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Hill RC, Caplan AS, Elewski B, Gold JAW, Lockhart SR, Smith DJ, Lipner SR. Expert Panel Review of Skin and Hair Dermatophytoses in an Era of Antifungal Resistance. Am J Clin Dermatol 2024; 25:359-389. [PMID: 38494575 DOI: 10.1007/s40257-024-00848-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 03/19/2024]
Abstract
Dermatophytoses are fungal infections of the skin, hair, and nails that affect approximately 25% of the global population. Occlusive clothing, living in a hot humid environment, poor hygiene, proximity to animals, and crowded living conditions are important risk factors. Dermatophyte infections are named for the anatomic area they infect, and include tinea corporis, cruris, capitis, barbae, faciei, pedis, and manuum. Tinea incognito describes steroid-modified tinea. In some patients, especially those who are immunosuppressed or who have a history of corticosteroid use, dermatophyte infections may spread to involve extensive skin areas, and, in rare cases, may extend to the dermis and hair follicle. Over the past decade, dermatophytoses cases not responding to standard of care therapy have been increasingly reported. These cases are especially prevalent in the Indian subcontinent, and Trichophyton indotineae has been identified as the causative species, generating concern regarding resistance to available antifungal therapies. Antifungal-resistant dermatophyte infections have been recently recognized in the United States. Antifungal resistance is now a global health concern. When feasible, mycological confirmation before starting treatment is considered best practice. To curb antifungal-resistant infections, it is necessary for physicians to maintain a high index of suspicion for resistant dermatophyte infections coupled with antifungal stewardship efforts. Furthermore, by forging partnerships with federal agencies, state and local public health agencies, professional societies, and academic institutions, dermatologists can lead efforts to prevent the spread of antifungal-resistant dermatophytes.
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Affiliation(s)
| | - Avrom S Caplan
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USA
| | - Boni Elewski
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeremy A W Gold
- Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, GA, USA
| | - Shawn R Lockhart
- Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, GA, USA
| | - Dallas J Smith
- Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, GA, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, 1305 York Avenue, New York, NY, 10021, USA.
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2
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Belmokhtar Z, Djaroud S, Matmour D, Merad Y. Atypical and Unpredictable Superficial Mycosis Presentations: A Narrative Review. J Fungi (Basel) 2024; 10:295. [PMID: 38667966 PMCID: PMC11051100 DOI: 10.3390/jof10040295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/07/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
While typically exhibiting characteristic features, fungal infections can sometimes present in an unusual context, having improbable localization (eyelid, face, or joint); mimicking other skin diseases such as eczema, psoriasis, or mycosis fungoides; and appearing with unexpected color, shape, or distribution. The emergence of such a challenging clinical picture is attributed to the complex interplay of host characteristics (hygiene and aging population), environment (climate change), advances in medical procedures, and agent factors (fungal resistance and species emergence). We aim to provide a better understanding of unusual epidemiological contexts and atypical manifestations of fungal superficial diseases, knowing that there is no pre-established clinical guide for these conditions. Thus, a literature examination was performed to provide a comprehensive analysis on rare and atypical superficial mycosis as well as an update on certain fungal clinical manifestations and their significance. The research and standard data extraction were performed using PubMed, Medline, Scopus, and EMBASE databases, and a total of 222 articles were identified. This review covers published research findings for the past six months.
