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Müller VL, Kreuter A, Uhrlaß S, Nenoff P. [Trichophyton mentagrophytes genotype VII increasingly causes anogenital infections]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:48-54. [PMID: 38189829 DOI: 10.1007/s00105-023-05275-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 01/09/2024]
Abstract
In the course of globalization, migration and global warming, we are increasingly confronted with pathogens that do not occur naturally in our latitudes or appear in a different form. We know keratinophilic dermatophytes as the cause of tinea pedis, onychomycosis and also tinea corporis and capitis. Transmission usually occurs via domestic or farm animals and via autoinoculation. In recent years dermatophytes have gained additional importance as a possible sexually transmitted disease between immunocompetent persons. For the first time, dermatophytosis was described as a sexually transmitted infection in travelers who developed pronounced pubogenital or anogenital tinea after travelling in Southeast Asia, including Thailand, mostly after intensive sexual contact. Molecular and cultural analyses have identified Trichophyton (T.) mentagrophytes ITS (internal transcribed spacer) genotype VII as the main pathogen. Although this dermatophyte genotypically belongs to the zoophilic complex, direct (sexual) and occasionally indirect human-to-human contact with infected persons is suspected to be the current route of transmission. The infection can lead to inflammatory and purulent dermatophytosis, causing a high level of suffering. In this respect, a rapid and reliable diagnosis is essential in order to be able to initiate targeted treatment. The discovery of infection pathways and the awareness of the need to take rare diseases into account in our everyday lives will increasingly accompany us over the next few years and present us with new challenges, particularly in terms of prevention and treatment.
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Affiliation(s)
- Valentina Laura Müller
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Johannes Klinikum Duisburg, Dieselstr. 185, 47166, Duisburg, Deutschland.
| | - Alexander Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Johannes Klinikum Duisburg, Dieselstr. 185, 47166, Duisburg, Deutschland
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen/Universität Witten-Herdecke, Oberhausen, Deutschland
| | - Silke Uhrlaß
- labopart - Medizinische Laboratorien, Labor Leipzig-Mölbis, Rötha OT Mölbis, Deutschland
| | - Pietro Nenoff
- labopart - Medizinische Laboratorien, Labor Leipzig-Mölbis, Rötha OT Mölbis, Deutschland
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Busili A, Makrami A, Keni A, Khardily A, Alzahrani D, Busaily I, Busayli F. COVID-19 exposure and depression-anxiety levels among Saudi adults in the Jazan region: a study with a predominantly female and undergraduate sample. Front Psychiatry 2023; 14:1200052. [PMID: 37645641 PMCID: PMC10462401 DOI: 10.3389/fpsyt.2023.1200052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/28/2023] [Indexed: 08/31/2023] Open
Abstract
Background The COVID-19 pandemic has caused significant mental health challenges worldwide, as evidenced by numerous studies indicating high levels of depression and anxiety among individuals. However, the extent of mental health disorders following the pandemic and the association between anxiety and depression and COVID-19 exposure levels in the Jazan region of the Kingdom of Saudi Arabia have received little research attention. Methods A convenience sample of 377 participants, predominantly female (85.4%) with undergraduate education (74.5%) and Saudi nationality (92.8%), was included in the study. The study utilized a self-administered questionnaire to collect data from participants between 1st August and 8th September 2022. The questionnaire consisted of four parts, including demographic characteristics, COVID-19 exposure, the Patient Health Questionnaire-9 (PHQ-9) for depression assessment, and the Generalized Anxiety Disorders-7 (GAD-7) for anxiety evaluation. Statistical techniques such as descriptive statistics, independent t-tests, ANOVA (Analysis of Variance), and regression analysis were employed to analyze the collected data. Results The mean age of the study participants was 30.97 years (SD = 9.072). The mean score for COVID-19 exposure was 2.98 (SD = 1.48). The mean level of depression was 7.83 (SD = 6.43), with 20% of participants experiencing moderate to severe depression. Additionally, the study found that the mean score of anxiety level among participants was 6.75 (SD = 6.57), with 26% of the participants experiencing moderate to severe anxiety. Independent t-test revealed significant differences in mean depression and anxiety scores between participants with varying COVID-19 exposure levels (p = 0.001). The regression analysis demonstrated that anxiety levels were significant predictors of depression (p < 0.001). There is a significant difference in the depression mean between participants with high levels of anxiety (≥10) compared to others with levels <10. Furthermore, significant predictors of anxiety levels included either student or unemployment status (p < 0.001), increased age (≥35) (p = 0.049), female gender (p = 0.009), marital status of not being married, divorced, or widowed (p = 0.004), low monthly income (p = 0.019), and increased depression level (p < 0.001). Conclusion This study provides evidence of significant depression and anxiety levels among participants, with higher COVID-19 infection exposure correlating with increased scores for both. Anxiety was identified as a significant predictor of depression. Demographic factors, such as employment status, age, gender, and marital status, played a role in influencing anxiety levels. The findings highlight the need for targeted mental health interventions to address the psychological impact of COVID-19 infection exposure and support affected individuals effectively.
