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PubMed1998

Relapsing tinea capitis by Microsporum canis in an adult female renal transplant recipient.

Scalp ringworm is very uncommon in adults. The occurrence and the atypical clinical course of this unusual dermatophytosis in a female renal transplant recipient are described. Furthermore, the prevalence and the clinical features of superficial fungal infection in renal transplant recipients are reviewed. As immunosuppression enhances the risk of antifungal therapy failure, more prolonged treatment and careful follow-up are necessary to obtain complete recovery from any dermatophytosis in renal transplant recipients.

Female↗
PubMed2000

Prevalence and awareness of tinea pedis in Italian sailors.

BACKGROUND: It is difficult to carry out studies on the prevalence of tinea pedis in the community. Some studies are performed on selected groups of subjects, exposed to the same risk factors, i.e. schoolchildren, public bathers, athletes and military men. OBJECTIVE: The aim of this work was to detect in a sample of military men the prevalence of tinea pedis and the awareness of their condition, and to relate the infection to risk factors of the group as well. METHODS: 410 male Italian navy cadets in an Italian navy petty officers school were clinically examined and mycological cultures were performed, employing the skin scrapings obtained from suspected lesions. RESULTS: Dermatophytes were isolated from toe clefts in 10 subjects, giving a point prevalence of 2.4% (95% confidence interval 1.3-4.4%). The isolated dermatophytes were Trichophyton mentagrophytes (70%), Trichophyton rubrum (20%) and Epidermophyton floccosum (10%). None of the subjects was aware of his disease. No significant association was observed between tinea pedis and risk factors (i.e. hyperhidrosis and habits). CONCLUSION: The prevalence in our sample was lower than that observed in previous studies on military men. That can be attributed to the general amelioration of hygienic conditions and strengthening of preventive habits. Therefore the prevalence of tinea pedis in Italian sailors seems to be reduced but still rather relevant. That is important because these subjects are a reservoir of ringworm infection.

Adolescent↗
PubMed1994

Johann Lukas Schönlein and his contribution to nephrology and medicine.

Schönlein published few papers, and most of what is known of his achievements in nephrology comes from notes and publications of his students. It seems, however, that he described the combination of rheumatic fever, affection of internal muscular organs, a typical exanthem and oliguria, coining the name purpura rubra to describe this syndrome. Although patients with symptoms of Schönlein's syndrome had been described earlier, Schönlein was the first to describe purpura rheumatica as an entity. Schönlein's greatest contribution was the discovery of the anthropophilic pathogenic fungus Trichophyton schönleinii as the cause of the contagious skin condition favus (honeycomb ringworm). This opened a new field--mycology--and allowed therapy to be aimed specifically at the cause of the disease.

Germany↗
PubMed2006

Prudent layperson definition of an emergent pediatric medical condition.

This study was designed to assess how well parents rated pediatric medical conditions based on their perceived degree of urgency so as to determine if the "Prudent Layperson Standard'' is reasonable. A self-administered, supervised survey was given to a convenience sample of 340 caregivers in the emergency department of an urban children's hospital. Respondents were asked to rank the urgency of 15 scenarios. A caregiver response within 1 point of the physician score was considered concordant with medical opinion. A 2-week-old infant with a rectal temperature of 103.7 degrees F was the only emergent scenario underestimated by caregivers. A 1 1/2-yr-old child with an upper respiratory tract infection, a 7-year-old child with ringworm, an 8-month-old infant with a simple forehead contusion, and a 4-year-old child with conjunctivitis were the non-urgent scenarios overestimated by caregivers. Laypeople are able to identify cases constructed to represent obvious pediatric medical emergencies. Several patient subgroups frequently overestimate medical urgency.

Adult↗
PubMed1989

Radiation-induced schwannomas.

The histopathology and clinical course of three patients with schwannomas of the brain and high cervical cord after therapeutic irradiation for intracranial malignancy and for ringworm of the scalp are described. Earlier reports in the literature indicated that radiation of the scalp may induce tumors in the head and neck. It is therefore suggested that therapeutic irradiation in these instances was a causative factor in the genesis of these tumors.

