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Dermatophyte Infections (dermatophyte + infections)
Selected AbstractsChange in pattern of skin disease in Kaduna, north-central NigeriaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2007Husain Yahya MSc Background, We report our experience on the pattern of skin disease in Kaduna, north-central Nigeria over a 6-year period, and compare it with a similar survey conducted in the same area 30 years ago and with surveys from Nigeria and from other parts of Africa. Methods, The medical records of new patients attending the dermatology outpatient clinics of Barau Dikko Specialist Hospital and Habbat Medical Center from March 2000 to December 2005 were retrieved. Demographic data (age and sex) and the diagnoses of skin disease were extracted and analyzed. Results, A total of 5982 cases was seen. Forty-nine per cent were males and 51% were females. One-third of the patients were aged under 20 years, and three quarters were aged below 40 years. Eczematous dermatitis was the most common skin disorder seen, making up 35% of cases, and had replaced dermatophyte infections and scabies, which were the most dominant skin diseases 30 years previously (now constituting 6% and 1.4% of cases, respectively). Atopic dermatitis had more than doubled in frequency (13.8% vs. 5.2%), and contact dermatitis had tripled in frequency (5.8% vs. 1.8%). Acne vulgaris (6.7%), pigmentary disorders (3.9%), urticaria (3.6%), papular urticaria (3.6%), hair disorders (3.3%), lichen simplex chronicus (3%), viral warts (2.9%), and drug eruptions (2.7%) had also increased. Human immunodeficiency virus-related skin disease constituted 4.3% of cases, with pruritic papular eruption being the most common condition. Conclusion, These changes in skin disease can be attributed mainly to an increase in urbanization and improved socio-economic conditions. [source] Deep dermatophytosis caused by Trichophyton rubrum: report of two casesMYCOSES, Issue 2 2007J. Q. Gong Summary Two patients presenting with subcutaneous nodules, plaques, papules and ulceration caused by Trichophyton rubrum are described in this report. The first case was a 46-year-old woman referred with erythema and desquamation over her trunk, hands and feet for 30 years, progressing to nodules and ulceration over her trunk, arms and scalp for the last 2 years. The second case was a 34-year-old man who presented with a 2-year-history of itchy, erythema and desquamation over the trunk, progressing to papules, nodules and cyst around his ear, on the neck and scalp for 1 year. The diagnoses were suspected after direct microscopical examinations of the discharge materials, which revealed the presence of hyaline hyphae. The histological examinations showed granulomatous inflammatory infiltrates with fungal elements in the dermis including epithelioid cells, giant cells, lymphocytes and eosinophils, and the periodic acid-Schiff stain showed hypha within the granulomas. Cultures of puncture materials, skin biopsies and nails confirmed the diagnosis identifying T. rubrum. Antifungal therapies with itraconazole were successful in both patients, the lesions were completely clear with atrophic scars after 3 months. Side effects were not noticed during the medication. We discuss the clinical types of granulomatous cutaneous lesions caused by dermatophyte infections and evaluate the therapeutic effect of itraconazole. [source] Onychomycosis in children: a survey of 46 casesMYCOSES, Issue 6 2005C. Romano Summary This is a retrospective study of the agents, clinical aspects, sources of infection and therapy of onychomycosis in children. In the period 1989,2000, we observed 46 consecutive children, until 16 years of age with onychomycosis (29 boys, 17 girls, mean age 10.8 years). Dermatophytes were isolated in 30 cases (Trichophyton rubrum in 22 cases, Trichophyton mentagrophytes in five, Epidermophyton floccosum in two and Trichophyton violaceum in one) and Candida spp. in 16, associated with Trichophyton rubrum in two. Moulds were isolated in three children (Fusarium oxysporum in one, Scopulariopsis brevicaulis in another and Aspergillus fumigatus associated with Trichophyton rubrum in a third). The commonest features were distal and distolateral subungual hyperkeratosis in dermatophyte infections (93%) and onychodystrophy and paronychia in Candida infections (56% and 50% respectively). Forty patients achieved clinical and mycological recovery. It is appropriate to suspect onychomycosis in children, perform microbiological diagnosis and undertake early treatment. An approach of this kind may help to prevent nail dystrophy and the spread of infection. [source] Extensive Tinea in a Patient With Severe Combined ImmunodeficiencyPEDIATRIC DERMATOLOGY, Issue 2 2009RAFAEL JIMÉNEZ-PUYA M.D. Although the X-linked recessive form is most common (60,70%), there are autosomal recessive forms (20%) and spontaneous mutations. While SCID may present with many nosocomial infections, dermatophyte infections are not common. We reported a case of SCID which was associated with a widespread skin infection with Trichophyton