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Affiliation(s)
- Amani Busili
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Nursing College, Jazan University, Jazan, Saudi Arabia
| | | | - Amnah Keni
- Damad General Hospital, Jazan, Saudi Arabia
| | - Alaa Khardily
- Diabetes and Endocrinology Center, Jazan, Saudi Arabia
| | | | - Idris Busaily
- Dental College, Jazan University, Jazan, Saudi Arabia
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3
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[Inflammatory and pustular lesions in the pubic area]. Rev Med Interne 2023; 44:148-149. [PMID: 36641238 DOI: 10.1016/j.revmed.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 11/30/2022] [Indexed: 01/15/2023]
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Saadia A, Reckhow J, Rozenblat M, Last O. Kerion of the pubis and vulva with bacterial superinfection: a rare occurrence. BMJ Case Rep 2019; 12:12/8/e230320. [PMID: 31466986 DOI: 10.1136/bcr-2019-230320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Kerion is a severe hypersensitivity reaction to fungal infection that is rarely seen in the groin. Frequent shaving of pubic hair and religious conservatism surrounding genital hygiene are common among Bedouin women in the Negev Desert, and may predispose to kerion. This case highlights the clinical course of a 20-year-old Bedouin woman who presented with severe kerion celsi of the pubis and vulva with secondary bacterial infection. The patient was successfully treated with intravenous antibiotics, oral antifungal medication and wet topical dressings. The case outlines the risk factors and treatment for severe kerion celsi of the groin, as well as possible preventive measures that may reduce its incidence.
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Affiliation(s)
- Adi Saadia
- Dermatology and Venereology, Soroka University Medical Center, Beer Sheva, Israel
| | - Jensen Reckhow
- Medical School for International Health, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Mati Rozenblat
- Dermatology and Venereology, Soroka University Medical Center, Beer Sheva, Israel
| | - Omer Last
- Dermatology and Venereology, Soroka University Medical Center, Beer Sheva, Israel
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Kupsch C, Czaika V, Deutsch C, Gräser Y. Trichophyton mentagrophytes
– ein neuer Genotyp des zoophilen Dermatophyten verursacht sexuell übertragbare Infektionen. J Dtsch Dermatol Ges 2019; 17:493-502. [DOI: 10.1111/ddg.13776_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 08/28/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Christiane Kupsch
- Nationales Konsiliarlabor für DermatophytenInstitut für Mikrobiologie und InfektionsimmunologieCharité – Universitätsmedizin Berlin
| | | | - Cornelia Deutsch
- Klinik für DermatologieVenerologie und AllergologieCharité – Universitätsmedizin Berlin
| | - Yvonne Gräser
- Nationales Konsiliarlabor für DermatophytenInstitut für Mikrobiologie und InfektionsimmunologieCharité – Universitätsmedizin Berlin
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Kupsch C, Czaika VA, Deutsch C, Gräser Y. Trichophyton mentagrophytes - a new genotype of zoophilic dermatophyte causes sexually transmitted infections. J Dtsch Dermatol Ges 2019; 17:493-501. [PMID: 30775844 DOI: 10.1111/ddg.13776] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 08/28/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND A new genotype of the zoophilic fungal species Trichophyton (T.) mentagrophytes was recently described in two studies. It was isolated from three patients who had visited Southeast Asia and one patient who had visited Egypt. In contrast to these studies, we have observed a number of cases with the dimensions of an epidemic outbreak. PATIENTS AND METHODS At the University Hospital Charité Berlin, 43 patients, mostly suffering from highly inflammatory, painful and persistent infections of the pubogenital region were observed between January 2016 and July 2017. Mycological examination was performed with fungal culture and sequencing of the ITS (internal transcribed spacer) region of the ribosomal DNA. Three additional genomic regions were spot-checked. RESULTS In 37 of the cases, a new genotype of T. mentagrophytes (referred to here as T. mentagrophytes VII) was isolated as the etiological agent, and sequencing revealed identical sequences for all isolates. Most of the infected patients had no history of travel, and only two patients reported contact with animals. CONCLUSIONS The new genotype clustered phylogenetically among the strains of the zoophilic species T. mentagrophytes with four different DNA markers. While human-to-human transmission of zoophilic dermatophytes is rare, transmission via sexual contact seemed to be quite effective here.
