A study of dermatophytoses in Esfahan (Iran)

A 10-Year Study of Dermatophytoses in Isfahan, Iran

Dermatophyte infections are very common worldwide and their epidemiological characteristics vary according to the geographical region and have altered in the last decades. The aim of the present investigation was to determine the diversity of causative agents of dermatophytoses and describe the epidemiological condition of infection in Isfahan, Iran, between 2003 and 2012. Specimens were collected from hair, nail, and skin and were examined by conventional methods such as direct microscopy, culture on sabouraud dextrose agar with chloramphenicol and cycloheximide (Mycosel agar) and sabouraud glucose agar, Trichophyton agars, growth on rice grains, urease test, and hair perforation test. Of 13,469 clinically suspected cases, 11.5% were affected with dermatophytoses. Tinea capitis was the most frequent form of infection (52.7%), followed by tinea corporis (24%), tinea pedis (8.9%). Trichophyton verrucosum was the most prevalent causative agent (40.6%), followed by T. mentagrophytes var. interdigitale (17.6%), Epidermophyton floccosum (13%), T. violaceum (12%), T. rubrum (4.1%). Age range of patients was between 1 and 80 years. Housewives were the most patients in our study. The study emphasizes importance of epidemiological surveys of dermatophyte species for the better management of infection.

Epidemiological trends in zoophilic and geophilic fungi in Iran

BACKGROUND

Dermatophytes can be divided into geophilic (soil), zoophilic (animals) and anthropophilic (human) strains, depending on the source of the keratin. The predominant organisms vary within a given geographical region during different periods, which is influenced by a number of factors, such as population movements, socioeconomic circumstances and level of surveillance. Thus, the incidence is very variable.

AIM

To determine the epidemiology of superficial fungal infections due to zoophilic and geophilic fungi in patients referred to the Pasteur Institute of Iran.

METHODS

The clinical presentation of zoophilic and geophilic dermatophyte-related infections was reviewed retrospectively from the medical records of all subjects referred to our laboratory for assessment of cutaneous fungal infection. Mycological examination consisted of culturing of pathological material followed by direct microscopy. Diagnosis was based on the macroscopic and microscopic characteristics of the colonies.

RESULTS

Of the 3976 clinically suspected cases of dermatophytosis, 239 (39.6%) were zoophilic dermatophytosis, confirmed by direct examination and culture. They occurred in 93 (39%) female patients and 146 (61%) male patients (median age 27.4 years, range 1.5-75). The commonest zoophilic fungi isolated were Trichophyton mentagrophytes var. mentagrophytes (28%), followed by Trichophyton verrucosum (9.3%) and Microsporum canis (2.2%). The geophilic fungus Microsporum gypseum was isolated from 0.33% of patients.

CONCLUSION

This study identifies the epidemiological trends and the predominant organisms causing zoophilic dermatophytosis in humans in Tehran. Consideration of the current epidemiological trends in the incidence of cutaneous zoophilic fungal pathogens is essential for investigation, diagnosis and treatment.

Tinea capitis due to Microsporum vanbreuseghemii: report of two cases

Two cases of dermatophytosis caused by Microsporum vanbreuseghemii are reported. A 7-year-old boy and his brother were examined for tinea capitis. Hair samples and skin scrapings were collected from each patient to microscopy and culture. Direct microscopic examination of the hairs using lactophenol revealed an ectothrix invasion. Cultures inoculated with portions of clinical material yielded M. vanbreuseghemii after 2 weeks. The identification of the fungi were based on colony morphology on mycobiotic agar, microscopic characteristic on slide cultures, biochemical reactions and hair perforation tests.