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Affiliation(s)
- Zoubir Belmokhtar
- Department of Environmental Sciences, Faculty of Natural Sciences, Djilali Liabes University of Sidi-Bel-Abbes, Sidi Bel Abbes 22000, Algeria;
- Laboratory of Plant and Microbial Valorization (LP2VM), University of Science and Technology of Oran, Mohamed Boudiaf (USTOMB), Oran 31000, Algeria
| | - Samira Djaroud
- Department of Chemistry, Djilali Liabes University of Sidi-Bel-Abbes, Sidi Bel Abbes 22000, Algeria
| | - Derouicha Matmour
- Central Laboratory, Djilali Liabes University of Medicine of Sidi-Bel-Abbes, Sidi Bel Abbes 22000, Algeria
| | - Yassine Merad
- Central Laboratory, Djilali Liabes University of Medicine of Sidi-Bel-Abbes, Sidi Bel Abbes 22000, Algeria
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Chandler DJ, Walker SL. HIV and skin infections. Clin Dermatol 2024; 42:155-168. [PMID: 38142787 DOI: 10.1016/j.clindermatol.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
HIV infection alters the skin microbiome and predisposes to a wide range of cutaneous infections, from atypical presentations of common skin infections to severe disseminated infections involving the skin that are AIDS-defining illnesses. Bacterial infection of the skin, most commonly caused by Staphylococcus aureus, occurs frequently and can result in bacteremia. Nontuberculous mycobacterial infections that are usually localized to the skin may disseminate, and guidance on the treatment of these infections is limited. Herpes simplex can be severe, and less common presentations such as herpetic sycosis and herpes vegetans have been reported. Severe herpes zoster, including disseminated infection, requires intravenous antiviral treatment. Viral warts can be particularly difficult to treat, and in atypical or treatment-resistant cases a biopsy should be considered. Superficial candidosis occurs very commonly in people living with HIV, and antifungal resistance is an increasing problem in non-albicans Candida species. Systemic infections carry a poor prognosis. In tropical settings the endemic mycoses including histoplasmosis are a problem for people living with HIV, and opportunistic infections can affect those with advanced HIV in all parts of the world. Most cutaneous infections can develop or worsen as a result of immune reconstitution in the weeks to months after starting antiretroviral therapy. Direct microscopic examination of clinical material can facilitate rapid diagnosis and treatment initiation, although culture is important to provide microbiological confirmation and guide treatment.
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Affiliation(s)
- David J Chandler
- Dermatology Department, University Hospitals Sussex NHS Foundation Trust, Brighton, UK; Department of Global Health & Infection, Brighton and Sussex Medical School, Brighton, UK.
| | - Stephen L Walker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; Hospital for Tropical Diseases and Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK
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Si H, Li Y, Huang Z, Cui Y, Li S. Erythroderma combined with deeper dermal dermatophytosis due to Trichophyton rubrum in a patient with myasthenia gravis: first case report and literature review. BMC Infect Dis 2023; 23:789. [PMID: 37957543 PMCID: PMC10644414 DOI: 10.1186/s12879-023-08752-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Dermatophytes are the most common causative pathogens of mycoses worldwide and usually cause superficial infections. However, they can enter deep into the dermis lead to invasive dermatophytosis such as deeper dermal dermatophytosis on rare occasions. Erythroderma is a severe dermatological manifestation of various diseases resulting in generalized skin redness, but erythroderma due to fungi infections is barely reported. In this article, we reported the first case of erythroderma combined with deeper dermal dermatophytosis due to Trichophyton rubrum (T. rubrum) in a patient with myasthenia gravis. CASE PRESENTATION A 48-year-old man was hospitalized because of erythema with scaling and nodules covering his body for a month. The patient had a history of myasthenia gravis controlled by regularly taking prednisolone for > 10 years and accompanied by onychomycosis and tinea pedis lasting > 8 years. Based on histopathological examinations, fungal cultures, and DNA sequencing results, the patient was finally diagnosed with dermatophyte-induced erythroderma combined with deeper dermal dermatophytosis caused by T. rubrum. After 2 weeks of antifungal treatment, the patient had recovered well. CONCLUSIONS This case report shows that immunosuppressed patients with long histories of superficial mycoses tend to have a higher risk of developing invasive dermatophytic infections or disseminated fungal infections. Dermatologists should be alert to this condition and promptly treat the superficial dermatophytosis.
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Affiliation(s)
- Henan Si
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Yang Li
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Zhiyang Huang
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Yan Cui
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, 130021, China.
| | - Shanshan Li
- Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, 130021, China.
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Xia XJ, Liu ZH. Invasive Microsporum canis infection as a presenting complaint of late-diagnosed HIV infection. Int J STD AIDS 2021; 32:1358-1360. [PMID: 34392714 DOI: 10.1177/09564624211037524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 43-year-old male barber presented with 1 year history of a painful, itchy plaque on the dorsal hand. Microsporum canis was recovered from pus of the lesion. Serologic testing for human immunodeficiency virus (HIV) antibody was positive, with a CD4+ count of 81 cells per cubic millimeter. Invasive cutaneous Microsporum canis infection is uncommon and can be suggestive of HIV infection or other conditions of immunocompromise.
