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[Etiology of pathogen-induced changes between the toes in patients working under moist conditions].

Referring to recent studies, we discuss the epidemiology of tinea pedis and its position within the range of polyetiological foot infections caused by microbial agents. 201 industrial workers used to wear rubber boots because of moist working conditions were examined with regard to their feet. 107 of them showed clinically altered toe web; in 45 cases, we found ringworm infection (22.4%), in correlation to increased daily wearing time of rubber boots. 85 workers showed colonization of pathogenic bacteria (42.4%), especially gram-negative species (25.8%). Frequently, mixed infections were found. The clinical picture not always allows definite conclusions as to the causal agents. The symptom "maceration" is seen in each of the 3 pathogenic groups of germs (fungi, gram-positive pathogenic cocci, gram-negative bacteria), frequently in bacterial foot infections, especially gram-negative infections. Marked clinical symptoms involve increased infection rates. The predisposing factors to foot infection such as interdigital maceration and the promoting role of rubber boots have been confirmed. The final diagnosis is to be reassured by cultural investigations, in order to set up a specific treatment.

Adult↗

[Mycoses caused by Trichophyton megninii in Galicia (with review of the taxonomy of this dermatophyte)].

The taxonomy of the dermatophyte Trichophyton megninii has been the subject of much discussion since it was first isolated by Sabouraud in 1893. Initially he named it Trichophyton à culture rose and later T. rosaceum. It has been confused with the Microsporum (Epidermophyton) gallinae described by Megnin. Nowadays most mycologists consider T. rosaceum to be a synonym of the T. megninii, although some French authors still use Sabouraud's denomination. It is an exclusively anthropophilic dermatophyte with a broad geographic distribution, but in general a low incidence in most countries, except in Portugal, Corsica and Sardinia where it causes infections of both hairy and glabrous skin zones and nails in humans. T. megninii is an uncommon cause of ringworm in Spain and is mainly restricted to Galicia, and even there the incidence is low; it has been isolated only five times in our clinical practice with two more cases described previously in the literature, and predominantly affects females. Case reports show that it produces slowly evolving lesions with little local symptomatology on the scalp and is recalcitrant to conventional antifungal treatment. Its identification in culture should be based on the macroscopical appearance of the colony and by its absolute requirement for 1-histidine.

Adult↗

Cell-mediated immunity in the immunopathogenesis of dermatophytosis.

CMI to dermatophyte antigens, principally trichophytin, is central to both (1) pathogenesis of the typical "ringworm" lesion and (2) an acquired, relative resistance that affords partial immunity to the host. The exact form of effector "T" cell immunity and the cellular and molecular mechanism(s) which eliminate dermatophytes from the skin, are poorly understood, but may involve lymphokine and accelerated epidermal turnover. Recent studies in the "nude" rat suggest that this thymic deficient animal offers potential for study of chronic, extensive dermatophytosis. The pathogenesis of the indolent inflammation of chronic infection is unclear, but may involve fungal derived chemotactic factors and/or activation of the alternative complement pathway. Chronic, extensive dermatophytosis may be caused by several different organisms, including T. rubrum, T. mentagrophytes, T. tonsurans and T. concentricum. Despite the multiple, microbial etiologies, most patients with this distinctive syndrome share similar immunological characteristics, including deficient, antigen-specific CMI to trichophytin. Approximately half of the patients have either an immediate hypersensitivity to trichophytin or an elevated serum IgE level, and in addition, they exhibit other stigmata of atopy including a positive family history. It is intriguing to consider the possibility that genetic control of the immune response may render a certain IgE hyperresponsive subpopulation unable to mount sufficient host resistance to reject dermatophyte infection.

Animals↗

Studies on the nutritional physiology of zoophilic dermatophytes isolated from horses in Ibadan, Nigeria.

The effects of the various growth factors with regard to the nutritional physiology of zoophilic dermatophytes isolated from horses are reported. The optimum temperature, pH and growth period for the fungal isolates were found to be 30 degrees-35 degrees C, 5-6 and 7-12 days respectively while the carbon and nitrogen sources utilised by the organisms were sucrose, fructose, maltose, L-arginine and calcium nitrate. The use of these factors in preparation of efficacious fungicides used in the treatment of ringworm infections in man and animals is discussed.

Animals↗

Trichophyton rubrum specific IgE in serum in patients with chronic T. rubrum infection as demonstrated by crossed radio-immuno-electrophoresis.