Dermatophytoses in outpatients attending the Dermatology Center of Avicenna Hospital in Qazvin, Iran

Dermatophytosis is still being considered as one of the major public health problems in many parts of the world. To identify the prevalence and etiological agents of dermatophytoses, a study was carried out between 2004 and 2006. Out of 1023 subjects suspected to have cutaneous mycoses, 348 (34%) patients were affected with dermatophytoses. The causative agents were identified macroscopically and microscopically after the clinical samples were subjected to potassium hydroxide examination and culture isolation. Epidermophyton floccosum was the most frequently isolated species representing 32.8% of isolates, followed by T. rubrum (18.1%), T. verrucosum (17.2%), T. mentagrophytes var. interdigitale (15.8%), T. mentagrophytes var. mentagrophytes (6.6%) and T. violaceum, T. schoenleinii and Microsporum canis (0.9%). The most common type of infection was tinea cruris (31.9%) affecting in particular male patients. Some other most prevalent tinea types were tinea corporis (20.7%), tinea pedis (19%), and tinea unguium (11.2%). To the best of our knowledge, this is the first report on dermatophytoses in Qazvin and the first study that shows tinea cruris as a major type of superficial fungal infection in Iran. The frequency of tinea was higher in males and tinea cruris showed a remarkably increasing tendency and was an important public health issue in Qazvin.

First Case of Microsporum ferrugineum from Iran

This is a first case of Microsporum ferrugineum from Iranian patient. A 42 year old man was examined for tinea faciei infection. Direct KOH preparations from skin scraping revealed hyaline septate branching mycelium. Cultures of skin scrapings yielded M. ferrugineum after three weeks. Isolate was identified based on colony morphology on Sabouraud's dextrose agar medium (S), microscopic morphology of slide culture, and biochemical reactions.

A study of dermatophytosis in South West of Iran (Ahwaz)

Two hundred and seventy nine patients suspected of having fungal lesions were examined. Skin scrapping, hair samples and nail clippings were collected from patients. Direct and culture examinations were performed for all samples. About 115 cases of examined subjects had dermatophytosis. Dermatophytosis occurred mainly in adults males (20-29 years). Tinea cruris (24.3%) was the most common type of dermatophytosis followed by tinea pedis (16.5%), tinea corporis (14.8%), tinea ungium (13%), tinea capitis (11.3%), tinea faciei (11.3%), tinea manuum (7%) and tinea barbae (1.7%). Trichophyton mentagrophytes was the most prevalent species followed by Epidermophyton floccosum.

Keratinophilic fungi isolated from hospital dust and soils of public places at Gulbarga, India

Keratinophilic fungi were isolated from corridor dust of 11 hospitals and soils of 21 public places using a hair baiting technique. A total of 41 species belonging to 24 genera were recovered. Among the dermatophytes and related species, Microsporum gypseum was predominant, followed by Chrysosporium keratinophilum, Trichophyton mentagrophytes, M. nanum and Ch. tropicum. Other species were represented by 32 species belonging to 21 genera. Most of the species isolated are known to be agents of human and animal infection or have been isolated from human and animal lesions. The fungi observed here are discussed in relation to their global distribution.

Characteristics of dermatophytoses among children in an area south of Tehran, Iran

The aim of this study was to determine the prevalence and etiological agents of dermatophytoses, and also their distribution according to age, gender, and body site among children in an area south of Tehran. A total of 382 children aged </=16 years suspected to have dermatophytic lesions were examined over a period of 3 years (1999-2001). The incidence rate of dermatophytoses was 6.6 per 100 000 person-years. Trichophyton violaceum was the most frequent isolate (28.3%) followed by Microsporum canis (15.1%), Epidermophyton floccosum (15.1%), T. rubrum (13.2%), T. mentagrophytes (11.3%), M. gypseum (7.5%), and T. verrucosum (5.7%). Tinea capitis (39.6%) was the most common type of infection, followed by tinea corporis (30.2%), tinea faciei (18.9%), and tinea manuum (7.5%).

In vitro evaluation of griseofulvin against clinical isolates of dermatophytes from Isfahan. In-vitro-Empfindlichkeit klinischer Dermatophyten-Isolate aus Isfahan, Iran, gegenuber Griseofulvin

Fifty dermatophyte isolates, recently obtained from clinical materials, belonging to Trichophyton mentagrophytes, T. verrucosum, Microsporum canis and Epidermophyton floccosum were examined for their susceptibility to griseofulvin. The minimum inhibitory concentration (MIC) values were obtained using the modified microdilution method. All 100% tested isolates had MIC geometric mean at a concentration between 0.43 and 0.95 microg ml(-1) The MIC(90)s and MIC(50)s were 8 microg ml(-1) and <0.25-1 microg ml(-1) respectively. From all isolates, 12% including three T. verrucosum, one M. canis and two T. mentagrophytes isolates had MIC values out of the standardized range, therefore, they were considered as relatively griseofulvin-resistant. At least some of the isolates tested might be difficult to eradicate in clinical terms with griseofulvin treatment in Isfahan.