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Affiliation(s)
- Christiane Kupsch
- National Reference Laboratory for Dermatophytes, Institute for Microbiology, Infectious Diseases and Immunology, Charité - University Medicine Berlin, Berlin, Germany
| | | | - Cornelia Deutsch
- Department of Dermatology, Venerology and Allergology, Charité - University Medicine Berlin, Berlin, Germany
| | - Yvonne Gräser
- National Reference Laboratory for Dermatophytes, Institute for Microbiology, Infectious Diseases and Immunology, Charité - University Medicine Berlin, Berlin, Germany
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Affiliation(s)
- Philippa Dickison
- Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Dermatology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Emily Forward
- Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Dermatology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Gayle Fischer
- Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Dermatology, Royal North Shore Hospital, Sydney, New South Wales, Australia
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Abstract
Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is commonly complicated by dryness and inflammation, which makes postmenopausal atrophic vaginitis a virtually ubiquitous condition. The differential of vaginitis includes inflammatory, infectious, and malignant diseases, plus drug hypersensitivity. Atrophic vaginitis is treated with estrogen replacement therapy. Vulvovaginal malignant melanoma occurs predominantly in postmenopausal women and carries a poor prognosis. Similarly, the incidence of vulvovaginal malignancies, such as squamous cell carcinoma and extramammary Paget disease, rises exponentially after 65 years of age. Early diagnosis of these malignancies is of utmost importance. Lichen sclerosus et atrophicus and vulvovaginal candidosis are among the most common postmenopausal vulvovaginal conditions. Lichen sclerosus et atrophicus is associated with significant morbidity, and its management can be challenging. The incidence of vulvovaginal candidosis increases in patients on estrogen replacement therapy.
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Affiliation(s)
- Natalie Matthews
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI
| | - Vivian Wong
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI
| | | | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI; Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil.
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Kerion Celsi with erythematous tumefaction on the groin due to Trichophyton mentagrophytes. Rev Iberoam Micol 2017; 34:249-250. [DOI: 10.1016/j.riam.2017.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/24/2017] [Accepted: 03/20/2017] [Indexed: 11/20/2022] Open
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Gallo JG, Woods M, Graham RM, Jennison AV. A severe transmissible Majocchi's granuloma in an immunocompetent returned traveler. Med Mycol Case Rep 2017; 18:5-7. [PMID: 28725545 PMCID: PMC5502794 DOI: 10.1016/j.mmcr.2017.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 07/03/2017] [Accepted: 07/05/2017] [Indexed: 11/25/2022] Open
Abstract
Severe dermatophyte infection is rare in immunocompetent adults. Recently cases have been described in travelers returning from South East Asia (Luchsinger et al., 2015) [1]. These may be sexually transmitted and can have permanent sequelae. We describe the first reported case of Majocchi's granuloma (MG) in an Australian returned traveler and its subsequent transmission via sexual contact. Both patients were successfully treated with systemic antifungals. MG should be considered in patients with severe rash after travel to South East Asia.
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Affiliation(s)
- James G Gallo
- Royal Brisbane & Women's Hospital Department of Infectious Diseases, Australia
| | - Marion Woods
- Royal Brisbane & Women's Hospital Department of Infectious Diseases, Australia
| | - Rikki M Graham
- Public Health Microbiology Forensic and Scientific Services, Health Support Queensland, Australia
| | - Amy V Jennison
- Public Health Microbiology Forensic and Scientific Services, Health Support Queensland, Australia
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Abstract
A multitude of infectious diseases of viral (genital herpes, herpes zoster, genital warts and molluscum contagiosum), bacterial (syphilis, chancroid, lymphogranuloma venereum, donovanosis, erysipelas, cellulitis and necrotising fasciitis, folliculitis, impetigo, bartholin gland abscess, trichomycosis and erythrasma), fungal (candidiasis and dermatophytosis) and parasitic (pediculosis pubis) origin may affect the vulvar area. Herein, we review the infections and their skin manifestations in the vulvar area.
