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[Dermatophytosis, pseudo-dermatophytosis and healthy cutaneous portage observed in Platyrhini and Cynomorpha monkeys (author's transl)].

The most frequent tinea of the subhuman Primates are microsporosis due to Microsporum canis or trichophytosis at Trichophyton mentagrophytes and T. simii. The T. mentagrophytes, an anthropo-zoophilic species must be differenciated from T. rubrum and T. interdigitale, dermatophytes of the man; due to the importance of that diagnosis in Primate mycology, some tests are used for the differenciation. Between the 226 monkeys investigated it was registered: 2 trichophytosis at T. mentagrophytes (an onychosis in a Cebus capucinus and a back-skin implantation in a Cercopithecus mona campbelli) and 13 cases of pseudo-dermatophytosis cutaneous disorders. From 40 of the 221 healthy subjects were discovered 14 porteur monkeys of keratinophilic fungi (2 T. terrestre, 1 Keratinomyces ajelloi, 5 Chrysosporium keratinophilus and 7 Chrysosporium sp.). The question of the alopecia of the Primates, without isolating a dermatophyte, was discussed.

Animals↗

Dermatophytosis of the ear.

OBJECTIVES: The prevalence and characteristics of patients with and without dermatophytosis of the ear were investigated. STUDY DESIGN AND SETTING: Prospective clinical study. In 54 patients who complained of slight itching or accumulation of cerumen, and/or who had erythema and scales in the ears, the presence of dermatophytosis was examined by potassium hydroxide and dimethyl sulfoxide (KOH-DMSO test). RESULTS: Nineteen patients had dermatophytosis of the ear. Dermatophytosis was more frequent in May and June. Other clinical characteristics did not differ markedly from those without dermatophytosis. CONCLUSION: About one third of patients had dermatophytosis and their characteristics were similar to those of patients without dermatophytosis except for seasonal variation. SIGNIFICANCE: Dermatophytosis of the ear may be increased. Its diagnosis is difficult without the KOH-DMSO test.

Adult↗

Prevalence of dermatophytosis in patients with rheumatoid arthritis.

OBJECTIVE: The prevalence of dermatophytic infections in rheumatoid arthritis is unknown. This study investigated the prevalence of dermatophytosis in patients with rheumatoid arthritis and the relationship between sulfasalazine, low-dose methotrexate and steroid therapy. METHODS: We examined 53 consecutive patients with rheumatoid arthritis for evidence of dermatophytosis and compared them 55 with age- and sex-matched, nonimmunocompromised controls recruited from the low back pain population. Nail scrapings were obtained from the subjects, and the clinical diagnosis of dermatophytosis was confirmed with a potassium hydroxide preparation. RESULTS: In 32% of the rheumatoid arthritis population we found dermatophytosis, compared with 16% of the control group, although statistical significant was only borderline. Tinea pedis was the most frequent type of dermatophytosis in both groups. The prevalence of dermatophytosis in patients receiving sulfasalazine, low-dose methotrexate, and steroid therapy was not found to be significantly increased. CONCLUSIONS: This study shows a slightly higher prevalence of dermatophytosis in rheumatoid arthritis population than in controls. Sulfasalazine, low-dose methotrexate, and steroid therapy had no effect on the prevalence of dermatophytic infections in patients with rheumatoid arthritis.

Adrenal Cortex Hormones↗

Antifungal therapy of dermatophytosis in guinea pigs and congenitally athymic rats.

Guinea pigs and athymic nude (RNU/RNU) rats were used to assess the efficacy of three orally administered antifungal agents--Tolciclate, Tolnaftate, and Ketoconazole--against Trichophyton mentagrophytes dermatophytosis. All three antifungal agents inhibited the test strain of T. mentagrophytes in vitro. Antifungal agents were tested in intervention (oral therapy started 5 days after challenge) or prophylaxis (oral therapy started 5 days before challenge) protocols. Oral treatment of dermatophytosis on guinea pig skin demonstrated that Tolciclate and Tolnaftate alleviated clinical symptoms and shortened the duration of the dermatophytosis, in comparison to nontreated controls. Assessment of antifungal efficacy in the guinea pig model was time consuming (30-35 days) and variability in the duration and severity of clinical symptoms on guinea pig skin was common. Oral therapy of chronically infected athymic rats demonstrated that Tolciclate, Tolnaftate, and ketoconazole were effective antifungal agents in vivo. Obvious improvement in clinical symptoms of dermatophytosis (i.e. less erythema and fewer lesions) was evident with all three antifungal agents within 10 days of starting oral therapy. By day 20, athymic rats that were treated with either Tolciclate or Ketoconazole showed marked clinical improvement of the chronic dermatophytosis. Chronically infected athymic rats, which lack thymus matured T-cells, are a promising new model to evaluate the efficacy of antifungal agents by culture, histology, and visual observations of clinical symptoms.

