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1.
J Med Microbiol ; 69(3): 436-442, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32068525

RESUMO

Introduction. Malassezia folliculitis (MF) and pityriasis versicolor (PV) are common dermatoses caused by Malassezia species. Their molecular epidemiology, drug susceptibility and exoenzymes are rarely reported in China.Aim. To investigate the molecular epidemiology, drug susceptibility and enzymatic profile of Malassezia clinical isolates.Methodology. Malassezia strains were recovered from MF and PV patients and healthy subjects (HS) and identified by sequencing analysis. The minimum inhibitory concentrations (MICs) of nine antifungals (posaconazole, voriconazole, itraconazole, fluconazole, ketoconazole, miconazole, bifonazole, terbinafine and caspofungin) and tacrolimus, the interactions between three antifungals (itraconazole, ketoconazole and terbinafine) and tacrolimus, and the extracellular enzyme profile were evaluated using broth and checkerboard microdilution and the Api-Zym system, respectively.Results. Among 392 Malassezia isolates from 729 subjects (289 MF, 218 PV and 222 HS), Malassezia furfur and Malassezia globosa accounted for 67.86 and 18.88 %, respectively. M. furfur was the major species in MF and PV patients and HS. Among 60M. furfur and 50M. globosa strains, the MICs for itraconazole, posaconazole, voriconazole and ketoconazole were <1 µg ml-1. M. furfur was more susceptible to itraconazole, terbinafine and bifonazole but tolerant to miconazole compared with M. globosa (P<0.05). Synergistic effects between terbinafine and itraconazole or between tacrolimus and itraconazole, ketoconazole or terbinafine occurred in 6, 7, 6 and 9 out of 37 strains, respectively. Phosphatases, lipases and proteases were mainly secreted in 51 isolates.Conclusions. Itraconazole, posaconazole, voriconazole and ketoconazole are theagents against which there is greatest susceptibility. Synergistic effects between terbinafine and itraconazole or tacrolimas and antifungals may be irrelevant to clinical application. Overproduction of lipases could enhance the skin inhabitation of M. furfur.


Assuntos
Antifúngicos/farmacologia , Dermatomicoses/epidemiologia , Foliculite/epidemiologia , Malassezia/isolamento & purificação , Tinha Versicolor/epidemiologia , Azóis/farmacologia , China/epidemiologia , Dermatomicoses/microbiologia , Foliculite/microbiologia , Humanos , Lipase/metabolismo , Malassezia/efeitos dos fármacos , Malassezia/enzimologia , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Pele/microbiologia , Tacrolimo/farmacologia , Terbinafina , Tinha Versicolor/microbiologia
2.
Mycoses ; 62(12): 1194-1201, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31556177

RESUMO

BACKGROUND: Biofilm formation represents a major microbial virulence attribute especially at epithelial surfaces such as the skin. Malassezia biofilm formation at the skin surface has not yet been addressed. OBJECTIVE: The present study aimed to evaluate Malassezia colonisation pattern on a reconstructed human epidermis (RhE) by imaging techniques. METHODS: Malassezia clinical isolates were previously isolated from volunteers with pityriasis versicolor and seborrhoeic dermatitis. Yeast of two strains of M furfur and M sympodialis were inoculated onto the SkinEthic™ RHE. The tissues were processed for light microscopy, wide-field fluorescence microscopy and scanning electron microscopy. RESULTS: Colonisation of the RhE surface with aggregates of Malassezia yeast entrapped in a multilayer sheet with variable amount of extracellular matrix was unveiled by imaging techniques following 24, 48, 72 and 96 hours of incubation. Whenever yeast were suspended in RPMI medium supplemented with lipids, the biofilm substantially increased with a dense extracellular matrix in which the yeast cells were embedded. Slight differences were found in the biofilm architectural structure between the two tested species with an apparently higher entrapment and viscosity in M furfur biofilm. CONCLUSION: Skin isolates of M furfur and M sympodialis were capable of forming biofilm in vitro at the epidermal surface simulating in vivo conditions. Following 24 hours of incubation, without added lipids, rudimental matrix was barely visible, conversely to the reported at plastic surfaces. The amount of biofilm apparently increased progressively from 48 to 96 hours. A structural heterogeneity of biofilm between species was found.


