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PubMed1986

Dermatophytosis of the external auditory meatus.

Thirty-two cases of dermatophyte infection in the external auditory meatus are reported. All the patients complained of slight itching or accumulation of cerumen; however, they had no other serious complaints. Otoscopy revealed lesions in the outer third of the ear canal. The skin of the meatus externus osseus and the surface of the tympanic membrane were all intact. In all cases, mycelial elements were demonstrated in KOH mounts of scrapings, and Trichophyton rubrum (29 cases), Microsporum canis (2 cases), and Epidermophyton floccosum (1 case) were isolated. All patients had ringworm of the pinna at the time of examination or in the past.

Adult↗

PubMedDate not supplied

The quality of life of families of female-headed households in Botswana: a secondary analysis of case studies.

Previous studies note a positive relationship between female-headed households (FHHs) and poverty in urban and rural areas of Botswana. To explore this further, data were collected from 7 FHHs through participant observation and open-ended interviews. A secondary analysis of data described the quality of life (QOL) of members of the households according to one's ability to meet basic human needs (food, water, shelter, safety, and health). FHHs ranged in age from 40-91 years, with family size ranging from 1-11 members. Monthly income for 6 of the 7 families was 30 dollars (U.S.) per month or less. Physical living environments were overcrowded, with poorly maintained latrines and unsafe refuse disposal. Family illnesses included hypertension, cataracts, mental illness, knee pain, ringworm, leg sores, and tonsillitis. Health risk behaviours included unprotected sex, alcohol abuse, and breastfeeding among potentially HIV positive mothers. Although Botswana claims rapidly rising levels of national income after independence, the QOL of FHHs remains poor. We suggest that, to alleviate poverty, governments in developing African countries should explore strategies that effectively target families headed by women.

Adult↗

PubMed2000

Molecular approaches to the study of dermatophytes.

Dermatophyte species are common keratinophilic fungi responsible for superficial infections called dermatophytosis or ringworm and composed of three anamorphic genera, Trichophyton, Microsporum and Epidermophyton. Through the use of several complementary molecular methods, dermatophytes have been shown to constitute an homogeneous group of species with very low genetic diversity contrasting with high phenotypic heterogeneity. For diagnostic applications, distinction among isolates to the species level was easily performed using polymerase chain reaction-based assays, which could be useful tools in the mycology laboratory, particularly for atypical isolates. In contrast, in all but a few cases distinction between dermatophyte strains has failed, which has hindered the development of molecular-based epidemiological investigations.

Animals↗

PubMed2000

Thallium poisoning during pregnancy: a case report and comprehensive literature review.

BACKGROUND: Thallium salts were once used to treat a variety of disorders such as tuberculosis, sexually transmitted diseases, and ringworm of the scalp. Although the clinical manifestations and treatment of patients with thallium poisoning are well characterized, little information is available on the outcome of pregnancy in thallium-poisoned women. A case of thallium poisoning that began during the first trimester of pregnancy and resulted in fetal demise is reported. METHODS: An extensive literature search identified reported cases of thallium poisoning during pregnancy from 1903 until the present time. All articles were obtained, translated, and abstracted using a standardized data collection form. References were hand-searched and abstracted to identify additional cases. RESULTS: From a total of 25 cases identified, only 18 met satisfactory criteria for inclusion. Five exposures occurred during the first trimester, 5 during the second trimester, and 8 during the third trimester. Mothers developed classic signs and symptoms of thallium poisoning. Summary of these cases demonstrates a range of fetal effects from severe toxicity with residual sequelae to outwardly normal development. Interestingly, some newborns appeared normal despite severe maternal toxicity. The only consistent effect identified was a trend toward prematurity and low birth weight in children exposed during early gestation. CONCLUSIONS: These cases document the transfer of thallium both across the placenta and in breast milk. Insufficient data are available to evaluate prognostic markers of fetal outcome, or the risks and benefits of various treatment regimens in pregnant patients with thallium poisoning.