Administration, Oral↗

Frequency and risk factors of dermatophytosis in students living in rural areas in Eskişehir, Turkey.

Our study included 2384 students from five villages around Eskişehir, Turkey. We asked every student for their personal identification and also for their sanitation in order to get an idea about dermatophytosis. Samples taken from suspicious lesion were collected and inoculated onto Sabouraud dextrose agar slants. For identification of fungi which were grown, macroscopic appearance of colonies, microscopic examination and biochemical tests were used. We found suspicious lesions in 245 (10.3%) and diagnosed dermatophytosis in 86 (3.6%) of the students. The dermatophyte species were Trichophyton rubrum 37 (43%) at first, Trichophyton mentagrophytes 17 (19.8%), Microsporum canis 11 (12.8%), Microsporum gypseum 8(9.3%), Epidermophyton floccosum 6 (7%), Trichophyton verrucosum 6 (7%) and Trichophyton violaceum 1 (1.1%). Tinea pedis (59.3%) was the most frequent clinic form of dermatophytosis, followed by tinea corporis (22.1%), tinea capitis (9.3%), tinea manum (7.0%) and tinea unguium (2.3%). Older age, male gender, poor hygiene, living in dormitory, low level mother education, history of dermatophytosis within family and sanitary conditions were computed as independently variables associated with dermatophytosis infection. For prevention and control of dermatophyte infection in children living rural areas, field studies should be done and sanitary conditions should be improved.

Adolescent↗

Development of an enzyme-linked immunosorbant assay (ELISA) for the serodiagnosis of canine dermatophytosis caused by Microsporum canis.

Abstract In dogs, dermatophytosis should be considered in any case of alopecic, papular or pustular lesion. The aim of this study was to develop an enzyme-linked immunosorbant assay (ELISA) as an aid in the diagnosis of canine dermatophytosis. The antigen used was a whole fungal extract obtained from an isolate of Microsporum canis cultured on a liquid medium from the parasitized hair of a cat with patches of alopecia. To assess the ELISA performances, sera from 18 dogs with dermatophytosis caused by M. canis (group A, n = 18), 20 dogs with skin diseases other than dermatophytosis and 22 healthy dogs (group B, n = 42) were tested. Four further animals were tested: three with dermatophytosis caused by M. gypseum and one by T. mentagrophytes. A significant difference (P < 0.01, Wilcoxon's test, w = 364) was found between IgG-specific levels of sera of recently M. canis-infected dogs (infection < 15 days) and controls (although three dogs had negative titres at this stage). A highly significant difference (P < 0.001, w = 462) was noted between controls and dogs with infection of longer duration (> 30 days). All dogs had positive titres at this stage. A highly significant correlation (P < 0.001, Spearman's test, rho = 0.86) between duration of infection and IgG concentration was noted. The test has good sensitivity (83.3%) and high specificity (95.2%) but some dogs retained positive titres after elimination of infection. The sensitivity is higher than that of direct microscopic hair examination and similar to that of fungal culture with DTM (dermatophyte test medium).

Animals↗

[Animal dermatophytosis. Recent advances].

The proportion of positive samples in relation to the number of samples examined from cases of dog and cat dermatophytosis varies considerably from one investigation to another. In dogs, it ranges between 4% and 10% and few studies show higher prevalences. On the other hand, the percentages of positive cultures cited in the reviewed literature from dogs with or without suspected dermatophytosis are quite similar. In dogs with suspected lesions of dermatophytosis, with few exceptions, Microsporum canis is the most common species isolated. Trichophyton mentagrophytes and Microsporum gypseum are less frequently isolated. In cats the prevalence of dermatophytes is usually higher than in dogs, and it is usually higher than 20%. However the frequency of positive findings is higher in cats with suspected dermatophytosis than in cats without visible lesions, with the exception of asymptomatic infected cats and transient carrier cats. Cats are accepted as the principal reservoir for M. canis. Griseofulvin is the drug of choice in canine and feline dermatophytosis.

English Abstract↗

Humoral immune responses in cats with dermatophytosis.

The IgG and IgM classes of antibodies to a water-soluble antigen preparation derived from Microsporum canis were determined by ELISA in the sera of 79 cats with dermatophytosis confirmed by results of fungal culture, and of 46 specific-pathogen-free-derived, barrier-maintained cats with no previous exposure to dermatophytes. Of the 79 cats with dermatophytosis, the species isolated were: M canis from 72, M gypseum from 6, and Trichophyton mentagrophytes from 1. Concentrations of soluble M canis antigen-specific IgG and IgM were significantly (P < 0.05) higher in the cats with dermatophytosis than in the control cats. The IgG concentration was > or = 2.0 ELISA units/ml ml in 71% of the cats with dermatophytosis and in 9% of the control cats, whereas IgM concentration was > or = 4.0 ELISA units/ml in 38% of the cats with dermatophytosis and in 11% of control cats. There was no significant difference in either IgG or IgM values between the cats with M canis infection and those with other non-M canis dermatophyte infections.