Assuntos
Biofilmes , Epiderme/microbiologia , Processamento de Imagem Assistida por Computador , Malassezia/isolamento & purificação , Pele Artificial/microbiologia , Dermatite Seborreica/microbiologia , Humanos , Malassezia/ultraestrutura , Microscopia Eletrônica de Varredura , Tinha Versicolor/microbiologia
4.
J Drugs Dermatol ; 18(3): s115-s116, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30909355

RESUMO

Hypopigmentation and depigmentation of the skin can be due to multiple causes and has a broad differential diagnosis. The most common cause of depigmentation worldwide is vitiligo. This disorder affects 1-2% of the world's population and is seen in all races. Vitiligo is an autoimmune disorder in which the predominant cause is an attack by CD8+ cytotoxic T cells on melanocytes in the epidermis. This condition can have a significant negative impact on the quality of life of affected individuals. Treatment options currently include psychological counseling, topical therapy, systemic therapy, phototherapy, surgical therapy, and depigmentation. In patients with stable, refractory disease, successful repigmentation has been achieved using mini-punch grafting, blister grafting, and non-cultured epidermal suspension (NCES) grafting. Emerging therapies include the Janus kinase (JAK) inhibitors ruxolitinib and tofacitinib. Further studies exploring the pathogenesis of vitiligo are warranted in order to optimize treatment for affected patients. J Drugs Dermatol. 2019;18(3 Suppl):s115-116.


Assuntos
Doenças Autoimunes/terapia , Qualidade de Vida , Vitiligo/terapia , Administração Cutânea , Administração Oral , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/imunologia , Doenças Autoimunes/psicologia , Linfócitos T CD8-Positivos/efeitos dos fármacos , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/metabolismo , Aconselhamento/métodos , Fármacos Dermatológicos/uso terapêutico , Diagnóstico Diferencial , Epiderme/transplante , Humanos , Janus Quinases/antagonistas & inibidores , Janus Quinases/imunologia , Melanócitos/transplante , Micose Fungoide/diagnóstico , Fototerapia/métodos , Piperidinas/uso terapêutico , Inibidores de Proteínas Quinases/uso terapêutico , Pirazóis/uso terapêutico , Pirimidinas/uso terapêutico , Pirróis/uso terapêutico , Pigmentação da Pele/efeitos dos fármacos , Pigmentação da Pele/imunologia , Tinha Versicolor/diagnóstico , Vitiligo/diagnóstico , Vitiligo/imunologia , Vitiligo/psicologia
6.
J Dermatolog Treat ; 30(8): 757-759, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30668183

RESUMO

Background: Treatment of alopecia areata (AA) involves use of high potency topical corticosteroids under occlusion that, even very effective, can lead to several adverse effects. Objective: We report 10 cases of patients with AA that, after using high potency topical corticosteroids, have developed tinea versicolor of the neck area. Methods: Ten patients with AA, aged 18-38 years, were prescribed with clobetasone propionate 0.05% cream under occlusion every other day but, after 3-4 months of treatment, they returned to our facility complaining the appearance of multiple white or red-brown round or oval macules in the neck area. Results: Diagnosis of pityriasis versicolor was confirmed by direct microscopy examination of skin scrapings in 10% potassion hydroxide (KOH) solution. All patients received systemic antifungal therapy associated with the daily use of ketoconazole shampoo. Conclusion: Tinea versicolor of the neck should be included among a rare but possible side effect of prolonged application of high potency topical steroids on the scalp. These cases reinforce the importance of careful dermatologic examination and recommend preventive measures in patients with alopecia areata that are using these drugs.


