Dermatophytes and dermatophytoses in the Milan area between 1970 and 1989

Anti-dermatophyte activity of the aqueous extracts of Thai medicinal plants

Medicinal plants have long been prescribed in Thailand for centuries. Different constituents of extracts have been used for treating of various infectious diseases. However, there is even less information available regarding the use in fungal skin infection. In order to assess traditional Thai claims about the therapeutic potential, this study is focused on exploring the anti-dermatophyte property of the plants that are currently used as traditional medicines. The potential of four different plant species were selected for investigate in vitro anti-dermatophyte activity. Ethanolic extracts of Chromolaena odorata (L.), Ageratina adenophora (Spreng.), Eclipta prostrate (Linn.), and Acorus calamus (L.). were analysed for their total phenolic content as well as total flavonoid content and were then subjected to test of their anti-dermatophyte properties using agar well diffusion method. Qualitative flavonoids and phenolics analysis of the extracts showed their biologically active constituents. Among the species examined, the result indicated that most of the extracts demonstrated anti-dermatophyte activity. In particular, A. calamus showed the highest efficacy against test organisms. The experiment confirmed the chemical constituents and efficacy of some selected plants and provides a scientific confirmation of the use of Thai plants in traditional medicine for fungal skin infections.

Human Infections with Microsporum gypseum Complex (Nannizzia gypsea) in Slovenia

Microsporum gypseum complex is a group of geophillic dermatophytes with a worldwide distribution and is a rare cause of dermatomycoses in humans. The infection most commonly presents as tinea corporis, with some geographical and occupational variations. We studied M. gypseum complex infections in patients examined in the Mycological Laboratory of the Department of Dermatovenereology, University Medical Centre Ljubljana, during the period 2000-2015. Diagnosis was confirmed by mycological examination. Skin scales were examined by direct microscopy and cultivated on Sabouraud glucose agar. A total of 226 patients were identified, representing 1.5% of all dermatophyte infections during the study period. Tinea corporis was diagnosed in majority of patients, followed by tinea manus, tinea faciei, tinea inguinalis and tinea pedis. Tinea capitis was observed in three and onychomycosis in two patients only. Infection was disseminated on different parts of the body in nine patients. In 39% of patients, infection was diagnosed in children younger than 9 years. Face and scalp infection was more often observed in children. The incidence was the highest during July and October. Contacts with soil and domestic animals were often reported. Data on the prevalence and clinical characteristics of M. gypseum complex infection in other countries are reviewed.

An outbreak of Microsporum canis in two elementary schools in a rural area around the capital city of Slovenia, 2012

An outbreak of Microsporum canis infection affected 12 persons in two elementary schools over a period of 48 days in 2012 in Slovenia. Epidemiological, microbiological, and animal investigations were conducted. We defined cases as pupils or employees with skin lesions and confirmed or probable M. canis infection, attending one of the implicated elementary schools. Two clusters of six primary and six secondary cases were included in an unmatched case-control study. Contact with an adopted stray kitten at a birthday party was identified as the most probable source of infection. Secondary cases were more likely to have participated in gymnastic classes with a primary case than controls and were also more likely to have touched an infected child. Prompt communication and implementation of adequate control measures after the primary cases occurred would have prevented the secondary cases in another school.

Cortisol levels in cats' hair in presence or absence of Microsporum canis infection

The purpose of this work was to perform a preliminary screening in the domestic cat to assess the concentration of cortisol in hairs by radioimmunoassay technique (RIA) in presence or absence of Microsporum canis infections. A total of 245 cats (7 with cutaneous lesions referable to dermatophytosis and 238 apparently healthy) coming from 14 shelters were examined. M. canis was isolated in 126 (51.4%) cats. The cortisol levels were significantly higher in cats with lesions or without lesions but with a high number of colonies in the plates (≥ 10 CFU) than in cats negative or with a lower number of colonies. The results obtained seem to highlight that chronic high levels of cortisol in cats could possibly promote the dermatophytes infections. Furthermore, in High-CFU asymptomatic cats, it could be present a state of infectious, and they, therefore, represents not a simple mechanical carrier.