A study of dermatophytoses in Sana'a, Yemen Republic

The present study describes the extent and causative agents of dermatophytoses in Sana'a, the capital of Yemen Republic. Out of 1100 patients with various skin diseases, 16.6% were affected with dermatophytoses. Among them, 70% were male and the age group 11-20 years was most susceptible to tinea infections. Tinea corporis was the most common disease, followed by tinea capitis. One hundred and seventy isolates of dermatophytes related to 9 species were identified. Microsporum canis was the most prevalent species, followed by Trichophyton violaceum.

The frequency of tinea pedis in patients with tinea cruris in Tehran, Iran

The objective of this study is to define the frequency of tinea pedis in patients with tinea cruris. Sixty patients (46 males and 14 females) entered our study. Epidermophyton floccosum was the most frequently isolated fungus in tinea cruris. Four patients (6.4%) had concurrent tinea pedis and the only isolate from the foot was Trichophyton mentagrophytes. In three of them, the corresponding dermatophyte in the groin was E. floccosum.

Characteristics of dermatophytoses in Basrah, Iraq

A total of 1199 clinical specimens were collected from 1144 patients clinically diagnosed as cases of superficial cutaneous mycoses in Basrah (Iraq). The collected specimens were examined for the etiologic agents of dermatophytoses by direct microscopy and culture. A total of 237 isolates representing eight species of dermatophytes as a causative agents of skin and nails infections were isolated. Among the tinea infections, tinea corporis and tinea cruris were the most common types of dermatophytoses revealed in this study.

A review of the epidemiology of tinea unguium in the community

Tinea unguium is a common, chronic fungal infection of the nails. Many epidemiological studies have looked at the frequency with which this condition is seen in hospital outpatients clinics or mycological laboratories along with other dermatomycoses. Only recently have studies begun to emerge looking at the prevalence of this condition in populations. Hospital and mycological laboratory-based studies give valuable information about tinea unguium prevalence in a particular clinic, but cannot be compared with other studies due to confounding factors inherent in the different people attending individual clinics. From population-based studies the prevalence of tinea unguium lies between 2 and 8%. Tinea unguium increases steadily with age. It is infrequent but definitely found in children. With the increasing life expectancy in the Western world the prevalence of tinea unguium is likely to increase further without adequate prevention and treatment.

Prevalence and aetiology of dermatophytoses in Isfahan, Iran

In this study the prevalence and causative agents of dermatophytoses in Isfahan, a large province of Iran, were determined. Of 16,578 clinically suspected cases 13.3% were affected with dermatophytoses. Lesions of tinea capitis were the most prevalent clinical type of dermatophytoses (54.1%), followed by tinea corporis (23.8%) and tinea pedis (8.9%). Trichophyton verrucosum was the most frequent causative agent (32.8%), followed by Epidermophyton floccosum (17.6%), T. mentagrophytes (16.2%) and Microsporum canis (12.3%). We found a relationship between the spread of dermatophytoses and live-stock infected with dermatophytoses in Isfahan.

A study of dermatophytoses in Hamadan, the governmentship of West Iran

In order to determine the extent and causative agents of dermatophytoses in the Hamadan region of West Iran; a study was made during a 9-month period from October 1991 to June 1992. A total of 7495 individuals were studied of whom 681 (9%) were suspect of having cutaneous mycoses. Among them dermatophytoses were the commonest infections (259/681 = 38%). Of 259 individuals infected with dermatophytes, tinea capitis were observed in 163 (62.9%); t. corporis in 27 (10.4%); t. manuum and t. cruris in 19 (7.3%) each; t. barbae and faciei in 14 (5.4%); t. pedis in 13 (5%) and t. unguium in 4 (1.5%). A total of 144 patients yielded dermatophyte cultures. The frequency of the isolated species in decreasing order was as follows: Trichophyton verrucosum, 78 (54.1%); T. schoenleinii, 48 (33.3%); Microsporum canis, 8 (5.5%); Epidermophyton floccosum, 5 (3.5%); T. mentagrophytes and M. gypseum, 2 (1.4%) each; T. tonsurans, 1 (0.7%). In conclusion, the most prevalent dermatophytosis in this region was t. capitis with the infecting agent of T. schoenleinii.