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Affiliation(s)
- Xiu-Jiao Xia
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Ze-Hu Liu
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China
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Wang R, Huang C, Zhang Y, Li R. Invasive dermatophyte infection: A systematic review. Mycoses 2020; 64:340-348. [PMID: 33217082 DOI: 10.1111/myc.13212] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/14/2022]
Abstract
Dermatophyte infections usually present as various types of superficial cutaneous mycoses; on very rare occasions, dermatophytes enter deep into the dermis and cause invasive infections. In this study, we aimed to perform a systematic review of all reported invasive dermatophytosis cases over the past 20 years. We performed systematic searches in PubMed/Medline, EMBASE and Web of Science and identified 123 papers reporting 160 individual cases of invasive dermatophytosis between 2000 and 2020. Our study included 103 (64.4%) males, and the mean age at diagnosis was 43.0 years (range: 3-87 years). The most common predisposing factor was superficial dermatophytosis (56.9%), followed by solid organ transplantation (26.9%), the use of topical immunosuppressants (15.6%), gene mutations (14.4%), diabetes (14.4%) and trauma (6.9%). Trichophyton (T.) rubrum was the most prevalent pathogen (53.1%) responsible for invasive dermatophytosis, followed by T. mentagrophytes (7.5%), Microsporum canis (6.9%), T. tonsurans (5.6%), T. interdigitale (5.0%) and T. violaceum (3.8%). Patients with CARD9 or STAT3 mutations were prone to have mixed infection of two or more dermatophytes, present with eosinophilia and high IgE, and develop disseminated infections. Overall mortality was 7.9%, and the mortality in patients with and without gene mutations was 17.4% and 5.5%, respectively. Most of the normal host patients responded well to oral antifungal agents, while gene-deficient patients usually required lifelong treatment to stabilise their infection status. Our review indicated the importance of preventive treatment of superficial tinea in patients with immunosuppression and gene deficiencies to avoid the development of invasive dermatophytosis.
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Affiliation(s)
- Ruojun Wang
- Department of Dermatology, Peking University First Hospital, Beijing, China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, China.,Research Center for Medical Mycology, Peking University, Beijing, China
| | - Chen Huang
- Department of Dermatology, Jiangsu Province Hospital, Nanjing, China
| | - Yi Zhang
- Department of Dermatology, Peking University First Hospital, Beijing, China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, China.,Research Center for Medical Mycology, Peking University, Beijing, China
| | - Ruoyu Li
- Department of Dermatology, Peking University First Hospital, Beijing, China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, China.,Research Center for Medical Mycology, Peking University, Beijing, China
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Rouzaud C, Chosidow O, Brocard A, Fraitag S, Scemla A, Anglicheau D, Bouaziz JD, Dupin N, Bougnoux ME, Hay R, Lortholary O, Lanternier F. Severe dermatophytosis in solid organ transplant recipients: A French retrospective series and literature review. Transpl Infect Dis 2018; 20. [PMID: 29094463 DOI: 10.1111/tid.12799] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 07/09/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Severe dermatophytosis is described in immunocompromised patients with defective cellular immunity. We report here a large series and a literature review of severe dermatophytosis in solid-organ transplant (SOT) recipients. METHOD The data main source was a national French retrospective study of severe dermatophytosis in SOT recipients between 2010 and 2016. Inclusion criteria were the presence of dermatophytes in skin culture and 1 severity criteria: dermal invasion by dermatophytes (invasive dermatophytosis) or involvement of at least two body sites or >10% of body surface area (extensive dermatophytosis). RESULTS A total of 12 patients were included (8 men, median age of 56 years [range: 33-71]). Of the 12 patients, 10 underwent kidney transplantation. The median time from transplantation to severe dermatophytosis diagnosis was 16 months [range: 2-94]. Clinical signs of superficial dermatophytosis were present in 8/12 patients before the emergence of severe dermatophytosis. Nine patients had invasive forms and three extensive ones, and nodules of the lower extremities were found in eight. Trichophyton rubrum was isolated in 11 cases. First-line treatment was terbinafine (7/12), posaconazole (3/12), or topical treatment alone (2/12). Immunosuppressive therapy was reduced in 3 patients because of associated infections. Complete response was obtained for 3/3 and 5/9 patients with extensive or invasive forms, respectively, after a median treatment's duration of 2.5 [range: 1.5-5] months and 7.5 months [range: 4-12]. Unrelated deaths (n = 2) and graft function impairment (n = 3) occurred. CONCLUSION Severe dermatophytosis is a late complication in SOT recipients presenting with lower limb nodules, which might be prevented by prompt treatment of superficial dermatophytosis.
