Tinea manuum: A report of 18 cases observed in the metropolitan area of Milan and review of the literature.

OBJECTIVE: Tinea manuum is considered in Italy as an uncommon infection, although no recent epidemiological data are available. METHODS: In the period 2000-2018, we observed in the metropolitan area of Milan 18 patients with mycologically tinea manuum. RESULTS: The infection was monolateral in all patients and characterised by erythema and scaling; in two patients, each vesicles and pustules were present. Two patients had also onychomycosis of one fingernail. No cases of simultaneous tinea pedis were observed. As far as the job of these patients is concerned, seven of them were masseurs, three barbers, two cattlemen, two masons, one car mechanic, one florist, one maid and one veterinarian. Trichophyton rubrum was isolated in 6 patients, Microsporum canis in 4, Trichophyton gypseum in 3, Trichophyton verrucosum in 3 and Trichophyton violaceum in 2 patients. CONCLUSION: Masseurs were the most affected. Trichophyton rubrum and Microsporum canis were the most frequent isolated dermatophytes.

Tinea pedis acquired in mosques?

We present four cases of interdigital tinea pedis in Italian tourists which was probably acquired in Turkish mosques and holy Muslim places. In all patients mycological examinations were positive for Trichophyton rubrum. All patients were successfully treated with bifonazole cream (one application/day for three weeks). It is advisable for tourists to wear socks when visiting mosques and holy Muslim places.

The association of isoconazole-diflucortolone in the treatment of pediatric tinea corporis.

BACKGROUND: Tinea corporis is a common mycotic infection in children. Staphylococcus aureus superinfections may be observed in atopic children with tinea corporis suffering from severe pruritus and consequent scratching. OBJECTIVE: From 2006 to 2011, we observed 288 children with mycologically proven tinea corporis. In 39 of them (13.5%) tinea corporis was superinfected by S. aureus: all these children were affected by atopic dermatitis. We interpreted these bacterial superinfections as the clinical result of scratching due to pruritus. METHODS: In 2012, we decided to treat all children with a single lesion of tinea corporis with a combination of 1% isoconazole nitrate and 0.1% diflucortolone valerate cream (one application/day for 5-7 days), followed by a treatment with isoconazole or clotrimazole or ciclopirox cream (two applications/day for two weeks). RESULTS: From 2012 to 2014, we observed 108 children with tinea corporis confirmed by mycological examinations. Clinical and mycological recovery was observed in 93 of them (86.1%). Only four of these children (3.7%) developed S. aureus superinfections. CONCLUSIONS: Our study in atopic children with tinea corporis superinfected by S. aureus confirms that a topical therapy with the association isoconazole-diflucortolone is useful and safe.

Onychomycosis by Paecilomyces lilacinus.

The authors describe a case of onychomycosis by Paecilomyces lilacinus in an 81-year-old Caucasian woman. The infection was characterized clinically by yellow-brown discoloration of the nail plate, distal-lateral onycholysis and subungual hyperkeratosis of the first left toenail. Microscopic examination showed irregular hyphae. Four cultures showed the development of lilac and powdery colonies. Conidiophores with divergent long narrow terminal phialides were observed at microscopic examination of culture samples. Therapy with amorolofine nail laquer, itraconazole and terbinafine was uneffective. This is the sixth case published in the literature of Paecilomyces lilacinus onychomycosis, and the second Italian case of Paecilomyces lilacinus infection.

Seborrheic dermatitis-like tinea faciei.

We report a 10-year-old Caucasian child who had erythema and abundant scaling on the nasolabial folds, the upper lip, and on the nose. Both the abundant scaling and the localization on the central part of the face led us to suspect seborrheic dermatitis. Direct microscopic examination of some scales removed from the lesions showed septate and ramified ectothrix hyphae. Cultural examination on Sabouraud medium led to the identification of the Trichophyton mentagrophytes species. We described this patient to highlight the importance of considering tinea faciei in the differential diagnosis of all facial eruptions and the value of mycologic examination.