Adult↗

PubMed1976

Follow-up study of patients treated by x-ray epilation for tinea capitis. Estimation of the dose to the thyroid and pituitary glands and other structures of the head and neck.

This study is a further investigation of radiation dose to various head structures in the children given X-ray therapy for tinea capitis (ringworm of the scalp). In this work, estimates of the dose to the thyroid and pituitary gland were obtained with lithium fluoride thermoluminescent dosemeters using a child's head phantom. Doses were also measured for the parotid gland and several skin sites where skin tumours developed in the irradiated cases. In a previous study, brain and scalp doses of 140 and 500-800 rad had been estimated for the treated group using this same head phantom. In this work dosemeters were also placed in the same brain locations so that comparisons could be obtained between the two studies. The thyroid dose was estimated to be 6 +/- 2 rad and the pituitary dose was 49 +/- 6 rad for the conventional tinea capitis treatment. The dose to the parotid gland was 39 rad and the dose to skin sites on the face and neck where tumours occurred ranged from 20 to 40 rad. The data for the thyroid adenoma response from this and other studies involving irradiation of children suggests a linear dose-response relationship within the first 30-40 years after exposure with a risk of about 0-04% per rad.

Adenoma↗

PubMed1999

The antifungal activity of mupirocin.

The antibacterial agent mupirocin (pseudomonic acid A) is used as a topical agent in the treatment of superficial infections by Gram-positive bacteria, particularly Staphylococcus aureus. However, we demonstrate here that the compound also inhibits the growth of a number of pathogenic fungi in vitro, including a range of dermatophytes and Pityrosporum spp. It inhibited the incorporation of amino acids and precursors of RNA, but not that of acetate, by Trichophyton mentagrophytes. It also inhibited the isoleucyl-tRNA synthetase from Candida albicans, indicating a mechanism of action similar to that in bacteria. When administered topically, mupirocin was efficacious in a T. mentagrophytes ringworm model in guinea pigs. These results suggest that mupirocin could have clinical utility for superficial infections caused by dermatophytes.

Administration, Topical↗

PubMed1996

Risk of basal cell and squamous cell skin cancers after ionizing radiation therapy. For The Skin Cancer Prevention Study Group.