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Affiliation(s)
- Claire Rouzaud
- Infectious Diseases and Tropical Medicine Department, Necker-Pasteur Infectious Diseases Center, Necker-Enfants malades Hospital, AP-HP, IHU Imagine, Paris Descartes University, Paris, France
| | - Olivier Chosidow
- Department of Dermatology, Henri Mondor Hospital, AP-HP, Paris-Est Créteil University, Créteil, France
| | - Anabelle Brocard
- Department of Dermatology, Nantes University Hospital, Nantes, France
| | - Sylvie Fraitag
- Department of Pathology, Necker-Enfants malades Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Anne Scemla
- Department of Nephrology-Transplantation, Necker-Enfants malades Hospital, AP-HP, Paris Descartes Sorbonne Paris Cité University, RTRS Centaure, Labex Transplantex, Paris, France
| | - Dany Anglicheau
- Paris Descartes University, Department of Nephrology-Transplantation, Necker-Enfants malades Hospital, AP-HP, Paris, France
| | | | - Nicolas Dupin
- Department of Dermatology, Cochin Tarnier Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Marie-Elisabeth Bougnoux
- Department of Mycology, Necker-Enfants malades Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Roderick Hay
- Dermatology Department, King's College Hospital NHS Trust, London, UK
| | - Olivier Lortholary
- Infectious Diseases and Tropical Medicine Department, Necker-Pasteur Infectious Diseases Center, Necker-Enfants malades Hospital, AP-HP, IHU Imagine, Paris Descartes University, Paris, France.,National Reference Center for Invasive Mycoses and Antifungals Molecular Mycology Unit, CNRS URA3012, Institut Pasteur, Paris, France
| | - Fanny Lanternier
- Infectious Diseases and Tropical Medicine Department, Necker-Pasteur Infectious Diseases Center, Necker-Enfants malades Hospital, AP-HP, IHU Imagine, Paris Descartes University, Paris, France.,National Reference Center for Invasive Mycoses and Antifungals Molecular Mycology Unit, CNRS URA3012, Institut Pasteur, Paris, France
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8
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Ohn J, Jo G, Mun JH. The influence of immune status, age, and sex on Majocchi granuloma: a review of 52 cases from a tertiary level hospital and published Korean cases in literature. Int J Dermatol 2017; 56:1139-1145. [PMID: 28929495 DOI: 10.1111/ijd.13746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/29/2017] [Accepted: 08/14/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Majocchi granuloma (MG) is a rare dermal and subcutaneous granulomatous inflammation caused by dermatophytes. The detailed characteristics of MG are not fully elucidated. This study investigated the influence of systemic immune status, age, and sex on the clinical, demographic, mycological, and therapeutic characteristics of MG in Korea. METHODS We analyzed cases of histopathologically diagnosed MG at our tertiary referral center from January 2001 to December 2016. We also analyzed all Korean MG cases published in Korean and English literature to date. The different features based on immune status, age, and sex were compared. P < 0.05 were considered statistically significant. RESULTS We enrolled 52 patients, 33 (63.5%) were male and 19 (36.5%) were female. The mean age was 45.4 ± 23.1 years. Immunosuppression was reported in 13 cases (26.5%). Statistical analysis showed that the immune status affects the anatomical location and clinical manifestation. Age has an influence on involved sites and identified fungal species. The frequent fungal pathogens were different based on sex. CONCLUSION The results of our study revealed that distinctive features of MG exist based on immune status, age, and sex.
