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Abstract
The population of older adults continues to increase in the United States, leading to a concomitant increase in cutaneous disease. Fungal disease, specifically, commonly affects this population but often goes undiagnosed for too long. It is therefore important that providers be aware of common fungal pathogens, recognizable symptoms of disease, and treatment options. This article discusses 3 groups of pathogens: dermatophytes, Candida species, and Pityrosporum species, all of which cause a host of conditions that can be debilitating for older adults.
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Affiliation(s)
- Saniya Shaikh
- Department of Dermatology, SSM Health SLU Care Physician Group Saint Louis University School of Medicine, 1225 S Grand Boulevard, Saint Louis, MO 63104, USA.
| | - Aditya Nellore
- Department of Internal Medicine, St. Luke's Hospital, 232 S Woods Mill Road, Chesterfield, MO 63017, USA
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2
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Abstract
Cutaneous mucormycosis in children is an opportunistic fungal infection associated with significant morbidity and mortality. We describe characteristics of 12 patients with healthcare-associated cutaneous mucormycosis at Texas Children's Hospital and results of an outbreak investigation. A definitive source was not identified. Skin lesions near medical device securement sites should raise concern for mucormycosis in patients with underlying medical conditions.
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Affiliation(s)
| | - Paula A Revell
- Department of Pathology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | | | - Lucila Marquez
- From the Section of Infectious Diseases, Department of Pediatrics
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3
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Chen WY, Lin SR, Hung SJ. Successful Treatment of Recurrent Cutaneous Purpureocillium lilacinum (Paecilomyces lilacinus) Infection with Posaconazole and Surgical Debridement. Acta Derm Venereol 2019; 99:1313-1314. [PMID: 31532536 DOI: 10.2340/00015555-3320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Wei-Yu Chen
- Department of Dermatology , Tzu-Chi General Hospital, No. 707, Sec. 3, Chung Yang Rd., Hualien 970, Taiwan
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4
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Jimenez-Cauhe J, Molins-Ruiz M, Fernandez-Guarino M. Rapidly progressing ulcer and a urine drainage bag. Dermatol Online J 2018; 24:13030/qt4r53q48g. [PMID: 30695980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 12/16/2018] [Indexed: 06/09/2023] Open
Abstract
Primary cutaneous mucormycosis is an opportunistic fungal infection caused by the order Mucorales, most frequently by the Rhizopus species. Both systemic factors, such as diabetes mellitus or malignancies and local factors disrupting the skin barrier are implicated in development of this entity. The initial manifestation is a red-to-black papule rapidly progressing to a necrotic and painful ulcer. Diagnosis is obtained by identification of fungal forms in a skin biopsy, typically showing branching and non-septate hyphae. The clinical course is highly variable and depends mostly on the fungal invasion of deep tissues. However, an early diagnosis is essential for implementation of prompt and optimal treatment, based upon antifungal therapy and aggressive surgical debridement.
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Affiliation(s)
- Juan Jimenez-Cauhe
- Dermatology, Ramon y Cajal Hospital, Carretera Colmenar Viejo km 9.100, 28034 Madrid.
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5
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Chuh A, Zawar V, Ooi C, Lee A. The Role of Dermatoscopy in Infectious Diseases Affecting the Skin, Part 2: Mycologic Infections and Ectoparasitic Infestations. Skinmed 2018; 16:315-319. [PMID: 30413225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Antonio Chuh
- Hong Kong Society of Primary Care Dermoscopy;
- Department of Family Medicine and Primary Care, The University of Hong Kong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Vijay Zawar
- Hong Kong Society of Primary Care Dermoscopy
- Department of Dermatology, Dr Vasantrao Pawar Medical College, Nashik, India
| | - Catriona Ooi
- Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia
- Centre for Infectious Diseases and Microbiology, Westmead Clinical School, University of Sydney, New South Wales, Australia
| | - Albert Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
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Kim HJ, Singh P, John AM, Jasterzbski T, Lambert WC, Lambert MW, Gagna CE. Tinea (Pityriasis) Obscurans: Don't Ignore the Spore! Skinmed 2018; 16:255-257. [PMID: 30207528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Hee J Kim
- From the Rutgers - New Jersey Medical School, Department of Biological Sciences, New York Institute of Technology, Old Westbury, New York
| | - Parmvir Singh
- From the Rutgers - New Jersey Medical School, Department of Biological Sciences, New York Institute of Technology, Old Westbury, New York
| | - Ann M John
- From the Rutgers - New Jersey Medical School, Department of Biological Sciences, New York Institute of Technology, Old Westbury, New York
| | - Thomas Jasterzbski
- From the Rutgers - New Jersey Medical School, Department of Biological Sciences, New York Institute of Technology, Old Westbury, New York
| | - W Clark Lambert
- Department of Pathology and Laboratory Medicine, Department of Biological Sciences, New York Institute of Technology, Old Westbury, New York;
- Department of Dermatology, Department of Biological Sciences, New York Institute of Technology, Old Westbury, New York
| | - Muriel W Lambert
- the Department of Pathology and Laboratory Medicine, Department of Biological Sciences, New York Institute of Technology, Old Westbury, New York
- Department of Dermatology, Department of Biological Sciences, New York Institute of Technology, Old Westbury, New York
| | - Claude E Gagna
- Rutgers - New Jersey Medical School, Newark, NJ, Department of Biological Sciences, New York Institute of Technology, Old Westbury, New York
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Affiliation(s)
- P Nenoff
- Haut- und Laborarzt/Allergologie, Andrologie, Tätigkeitsschwerpunkt: Tropen- und Reisedermatologie (DDA), Labor für medizinische Mikrobiologie, Partnerschaft Prof. Dr. med. Pietro Nenoff & Dr. med. Constanze Krüger, Mölbiser Hauptstraße 8, 04571, Rötha/OT Mölbis, Deutschland.
