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1.
Dermatol Online J ; 26(2)2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-32239896

RESUMO

An 89-year-old woman presented with plaque-like lesions, accompanied with pustules and desquamation on the back and front of the trunk for approximately one year. Long term use of potent topical corticosteroids was ineffective. Because of the chronicity of her condition, the diagnoses of subcorneal dermatosis or subcorneal pustular dermatosis type of IgA pemphigus were considered. However, fungal hyphae were observed in the potassium hydroxide examination. Therefore, we present this case since this clinical appearance of tinea incognito can also mimic various pustular dermatoses.


Assuntos
Dermatopatias Vesiculobolhosas/diagnóstico , Tinha/diagnóstico , Administração Tópica , Corticosteroides/administração & dosagem , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Fungos/isolamento & purificação , Humanos , Dermatopatias Vesiculobolhosas/tratamento farmacológico
3.
BMC Infect Dis ; 20(1): 171, 2020 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-32087692

RESUMO

BACKGROUND: Trichophyton benhamiae is a zoophilic dermatophyte that can cause tinea in humans and animals. Lesions caused by T. benhamiae tend to be highly inflammatory, and patients are often infected by animals or other patients infected with T. benhamiae. In this paper, we report the first case of tinea faciei caused by T. benhamiae in a Chinese girl who might be transmitted from a fox. CASE PRESENTATION: A 4-year-old girl from HaiNing city developed an itchy, erythematous, and annular plaque on her right face for the past 2 months. Before the lesion appeared, she was in close contact with the fur of a fox for almost 1 week. Septate hyaline hyphae were detected by direct mycological examination of the scales. Cultures grew on Sabouraud's dextrose agar (SDA) at 26 °C for 2 weeks revealed the presence of T. mentagrophytes. A molecular sequencing test confirmed that the isolate was consistent with reference strains to T. benhamiae. Then, the diagnosis of tinea faciei due to T. benhamiae was made. Treatment with terbinafine (oral 125 mg/d) and sertaconazole nitrate cream (topical, twice daily) for 4 weeks was initiated and achieved significant improvement of the skin lesions. CONCLUSIONS: This rare dermatophytosis case highlights the importance of ITS sequencing in helping to recognize rare pathogenic fungi that can be easily misdiagnosed with a conventional morphological diagnosis.


Assuntos
Arthrodermataceae/genética , Dermatomicoses/diagnóstico , Tinha/diagnóstico , Trichophyton/genética , Administração Oral , Administração Tópica , Animais , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Arthrodermataceae/isolamento & purificação , Pré-Escolar , China , Dermatomicoses/tratamento farmacológico , Dermatomicoses/microbiologia , Face/patologia , Feminino , Humanos , Imidazóis/administração & dosagem , Imidazóis/uso terapêutico , Pele/patologia , Terbinafina/administração & dosagem , Terbinafina/uso terapêutico , Tiofenos/administração & dosagem , Tiofenos/uso terapêutico , Tinha/tratamento farmacológico , Tinha/microbiologia , Resultado do Tratamento , Trichophyton/isolamento & purificação
4.
Mycoses ; 63(1): 113-118, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31642133

RESUMO

Onychomycosis (OM), has a worldwide prevalence of 5% and 0.5%-5% in India. Trichophyton. rubrum (T rubrum) and T mentagrophytes are the most commonly isolated fungi. As the clinical and mycological characteristics change with time and geographical region; it is important to study the temporal and topographic patterns periodically. The study was conducted to identify the epidemiological and clinico-mycological characteristics of patients with OM attending a tertiary care hospital in Delhi. Hundred patients with clinical diagnosis of OM were recruited. Among these, 88 patients who tested positive for OM on direct microscopy with KOH, culture and/or histopathology with periodic acid-Schiff were included in the study. The clinico-mycological characteristics and risk factors associated with OM were evaluated. OM was more common in males (M:F = 2.5:1). The mean age of patients with OM was 39 ± 15.3 years (SE 1.52) with mean disease duration of 27.6 ± 46.1 months (SE 4.9). Seventeen (19.3%) patients had concomitant diabetes mellitus. The patients displayed mean body mass index (BMI) of 25.67 ± 1.35 kg/sq m. Concurrent dermatophytosis of skin was present in 35 (39.77%) patients. Two feet-one hand syndrome was present in 5 patients. Fingernail involvement without toenail involvement was more common than toenail involvement alone. (43.18% vs 38.63%). Distal and lateral subungual OM (DLSO) was the commonest clinical variant (81.8%). Mycological culture showed growth in 47 (53.40%) patients. Dermatophytes were isolated in majority, that is in 30 (63.82%) patients followed by non-dermatophytic moulds (NDM) in 7 (14.8%) and Candida spp. in the remaining 10 (21.27%) patients.