BACKGROUND: Human evidence that ionizing radiation is carcinogenic first came from reports of nonmelanoma skin cancers (NMSCs) on the hands of workers using early radiation devices. An increased risk of NMSC has been observed among uranium miners, radiologists, and individuals treated with x rays in childhood for tinea capitis (ringworm of the scalp) or for thymic enlargement; NMSC is one of the cancers most strongly associated with the atomic bombing of Hiroshima and Nagasaki. Although exposure to ionizing radiation is a known cause of NMSC, it is not yet clear whether therapeutic radiation causes both major histologic types of NMSC, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Additionally, the potentially modifying effects, such as latency, age when treated, and type of treatment, are not well understood. PURPOSE: We investigated the relative risks of BCC and SCC associated with previous radiation therapy and evaluated these risks in relation to age and time since initial treatment and the medical condition for which radiation therapy was given. METHODS: The study group comprised individual diagnosed with at least one BCC or SCC from January 1980 through February 1986, who were recruited to participate in a skin cancer prevention trial designed to test whether oral beta-carotene supplementation would reduce the risk of new NMSCs. Patients were identified through the dermatology and pathology records of academic medical centers in Hanover, NH; Los Angeles, CA; San Francisco, CA; and Minneapolis, MN. Each participant completed a questionnaire detailing lifetime residence, pigmentary characteristics, occupational and recreational sun exposure, and history of radiation therapy. At enrollment, a study dermatologist assessed skin type (tendency to burn or tan) and extent of actinic skin damage. Participants were followed with an annual dermatologic examination for an average of 4 years. Of the 5232 potentially eligible individuals, 1805 were enrolled in the trial. We excluded 112 patients who reported previous radiation therapy for skin cancer only and three with missing information on whether they were ever treated with radiation therapy, leaving 1690 patients for the analysis. Approximately 4% of the patients died or discontinued participation for other reasons during each study year. We examined time to occurrence of first new histopathologically confirmed BCC and SCC during the follow-up period in relation to history of radiation therapy (for reasons other than NMSC) using a proportional hazards model. A multiple end points survival model was used to compare the rate ratios (RRs) for BCC and SCC. We also used a longitudinal method of analysis to compute the RR of total new BCC and SCC tumors per person per study year associated with radiation therapy. Using this method, we additionally assessed the potential modifying effects of age at treatment, latency, and type of therapy. All P values were derived from two-sided statistical tests of significance. RESULTS: Among the participants we studied, 597 developed a new BCC (n = 1553 tumors) and 118 developed a new SCC (n = 179 tumors). The time to first new BCC, but not SCC, was associated with prior radiation therapy (RR = 1.7; 95% confidence interval [CI] = 1.4-2.0 and RR = 1.0; 95% CI = 0.6-1.7, respectively; P = .03 for the difference between the RRs). The RR of total BCC tumors was slightly higher (RR = 2.3; 95% CI = 1.7-3.1), but it was still unity for SCC (RR = 1.0; 95% CI = 0.5-1.9). BCC risk appeared to increase with younger age at exposure and time since initially treated, although these effects were only marginally statistically significant (P for trend = .06 and .07, respectively). Also, risk of BCC was more strongly related to treatment for acne (RR = 3.3; 95% CI = 2.1-5.2) than other conditions. CONCLUSIONS AND IMPLICATIONS: Our data suggest that exposure to therapeutic radiation is associated with BCC but not with SCC.

Adult↗

PubMed2002

Radiation exposure from diagnostic and therapeutic treatments and risk of breast cancer.

An association between low-dose diagnostic X-ray exposure or therapeutic radiation treatment and breast cancer risk has not been established. To further investigate the issue, we analysed data from a case-control study of breast cancer in Connecticut in 1994-1997. A total of 1217 subjects (608 breast cancer cases and 609 controls), 30-80 years old, participated in the study. A standardized, structured questionnaire was used to collect information through in-person interviews on diagnostic or therapeutic radiation and other breast cancer risk factors. An odds ratio (OR) of 1.7 (95% confidence interval (CI) 0.8-3.6) was observed for postmenopausal women with therapeutic radiation treatment for skin problems such as ringworm and acne, and an OR of 2.5 (95% CI 1.0-6.8) for those who reported having been treated six or more times. Radiation treatment received at younger ages seems to carry a higher risk. In earlier studies therapeutic radiation for skin problems has been associated with an increased risk of breast cancer. Therefore, it is possible that scattered radiation from these treatments could increase the risk of breast cancer. Radiation exposure from diagnostic X-rays was not associated with a significantly increased risk of breast cancer in this study.

Adult↗

PubMed2000

Application of PCR to the identification of dermatophyte fungi.

Infection of the keratinised tissues (skin, hair and nails) in man and animals by keratinophilic fungi (dermatophytes) results in dermatophytosis (also known as tinea or ringworm). As conventional laboratory procedures for the identification of dermatophytes are either slow or lack specificity, improved diagnostic methods are required. The application of nucleic acid amplification technology has made rapid and precise identification of dermatophytes possible. Recent studies have shown that when one of the four random primers (OPAA11, OPD18, OPAA17 and OPU15) was used in arbitrarily primed PCR (AP-PCR), up to 20 of the 25 dermatophyte species or subspecies under investigation could be distinguished on the basis of characteristic band patterns detected in agarose gel electrophoresis. A combination of two random primers (OPD18 and OPAA17) used in separate reaction tubes identified 23 of the 25 dermatophyte species or subspecies examined. AP-PCR provides a rapid and practical tool for identification of dermatophyte isolates that is independent of morphological and biochemical characteristics and thus enhances laboratory diagnosis of dermatophytosis.