Adult↗
PubMed1978

Follow-up study of patients treated by X-ray epilation for tinea capitis: psychiatric and psychometric evaluation.

To investigate the late effects of radiation to the head upon subclinical mental disorders, a psychiatric and psychometric evaluation was performed on 177 cases treated 10-29 years earlier for ringworm of the scalp by X-ray therapy (N :109) or, by chemotherapy (N :68). Analyses which controlled for educational level and family psychiatric disorders showed that, among whites, the irradiated group manifested more psychiatric symptoms and more deviant MMPI (Minnesota Multiphasic Personality Inventory) scores. They were also judged more maladjusted from their MMPI profiles, and more frequently had a history of treated psychiatric disorders; however, the psychiatrist's overall rating of current psychiatric status showed only a borderline differnece between the two groups. There were no significant differences between irradiated and chemotherapy treated blacks.

Adult↗
PubMed2004

Optimal management of fungal infections of the skin, hair, and nails.

Superficial fungal infections are chronic and recurring conditions. Tinea capitis is a scalp infection, primarily affecting prepubescent children. Ringworm infections, such as tinea corporis and tinea cruris, involve the glabrous skin. Tinea nigra is a rare mycotic infection that may be related to travel abroad. Piedra, black or white, is limited to the hair shaft without involvement of the adjacent skin. Pityriasis (tinea) versicolor and seborrheic dermatitis are dermatoses associated with yeasts of the genus Malassezia that affect the lipid-rich areas of the body. The taxonomy of the Malassezia yeasts has been revised to include nine species, eight of which have been recovered from humans. Tinea pedis, an infection of the feet and toes, is one of the most common forms of dermatophytosis. Onychomycosis is a fungal infection affecting the nail bed and nail plate; it may be chronic and can be difficult to treat. In instances where the superficial fungal infection is severe or chronic, an oral antifungal agent should be considered. Terbinafine, itraconazole, and fluconazole are oral antifungals that are effective in the treatment of superficial mycoses.

Administration, Oral↗
PubMed2004

Topical therapy for dermatophytoses: should corticosteroids be included?

Dermatophytoses, commonly known as ringworm or tinea, represent superficial fungal infections caused by dermatophytes, which are among the most common infections encountered in medicine. The use of corticosteroid-containing combinations in dermatophyte infections that are usually treated with topical medications is still a much-debated issue. The addition of a corticosteroid to local antifungal therapy may be of value in reducing local inflammatory reaction and thus carries the theoretical advantage of rapid symptom relief in acute dermatophyte infections associated with heavy inflammation. However, the use of such combinations requires caution as they have some potential risks, especially with long-term use under occlusive conditions. Corticosteroid-induced cutaneous adverse effects have been reported primarily in pediatric patients due to inappropriate application of these preparations on diaper areas. Additionally, the corticosteroid component may interfere with the therapeutic actions of the antifungal agent, or fungal growth may accelerate because of decreased local immunologic host reaction, such that underlying infection may persist, and dermatophytes may even acquire the ability to invade deeper tissues. Analysis of the literature documenting clinical study data and adverse reactions related to combination therapy, drew the following conclusions: (i) combination products containing a low potency nonfluorinated corticosteroid may initially be used for symptomatic inflamed lesions of tinea pedis, tinea corporis, and tinea cruris, in otherwise healthy adults with good compliance; (ii) therapy should be substituted by a pure antifungal agent once symptoms are relieved, and should never exceed 2 weeks for tinea cruris and 4 weeks for tinea pedis/corporis; and (iii) contraindications for the use of these combinations include application on diaper or other occluded areas and facial lesions, as well as in children <12 years of age and in immunosuppressed patients for any reason.

Administration, Cutaneous↗
PubMed2000

Seeing through the stratum corneum.

