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[Dermatomycosis and environment].

Environments may act as reservoirs for pathogenic fungi, a determinant of the establishment of fungal infection, or an exacerbating factor of disease. In recent years, skin disease caused by geophilic fungi has been decreasing, while case reports of zoonoses from various animals are increasing. Outbreaks of anthropophilic T. tonsurans infection pose a problem to medical mycologists. Tinea pedis is the most common exogenous dermatomycosis in Japan. Although T. rubrum is presumed to be the dominant pathogen of this disease, T. mentagrophytes is detected more frequently from various environments, so far, the reason for this discrepancy has not been fully understood. The latest knowledge about the route of dermatophyte foot infection is as follows: (1) Dermatophyte propagules disseminated from patients may contaminate not only bath-mats but also wood floors, Japanese style mattings, concrete floors, slippers, cushions, etc., and from them adhere to healthy skin. (2) The agar stamping method can easily detect dermatophytes from the skin and the environment. (3) Propagules of T. mentagrophytes can survive for more than three months under certain conditions such as in rubber boots. (4) In order to eliminate dermatophytes gathered in socks and footwear, simple procedures (washing, bathing with hot water, or wiping with a towel) are all effective. (5) Prior application of an antifungal agent promptly eradicates dermatophyte propagules adhering to the skin from the environment. The author also mentioned the possibility of asymptomatic dermatophyte colonization, and the high prevalence of dysgeucia in oral carriers of Candida albicans.

Animals↗

Occurrence of dermatomycosis (ringworm) due to Trichophyton verrucosum in dairy calves and its spread to animal attendants.

Persistent dermatomycosis (ringworm) caused by Trichophyton verrucosum affected 20 dairy calves aged between 3 months and 1 year and housed together. The infection also spread to 2 animal attendants working among the calves. The major clinical lesions observed on the affected calves were extensive alopecia and/or circumscribed thick hairless skin patches affecting the head, neck, flanks and limbs. The observed lesions persisted for more than 17 weeks and most of the calves did not respond to topical treatment with various anti-fungal drugs within the anticipated period of 9 weeks. Two animal attendants developed skin lesions that were circumscribed and itchy and there was good response to treatment following the application of anti-fungal skin ointment. Although ringworm in dairy animals in Kenya has not previously been associated with spread to humans, the potential is evident from this report.

Animal Technicians↗

[Update on the diagnosis of dermatomycosis].

Dermatomycosis are mycotic diseases of skin caused by a few mycetes: dermatophytes, and some opportunistic fungi as Malassezia, Candida (not C. albicans), Trichosporon, Rhodutorula, Cryptococcus or Aspergillus, Geotrichum, Alternaria, etc. Dermatophytes are a group of closely related filamentous fungi that invade keratinized tissue (skin, hair, nails) of humans and other animals and produce infection called dermatophytosis or ringworm or "tinea". The etiological agents of dermatophytosis are classified in three genera: Microsporum, Trichophyton and Epidermophyton (Deuteromycetes). On the basis of their primary habitat dermatophytes are divided in Anthropophilic dermatophytes (parasitic organisms that infect humans), Zoophilic dermatophytes (parasitic organisms that infect animals, but also humans: agents of zoonosis) and Geophilic dermatophytes (saprobic fungi associated with keratinous materials in soil). In the soil there are also structure associated with contagion, ("spore", "arthroconidium", or "clamydospore") of anthropophilic and zoophilic dermatophytes that may persist for years, in the environment, in hair or skin scales. Since on the skin of animals there are many saprobic organisms (Malassezia) and many fungi may infect the fur, it is important to make an accurate diagnosis. Dermatophytosis are communicable diseases acquired from infected animals or from fomites. Infections caused by dermatophytes is a ringworm. These infections may range from mild and superficial, almost subclinical, to a few areas of scaling to a highly inflammatory reaction with extensive areas of scarring and alopecia. Granuloma formations (mycetoma-like) may occur especially in cats. Dermatophytes, as filamentous fungi, undergo radial fungi: collection of skin material is best made by collecting the scales near the edges of the rings. Hairs are best sampled by plucking; a scalpel may be used to scrape scales; brushes have also been used. Sample materials are best transported in dry packet. The Wood's light may be used to identify infected fluorescent hairs. Direct microscopy, although false negative up to 50% of cases, is a highly efficient screening technique. Scraping and hairs should mixed to 10-15% KOH. Culture is a valuable adjunct to direct microscopy and is essential to identify more dermatophytes. A medium selective against most nondermatophytic moulds and bacteria is used as a primary isolation medium. Many typical isolates of common dermatophytes can be identified directly from primary isolation media. Identification characters include: colony pigmentation, texture, morphological structure (macroconidia, microconidia, spirals, pectinate branches, etc). Nutritional requiment, growth in special media, "in vitro" perforation, mating studies are procedures used to identify atypical isolates. Serological approaches have revealed difficulties. Many kinds of molecular biologic techniques have been made available for clinical diagnosis recently; almost all of these techniques involve the polymerase chain reaction (PCR).

Alopecia↗

Comparison of trypsin treatment method and standard laboratory technique for diagnosis of dermatomycosis.