| | - P Mayser
- , Hofmannstr. 11, 35444, Biebertal, Deutschland.
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8
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Abstract
BACKGROUND Mucormycosis is a rare, aggressive, and life-threatening infection that is caused by organisms belonging to the order Mucorales. It is usually acquired through direct means and virtually always affects immunocompromised patients with the port of entry reflecting the site of infection, in this case, cutaneous. Unlike other mucormycoses, patients affected by Apophysomyces elegans (A elegans) are known to be immunocompetent. This locally aggressive disease penetrates through different tissue plains invading adjacent muscles, fascia, and even bone causing extensive morbidity and may prove fatal if treated inadequately. Cutaneous mucormycosis is associated with disruption of cutaneous barriers such as trauma. However, rarely, it may be iatrogenic. No cases have been previously reported postcosmetic surgery, especially one that is so commonly performed, lipofilling. CASE REPORT The patient is a, previously healthy, 41-year-old middle-eastern female who was admitted to the plastic surgery department 17 days after undergoing cosmetic surgery. She suffered from extensive tissue inflammation and necrosis in both gluteal regions. Following admission, she was initially started on empirical antimicrobial therapy which was changed to an antifungal agent, voriconazole, when preliminary microbiological results showed filamentous fungi. This was discontinued and liposomal amphotericin B was commenced when further mycological analysis identified A elegans. Furthermore, she underwent a total of 10 sessions of extensive debridement to the extent that portions of the sacrum and left femoral head became exposed. Her clinical status and wounds improved with the appropriate management and she remained an inpatient for 62 days. Subsequently, she had defects in both gluteal regions which required reconstructive surgery. CONCLUSION A elegans is an uncommon cause of iatrogenic cutaneous mucormycosis. A high index of clinical suspicion is required, especially in the absence of clinical improvement despite conventional methods of treatment, so that early diagnosis can be reached and the appropriate management instigated promptly in order to mitigate morbidity and mortality. Reversal of predisposing risk factors, regular extensive surgical debridement, and antifungal therapy remain the cornerstones of therapy for this life-threatening condition.
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Affiliation(s)
- Khaled Al-Tarrah
- Department of Burns and Plastic Surgery
- Correspondence: Khaled Al-Tarrah, Burns and Plastic Surgery Department, Ibn Sina Specialist Hospital, Al-Sabah Health District, Kuwait (e-mail: )
| | | | | | - Eman Mokaddas
- Department of Microbiology, Ibn Sina Specialist Hospital
- Department of Microbiology, University of Kuwait, Kuwait
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9
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Abstract
Primary cutaneous aspergillosis (PCA) is an uncommon infection of the skin. There is a paucity of organized literature regarding this entity in regard to patient characteristics, associated Aspergillus species, and treatment modalities on outcome (disease recurrence, disease dissemination, and mortality).We reviewed all published reports of PCA from 1967 to 2015. Cases were deemed eligible if they included the following: patient baseline characteristics (age, sex, underlying condition), evidence of proven or probable PCA, primary treatment strategy, and outcome.We identified 130 eligible cases reported from 1967 to 2015. The patients were predominantly male (63.8%) with a mean age of 30.4 ± 22.1 years. Rates of PCA recurrence, dissemination, and mortality were 10.8%, 18.5%, and 31.5%, respectively. In half of the cases, there was an association with a foreign body. Seven different Aspergillus species were reported to cause PCA. Systemic antifungal therapy without surgery was the most common form of therapy (60% of cases). Disease dissemination was more common in patients with underlying systemic conditions and occurred on average 41.4 days after PCA diagnosis (range of 3-120 days). In a multivariate linear regression model of mortality including only patients with immunosuppressive conditions, dissemination and human immunodeficiency virus/acquired immune deficiency syndrome were statistically significantly associated with increased mortality.Nearly one-third of patients with PCA die with the disease. Dissemination and host status are critical in patient outcome.