mentagrophytes. [source] Skin disease is common in rural Nepal: results of a point prevalence studyBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2008S.L. Walker Summary Background, Skin problems are the commonest reason for people accessing healthcare services in Nepal but there is little information about the prevalence of skin disease. Objectives, To perform a point prevalence study of skin disease in the Terai region of Nepal. Methods, Five villages were randomly selected in Bara District in the Terai region of Nepal, and 878 people were examined. Results, The number of individuals identified as having a skin disease was 546. The point prevalence of identifiable skin abnormalities was 62·2% (546 of 878) (with 95% exact confidence intervals 58·9,65·4%). A wide range of dermatoses was identified. The six most prevalent were dermatophyte infections (11·4%), followed by pityriasis versicolor (8·9%), acne (7·7%), melasma (6·8%), eczema (5·6%) and pityriasis alba (5·2%). Overall, treatable skin infections and infestations were by far the commonest skin diseases identified. Conclusions, Our study has demonstrated a very high point prevalence (62·2%) of skin disease in rural Nepal. This study represents the first formal survey of skin disease in Nepal and demonstrates a large burden of disease, in particular treatable infections. [source] Diagnosis of common dermatophyte infections by a novel multiplex real-time polymerase chain reaction detection/identification schemeBRITISH JOURNAL OF DERMATOLOGY, Issue 4 2007M. Arabatzis Summary Background, In the absence of a functional dermatophyte-specific polymerase chain reaction (PCR), current diagnosis of dermatophytoses, which constitute the commonest communicable diseases worldwide, relies on microscopy and culture. This combination of techniques is time-consuming and notoriously low in sensitivity. Objectives, Recent dermatophyte gene sequence records were used to design a real-time PCR assay for detection and identification of dermatophytes in clinical specimens in less than 24 h. Patients and methods, Two assays based on amplification of ribosomal internal transcribed spacer regions and on the use of probes specific to relevant species and species-complexes were designed, optimised and clinically evaluated. One assay was for detecting the Trichophyton mentagrophytes species complex plus T. tonsurans and T. violaceum. The second assayed for the T. rubrum species complex, Microsporum canis and M. audouinii. Results, The analytical sensitivity of both assays was 0·1 pg DNA per reaction, corresponding to 2·5,3·3 genomes per sample. The protocol was clinically evaluated over 6 months by testing 92 skin, nail and hair specimens from 67 patients with suspected dermatophytosis. Real-time PCR detected and correctly identified the causal agent in specimens from which T. rubrum, T. interdigitale, M. audouinii or T. violaceum grew in culture, and also identified a dermatophyte species in an additional seven specimens that were negative in microscopy and culture. Conclusions, This highly sensitive assay also proved to have high positive and negative predictive values (95·7% and 100%), facilitating the accurate, rapid diagnosis conducive to targeted rather than empirical therapy for dermatophytoses. [source] Could proximal white subungual onychomycosis be a complication of systemic spread?BRITISH JOURNAL OF DERMATOLOGY, Issue 5 2005The lessons to be learned from Maladie Dermatophytique, other deep infections Summary There are several published cases where dermatophyte infections have spread systemically, resulting in widespread internal dissemination as well as spread to local lymphatics and lymph nodes. The best example is provided by the condition known as Maladie Dermatophytique. In this commentary the arguments are discussed for a potential role of lymphatic dissemination in the development of proximal white subungual onychomycosis, where invasion of the nail plate by fungi proceeds from the proximal nail fold. [source] Trichophyton rubrum showing deep dermal invasion directly from the epidermis in immunosuppressed patientsBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2001K.J. Smith Trichophyton rubrum is the most widely encountered dermatophyte infection, and is usually regarded as exclusively keratinophilic often leading to chronic cutaneous and nail infections, even in healthy individuals. We present three patients with acute leukaemias, with ill-defined pre-existent cutaneous eruptions that were treated with a potent topical corticosteroid. All three patients received aggressive marrow toxic chemotherapy. These patients had progression of their cutaneous disease, which showed deep dermal invasion of T. rubrum, invading directly from the epidermis with no evidence of systemic spread. We conclude that systemic pancytopenia, in association with prolonged local immunosuppression, may increase the risk of direct dermal invasion of dermatophyte infections. However, even in these patients, the risk of systemic spread still appears very low. Amphotericin B did not appear effective in treating these dermatophyte infections. [source] | ||||||||||