Isolation of dermatophytes and other keratinophilic fungi from surface sediments of the Shatt Al-Arab River and its creeks at Basrah, Iraq

Twenty-five sediment samples were taken from randomly selected sites in the Shatt Al-Arab River and its creeks and analysed for dermatophytes and related keratinophilic fungi. The results revealed that out of 25 samples only 13 (52%) yielded dermatophytes and related keratinophilic fungi. A total of nine species in four genera were isolated. The most frequent genera isolated in this study were Chrysosporium and its teleomorph Aphanoascus. The species most frequently found were Aphanoascus fulvescens, A. durus, Chrysosporium crassitunicatum, Chr. keratinophilum and Chr. tropicum (each n = 3). Microsporum was represented by two species, namely M. fulvum and M. gypseum. Trichophyton was represented by one species, T. verrucosum. The occurrence of these fungi illustrates that sediments may act as a reservoir for potentially pathogenic fungi for human and animals.

Tinea capitis in Lahore, Pakistan

BACKGROUND

The causative fungi of tinea capitis vary with geography and time. This study was planned to identify the etiologic agents and determine clinicoetiologic correlations of tinea capitis in Lahore, Pakistan.

METHODS

From clinically suspected cases of tinea capitis, skin scrapings and hair samples were taken and subjected to microscopy and culture.

RESULTS

Of 180 evaluable patients, 95% were children below 12 years of age with equal sex incidence. Noninflammatory lesions were seen in 62.2% of cases. Trichophyton violaceum was the most common etiologic agent responsible for 69.4% of infection, followed by T. tonsurans (16.7%), T. verrucosum (10%), Microsporum audouinii (2.2%), and T. mentagrophytes (1.7%).

CONCLUSIONS

T. violaceum is the predominant pathogen causing tinea capitis in children and adults in this part of the world and gives rise to a varied clinical picture. Our findings agree with data from other parts of Pakistan and many countries abroad.

Dermatophytoses in Iran

A total of 12,150 cases of suspected dermatophytoses in different areas of Iran were studied between 1986 and 1991. The age groups most commonly infected were 1-9 and 20-29 years. Clinical diagnosis was confirmed in only 9345 cases by laboratory examination. Of these positive samples, 1633 cases were found to be positive by direct microscopic observation only, 429 by culture only and 7283 by both techniques. Scalp ringworm of children was the most common type of tinea. But according to the rate of infection, tinea corporis, tinea pedis, tinea cruris, tinea manuum, tinea unguium and tinea barbae were the next most prevalent in that order. The frequencies of dermatophytes isolated from patients were as follows: Microsporum canis 19.4%, Trichophyton rubrum 16.5%, Epidermophyton floccosum 14.9%, Trichophyton mentagrophytes var. interdigitale 14.6%, Trichophyton verrucosum 11.5%, Trichophyton mentagrophytes 6%, Trichophyton violaceum 8.7%, Trichophyton schoenleinii 5.5%, Trichophyton tonsurans 1.3%, Trichophyton erinacei 0.8% and Microsporum gallinae 0.2%.

A study of dermatophytoses in Bangkok (Thailand)

A total of 719 cases of dermatophytoses was studied in the Division of Dermatology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand, during January to December 1986. Infection caused by fungus comprises 12%, while the incidence of dermatophytoses was 5.5% of skin disorders. The age group commonly infected was 12-21 years old (mean age of 18 years); 40% was female and 47.5% was male. In the female patients the common prevalent infections were tinea corporis 29%, tinea cruris 23%, tinea pedis 16%, while in male patients it was 28%, 39% and 14% respectively. Only 4 species of dermatophytes were isolated. The prevailing ones were: Trichophyton rubrum 66%, T. mentagrophytes 15%, Epidermophyton floccorum 13% and Microsporum gypseum 6%.