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Affiliation(s)
- Alexander M. Tatara
- Department of Bioengineering, Rice University
- Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Dimitrios P. Kontoyiannis
- Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX
- Correspondence: Dimitrios P. Kontoyiannis, Department of Infectious Diseases, Infection Control and Employee Health, Unit 1416, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 (e-mail: )
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10
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Panthagani AP, Tidman MJ. Diagnosis directs treatment in fungal infections of the skin. Practitioner 2015; 259:25-3. [PMID: 26738249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Dermatophyte fungi are confined to the keratin layer of the epidermis and include three genera: Microsporum, Epidermophyton and Trichophyton. These infections can be transmitted by human contact (anthropophilic), from the soil (geophilic) and by animal (zoophilic) spread. Dermatophyte infections usually present as an erythematous, scaly eruption, which may or may not be itchy. Asymmetry is an important clinical clue to fungal infection, as is annular morphology. Examination under ultraviolet (Wood's light) can be helpful. The gold standard for diagnosing cutaneous fungal infections is microscopy and culture of scale, hair or nail, and a definite diagnosis is desirable before commencing treatment, especially with oral therapy. Any dermatophyte species affecting the body can affect the hands. The most common organism is T. rubrum. Tinea corporis infection affects the trunk mainly in children and adolescents, and all genera of dermatophyte can cause it. Tinea cruris infection involves the groin region and is more common in men than women. T. rubrum is the most common causative dermatophyte. The clinical features of tinea capitis include patchy hair loss with varying degrees of scale, erythema and pustules. Infected hairs tend to break at the base, leaving stubble. Occasionally, there is invasion of the visible epidermis, resulting in a boggy, painful swelling with associated alopecia and regional lymphadenopathy known as a kerion.
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Bandino JP, Hang A, Norton SA. The Infectious and Noninfectious Dermatological Consequences of Flooding: A Field Manual for the Responding Provider. Am J Clin Dermatol 2015; 16:399-424. [PMID: 26159354 DOI: 10.1007/s40257-015-0138-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Meteorological data show that disastrous floods are increasingly frequent and more severe in recent years, perhaps due to climatic changes such as global warming. During and after a flood disaster, traumatic injuries, communicable diseases, chemical exposures, malnutrition, decreased access to care, and even mental health disorders dramatically increase, and many of these have dermatological manifestations. Numerous case reports document typical and atypical cutaneous infections, percutaneous trauma, immersion injuries, noninfectious contact exposures, exposure to wildlife, and exacerbation of underlying skin diseases after such disasters as the 2004 Asian tsunami, Hurricane Katrina in 2005, and the 2010 Pakistan floods. This review attempts to provide a basic field manual of sorts to providers who are engaged in care after a flooding event, with particular focus on the infectious consequences. Bacterial pathogens such as Staphylococcus and Streptococcus are still common causes of skin infections after floods, with atypical bacteria also greatly increased. Vibrio vulnificus is classically associated with exposure to saltwater or brackish water. It may present as necrotizing fasciitis with hemorrhagic bullae, and treatment consists of doxycycline or a quinolone, plus a third-generation cephalosporin and surgical debridement. Atypical mycobacterial infections typically produce indolent cutaneous infections, possibly showing sporotrichoid spread. A unique nontuberculous infection called spam has recently been identified in Satowan Pacific Islanders; combination antibiotic therapy is recommended. Aeromonas infection is typically associated with freshwater exposure and, like Vibrio infections, immunocompromised or cirrhotic patients are at highest risk for severe disease, such as necrotizing fasciitis and sepsis. Various antibiotics can be used to treat Aeromonas infections. Melioidosis is seen mainly in Southeast Asia and Australia, particularly in rice farmers, and can remain latent for many years before presenting as the host's immunocompetence wanes. It can present with a variety of skin findings or as a nonspecific febrile illness, and preferred treatment consists of ceftazidime or a carbapenem with trimethoprim/sulfamethoxazole (TMP/SMX) for 2 weeks, then continuing TMP/SMX for at least 3 months. Leptospirosis is a waterborne zoonosis that is often prevalent after heavy rains or flooding. Different forms exist, including Fort Bragg fever, which produces a distinctive erythematous papular rash on the shins. Doxycycline is often sufficient; however, volume and potassium repletion may be necessary if renal involvement exists. Chromobacterium violaceum infection may occur after open skin is exposed to stagnant or muddy water. Cultured colonies produce a unique violacein pigment, and treatment typically consists of a carbapenem. Both typical and atypical fungal infections are increased in the flooding disaster scenario, such as dermatophytosis, chromoblastomycosis, blastomycosis, and mucormycosis. Appropriate antifungals should be used. In addition, land inundated with water expands the habitat for parasites and/or vectors, thus increased vigilance for regional parasitic infections is necessary after a flood. Lastly, noninfectious consequences of a flooding disaster are also common and include miliaria, immersion foot syndromes, irritant and allergic contact dermatitis, traumatic wounds and animal bites, and arthropod assault, as well as exacerbation of existing skin conditions such as atopic dermatitis, psoriasis, and alopecia areata due to increased stress or nonavailability of daily medications.