Epidemiology of dermatophytic infections in Rome, Italy: a retrospective study from 2002 to 2004

In the present study, we determined the incidence of dermatophyte species causing superficial mycoses among outpatients referred to the Department of Dermatology of the "La Sapienza" University of Rome between 2002 and 2004. Of the 3160 subjects studied, 1275 (40.3%) were positive for fungal infection, but only 252 (19.7%) of these had infections caused by dermatophytes. The dermatophyte most frequently isolated was Microsporum canis. Our epidemiological data were compared with those obtained previously by other authors in the same geographic area. For the first time we described an inversion of the T. rubrum/T. mentagrophytes ratio, the latter being more frequently encountered. We also observed the emergence of M. audouinii.

Micoses superficiais na cidade de Manaus, AM, entre março e novembro/2003

FUNDAMENTOS: Micoses superficiais estritas são infecções fúngicas que se localizam nas camadas superficiais da pele e seus anexos. As micoses superficiais cutâneas representadas pelas dermatofitoses e candidíases podem ultrapassar a camada córnea da pele. Na região amazônica possuem incidência elevada. OBJETIVOS: Estudar as micoses superficiais, estritas e cutâneas, diagnosticadas sob o ponto de vista epidemiológico e micológico. PACIENTES E MÉTODOS: Pacientes com suspeita clínica de micoses superficiais submetidos a exame micológico no período de março a novembro de 2003 no Laboratório de Micologia Médica/CPCS/INPA. RESULTADOS: Foram realizados 394 exames, tendo 256 apresentado diagnóstico positivo. As micoses mais incidentes foram onicomicoses (135) e pitiríase versicolor (98). Malassezia spp. (77) e Candida spp. (72) foram os agentes fúngicos mais isolados. Tinea capitis apresentou maior ocorrência nos pré-escolares (3), e onicomicoses em adultos (94). O sexo feminino foi o mais acometido (91). Todas as classes sociais foram infectadas, com predominância da C (37). CONCLUSÃO: Onicomicoses e pitiríase versicolor acometeram sobretudo adultos. A Tinea capitis ocorre principalmente, em crianças. As micoses superficiais apresentaram mais incidentes nas mulheres. Malassezia spp. e Candida spp. foram os agentes mais isolados.

The epidemiology of canine and feline dermatophytoses in southern Italy

A total of 424 animals (268 dogs and 156 cats) with skin lesions (alopecia and peripheral scaling) were examined from January 1999 to December 2002. Of the 424 samples examined, 99 (23.3%) yielded a positive culture and, in particular, 20.5% of the dog samples and 28.2% of the cat samples. Microsporum canis was the most common dermatophyte isolated from dogs and cats (77.7%), followed by geophilic dermatophyte species (M. gypseum, Trichophyton terrestre). Young dogs and cats, especially those younger than 1 year, showed a statistically significant higher prevalence of M. canis infection than older animals. No statistically significant association was found between infection and sex in cats, while male dogs were more affected by dermatophytes. Among breeds, Yorkshire terriers showed the highest positivity (50%) caused mainly by M. canis (46.6%), while no differences were noticed for cats. A significantly higher prevalence of positive samples was registered in summer and in autumn for cats. The presence of dermatophytes was not associated with itching. The diagnostic value of Wood's lamp fluorescence and microscopic examination proved to be scarce compared with fungal cultures as only 45.5% of the 77 samples that tested positive for M. canis at the cultural examination was positive under Wood's lamp florescence and 53.2% at microscopic examination.