The stratum corneum (SC) provides a vital barrier membrane between the external environment and the vulnerable internal tissues of the skin. It impedes the flow of water, the penetration of xenobiotics, and invasion of pathogenic micro-organisms. It also has protective capacity against ultraviolet radiation and thermal injury. As routine histopathology provides a misleading picture of a disorganized and shadowy SC, we would recommend the skin surface biopsy technique. This painless technique is easy and reliable in obtaining information from the SC. It demonstrates the geometric patterns of the surface, the openings of the eccrine ducts and hair follicles. The skin surface biopsy technique is also ideal for the investigation of the in situ microbiology of skin. Staining with periodic acid Schiff reagent makes it possible to see ringworm fungi, pityriasis versicolor, candida species, or erythrasma micro-organisms. Scanning electron microscopy can be employed when the higher magnification is needed. Histochemical applications include silver staining for melanin particle, potassium ferricyanide staining for blood pigments and lipid staining with Sudan red, for sebum. The rate of movement of topically applied drugs into the skin can be measured using the skin surface biopsy technique. The concentration of radiolabelled drugs can be counted and compared. Comedogenicity and DNA analysis are other applications of this non-invasive technique.

Biopsy↗
PubMed2001

Training failure among yearling horses.

OBJECTIVE: To compare financial returns between pinhooked yearling horses (ie, bought and trained for approximately 5 months with the goal of selling the horse at "2-year-olds in training" sales) that had mild or severe training failure and horses that had planned versus nonplanned training failure. ANIMALS: 40 Thoroughbred pinhooked yearling horses. PROCEDURE: During the period from September 1998 through and April 1999, 20 horses had mild training failure (1 to 11 days lost), and 20 horses had severe training failure (13 to 108 days lost). Horses were assigned to these 2 groups on the basis of frequency distribution (median) of days lost during training. Horses were also categorized on the basis of type of training failure (planned vs nonplanned training failure). The outcome of primary interest was financial return. Median financial returns were compared among groups by use of the Mann-Whitney U test. RESULTS: Median financial returns for horses that had severe training failure ($1,000) were significantly different, compared with horses that had mild training failure ($24,000). Analysis of results also indicated that median returns were significantly different among horses that had planned training failure (-$2,000; eg, horses with radiographic abnormalities detected during routine prepurchase examinations that required surgical treatment, resulting in days lost during training), compared with horses that did not ($10,000). CONCLUSIONS AND CLINICAL RELEVANCE: Training failure has an economic impact on revenues in pinhooked yearling horses. Lameness, planned training failure, respiratory disease, and ringworm were common and important causes of training failure.

Animals↗
PubMed2000

[Dermatophytes from animals].

Dermatophytes from animal dermatophytoses were investigated, especially for their teleomorphs and molecular characteristics. Microsporum canis, M. equinum, M. gypseum, M. nanum, Trichophyton equinum, T. mentagrophytes complex, T. rubrum and T. verrucosum were isolated as the etiological agents of animal ringworm in Japan. They were morphologically and biochemically identified and their perfect states were examined. The teleomorph of M. canis was first obtained and reported as Nanizzia otae in 1975. The isolates of M. canis of which the teleomorph was confirmed were all "-" excepted two Japanese isolates. Mating experiments indicated that the isolates of M. gypseum were "+" or "-" of A. gypseum and A. incurvatum, respectively. Most of the isolates of T. mentagrophytes complex of which a perfect state was detected were A. vanbreuseghemii. One isolate from a monkey was A. simii and one from a rabbit was A. benhamiae. However, the teleomorph remained unknown in many isolates. Molecular characteristics in random amplification of polymorphic DNA and Southern hybridization analyses were found to be effective to differentiate the species of Microsporum. Nucleotide sequences of chitin synthase 1 (CHS1) gene of dermatophytes were also analyzed for their phylogenetic relatedness. The phylogenetic analysis revealed four clusters: the first cluster consisted of A. benhamiae, A. simii, A. vanbreuseghemii, T. mentagrophytes var. interdigitale, T. rubrum and T. violaceum; the second of A. fulvum, A. gypseum and A. incurvatum; the third of A. grubyi and A. otae; and the fourth of Epidermaphyton floccosum, providing useful information for the classification and understanding of their evolution.