Assuntos
Alopecia em Áreas/tratamento farmacológico , Esteroides/uso terapêutico , Tinha Versicolor/diagnóstico , Administração Tópica , Adolescente , Adulto , Antifúngicos/uso terapêutico , Clobetasol/efeitos adversos , Clobetasol/uso terapêutico , Esquema de Medicação , Feminino , Humanos , Cetoconazol/uso terapêutico , Masculino , Pessoa de Meia-Idade , Pescoço , Tinha Versicolor/tratamento farmacológico , Tinha Versicolor/etiologia , Adulto Jovem
7.
J Dermatolog Treat ; 30(8): 760-771, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30668185

RESUMO

Introduction: Although labeling changes and market withdrawal have been implemented for oral ketoconazole (KTZ) due to serious adverse effects (AEs), topical KTZ is generally thought to be effective and safe for the treatment of superficial fungal infections. New dermatologic indications for the use of topical KTZ have arisen such as onychomycosis, blepharitis, and hair loss. This article aims to review the literature on topical KTZ's efficacy and AEs, as well as provide an overview on current insights regarding its mechanism of action and upcoming developments. Methods: A PubMed search was done to include randomized controlled trials (RCTs) focusing on the use of topical KTZ in human subjects. Results: Forty studies with 4566 patients were included in this review. Topical KTZ is clinically effective for the treatment of Malassezia-related conditions such as seborrheic dermatitis (SD) and pityriasis versicolor (PV) with a reported efficacy of 63-90% and 71-89%, respectively. Conclusions: Topical KTZ demonstrates high clinical efficacy for Malassezia-related conditions. More efficacious alternatives are now available for Tinea and Candida. Although topical KTZ is safe, clinicians should be aware that allergic contact dermatitis may occur. Further studies should be completed to investigate the use of topical KTZ for hair loss and inflammatory dermatoses.


Assuntos
Antifúngicos/uso terapêutico , Dermatite Seborreica/tratamento farmacológico , Cetoconazol/uso terapêutico , Tinha Versicolor/tratamento farmacológico , Administração Tópica , Alopecia/diagnóstico , Alopecia/etiologia , Antifúngicos/efeitos adversos , Humanos , Cetoconazol/efeitos adversos , Malassezia/fisiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Tinha Versicolor/microbiologia , Resultado do Tratamento
8.
J Am Acad Dermatol ; 80(5): 1233-1250.e10, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30236514

RESUMO

Acquired hypopigmented skin changes are commonly encountered by dermatologists. Although hypopigmentation is often asymptomatic and benign, occasional serious and disabling conditions present with cutaneous hypopigmentation. A thorough history and physical examination, centered on disease distribution and morphologic findings, can aid in delineating the causes of acquired hypopigmented disorders. The second article in this 2-part continuing medical education series focuses on conditions with a hypopigmented phenotype. Early diagnosis and appropriate management of these disorders can improve a patient's quality of life, halt disease progression, and prevent irreversible disability.


Assuntos
Hipopigmentação/etiologia , Micose Fungoide/complicações , Neoplasias Cutâneas/complicações , Intoxicação por Arsênico/complicações , Dermatite/complicações , Humanos , Hipopigmentação/diagnóstico , Hipopigmentação/terapia , Leishmaniose Visceral/complicações , Hanseníase Paucibacilar/complicações , Micose Fungoide/diagnóstico , Neoplasias Cutâneas/diagnóstico , Sífilis/complicações , Tinha Versicolor/complicações , Tinha Versicolor/tratamento farmacológico
11.
Ghana Med J ; 53(4): 287-293, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32116340