Dermatophyte infections in the Ljubljana region, Slovenia, 1995-2002

We studied dermatophyte infections in patients, examined in the Mycological Laboratory of the Department of Dermatology, University Medical Centre Ljubljana during the period 1995-2002. A total of 42,494 samples were collected from 33,974 patients suspected to have dermatomycosis. Dermatophytes were identified in 8286 (71.2%) positive cultures. Microsporum canis was the most frequent dermatophyte isolated (46.8%), followed by Trichophyton rubrum (36.7%), T. mentagrophytes var. interdigitale (7.9%) and T. mentagrophytes var. mentagrophytes (4.9%). Less frequently isolated were M. gypseum, T. verrucosum, Epidermophyton floccosum, T. tonsurans and T. violaceum. The most common dermatophyte infections included tinea corporis, onychomycosis, tinea pedis and tinea faciei. Zoophilic dermatophytes were most commonly recovered from children and adolescents with tinea capitis, tinea corporis and tinea faciei. Anthropophilic species were identified mostly in adults with tinea pedis, onychomycosis and tinea inguinalis. During the period studied, we recorded a decline in the rate of M. canis infections, while infections produced by T. rubrum increased in frequency.

Case reports: tinea corporis in a 13-year-old German girl due to Trichophyton schoenleinii. Fallbericht. Tinea corporis in einem 13jahrigen Madchen verursacht durch Trichophyton schoenleinii

We report the first case of a tinea corporis with partly profound lesions in a 13-year-old girl on her arms, legs and trunk due to Trichophyton schoenleinii but without any lesion on scalp and hair. Moreover, this is the first case of an infection with Trichophyton schoenleinii in Germany since more than 40 years. The diagnosis was confirmed by microscopy of mycological specimens. Other causes of the skin symptoms could be excluded (atopic dermatitis, bacterial or other fungal infection). Clinical and epidemiological aspects of this anthropophile dermatophyte are briefly reviewed.

Tinea pedis observed in Cagliari, Italy, between 1996 and 2000

The aim of this study was to verify the incidence of tinea pedis in patients observed in the Department of Dermatology of the University of Cagliari, Italy, in the period from 1996 to 2000. We examined 722 patients, 536 with lesions and 186 without lesions of the feet and in 169 of them (23.4%) we diagnosed tinea pedis. All patients suffering from tinea pedis belonged to the group with lesions. In the 536 patients with clinical manifestations which were evident to a certain degree, microscope and cultural examination gave positive results for dermatophytes in 169 cases (31.5%). The most frequently isolated dermatophyte was Trichophyton mentagrophytes (51.5%), followed by Trichophyton rubrum (45.2%) and Epidermophyton floccosum (3.3%). In the 186 patients without lesions, direct microscope examination was consistently negative while cultural examination showed the growth of sparse colonies of Candida albicans in two cases (1.1%) We analysed distribution by sex, age, residence, occupation and clinical manifestations. Stressing the high frequency of tinea pedis in this region, the discovery of a dermatophytic infection of the feet with an absence of signs and symptoms is an exceptional event.

Case Reports. Tinea capitis due to Trichophyton soudanense and Trichophyton schoenleinii

Four cases of tinea capitis, two due to Trichophyton soudanense in Italian children who had had contact with Africans, and two due to Trichophyton schoenleinii in an African and an Italian child, respectively, are reported. Infections caused by anthropophilic dermatophytes are rare in Italy and are related to immigration. The most frequent agents of tinea capitis in Italy are zoophilic dermatophytes.

Tinea capitis

Tinea capitis is a common dermatophyte infection of the scalp in children. Dermatophytes are classified into three genera; tinea capitis is caused predominantly by Trichophyton or Microsporum species. On the basis of host preference and natural habitat, dermatophytes are also classified as anthropophilic, geophilic and zoophilic. The etiological agents of tinea capitis usually fall in the first and last categories. In North America, tinea capitis is now predominantly due to Trichophyton tonsurans. During the past 100 years the most common North American organism for tinea capitis was initially Microsporum canis followed later by M. audouinii. In other parts of the world the epidemiology varies. Tinea capitis is generally observed in children over the age of 6 years and before puberty, with African Americans being the most affected group. Clinical presentations are seborrheic-like scale, 'black dot' pattern, inflammatory tinea capitis with kerion and tiny pustules in the scalp. The clinical diagnosis should be confirmed by mycological examination. Wood's light examination was of value in diagnosing tinea capitis due to M. canis and M. audouinii; however, it is not helpful in T. tonsurans tinea capitis. Asymptomatic carriers may be a significant reservoir of infection and spread of spores may also involve inanimate objects. Carriers may benefit from shampooing their hair. Treatment of tinea capitis requires an oral antifungal agent. The data from the use of terbinafine, itraconazole and fluconazole are promising and suggest that these agents have an efficacy similar to griseofulvin while shortening the duration of therapy. Both griseofulvin and the newer antimycotics have a favorable adverse-effect profile and are associated with high compliance.