Animals↗
PubMed2005

[Trichophyton violaceum infection occurring in a nursing home].

Six cases of Trichophyton (T.) violaceum infection seen in a nursing home are reported. A 66-year-old female (case 1) was found with tinea corporis on her face, chest and shoulder, associated with black dot ringworm. A KOH examination of hair showed endothrix parasitism. Reddish purple colonies were isolated from the patient on Sabouraud's dextrose agar, and intercalary and terminal chlamydospores were observed on slide culture. PCR-RFLP analysis of the microorganism showed a pattern of T. violaceum type. Therefore, the isolated fungus was identified as T. violaceum, a typical anthropophilic dermatophyte which had spread among residents and staffs easily. Using a mycological method, we examined 59 persons (21 residents and 38 staff members) who had had contact with case 1. The results were as follows. An 85-year-old female (case 2) and an 83-year-old female (case 3) were carriers of T. violaceum. A 23-year-old male (case 4) had tinea corporis on his right forearm due to T. violaceum. A 24-year-old male (case 5) probably had tinea corporis on his right forearm due to T. violaceum. One year after case 1's first visit to our clinic, we observed an 88-year-old female (case 6) of tinea capitis by T. violaceum. It seems that the organism was preserved in surroundings and members of the nursing home. The contagion in our cases could either have been caused by directly touching the person or by sharing their comb. PCR-RFLP analysis was performed within a short time, so that we managed effectively to select a way of treatment and to prevent the infection from spreading.

Adult↗
PubMed1980

Zoophilic dermatophytes and their natural hosts in Western Australia.

Zoophilic dermatophytes were a common source of both human and animal ringworm infections in Western Australia. Microsporum canis was the chief aetiologic agent of infections in kittens and children. Trichophyton mentagrophytes was isolated from domestic pets, farm animals, laboratory animals and wild animals as well as humans. T. verrucosum was a less frequent cause of infection in both man and animals. Other zoophilic species isolated included M. Gypseum, M. nanum and T. equinum var. autotrophicum.

Animals↗
PubMed2001

Dermatophytosis in Vietnam.

Professor Taplin describes his experiments producing clinical lesions with 2 endemic dermatophytes encountered in Vietnam during the Vietnam War: the human-adapted Trichophyton raubitschekii, possibly a regional form of Trichophyton rubrum that was causing chronic tinea corporis in the Vietnamese, and a zoophilic Trichophyton mentagrophytes that caused highly inflammatory ringworm in the previously unexposed American soldiers. (This particular T mentagrophytes was also the fungus studied by Dr. Jones.).

Female↗
PubMed2001

Thyroid cancer following scalp irradiation: a reanalysis accounting for uncertainty in dosimetry.

In the 1940s and 1950s, over 20,000 children in Israel were treated for tinea capitis (scalp ringworm) by irradiation to induce epilation. Follow-up studies showed that the radiation exposure was associated with the development of malignant thyroid neoplasms. Despite this clear evidence of an effect, the magnitude of the dose-response relationship is much less clear because of probable errors in individual estimates of dose to the thyroid gland. Such errors have the potential to bias dose-response estimation, a potential that was not widely appreciated at the time of the original analyses. We revisit this issue, describing in detail how errors in dosimetry might occur, and we develop a new dose-response model that takes the uncertainties of the dosimetry into account. Our model for the uncertainty in dosimetry is a complex and new variant of the classical multiplicative Berkson error model, having components of classical multiplicative measurement error as well as missing data. Analysis of the tinea capitis data suggests that measurement error in the dosimetry has only a negligible effect on dose-response estimation and inference as well as on the modifying effect of age at exposure.

Biometry↗
PubMed1975

Microsporum canis infection in calves.

Microsporum canis infection, seldom reported in calves, is described. The organism was isolated from skin scrapings collected from ringworm lesions mainly on the heads of 2 naturally infected calves. The organism was studied in vitro, and experimentally on guinea-pigs.

Animals↗