RESUMO

Background: Acne is an inflammatory disorder of the pilosebaceous gland, and the most common dermatosis in adolescents globally. Infectious dermatoses are common in the tropics, but due to the paucity of epidemiologic surveys, not much is known about the prevalence and common types found in different sub-populations including adolescents. It is however presumed that the prevalence will be high and the pattern diverse. We therefore conducted a school-based survey to ascertain the prevalence and pattern of infectious dermatoses, infestations, and papular urticaria (insect bite reactions) in teenage adolescents in Calabar, Nigeria. Methods: A cross sectional observational survey of adolescents aged 13-19 years attending randomly selected secondary schools in Calabar, Nigeria. It involved the use of questionnaires and subsequent whole body examination. Results: A total of 1447 senior secondary school students were examined. Infectious dermatoses, infestations, and papular urticaria (IDIP) were observed in 505 (34.9%) persons, among whom were 269 (53.3%) males, and 236 (46.7%) females (X2=34.87, p=<0.001). Fungal dermatoses constituted more than 90% of the diseases, the bulk of which was contributed by pityriasis versicolor [430 (79.6%)]. The six most common dermatoses in descending order of frequencies were Pityriasis versicolor, tinea, papular urticaria, candidiasis, furuncles, and viral warts. Conclusion: A high prevalence of cutaneous infections exists among teenage adolescents in Calabar, Nigeria. Males have a higher predisposition to fungal dermatoses. Control of the predominant cause of cutaneous infections - pityriasis versicolor, will significantly affect the prevalence of infectious dermatoses, and invariably, the burden of skin disorders in adolescents in Calabar, Nigeria. Funding: Self sponsored.


Assuntos
Mordeduras e Picadas/epidemiologia , Insetos , Dermatopatias Infecciosas/epidemiologia , Urticária/epidemiologia , Adolescente , Animais , Mordeduras e Picadas/complicações , Candidíase/epidemiologia , Estudos Transversais , Feminino , Furunculose/epidemiologia , Humanos , Masculino , Nigéria/epidemiologia , Prevalência , Escabiose/epidemiologia , Instituições Acadêmicas , Tinha/epidemiologia , Tinha Versicolor/epidemiologia , Urticária/etiologia , Verrugas/epidemiologia , Adulto Jovem
12.
Indian J Med Microbiol ; 37(3): 454-456, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32003353

RESUMO

Post-renal transplant fungal infections continue to be a major cause of mortality and morbidity. Universally reported fungi are Candida, especially Candida albicans, Cryptococcus, Aspergillus, Trichophyton rubrum and Pityriasis versicolor. Here, we report a case of infection caused by a rare fungus Diaporthe. It is an endophyte reported as plant pathogens and infrequently in humans and mammals. The patient was a renal transplant recipient on immunosuppressant. He had hypothyroidism and diagnosed with permanent pacemaker due to a complete heart block. The patient was treated with itraconazole (200 mg) successfully.


Assuntos
Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/microbiologia , Micoses/tratamento farmacológico , Micoses/microbiologia , Animais , Aspergillus/efeitos dos fármacos , Aspergillus/patogenicidade , Candida/efeitos dos fármacos , Candida/patogenicidade , Cryptococcus/efeitos dos fármacos , Cryptococcus/patogenicidade , Humanos , Imunossupressores/uso terapêutico , Itraconazol/uso terapêutico , Tinha Versicolor/tratamento farmacológico , Tinha Versicolor/microbiologia
13.
Clin Dermatol ; 37(5): 561-579, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31896410

RESUMO

White diseases are a heterogenous group characterized by hypopigmentation or depigmentation. Skin and eye color are determined by the number and size of melanosomes present. Melanin is produced by melanosomes in the melanocytes present within the epidermis of the skin, uvea, and retinal pigmented epithelium (RPE). Conditions altering the number of melanocytes or concentration of melanin result in a lack of pigmentation, appearing as "white diseases" ranging from the well-known albinism and vitiligo to more esoteric white hand syndrome and Degos disease.