Assuntos
Unhas/microbiologia , Onicomicose , Adolescente , Adulto , Idoso , Arthrodermataceae/isolamento & purificação , Candida/isolamento & purificação , Estudos Transversais , Diabetes Mellitus , Feminino , Dermatoses do Pé/microbiologia , Dermatoses da Mão/microbiologia , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Unhas/patologia , Onicomicose/diagnóstico , Onicomicose/epidemiologia , Onicomicose/patologia , Prevalência , Fatores de Risco , Centros de Atenção Terciária , Tinha/diagnóstico , Trichophyton/isolamento & purificação , Adulto Jovem
5.
BMC Infect Dis ; 19(1): 983, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752715

RESUMO

BACKGROUND: Dermatophytosis is a fungal infectious disease caused by dermatophytes, which produce protease and keratinase to digest keratin, leading to the colonization, invasion, and infection of the stratum corneum of the skin, hair shafts, and nails. Trichophyton interdigitale belongs to Trichophyton mentagrophytes complex, which is the common pathogen causing dermatophytosis. Fungal keratitis, also called keratomycosis, is an infectious disease of cornea. CASE PRESENTATION: Here, we report a case of simultaneous dermatophytosis and keratomycosis caused by Trichophyton interdigitale. A 67-year-old man presented with extensive erythema all over the body since 4 years ago, fungal infection of left eye for 2 years, and loss of vision in the eye. These symptoms had become aggravated in the last month. Dermatological examinations showed extensive erythematous plaques with clear borders and scales, scattered red papules with ulceration, and scabs throughout the body. Onychomycosis was observed on the nails of left hand, conjunctival infection with secretion and loss of vision were noted in left eye. Hyaline septate hyphae were observed under direct microscopic examination, fungal culture and internal transcribed spacer sequencing revealed T. interdigitale. Histopathological examination suggested infectious granuloma. A diagnosis of dermatophytosis and keratomycosis caused by T. interdigitale with loss of vision in left eye was made. The patient was treated with luliconazole cream (two applications per day) and itraconazole (100 mg, BID, PO). Complete clinical remission was achieved after 1 month. Subsequently, the patient underwent left eye enucleation in the ophthalmology department. CONCLUSIONS: In the present study, we reported a case of simultaneous dermatophytosis and keratomycosis caused by T. interdigitale, and reviewed the literature on corneal infection caused by Trichophyton. A total of 10 articles with 45 patients were published between 1973 and 2018. The pathogen of 27 patient were identified to species level. There were T. schoenleinii (17), T. mentagrophytes (4), T. verrucosum (3), T. rubrum (1), T. erinacei (1), and T. interdigitale (1). Five patients had corneal trauma, one had contact lens use history. Direct microscopic examination, fungal culture, and analysis of physiological characteristics were the main methods of identification. Early diagnosis and prompt treatment may help improve the management and outcomes.


Assuntos
Ceratite/microbiologia , Tinha/microbiologia , Trichophyton/isolamento & purificação , Idoso , Antifúngicos/administração & dosagem , Humanos , Itraconazol/administração & dosagem , Ceratite/diagnóstico , Ceratite/tratamento farmacológico , Masculino , Unhas/microbiologia , Pele/microbiologia , Tinha/diagnóstico , Tinha/tratamento farmacológico , Trichophyton/genética , Trichophyton/crescimento & desenvolvimento , Trichophyton/fisiologia
7.
J Mycol Med ; 29(4): 352-355, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31611164

RESUMO

Trichophyton is the most common dermatophyte genus responsible for tinea corporis and topical treatment with terbinafine is effective for limited disease but extensive disease required systemic therapy. Failure of terbinafine therapy in patients infected with T. rubrum or T. mentagrophytes is associated with mutations in the gene encoding squalene epoxidase, the terbinafine target. We report two cases of tinea corporis resistant to systemic terbinafine in a 60-year-old man and his wife, a 51 year-old-woman. Both patients had multiple diffuse erythematous annular scaly plaques and T. mentagrophytes was isolated in culture. Systemic treatment with terbinafine in combination with topical terbinafine and then topical ketoconazole failed to improve the disease after 8 weeks. The broth microdilution tests performed to evaluate the antifungal sensitivity of the T. mentagrophytes isolate revealed a high MIC for terbinafine but a low MIC for posaconazole and itraconazole. An A1223T point mutation leading to a Q408L substitution was identified by DNA sequencing the SQLE gene of the isolate. Itraconazole 200mg daily was then introduced but stopped because of elevated liver transaminases in the man. Finally, complete healing was achieved only six months later for both patients and required a 3 and 2-week regimen of itraconazole with topical eberconazole in the man and woman respectively. We believe that a close monitoring and antifungal susceptibility tests should now be done more systematically in dermatophytic infections that do not respond to conventional treatment as terbinafine resistant strains are likely to spread worlwide.