Animals↗

PubMed1975

Effect of experimental dermatophyte infection on cutaneous flora.

The cutaneous aerobic bacterial flora was monitored during the course of experimental dermatiphyte (ringworm) infections on the forearms of 9 volunteers. Micrococcaceae were identified by the new Baird-Parker classification with the aid of a replica-plating technique. There were significant differences in total populations but not in kinds of flora compared with control (opposite) forearms. The proportion of penicillin-resistant microorganisms, however increased the infection, to a degree which varied as to individual. All coccal groups were affected; resistant flora diminished when the fungus was no longer DETECTED. Staphylococci were more frequently isolated than micrococci on the infected areas, but Staphylococcus aureus was not found. Trends toward hierarchies in persistance and quantities IV were observed among the flora, with Staphylococcus subgroups II and dominating the infected sites. On both areas almost all diphtheroids were nonfluorescent, lipophilic, and lipolytic. One subject consistently carried Bacillus firmus; another's normal microbiota contained Alcaligenes faecalis.

Aerobiosis↗

PubMed1980

The dysgonic form of Microsporum canis in N.W. London.

An account is given of the occurrence in N.W. London of ringworm due to the dysgonic form of Microsporum canis in cats, dogs, and humans. The unusual morphology of the dysgonic strain is described as is the extraordinary lability of the fungus in culture. The distribution of cases in man and animals in the area is mapped. The clinical and epidemiological behaviour of the fungus, as illustrated by four family outbreaks, differs little from that of the typical strain. The origin of the dysgonic strain is unknown.

Animals↗

PubMed1989

Fungal kerion--total scalp involvement due to Microsporum canis infection.

We report the case of a 5-year-old girl who developed a remarkably extensive kerion of the scalp due to Microsporum canis infection. Total scalp involvement of this severity and prolonged duration is now unusual, but there has been surprisingly little residual cicatricial alopecia. Microsporum canis does not respond well to ketoconazole, and griseofulvin remains the drug of choice for dermatophyte infections involving hair; a prolonged course may be necessary. This case also demonstrates the benefit of corticosteroids for certain cases of inflammatory ringworm where the host's response to the fungus is exceptionally marked.

Administration, Topical↗

PubMed1992

Widespread dermatophytosis due to Microsporum (Trichophyton) gallinae in a patient with AIDS--a case report from Spain.

We report the case of a 25-year-old, HIV-positive patient (group IV, A, C2 clinical stage) with a widespread dermatophyte infection. He was a male gypsy with a known history of intravenous drug abuse. After an episode of cerebral toxoplasmosis for which he was treated with systemic steroids (because of cerebral oedema) he developed, over 16 days, a remarkably extensive ringworm of the trunk due to an unusual zoophilic dermatophyte, Microsporum (Trichophyton) gallinae. Human infection with this dermatophyte species is unusual: there are as few as seven proven reported cases, all of whom had localized lesions. This is the first widespread and severe case reported in man and also the first reported from Spain.

AIDS-Related Opportunistic Infections↗

PubMed2006

An experience from an outbreak of tinea capitis gladiatorum due to Trichophyton tonsurans.

'Tinea corporis gladiatorum' describes a dermatophytosis transmitted mainly from close skin contact among wrestlers. Although tinea corporis is well recognized, no data are available for tinea capitis infections in wrestlers. After finding tinea capitis infection in a student wrestler, we aimed to search for possible ringworm infections among wrestlers in a wrestling boarding-school. Of the 32 wrestlers, 29, aged 12-18 years, were affected, of whom 22 had scalp involvement. Trichophyton tonsurans was isolated from 20 of the patients, and T. mentagrophytes from the remaining two. Isolated strains of dermatophytes were susceptible to terbinafine and itraconazole. The patients with tinea capitis received oral terbinafine for 4 weeks, and patients with more than two lesions but without scalp involvement received oral terbinafine for 2 weeks. Overall clinical and mycological cure rate was 72.4% and 70%, respectively, at assessment at week 6. The asymptomatic dermatophyte carrier rate was negative 1 year after control of the epidemic. Terbinafine seems to be an alternative drug for the treatment of tinea capitis caused by T. tonsurans; however, control of an outbreak may be very difficult and effective preventive measures should be considered.