Assuntos
Hipopigmentação/diagnóstico , Hipopigmentação/etiologia , Albinismo/diagnóstico , Albinismo/etiologia , Albinismo/terapia , Cor , Cosméticos/efeitos adversos , Diagnóstico Diferencial , Humanos , Hipopigmentação/patologia , Hipopigmentação/terapia , Inflamação/complicações , Líquen Escleroso e Atrófico/diagnóstico , Líquen Escleroso e Atrófico/etiologia , Líquen Escleroso e Atrófico/patologia , Líquen Escleroso e Atrófico/terapia , Papulose Atrófica Maligna/diagnóstico , Papulose Atrófica Maligna/etiologia , Papulose Atrófica Maligna/patologia , Membrana Mucosa , Doenças da Unha/etiologia , Nevo com Halo/diagnóstico , Nevo com Halo/etiologia , Nevo com Halo/patologia , Pitiríase Liquenoide/diagnóstico , Pitiríase Liquenoide/etiologia , Pitiríase Liquenoide/terapia , Prognóstico , Preparações Clareadoras de Pele/efeitos adversos , Tinha Versicolor/diagnóstico , Tinha Versicolor/tratamento farmacológico , Tinha Versicolor/etiologia , Vibração/efeitos adversos , Vitiligo/diagnóstico , Vitiligo/etiologia , Vitiligo/terapia , Síndrome de Waardenburg/diagnóstico , Síndrome de Waardenburg/etiologia
14.
BMC Dermatol ; 18(1): 11, 2018 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-30509232

RESUMO

BACKGROUND: Skin diseases are common and often have an impact on an individual's health-related quality of life. In rural communities where access to healthcare may be limited and individuals rely on farming for food and income, the impact of skin diseases may be greater. The objectives for this study were to perform an assessment of skin disease prevalence in a rural village in Laos and assess the associated impact of any skin disease found using the Dermatology Life Quality Index (DLQI). METHODS: A rural village was purposively selected and 340 participants examined by dermatologists over a four day period. Brief questionnaires were performed, followed by full body skin examinations and DLQI questionnaires completed were relevant. The data were analysed using chi square and Wilcoxon signed rank tests. RESULTS: One hundred and eighty-one participants were found to have a skin disease (53%). The six most common skin diseases were: eczema (22%), dermatophyte infections (19%), acne (10%), scabies infestation (9%), melasma (8%) and pityriasis versicolor (4%). Just over half of those with skin disease (51%) completed the DLQI, with scores ranging from 0 to 24. Those with skin problems on examination were significantly more likely to be farmers, have had a previous skin problem, be older or live in a smaller family. Conclusions This study represents the first formal documentation of skin disease prevalence in Laos and establishes the high rate of skin disease in the rural community and the associated impact these diseases have on health-related quality of life.


Assuntos
Nível de Saúde , Qualidade de Vida , População Rural/estatística & dados numéricos , Dermatopatias/epidemiologia , Acne Vulgar/epidemiologia , Acne Vulgar/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bullying , Criança , Pré-Escolar , Dermatomicoses/epidemiologia , Dermatomicoses/psicologia , Eczema/epidemiologia , Eczema/psicologia , Feminino , Acesso aos Serviços de Saúde , Humanos , Lactente , Laos , Masculino , Melanose/epidemiologia , Melanose/psicologia , Pessoa de Meia-Idade , Neurodermatite/epidemiologia , Neurodermatite/psicologia , Dor , Prevalência , Prurido , Escabiose/epidemiologia , Escabiose/psicologia , Dermatopatias/psicologia , Participação Social , Inquéritos e Questionários , Tinha Versicolor/epidemiologia , Tinha Versicolor/psicologia , Adulto Jovem
15.
Sci Rep ; 8(1): 17583, 2018 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-30514955

RESUMO

Mycelium and mycelium-biomass composites are emerging as new sustainable materials with useful flame-retardant potentials. Here we report a detailed characterisation of the thermal degradation and fire properties of fungal mycelium and mycelium-biomass composites. Measurements and analyses are carried out on key parameters such as decomposition temperatures, residual char, and gases evolved during pyrolysis. Pyrolysis flow combustion calorimetry (PCFC) evaluations reveal that the corresponding combustion propensity of mycelium is significantly lower compared to poly(methyl methacrylate) (PMMA) and polylactic acid (PLA), indicating that they are noticeably less prone to ignition and flaming combustion, and therefore safer to use. The hyphal diameters of mycelium decrease following pyrolysis. Cone calorimetry testing results show that the presence of mycelium has a positive influence on the fire reaction properties of wheat grains. This improvement is attributable to the relatively higher charring tendency of mycelium compared to wheat grain, which reduces the heat release rate (HRR) by acting as a thermal insulator and by limiting the supply of combustible gases to the flame front. The mycelium growth time has been found to yield no significant improvements in the fire properties of mycelium-wheat grain composites.