Assuntos
Proteínas Fúngicas/genética , Mutação Puntual , Terbinafina/farmacologia , Tinha/microbiologia , Trichophyton/genética , Antifúngicos/farmacologia , Farmacorresistência Fúngica , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Tinha/diagnóstico , Tinha/tratamento farmacológico , Trichophyton/efeitos dos fármacos , Trichophyton/isolamento & purificação
10.
BMJ Case Rep ; 12(8)2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31466986

RESUMO

Kerion is a severe hypersensitivity reaction to fungal infection that is rarely seen in the groin. Frequent shaving of pubic hair and religious conservatism surrounding genital hygiene are common among Bedouin women in the Negev Desert, and may predispose to kerion. This case highlights the clinical course of a 20-year-old Bedouin woman who presented with severe kerion celsi of the pubis and vulva with secondary bacterial infection. The patient was successfully treated with intravenous antibiotics, oral antifungal medication and wet topical dressings. The case outlines the risk factors and treatment for severe kerion celsi of the groin, as well as possible preventive measures that may reduce its incidence.


Assuntos
Infecções Bacterianas/tratamento farmacológico , Osso Púbico/microbiologia , Tinha do Couro Cabeludo/complicações , Tinha/complicações , Vulva/microbiologia , Administração Intravenosa , Administração Oral , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/etiologia , Feminino , Virilha/microbiologia , Virilha/patologia , Humanos , Osso Púbico/patologia , Tinha/diagnóstico , Tinha/tratamento farmacológico , Tinha do Couro Cabeludo/diagnóstico , Tinha do Couro Cabeludo/tratamento farmacológico , Resultado do Tratamento , Trichophyton/isolamento & purificação , Vulva/patologia , Adulto Jovem
11.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-31434126

RESUMO

Dermatophytosis is a cutaneous infection, caused by several types of keratophilic fungi (dermatophytes). It represents a serious and common contagious skin disease in dogs and cats. The significance of this disease for pet owners is based on the zoonotic potential. The prevalence varies with climate and local dermatophyte infestation. The most common infection in dogs and cats are caused by the genera Microsporum (M.), Nannizzia (N.) or Trichophyton (T.). The aim of this article is to summarise novel taxonomy, diagnosis, and treatment recommendations as well as the recently revised recommendations of the World Association of Veterinary Dermatology.


Assuntos
Doenças do Gato/microbiologia , Doenças do Cão/microbiologia , Tinha/veterinária , Animais , Arthrodermataceae/genética , Arthrodermataceae/isolamento & purificação , Arthrodermataceae/patogenicidade , Biópsia/veterinária , Doenças do Gato/diagnóstico , Doenças do Gato/terapia , Gatos , Diagnóstico Diferencial , Doenças do Cão/diagnóstico , Doenças do Cão/terapia , Cães , Meio Ambiente , Humanos , Microsporum/isolamento & purificação , Microsporum/patogenicidade , Tinha/diagnóstico , Tinha/microbiologia , Tinha/terapia , Trichophyton/patogenicidade , Zoonoses/diagnóstico , Zoonoses/microbiologia
12.
J Drugs Dermatol ; 18(8): 825-826, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31424715

RESUMO

Psoriasis is a common dermatologic condition with a variety of morphologic presentations. These variations include the less common hyperkeratotic form, psoriasis ostracea, defined as having pronounced adherent scales resembling an oyster shell. Of the ostraceous cases that have been reported in the literature, many occur as generalized outbreaks in patients with long-standing history of psoriasis. Rarely does this remarkable variant occur as a direct flare from a cutaneous insult. In these situations, when a pre-existing dermatosis appears in response to a traumatic insult to skin, the process is referred to as the Koebner phenomenon. In addition to lichen planus and vitiligo, psoriasis is a commonly known condition that can present as a Koebner reaction. In this atypical case, the authors present a 21-year-old male with remarkable ostraceous psoriatic lesions precipitated by an upper arm tattoo, demonstrating the Koebner phenomenon.


Assuntos
Psoríase/diagnóstico , Tatuagem/efeitos adversos , Biópsia , Dermatite Seborreica/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Psoríase/etiologia , Psoríase/patologia , Índice de Gravidade de Doença , Pele/patologia , Tinha/diagnóstico , Adulto Jovem
13.
Braz J Microbiol ; 50(4): 985-987, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31463867

RESUMO

Arthroderma benhamiae is a zoophilic dermathophyte that can cause highly inflammatory tinea corporis and tinea capitis in humans. This is the first report of a patient with dermatophytosis caused by A. benhamiae in Brazil. The lesion was an erythematous, annular plaque on the lumbar region that appeared few weeks after playing with a street cat in a 19-month-old girl. Initial presumed diagnosis was tinea corporis caused by Microsporum canis. Topical treatments were ineffective and the patient required systemic treatment with griseofulvin. Mycological diagnosis was inconclusive: morphological differentiation between M. canis and Trichophyton benhamiae may be difficult, especially when the latter present yellow colonies. The etiological agent was identified only by ITS sequencing of the isolates aligned with reference strains to A. benhamiae. This report highlights the importance of ITS sequencing in the identification of isolates from some cases of dermatophytosis, because conventional morphological diagnosis may result in misdiagnosis of the agent and delay proper treatment.