Identification of common dermatophytes (Trichophyton, Microsporum, Epidermophyton) using polymerase chain reactions

Polymerase chain reaction (PCR) fingerprinting detected DNA polymorphisms among frequently isolated species and strains of the genera Trichophyton, Microsporum and Epidermophyton. The patterns generated by this DNA-based method permitted species and strains to be identified. The conventional methods to identify dermatophytes rely on the expression of characteristic morphological features, as well as several physiological properties. Identification is often delayed or problematic because isolates may be slow to form conidia or produce atypical microscopic structures or colony appearances. Using non-specific primers such as (AC)10, (GTG)5, M13 core sequence and AP3, characteristic PCR profiles were generated for 17 species. Intraspecies variables were also observed for four of six varieties of T. mentagrophytes, whereas no detectable DNA variability was found within the three varieties of T. tonsurans. Comparing species-specific PCR fingerprints of clinical isolates with those of type strains, species could be identified by their PCR fingerprints, even if they could not be identified by the accepted phenotypic characteristics.

Dermatophytoses in Crete, Greece, between 1992 and 1996

Pathological specimens from 1361 patients with clinical manifestations of dermatophytosis from the island of Crete, Greece, were examined for dermatophytes during a 5-year period (1992-96). Dermatophytes of the genus Trichophyton, Microsporum and Epidermophyton were isolated from 327 (24%) of the patients. Trichophyton rubrum was the most frequently isolated dermatophyte accounting for 44.4% of the strains, followed by M. canis (25%), T. mentagrophytes var. interdigitale (14.4%) and E. floccosum (7.6%). Less frequent isolates included T. mentagrophytes (3.4%), T. violaceum (3.1%), T. verrucosum (1.8%) and M. gypseum (0.3%). An analysis of the distribution and frequency of the dermatophytes according to the cutaneous area affected and the sex of the patients is also reported.

Fungi responsible for skin mycoses in Turin (Italy)

There has been a recent increase in the frequency of skin mycoses, coupled with changes in the epidemiology and distribution of the species responsible. Periodic epidemiological analyses of these disease are thus required to ensure their efficacious control. Hair fragments, skin scrapings, specimens from vesicles and blisters and nail parings were seeded on Petri dishes loaded with Sabouraud or Mycosel agar, supplemented with chloramphenicol and with chloramphenicol plus cycloheximide respectively. Parts of each specimen were also mounted in 10% potassium hydroxide for examination under the microscope. Yeasts prevailed over dermatophytes. Microsporum canis was the most frequent dermatophyte, followed by Trichophyton rubrum, T. mentagrophytes and Epidermophyton floccosum. Tinea corporis was the most common mycosis, followed by tinea unguis, tinea capitis and tinea pedis. Men were chiefly bearers of tinea cruris and tinea pedis, women of tinea corporis, and children and teenagers of tinea capitis. Some examples of the transmission of infection through interhuman contact, via animals and from the soil are also presented.