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Affiliation(s)
- Jungyoon Ohn
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Human-Environment Interface Biology, Seoul National University, Seoul, Republic of Korea
| | - Gwanghyun Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.,Institute of Human-Environment Interface Biology, Seoul National University, Seoul, Republic of Korea
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Hambro CA, Yin NC, Yang C, Husain S, Silvers DN, Grossman ME. Trichophyton rubrum tinea capitis in an HIV-positive patient with generalized dermatophytosis. JAAD Case Rep 2016; 3:19-21. [PMID: 28050591 PMCID: PMC5192346 DOI: 10.1016/j.jdcr.2016.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Caely A Hambro
- Department of Dermatology, Columbia University Medical Center, New York, New York
| | - Natalie C Yin
- Department of Dermatology, Columbia University Medical Center, New York, New York
| | - Christine Yang
- Department of Dermatology, Columbia University Medical Center, New York, New York
| | - Sameera Husain
- Department of Dermatology, Columbia University Medical Center, New York, New York; Department of Pathology, Columbia University Medical Center, New York, New York
| | - David N Silvers
- Department of Dermatology, Columbia University Medical Center, New York, New York; Department of Pathology, Columbia University Medical Center, New York, New York
| | - Marc E Grossman
- Department of Dermatology, Columbia University Medical Center, New York, New York
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Severe Dermatophytosis and Acquired or Innate Immunodeficiency: A Review. J Fungi (Basel) 2015; 2:jof2010004. [PMID: 29376922 PMCID: PMC5753085 DOI: 10.3390/jof2010004] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 11/16/2015] [Accepted: 12/14/2015] [Indexed: 12/14/2022] Open
Abstract
Dermatophytes are keratinophilic fungi responsible for benign and common forms of infection worldwide. However, they can lead to rare and severe diseases in immunocompromised patients. Severe forms include extensive and/or invasive dermatophytosis, i.e., deep dermatophytosis and Majocchi’s granuloma. They are reported in immunocompromised hosts with primary (autosomal recessive CARD9 deficiency) or acquired (solid organ transplantation, autoimmune diseases requiring immunosuppressive treatments, HIV infection) immunodeficiencies. The clinical manifestations of the infection are not specific. Lymph node and organ involvement may also occur. Diagnosis requires both mycological and histological findings. There is no consensus on treatment. Systemic antifungal agents such as terbinafine and azoles (itraconazole or posaconazole) are effective. However, long-term outcome and treatment management depend on the site and extent of the infection and the nature of the underlying immunodeficiency.
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S HRE, M AN, C NF, S PBT, F XE. In-vitro effects of almond oil, barks and leaves extracts of Baillonella toxisperma (Pierre) against Trichophyton soudanense and Trichophyton rubrum. ACTA ACUST UNITED AC 2015. [DOI: 10.5897/jmpr2015.5908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Quantification of iodiconazole by LC–MS/MS, a new topical transdermal cream, in dermatophytosis patients’ plasma. Bioanalysis 2015; 7:895-905. [DOI: 10.4155/bio.15.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: A rapid and sensitive LC–MS/MS method was established to measure iodiconazole (ADKZ) in dermatophytosis patients treated topically with 2% ADKZ cream. Methodology: ADKZ was extracted by liquid-liquid extraction (LLE) and separated by an Agilent Zorbax SB-C18 column (2.1 × 150 mm, 3.5 μm) using methanol – 0.01% formic acid (70:30, v/v) as the mobile phase. All the validation assays met the acceptable criteria and the linearity ranged from 10 to 1000 pg/ml. Conclusion: The method has been validated to be simple, sensitive and successfully applied to the study. The average amount of ADKZ absorbed into blood was approximately 0.51 μg daily, and ADKZ blood concentrations were consistent during the four-week treatment course. The cumulation of ADKZ in vivo was almost negligible.