Assuntos
Arthrodermataceae/isolamento & purificação , Dermatomicoses/microbiologia , Tinha do Couro Cabeludo/microbiologia , Tinha/microbiologia , Antifúngicos/administração & dosagem , Arthrodermataceae/classificação , Arthrodermataceae/genética , Brasil , Dermatomicoses/diagnóstico , Dermatomicoses/tratamento farmacológico , Feminino , Humanos , Lactente , Tinha/diagnóstico , Tinha/tratamento farmacológico , Tinha do Couro Cabeludo/diagnóstico
14.
Cutis ; 103(6): 357-360, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31348450

RESUMO

Erythema gyratum repens (EGR) is a rare and poorly understood dermatosis. The relationship of superficial dermatophytic infection to EGR-like eruptions in mycosis fungoides (MF) is unclear. We present a case of an EGR-like eruption in a patient with Sézary syndrome (SS). Histopathologic examination revealed both a superficial dermatophyte (Trichophyton rubrum) and cutaneous T-cell lymphoma (CTCL) in biopsies of the skin, regardless of whether those biopsies showed EGR-like lesions or erythroderma clinically. On 2 occasions, treatment of the superficial dermatophytic infection led to resolution of the EGR-like eruption and associated pruritus but not to resolution of the erythroderma. This case supports a role for dermatophytic superinfection in an EGR-like eruption in SS. Further investigation is necessary to fully understand the impact of dermatophytic infection in this clinical setting.


Assuntos
Eritema/diagnóstico , Linfoma Cutâneo de Células T/diagnóstico , Síndrome de Sézary/patologia , Neoplasias Cutâneas/diagnóstico , Tinha/diagnóstico , Idoso , Biópsia , Eritema/etiologia , Feminino , Humanos , Linfoma Cutâneo de Células T/patologia , Neoplasias Cutâneas/patologia , Tinha/patologia , Trichophyton/isolamento & purificação
16.
Medwave ; 19(6): e7666, 2019 Jul 17.
Artigo em Espanhol | MEDLINE | ID: mdl-31348769

RESUMO

Tinea nigra is an infrequent superficial mycosis caused by the dematiaceous fungus Hortaea werneckii. It usually occurs in tropical coastal areas, with very few reports in South American countries with temperate climates, generally corresponding to infections imported by travelers. We present the case of a Chilean adult patient, with no previous history of recent trips, with clinical and microbiological background consistent with palmar tinea nigra, treated with oral itraconazole and topical sertaconazole with a favorable response. This article is the first case reported in Chile, of autochthonous origin.


Assuntos
Antifúngicos/administração & dosagem , Imidazóis/administração & dosagem , Itraconazol/administração & dosagem , Tiofenos/administração & dosagem , Tinha/diagnóstico , Adolescente , Chile , Feminino , Humanos , Tinha/tratamento farmacológico , Resultado do Tratamento
19.
Adv Skin Wound Care ; 32(8): 350-357, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31335433

RESUMO

GENERAL PURPOSE: To provide information about the epidemiology, clinical features, and management of cutaneous tinea infections. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be better able to:1. Summarize the epidemiology related to cutaneous tinea infections.2. Describe the clinical features of cutaneous tinea infections.3. Identify features related to the diagnosis and management of cutaneous tinea infections. ABSTRACT: Dermatophyte or tinea infection refers to a group of superficial fungal infections of the hair, skin, and nails. Tinea infections are most commonly caused by fungi of the genus Trichophyton, Microsporum, or Epidermophyton. Cutaneous manifestations of tinea infections are seen worldwide and classified based on the affected body site. The diagnosis of these conditions is complicated by morphologic variations in presentation and overlap with other common infectious and noninfectious entities. As a result, diagnosis and appropriate management of these conditions are essential to avoid patient morbidity. This case-based review summarizes the epidemiology, relevant clinical features, microbiology, and management considerations for commonly encountered tinea infections.


Assuntos
Antifúngicos/uso terapêutico , Higiene da Pele/normas , Tinha/diagnóstico , Tinha/tratamento farmacológico , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Humanos , Trichophyton/isolamento & purificação
20.
CMAJ ; 191(22): E615-E616, 2019 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-31160499
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