Assuntos
Fogo , Retardadores de Chama , Micélio/metabolismo , Tinha Versicolor/metabolismo , Triticum/metabolismo , Grãos Integrais/metabolismo , Calorimetria , Gases/análise , Poliésteres/química , Polimetil Metacrilato/química , Pirólise , Temperatura
17.
J Mycol Med ; 28(4): 590-593, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30340859

RESUMO

Pityriasis versicolor (PV) is a superficial mycosis caused by yeast of the genus Malassezia. The most common isolated Malassezia species in PV lesions differ among M. furfur, M. globosa and M. sympodialis. We purpose to determine the distribution of Malassezia species in PV patients at the seafarers' medical service in Dakar, Senegal and to examine whether any association between identified Malassezia species and patients' profile. From May 2017 to August 2017, first a questionnaire was filled to get informative data before collection of skin scrapings taken from most scaly site using sterile scalpel blade and application of scotch® for direct examination (DE). At the laboratory, DE, culture and identification by MALDI-TOF MS were done. One hundred patients with PV - all men - were included with a mean age of 34 years. Among seafarers, 81% were sailors. Clinical prevalence of PV was highest in aged adults patients with ages of 31 to 60 years (56%). Seafarers with high level of education were less representative with only 2%. The mean duration of the PV was 26.83 months. 20% of subjects suffered lesions in more than one location. The chest was the most affected anatomical site. Furthermore, possible predisposing factors associated with PV were also detected. DE was positive in 95% but culture growth only in 46%. MALDI-TOF MS analysis of the positive cultures could be performed in 84.8% (39/46). Only M. furfur was identified in 100% (39/39). In definitive, M. furfur is the only causative agent of PV in Dakar.


Assuntos
Malassezia/classificação , Malassezia/isolamento & purificação , Tinha Versicolor/microbiologia , Adolescente , Adulto , Humanos , Malassezia/genética , Masculino , Pessoa de Meia-Idade , Militares/estatística & dados numéricos , Prevalência , Fatores de Risco , Senegal/epidemiologia , Pele/microbiologia , Pele/patologia , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Tinha Versicolor/epidemiologia , Tinha Versicolor/patologia , Adulto Jovem
19.
Mycoses ; 61(12): 938-944, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30106184

RESUMO

Dihydroxyacid dehydratase (DHAD) is a key enzyme in biosynthetic pathway of isoleucine and valine. This pathway is absent in human but exists in various organisms such as fungi. Using RNA-seq analysis in this study, we identified MGL_3741gene which encodes DHAD protein in Malassezia globosa (M. globosa). Furthermore, we found that mentioned gene is homologous to the Ustilago maydis, Saccharomyces cerevisiae, Aspergillus flavus, and Aspergillus fumigatus ILV3P. For understanding the probable role of this gene in pathogenicity of M. globosa, we applied Real-time PCR to investigate the differentially expressed of the MGL_3741 gene in healthy and pathogenic states. Our results indicate a significant difference between two mentioned stats. These results revealed that ILV3-like gene in M. globosa can be related to the pathogenicity of this yeast.


Assuntos
Hidroliases/genética , Malassezia/enzimologia , Malassezia/patogenicidade , Tinha Versicolor/patologia , Fatores de Virulência/genética , Perfilação da Expressão Gênica , Humanos , Hidroliases/metabolismo , Malassezia/genética , Reação em Cadeia da Polimerase em Tempo Real , Análise de Sequência de RNA , Homologia de Sequência , Tinha Versicolor/microbiologia , Fatores de Virulência/metabolismo
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