Extracellular enzymatic activity of Microsporum canis isolates

The enzymatic activity of 70 feline and canine Microsporum canis isolates was determined by the Api-Zym test. The liquid phase of cultures, inoculated into Tryptic Soy Broth, was used to examine 19 enzymes. Considerable differences were observed among the extracellular enzymatic patterns. All the isolates produced alkaline phosphatase and beta-glucosidase, while lipase (C14), trypsin, chymotrypsin, beta-glucuronidase, and alpha-fucosidase activity was never revealed. Esterase (C4) activity was present in 57 samples (81%), esterase lipase (C8) in 31 (44%), leucine arylamidase in 35 (50%), valine arylamidase and cystine arylamidase in 7 (10%), acid phosphatase in 64 (91%), naphthol-AS-BI-phosphohydrolase in 60 (86%), alpha-galactosidase in 5 (7%), beta-galactosidase in 6 (8%), alpha-glucosidase in 25 (36%), N-acetyl-beta-glucosaminidase in 41 (58%), and alpha-mannosidase in 51 (73%). The beta-galactosidase activity of M. canis has not been reported previously. Remarkable variations of intensity for each enzymatic activity were also detected. It is believed that these results could provide basic data for further investigations on the pathogenic role of enzymes secreted by M. canis.

Dermatophytes in northern Finland in 1982-90

The epidemiology of human dermatophytes was studied in northern Finland in 1982-90. The samples were analysed at the Department of Medical Microbiology, University of Oulu. The total number of samples was 17,822, of which 3185 (18%) were positive. The annual number of samples and positive cultures remained relatively constant. Trichophyton rubrum was the most common species being isolated from 2101 samples (66% of all positive cultures), while Trichophyton mentagrophytes was isolated from 815 samples (26%) and Epidermophyton floccosum from 193 samples (6%). T. verrucosum caused an epidemic among cattle keepers in 1987-90, causing 47 infections. Microsporum canis, T. terrestre and T. violaceum were rare. The same species affected both children and adults. There was a tendency towards a decrease in tinea in the groin and a slight increase in tinea pedis. T. rubrum and T. mentagrophytes occurred most frequently in patients aged 41-45 years and as foot infections. E. floccosum usually affected the toe web and the groin in patients aged 21-25 years, more often infecting men. Fifty-four per cent of all positive samples came from men and 46% from women.

Epidemiology of dermatophytoses observed in Rome, Italy, between 1985 and 1993

Between 1985 and 1993, 13,880 patients were studied for possible forms of dermatophytoses. The most frequently isolated dermatophyte was in 2821 positive cases Microsporum canis (50%), followed by Trichophyton rubrum (27%), Trichophyton mentagrophytes (10.6%), Epidermophyton floccosum (9.3%), Microsporum gypseum (2.3%), Trichophyton violaceum (0.6%), Trichophyton tonsurans (0.2%) and Trichophyton verrucosum (< 0.1%). The genera and species isolated were also considered in relation to the site of the lesion. Our epidemiological data were compared with those obtained by other authors in other cities and with those obtained in Rome in previous studies conducted between 1972-77 and 1978-83. Results obtained by various investigators in Europe are also discussed.

Tinea capitis in the Florence area between 1985 and 1993

This paper describes the main epidemiological findings in 203 patients with tinea capitis and in seven other patients with dermatophytosis that had also extended to the scalp. The patients were observed over a 9-year period (from 1985 to 1993) at the Department of Dermatology of the University of Florence. Tinea capitis was the fourth most frequent dermatophytosis. Most of the patients were children, although 23 were adults. The most frequent aetiological agent was Microsporum canis. It is interesting to note that there were 12 cases of tinea capitis due to Trichophyton violaceum in African immigrants. This dermatophyte was believed to have disappeared from Italy. One case was due to Epidermophyton floccosum.

Dermatophytosis in northern Greece during the decade 1981-1990

Dermatophytic infections are very common in Greece. In the Mycological Laboratory of the Venereal and Skin Diseases Hospital in Thessaloniki, 6572 isolates of different dermatophytes were obtained from 17,120 patients examined. It is suggested that 5% of the people who present with skin problems in Greece suffer from dermatophyte infections. They are frequent causative agents of tinea pedis, tinea cruris, tinea corporis, tinea capitis and tinea unguium. In this paper, the species, the number and the prevalence of the dermatophytes were studied according to location and sex of the patients. The contribution of dermatophyte infections to the overall incidence of superficial fungal infection over 10 years was also studied.