Animals↗

[Epidemiological survey of dermatophytosis in Spain (April-June 2001)].

INTRODUCTION: A three-month (April-June 2001) cross-sectional study was designed to assess the epidemiological profile of dermatophytosis in Spain. METHODS: Sixty-two medical centers belonging to 14 different autonomous regions of Spain took part in the survey. A total of 491 strains were sent the Mycology Unit of the National Microbiology Center together with a form containing information on each patient. Isolates were identified by routine methods. RESULTS: The average age of the patients was 38.7 years and 55.6% were men. The most frequent dermatophytoses were tinea unguium (39.1%), tinea corporis (25.1%), tinea pedis (12.6%), and tinea capitis (11.2%). Trichophyton rubrum (43%) was the most prevalent species. T. mentagrophytes (21.2%) and Microsporum canis (9.8%) were the second and third most common species, respectively. Tinea unguium was significantly associated with urban residence, and tinea corporis with rural residence and contact with animals. T. rubrum was related with urban dermatophytosis and T. mentagrophytes with rural cases. Tinea capitis due to T. tonsurans and T. violaceum was related with patients of North African origin. Tinea unguium was the most prevalent infection by autonomous region, except in Castilla-León, Asturias, Andalucía and Aragón, where tinea corporis was the most common dermatophytosis. Tinea capitis was the most frequent infection in Castilla-La Mancha and Extremadura. T. mentagrophytes was more prevalent than T. rubrum in Valencia, Castilla-La Mancha, Aragón and Murcia. CONCLUSION: This cross-sectional study shows regional differences in the clinical and microbiological features of dermatophytosis in Spain. Epidemiological surveys are an essential tool for developing strategies for infection control.

Adult↗

Local expression of IFN-gamma mRNA in skin lesions of patients with dermatophytosis.

Delayed type hypersensitivity (DTH) response to dermatophyte antigens is one of the host defense mechanisms in dermatophytosis. Skin lesions of dermatophytosis were examined for the cytokine mRNAs expression using the reverse transcriptase/polymerase chain reaction (RT-PCR) method. Interferon-gamma (IFN-gamma) mRNA was expressed in all of the dermatophytosis lesions. IFN-gamma plays an important role in the effector phase of the DTH reaction. Therefore, these findings indicate that DTH response is elicited in the skin lesions with dermatophytosis.

Adult↗

Interdigital tinea pedis (dermatophytosis simplex and complex) and treatment with ciclopirox 0.77% gel.

The most common presentation of tinea pedis (athlete's foot) is that involving the interdigital spaces. Tinea pedis interdigitalis may present as asymptomatic dermatophytosis simplex or dermatophytosis complex, which is symptomatic, with secondary bacterial infection. In the dermatophytosis complex presentation there may be inflammation, maceration and odor, with bacterial involvement. Ciclopirox gel offers advantages in the treatment of tinea pedis, especially in the dermatophytosis complex presentation, with antifungal, antibacterial, and anti-inflammatory activity; furthermore, the gel formulation is fast drying, which is an advantage when the toe web area is moist.

Administration, Topical↗

Dermatophytosis in children and adolescents: epidemiological, clinical, and microbiological aspects changing with age.

During a four year period, a total of 84 cases of dermatophytosis were seen in patients from 0 to 17 years of age attending our out-patient department. The sex distribution was about equal in preadolescents. Males predominated among adolescents. A peak incidence at early school age was due to cases of tinea capitis, mainly caused by Microsporum canis. A peak among adolescents was due to cases of tinea pedis, mainly caused by Trichophyton rubrum. In general, patients with Trichophyton rubrum infections were older than those with other types of dermatophytosis (p less than 0.05). Dermatophytosis due to Microsporum canis was most frequently seen in January and in September (p less than 0.01). Although onychomycosis due to dermatophytes was a comparatively rare disease, it did occur within all age subgroups. Entities which were very frequent in former times and which have become rare during the last decades, such as tinea capitis due to Trichophyton schönleinii, still contribute to the spectrum of dermatophytosis in childhood.

Adolescent↗

ABO blood groups in relation to the infection rate of dermatophytosis.