Dermatomycosis is prevalent worldwide. Discrepancy between microscopic examination and culture findings can create problems in the diagnosis of this common infection. In this study, samples from 60 patients were processed after trypsin treatment and examined by neutral red staining to distinguish viable and non-viable fungal elements. The trypsin treatment method was compared with standard laboratory techniques. A higher number of direct-microscopy-positive, culture-negative samples were obtained without trypsin treatment. Trypsin treatment increased the isolation of fungi from clinical samples, and neutral red staining was able to distinguish viable fungal elements.

Candida↗

[Three cases of imported dermatomycosis by Scytalidium dimidiatum].

Scytalidium dimidiatum dermatomycosis are usually reported in tropical and subtropical countries. Some cases in Spain have been diagnosed due to the increasing number of immigrants from these areas. We herein describe three new cases of S. dimidiatum infections detected in Madrid. Two patients were from Guinea Ecuatorial and the third from Angola. We also report the first case of S. dimidiatum infection in a HIV patient in Spain. Clinical and epidemiological characteristics of S. dimidiatum infections reported in Spain are discussed.

English Abstract↗

Trichophyton mentagrophytes var. quinckeanum as a cause of zoophilic dermatomycosis in a human family.

Trichophyton mentagrophytes var. quinckeanum is a zoophilic form of T. mentagrophytes. It induces murine favus in the form of coarse yellow scutules bigger than 1 cm in diameter. In March, 2002, a 52-year-old male patient was examined at the Dermatology Clinic of the Medical Faculty in Kosice with a 1-week anamnesis of a solitary, oval, annular focus, 3 cm in diameter, on the right side of his face, located subauricularly. When providing the history, he has mentioned that his 12-year-old son has a ,,similar skin disease". Clinical examination of the son showed similar annular oval lesion, size about 2 x 3 cm, located in the right chest region. Since January 2002 the family has kept a guinea pig. They have obtained it through a mediator from the Kosice ZOO. The material for mycological examination was taken from peripheral parts of the foci or desquamating lesions from the father, son, and the guinea pig. Scales were examined microscopically in 20 % KOH solution with Parker's blue-black ink. The findings proved the presence of septal hyphae and formation of arthrospores. Thus, dermatomycosis was confirmed in the father and son, caused by T. mentagrophytes var. quinckeanum, the source of which was a pet guinea pig (Fig. 3, Ref. 17).

Animals↗

Some systemic effects of superficial dermatomycosis.

A baffling case of systemic dermatomycosis is presented and the course of therapy instituted for 12 months described. There has been marked improvement in the patient, both subjectively and objectively, the first in his five-year history. Thirty-five additional and comparative patients were identified during the 12-month time period. These patients were placed on therapy and their responses to treatment were equally impressive.

Dermatomycoses↗

[Dermatomycosis in sheep caused by a rare strain of Trichophyton verrucosum].

In the group of sheep reared for blood collections the enzootic occurrence of dermatomycosis was found affecting the hair on the head and back. From the pathological material obtained from the lesions of twelve animals an identical strain of Trichophyton verrucosum was cultivated which differed from common isolates of this type macromorphologically. By its ability to grow in the medium without vitamin and by its thermotolerance this isolate resembled the physiological variety T. verrucosum Bodin 1902, var. autotrophicum Scott 1976. On the example of trichophytosis in the described sheep flock epizootological importance of foci of this infection is demonstrated in flocks where no immunopreventive precautions are taken.

Animals↗

Antifungal activity of fenticonazole in experimental dermatomycosis and candidiasis.

The antifungal activity of alpha-(2,4-dichlorophenyl)-beta,N-imidazolylethyl 4-phenylthiobenzyl ether nitrate (fenticonazole, Rec 15/1476) in experimental dermatomycosis and candidiasis in guinea pigs was studied. Fenticonazole proved to be a very active drug with a healing capacity generally higher than that of the reference compounds. The adequate range of activity was from 1% to 3%, giving complete healing without relapses in 100% of cases treated. Fenticonazole is presently undergoing further experimental studies and on the basis of our results a clinical trial would therefore seem to be essential.

Animals↗

Double-blind comparative examination of ketoconazole 1% cream and clotrimazole 2% ointment in superficial dermatomycosis.

Comparative examinations were performed with ketoconazole (Nizoral) 1% cream and clotrimazole (Canesten) 2% ointment in 41 patients suffering from superficial dermatomycosis. Twenty-one patients were treated with ketoconazole, twenty patients, with clotrimazole twice daily, for a maximum 4 weeks. The results of the clinical and mycological examinations showed no significant differences when comparing the two groups treated with the different products. Trichophyton rubrum was the most frequently isolated strain in both groups. Side-effect occurred in two of the patients treated with ketoconazole cream (erythema, burning sensation) which did not require the discontinuation of therapy. In the clotrimazole-treated group the therapy had to be discontinued in 3 patients because of dryness of skin, burning sensation, and aggravation of inflammatory symptoms.

Administration, Cutaneous↗

Mycological aspects of dermatomycosis in Ludhiana.

159 clinically diagnosed cases of dermatomycosis were examined and subjected to mycological study. In the direct microscopic examination, 78 (49.05%) cases were positive and cultures were positive in 66 (41.5%) cases. The common clinical presentation was T. corporis in 60 (37.7%) cases. The commonest species encountered was T. rubrum (42.42%) followed by Epidermophyton floccusum (15.15%), Candida (13.63%), T. violaceum (12.12%), T. mentagrophyte (6.06%) & T. tonsurans (1.5%) in this study. The prevalence of infection was more in males.

Adolescent↗