By means of crossed radio-immunoelectrophoresis specific IgE antibodies to Trichophyton rubrum were demonstrated in serum from seven of eight patients with chronic T. rubrum infection. Total IgE values were within normal limits in all. In contrast, no specific IgE antibodies were found in sera from 10 patients with inflammatory ringworm lesions due to Microsporum canis, T. mentagrophytes or T. verrucosum or from six non infected controls. A long-lasting exposure to a constant antigen load is considered of importance for the development of humoral immunity including IgE production.

Antibodies, Fungal↗

A livestock disease survey from auction mart inspection in Saskatchewan.

The data on health problems from visual livestock inspection at an auction mart in Saskatchewan during a two year period were tabulated for swine, cattle and calves. The major conditions seen in swine were underweight animals, infectious diseases or congenital abnormalities. Infectious diseases such as Hypoderma spp. infestations, ringworm or eye infections were the primary troubles in older cattle. Young calves demonstrated a predominance of congenital (herniation) and infectious (enteritis or navel infection) diseases.

Animals↗

Laboratory-acquired infections at the National Animal Disease Center 1960--1976.

Experience with exposure to, or infection with pathogenic agents at the National Animal Disease Center is summarized. A total of 60 laboratory-associated exposures to infectious disease agents were reported. Forty-nine exposures resulted from known accidents, but the other 11 were identified only after the development of clinical or serological manifestations of infection. Eighteen cases of laboratory-acquired infections were reviewed. Brucellosis, the most frequently reported laboratory-acquired infection, accounted for one-half of the cases summarized. Three cases of leptospirosis, two cases of Newcastle disease, two cases of ringworm, and a single infection with Mycobacterium bovis and with Salmonella arizonae were also encountered. The most frequently reported causes of exposure were: auto-inoculation or spray exposure associated with the use of the hypodermic syringe, cuts or lacerations, direct contact with infected animals, and mouth pipetting. Although the infecting event could not be identified in 11 infections, presumptive evidence suggests aerogenic transmission as a probable route of exposure in a number of such cases.

Animal Diseases↗

Screening for early detection of radiation-associated thyroid cancer: a pilot study.

In the 1950s, approximately 20,000 Israeli children received scalp irradiation as treatment for tinea capitis (ringworm of the scalp). To evaluate the necessity and feasibility of early screening of these individuals for thyroid cancer, a small pilot program was undertaken. The examination consisted of a thorough palpation of the thyroid gland and the surrounding area. A 99mTc thyroid scan and thyroid function tests were performed on individuals in whom palpation suggested a nodular abnormality. A multidisciplinary committee then made a recommendation for or against surgery. A total of 443 persons were screened, and nodular abnormalities of the thyroid were detected in 24 (5.4%). Of these persons, nine displayed symptomatology or reported knowledge of a thyroid condition; despite this, three of them were not receiving treatment. This left 18 subjects--15 new cases and 3 previously untreated patients--needing follow-up care. Altogether nine persons were recommended for surgery, but one refused. All eight of the excised lesions were benign: four colloid nodules and four adenomas. While the screening program was feasible, the fact that no cancers were detected suggested that in a population exposed to a very low dose of radiation, thyroid screening may not be justified on a large scale.

Adult↗

Isolation of dermatophytes from rural and urban soil samples in premises of infected and non-infected animals.

Animal houses wherein animals infected with ringworm were detected were considered as premises of infected and infection free houses were considered as premises of the non-infected. Fifty soil samples from each of the premises in each of rural and urban areas were examined for the presence of dermatophytes. The premises of the infected showed higher Isolation Rate of dermatophytes. Of the four species of dermatophytes isolated, T. mentagrophytes (granular) was present in the soil of the infected premises only, while T. terrestre, M. nanum and M. gypseum were present in both the premises in both the rural and urban areas.

Animals↗

A clinical and immunological study of four babies of mothers with lepromatous leprosy, two of whom developed leprosy in infancy.

One hundred thirteen women and 27 healthy controls were studied throughout pregnancy, at delivery, and followed up with their babies during lactation. Thirty-eight of the mothers with lepromatous leprosy were found to have solid-staining bacilli in skin smears or biopsies, and hence were considered potentially highly infectious to their unborn children by hematogenous spread via the placenta. Two babies of mothers within this group were diagnosed as having leprosy on clinical and histological grounds. A third baby could well have had leprosy, but the case was not proven. The fourth baby did not have leprosy and, although it did have ringworm, was thus deemed to be a reasonable control. The leprosy skin lesions were first observed at a special followup clinic when the children were between the aged of 9 and 17 months. The demonstration of IgA and IgM anti-M. leprae antibodies in cord sera was taken as an indication of intrauterine immunologic stimulation, and hence transplacental transmission of M. leprae. The two babies with proven leprosy showed an early and significant increase in serum IgA and in particular serum IgM anti-M. leprae antibody activity. A third baby, suspected of having leprosy but in whom the diagnosis was not proven, showed a similar but less marked increase in serum IgA and IgM activity. The fourth baby showed no such rise in anti-M. leprae activity. A decrease in serum IgG anti-M. leprae antibody activity could be demonstrated in one of the babies with leprosy after healing of the leprosy lesions, but not in the second baby.