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Affiliation(s)
- Freja Lærke Sand
- a Department of Dermatology , Bispebjerg Hospital , Copenhagen , Denmark
| | - Simon Francis Thomsen
- a Department of Dermatology , Bispebjerg Hospital , Copenhagen , Denmark.,b Department of Biomedical Sciences , University of Copenhagen , Copenhagen , Denmark
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12
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Gracia-Cazaña T, Milagro A, Rezusta A, Gilaberte Y. Querion de Celso de la vulva: una enfermedad común en una localización infrecuente. Rev Iberoam Micol 2017; 34:123-125. [DOI: 10.1016/j.riam.2016.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 10/16/2016] [Accepted: 11/04/2016] [Indexed: 12/01/2022] Open
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14
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Bakardzhiev I, Chokoeva A, Tchernev G, Wollina U, Lotti T. Tinea profunda of the genital area. Successful treatment of a rare skin disease. Dermatol Ther 2015; 29:181-3. [PMID: 26555874 DOI: 10.1111/dth.12311] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present a rare case of 36-year-old female patient, who developed a severe Majocchi granuloma in the pubis after waxing, with isolated causative agent Trichophyton mentagrophytes. The condition was initially misdiagnosed as a bacterial folliculitis and treated unsuccessfully with topical corticosteroids and antibiotics. After the adequate diagnose was confirmed by mycological examination, followed by histopathological verification, complete remission of the symptoms was achieved at the 4th week after initiating 6 weeks course of antifungal therapy with Terbinafine 250 mg/daily dose, while good therapeutic response was observed even in the 10th day. The etiopathogenesis of the disease, as well as its current treatment options are considered, in respect to the rare occurrence of this condition in the pubic area and its frequent misdiagnosis.
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Affiliation(s)
- Ilko Bakardzhiev
- Medical College, Medical University of Varna, 84 Tzar Osvoboditel str., Varna, 9000, Bulgaria
| | - Anastasiya Chokoeva
- "Onkoderma"-Policlinic for Dermatology and Dermatologic Surgery, General Skobelev 26 blvd., Sofia, Bulgaria
| | - Georgi Tchernev
- Medical Faculty, Policlinic for Dermatology and Venereology, Saint Kliment Ohridski University, University Hospital Lozenetz, Koziak street 1, Sofia, 1407, Bulgaria
| | - Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany
| | - Torello Lotti
- University of Rome "G. Marconi", Rome, Italy.,Department of Biotechnology, Delft University of Technology, 2628, BC, Delft, The Netherlands
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Luchsinger I, Bosshard PP, Kasper RS, Reinhardt D, Lautenschlager S. Tinea genitalis: a new entity of sexually transmitted infection? Case series and review of the literature. Sex Transm Infect 2015; 91:493-6. [PMID: 26071391 PMCID: PMC4680168 DOI: 10.1136/sextrans-2015-052036] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/31/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Investigation on recent cases of tinea genitalis after travelling to South East Asia. METHODS Patients with tinea in the genital region, which emerged after sex in South East Asia, underwent further assessment including microscopy, cultures and DNA analyses. RESULTS The case series includes seven patients. In six patients, Trichophyton interdigitale (former Trichophyton mentagrophytes) was detected. Three patients suffered from a severe inflammatory reaction of the soft tissue and two of them needed hospitalisation due to severe pain. In four patients, cicatrising healing was noticed. Five patients were declared incapacitated for work. CONCLUSIONS Sexual activity should be considered as a potentially important and previously underappreciated means of transmission of T. interdigitale. To avoid irreversible scarring alopecia, prompt initiation of antifungal treatment is essential and adequate isolation and identification of the pathogen is mandatory.
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Affiliation(s)
| | | | | | - Dominic Reinhardt
- Outpatient Clinic of Dermatology, Triemli Hospital, Zurich, Switzerland
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