Adolescent↗

PubMed1983

Dermatophytic infection of the scalp in the region of Butare (Rwanda).

We examined samples of hairs taken from 60 children presenting with the clinical picture of tinea capitis. In 53 cases, direct microscopic examination showed either ectothrix or endothrix parasitism, and we were able to grow the causative dermatophyte. We had 34 strains of Trichophyton violaceum, 19 of Microsporom langeroni, and two of Trichophyton verrucosum. The latter is found for the first time in this region to be a cause of ringworm in humans.

Adolescent↗

PubMed1991

Tinea capitis in adults in southern Taiwan.

We report the clinicomycologic study of 27 culture-proven cases of tinea capitis from southern Taiwan during the years 1988 to 1990. The series is notable for its predominance of adults (63%), of women (89%), and of Trichophyton violaceum infection (74%). The age distribution was clearly bimodal; the median age was 6 years for children and 56 years for adults (older than 18 years). Whether or not these findings represent a new trend of tinea capitis in southern Taiwan remains to be determined. Clinically, our cases of black-dot ringworm caused by T. violaceum often presented with subtle changes of scaling, hair loss, and black dots. The keys to the correct diagnosis are (1) a high clinical index of suspicion with careful inspection of the scalp for the presence of black dots, and (2) microscopic examination and culturing of the black dots or plucked hairs.

Adolescent↗

PubMed1995

Antidermatophytic activity of garlic (Allium sativum) in vitro.

BACKGROUND: Interest in herbal medicine is enjoying a renaissance at present. Garlic (Allium sativum) is an intriguing herb with a long history of medicinal use for a variety of diseases including ringworm infections. METHODS: Antidermatophytic activity of the aqueous extract of garlic (A. sativum) was investigated against 88 clinical isolates of dermatophytes by an agar dilution technique. The isolates included Microsporum canis (50), M. audouinii (5), Trichophyton rubrum (6), T. mentagrophytes (5), T. violaceum (12), T. simii (5), T. verrucosum (1), T. erinacei (1), and Epidermophyton floccosum (2). The results were compared with the minimal inhibitory concentrations of ketoconazole. RESULTS: The aqueous extract of garlic, diluted 1:150 and 1:100, had inhibited 50 and 90% of the isolates tested, whereas the respective values for ketoconazole were 1 and 2.5 micrograms/mL. CONCLUSIONS: Garlic (A. sativum) could be used as an effective antidermatophytic agent. Further purification and extraction of the active principle of garlic would give a true antidermatophytic activity comparable to standard antifungal drugs.

Antifungal Agents↗

PubMed1998

Epidemiological aspects of dermatophyte infections in horses and cattle.

Ringworm infections in the principal domestic animals are a major public and veterinary health problem. The aetiology, epidemiology and symptomatology of these mycoses are quite heterogeneous and complex. In this context, the AA carried out an epidemiological study to investigate the prevalence of dermatophytes in two different animal species, horses (n = 200) belonging to 10 private stables and cattle (n = 1900) belonging to farms with different breeding purposes and management. With regard to horses the results showed a positive level of 9% and Trichophyton equinum was the major organism isolated. The results concerning the cattle showed positive values that varied both in relation to the type of animals and their management as well as to the productive objectives: 19% in intensive beef breeding, 4.5% in intensive dairy farms (the aetiologic agent isolated in both types of farms was Trichophyton verrucosum) and 8% in traditional-type farms (the species of fungi isolated were T. verrucosum and Trichophyton mentagrophytes). The results are discussed both in clinical and in hygiene and management terms.

Animals↗