Antibodies, Bacterial↗

[A rapid method for the diagnosis of Trichophyton verrucosum (author's transl)].

200 dermatological specimens from cattle with clinical symptoms resembling ringworm have been examined using direct microscopy of lye-treated material and cultivation on glucose peptone agar with examination of the cultures for microcolonies of Trichophyton verrucosum after 2-4 days incubation (Fig. 1 and 2). The results (Table I) show good correlation between the two examination methods. In 77 specimens arthrospores were demonstrated on direct microscopy and microcolonies of T. verrucosum on cultivation, 9 specimens were positive on direct microscopy only, 13 specimens were positive on cultivation only, and 101 specimens were negative on both methods. Other dermatophytes than T. verrucosum were not demonstrated.

Agar↗

A glabrous Microsporum canis in Greater London.

A variant of Microsporum canis, which produces glabrous colonies on primary culture, has been frequently isolated from cases of scalp and body ringworm by this department. The records of this laboratory, which undertakes a diagnostic service covering most of the Greater London Area, show that the prevalence of M. canis among scalp infections has increased during the past ten years, and this species is presently responsible for the majority of cases diagnosed by culture. The glabrous form now represents one third of the scalp isolates of M. canis and it has been found most commonly in the West and South of Greater London.

Dermatomycoses↗

[Kerion celsi. Clinical aspects and pathogenesis of deep trychophytosis of the scalp].

Kerion Celsi (scalp ringworm) is a highly inflammatory, suppurative fungal infection of the scalp caused by zoophilic dermatophytes transmitted from animals to man. The clinical picture extends to patchy infiltrated suppurative lesions in which hairs are broken or eliminated completely. Diagnosis is performed by detection of the organisms in or around the hairs involved and through culture. Kerion Celsi is treated with griseofulvin orally in combination with local symptomatic and antimycotic therapy. In the beginning systemic glucocorticoids might possibly be of help reducing the risk of scar formation and irreversible alopecia.

Child↗

Common facial skin lesions in children.

A variety of facial skin problems are encountered in a busy pediatric dental practice. The dentist should recognize and be able to identify the more common important skin lesions. The etiology, presentation, and prognosis of acne vulgaris, impetigo, warts, molluscum contagiosum, ringworm, tinea versicolor, spider nevus, atopic dermatitis, seborrhea, herpes simplex, and lesions of child abuse are discussed. Several of these conditions require prompt referral to a pediatrician or dermatologist.

Child↗

[Tinea capitis in school children in London].

An account is given of the increase in incidence of scalp ringworm seen in London school children over a twelve year period. The increase was accompanied by the isolation of a greater variety of species of dermatophytes some of which are not indigenous to Britain, such as Trichophyton soudanense. Four main radical groups of children were investigated and the distribution of the fungi causing scalp infections among them determined.

Africa↗

Temporal correlation of lymphocyte blastogenesis, skin test responses and erythema during dermatophyte infections.

The development of cellular hypersensitivity, as measured by lymphocyte blastogenic and skin tests assays, was correlated with intensification of lesion erythema in guinea-pigs infected with Trichophyton mentagrophytes. Development of lymphocyte blastogenic responses to trichophytin was assayed using forty infected animals and twenty controls; blastogenic conversion occurred between 9-11 days post spore application. The onset of cellular hypersensitivity was assayed in vivo in twenty infected guinea-pigs by skin testing at intervals after infection; positive responses occurred between 9-11 days post spore application which coincided with the time of blastogenic conversion. Clinical characteristics of lesions were followed in a group of twenty-four animals: lesions first appeared on day 7; erythema intensified until day 10; lesions reached maximum size by day 13; and alopecia began on day 17. Since cellular hypersensitivity (positive skin test and lymphocyte blastogenesis) develops at the same time as lesions reach maximum erythema, cellular hypersensitivity appears to be responsible for the intense inflammatory response associated with ringworm infections.

Animals↗