The role of ABO blood groups in the carriage rate of dermatophytosis was studied. Blood grouping was done for 108 culture-proven dermatophytosis patients. Forty-nine patients belonged to blood group A, 54 to blood group O, three to blood group B and two to blood group AB. The incidence of dermatophytosis was found to be high in patients of blood group O and A. However, chronicity of the disease was more frequent in those in blood group A. The control group consisted of 100 healthy subjects. Sixteen out of 29 control subjects belonging to blood group A had a history of skin infections. None of the O blood group control subjects had a history of skin infections. Our study suggests that A blood group subjects may be prone to chronic dermatophytosis.

ABO Blood-Group System↗

[Immune response in dermatophytosis].

A delayed-type hypersensitivity (DTH) response to a dermatophyte antigen is one of the host defense mechanisms. Peripheral blood mononuclear cells from patients with dermatophytosis produce a high level of IFN-gamma in response to stimulation with trichophytin. The presence of IFN-gamma mRNA in skin lesions of dermatophytosis was detected using reverse transcription-polymerase chain reaction. IFN-gamma-positive cells were observed immunohistochemically in the upper dermis of the skin lesions. These findings support the hypothesis that the skin lesions of dermatophytosis are associated with a Th1 response. The Th1 response, which is characterized by IFN-gamma release, is thought to be involved in the host defense against dermatophytes and to reflect cutaneous reaction in dermatophytosis. The stimulation of trichophytin significantly enhanced the release of IL-8 from keratinocytes. These findings account for the accumulation of neutrophils beneath the stratum corneum. The capacity of trichophytin-stimulated keratinocytes to release an enhanced level of IL-8 thus suggests that these cells can indeed help to induce the acute inflammatory response seen in dermatophyte infection. It therefore appears that keratinocytes not only play an important structural role in the formation of a physical barrier to dermatophytes but may also play an important functional role in initiating cutaneous inflammatory reactions, which might be involved in the host defense against dermatophytes. The production of IFN-gamma by peripheral blood mononuclear cells from patients with tinea unguium in response to stimulation with trichophytin was not impaired in contrast to that from patients without tinea unguium. Comparable lymphocyte proliferation with trichophytin was observed in both groups. No deficiency in Th1 response to dermatophyte antigen was shown in patients with tinea unguium by measuring the release of IFN-gamma, which plays a role in the effector phase of the DTH reaction. A deficiency of Th1 response to dermatophyte antigen, therefore, does not appear to play an important role in the establishment of tinea unguium.

Cytokines↗

[Screening Examination and Management of Dermatophytosis by Trichophyton tonsurans in the Judo Club of a University].

Thirty-one members of the Judo Club of a certain university (age: 18~23) underwent a screening examination for dermatophytosis by Trichophyton tonsurans. Test items were: age, sex, height, weight, living mode, exercise duration, number of judo contestants, presence of foreign contestants, occurrence, if any, of dermatophytosis past or present according to a subject's answers to a questionnaire, medical examinations and mycological examinations (KOH, cellophane tape culture, and hairbrush culture). Twenty-four subjects (77%) replied that they had suffered from dermatophytosis in the past, and 8 subjects (26%) had had head eruption in the past. Eleven subjects (35%) had suspicious dermatophytosis at the time of screening; 3 of them were found positive by direct microscopy, 2 of them were positive by cellophane tape culture. Eleven subjects (35%) were found positive by the hairbrush culture, but only 2 had eruption-like folliculitis. The remaining 9 subjects were free from clinical symptoms and were judged to be asymptomatic carriers. As countermeasures, we recommended cleaning and the use of shampoo containing miconazole nitrate. Subjects with suspicious tinea corporis were treated with antimycotic ointment. The 7 subjects who showed more than 5 colonies by the hairbrush culture were treated with 1-week pulse therapy of 400 mg itraconazole, and 3 of these who took a total dose of a pulse became negative through one pulse therapy.

Administration, Topical↗

Immunohistochemical detection of interferon-gamma-producing cells in dermatophytosis.

Skin lesions of dermatophytosis are thought to be a result of a T cell-dependent inflammatory response that is mediated by various cytokines. We examined whether IFN-gamma-positive cells (as expression of Th1 response) were present in the skin lesions of dermatophytosis in situ by immunohistochemical techniques. Mixtures of CD4-positive T cells and CD8-positive T cells were found to be present in the dermal infiltrates of the lesions. Considerable numbers of CD1a-positive cells were detected in the upper dermis and epidermis. A marked accumulation of CD68-positive cells was found in the upper dermis. IFN-gamma-positive cells were present in the upper dermis of the lesions. The pattern of IFN-gamma staining appeared to be intracellular in mononuclear lymphoid cells. The staining was considered to be highly specific because it could be completely blocked by preabsorption with recombinant IFN-gamma. Our data support the hypothesis that the skin lesions of dermatophytosis may be associated with a Th1 response. Th1 response, which is characterized by IFN-gamma release, is thought to be involved in the host defense against dermatophytes and to reflect cutaneous reaction in dermatophytosis.

Animals↗