. floccosum tinea cruris outbreak among naval cadets was characterized by a gradual onset and mild symptoms. OTC medication use without physician consultation was prevalent.

Herpes Zoster after COVID-19 Infection or Vaccination: A Prospective Cohort Study in a Tertiary Dermatology Clinic.

Background: Herpes zoster (HZ) has been observed to occur after COVID-19 infection and vaccination; however, knowledge regarding the demographic data, clinical presentations, and treatment outcomes of HZ is limited. Objective: To compare the demographic data, clinical manifestations, treatments, and outcomes of patients with and without HZ within 14 days of COVID-19 infection or vaccination. Methods: This prospective cohort study involving patients diagnosed with cutaneous HZ was conducted at a dermatology clinic from October 2021 to January 2023. Results: Among a total of 232 patients with HZ, the median age was 62.0 years and 59.1% were female. HZ developed in 23 (9.9%) and four (1.7%) patients after COVID-19 vaccination and infection, respectively. The mean duration from vaccination and the median duration from infection to HZ onset were 5.7 and 8.5 days, respectively. The proportion of female patients was significantly higher in the group of patients with COVID-19 vaccination or infection than in those without such a history (P = 0.035). Patients who developed HZ following the recent COVID-19 infection had a median age of 42.5 years, which was lower than that of the other groups. Dissemination occurred in 8.7% of the patients after COVID-19 vaccination. HZ recurrence was reported in five cases, of which 80% had been vaccinated or infected with COVID-19 during the previous 21 days. All patients had similar durations of antiviral treatment, crust-off time, and duration of neuralgia. Conclusions: HZ after COVID-19 vaccination is more frequently observed in females, while HZ after COVID-19 infection tends to occur in younger patients. Disseminated HZ is more common in patients recently vaccinated against COVID-19. COVID-19 vaccination or infection may trigger recurrent HZ infection.