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Cheng CY, Hsiao YH, Ko JH. Disseminated deep dermatophytosis caused by Trichophyton rubrum. DERMATOL SIN 2014. [DOI: 10.1016/j.dsi.2013.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Dan P, Rawi R, Hanna S, Reuven B. Invasive cutaneous Trichophyton shoenleinii infection in an immunosuppressed patient. Int J Dermatol 2012; 50:1266-9. [PMID: 21950294 DOI: 10.1111/j.1365-4632.2009.04458.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Petronius Dan
- Department of Dermatology, Rambam Health Care Campus and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
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Medeiros MRF, de Melo Prado LA, Fernandes VC, Figueiredo SS, Coppede J, Martins J, Fiori GML, Martinez-Rossi NM, Beleboni RO, Contini SHT, Pereira PS, Fachin AL. Antimicrobial Activities of Indole Alkaloids from Tabernaemontana catharinensis. Nat Prod Commun 2011. [DOI: 10.1177/1934578x1100600209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Tabernaemontana catharinensis root bark ethanol extract, EB2 fraction and the MMV alkaloid (12-methoxy-4-methylvoachalotine) were evaluated for their antimicrobial activities. T. catharinensis ethanol extract was effective against both strains of the dermatophyte Trichophyton rubrum at concentrations of 2.5 mg/mL (wild strain) and 1.25 mg/mL (mutant strain), while the EB2 fraction and MMV alkaloid showed a strong antifungal activity against wild and mutant strains with MIC values of <0.02 and 0.16 mg/mL, respectively. The EB2 fraction showed a strong antibacterial activity against ATCC strains of S. aureus, S. epidermidis, E. coli and P. aeruginosa with MICs from <0.02 to 0.04 mg/mL, as well as against resistant clinical isolates species of Enterococcus sp, Klebsiella oxytoca, Citrobacter, K. pneumoniae, P. mirabilis, S. aureus, S. epidermidis, E. coli and P. aeruginosa with MIC values ranging from 0.04 to 0.08 mg/mL. The MMV alkaloid presented a MIC of 0.16 mg/mL against the strains of S. aureus and E. coli ATCC. For the resistant clinical isolates Enterococcus sp, Citrobacter, S. aureus, S. epidermidis, E. coli and P. aeruginosa the MIC of MMV ranged from 0.08 to 0.31 mg/mL. The chromatography analysis of the EB2 fraction revealed the presence of indole alkaloids, including MMV, possibly responsible for the observed antimicrobial activity.
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Affiliation(s)
| | | | | | | | - Juliana Coppede
- Unidade de Biotecnologia, Universidade de Ribeirão Preto, SP, Brasil
| | - Juliana Martins
- Unidade de Biotecnologia, Universidade de Ribeirão Preto, SP, Brasil
| | | | - Nilce Maria Martinez-Rossi
- Departamento de Genética, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo Ribeirão Preto, SP, Brazil
| | | | | | | | - Ana Lúcia Fachin
- Unidade de Biotecnologia, Universidade de Ribeirão Preto, SP, Brasil
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Marconi VC, Kradin R, Marty FM, Hospenthal DR, Kotton CN. Disseminated dermatophytosis in a patient with hereditary hemochromatosis and hepatic cirrhosis: case report and review of the literature. Med Mycol 2010; 48:518-27. [DOI: 10.3109/13693780903213512] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bienvenu AL, Ducray F, Schneider A, Putin C, Picot S. Manifestations cliniques atypiques dues à Trichophyton rubrum chez un patient immunodéprimé. J Mycol Med 2009. [DOI: 10.1016/j.mycmed.2008.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Vilela R, de Oliveira Teixeira F, Vilela L, Mendoza L. Exacerbated inflammatory reaction to Trichophyton rubrum infection on an HIV-positive patient successfully treated with fluconazole. Mycopathologia 2007; 163:203-5. [PMID: 17390235 DOI: 10.1007/s11046-007-9001-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2006] [Accepted: 02/20/2007] [Indexed: 11/27/2022]
Abstract
A 33 year-old HIV-positive Brazilian female patient was diagnosed with a cutaneous inflammatory reaction on her left forearm. The lesion spread rapidly affecting most of her forearm. The clinical diagnosis of tinea corporis (ringworm) was confirmed by wet mount preparations on 20% KOH and by the isolation of Trichophyton rubrum on pure cultures. Treatment with Fluconazole for a period of four weeks successfully cured the infection.
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Affiliation(s)
- Raquel Vilela
- Graduate Program da Santa Casa de Misericórdia, Green River Valley University UNINCOR, Itabira, MG, Brazil
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