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Affiliation(s)
- Justin P Bandino
- Dermatology, USAF Hospital Langley, Hampton, VA, USA.
- , Yorktown, VA, 23693, USA.
| | - Anna Hang
- University of North Carolina, Chapel Hill, NC, USA
| | - Scott A Norton
- Dermatology Division, Children's National Medical Center, Washington, DC, USA
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12
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Asahina A, Kobayashi M, Nakano K, Saito I, Yarita K, Kamei K, Tokura Y. Deep cutaneous infection with Microsphaeropsis arundinis: report of two Japanese cases. Acta Derm Venereol 2015; 95:855-7. [PMID: 25758776 DOI: 10.2340/00015555-2091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Akihiko Asahina
- Department of Dermatology, The Jikei University School of Medicine , 105-8461 Tokyo, Japan.
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13
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Monod M, Fratti M, Mignon B, Baudraz-Rosselet F. [Dermatophytes transmitted by pets and cattle]. Rev Med Suisse 2014; 10:749-753. [PMID: 24772808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Most inflammatory skin and hair dermatophytoses are caused by one of four zoophilic dermatophyte species: Microsporum canis (from cats and dogs), Trichophyton verrucosum (from cattle), Arthroderma benhamiae (from Guinea-pigs) and Arthrodermna vanbreuseghemii (generally from cats and dogs). In cases of highly inflammatory tinea corporis, tinea faciae and tinea capitis in humans, it is important to identify with certainty the precise etiologic agent and to examine pets as the possible source of infection. The recurrence of infections or new infections can be prevented by adequately treating incriminated domestic animals and their environments. Cooperation between the medical and veterinary professions is required in this situation.
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Muhammed M, Anagnostou T, Desalermos A, Kourkoumpetis TK, Carneiro HA, Glavis-Bloom J, Coleman JJ, Mylonakis E. Fusarium infection: report of 26 cases and review of 97 cases from the literature. Medicine (Baltimore) 2013; 92:305-316. [PMID: 24145697 PMCID: PMC4553992 DOI: 10.1097/md.0000000000000008] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Fusarium species is a ubiquitous fungus that causes opportunistic infections. We present 26 cases of invasive fusariosis categorized according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria of fungal infections. All cases (20 proven and 6 probable) were treated from January 2000 until January 2010. We also review 97 cases reported since 2000. The most important risk factors for invasive fusariosis in our patients were compromised immune system, specifically lung transplantation (n = 6) and hematologic malignancies (n = 5), and burns (n = 7 patients with skin fusariosis), while the most commonly infected site was the skin in 11 of 26 patients. The mortality rates among our patients with disseminated, skin, and pulmonary fusariosis were 50%, 40%, and 37.5%, respectively. Fusarium solani was the most frequent species, isolated from 49% of literature cases. Blood cultures were positive in 82% of both current study and literature patients with disseminated fusariosis, while the remaining 16% had 2 noncontiguous sites of infection but negative blood cultures. Surgical removal of focal lesions was effective in both current study and literature cases. Skin lesions in immunocompromised patients should raise the suspicion for skin or disseminated fusariosis. The combination of medical monotherapy with voriconazole or amphotericin B and surgery in such cases is highly suggested.
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Affiliation(s)
- Maged Muhammed
- From the Division of Infectious Diseases (MM, TA, AD, TKK, HAC, JG-B, JJC, EM), Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts; and Division of Infectious Diseases (TA, JJC, EM), Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island
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15
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Abstract
There are many common skin infections that may affect children at any time. Certain conditions may be recurrent, while others tend to result in the child developing immunity and do not recur. Skin infections may be bacterial, fungal or viral in origin, and the article outlines some of the most common of these and the management options available.
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Affiliation(s)
- Heulwen Wyatt
- Paediatric dermatology, St Woolos Hospital, Newport, Wales.
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16
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Skiada A, Petrikkos G. Cutaneous mucormycosis. Skinmed 2013; 11:155-160. [PMID: 23930354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Mucormycosis is an invasive fungal infection caused by fungi of the order Mucorales, mainly affecting immunocompromised patients. Cutaneous mucormycosis is the third most common clinical form of the disease, after pulmonary and rhino-cerebral. The usual factors predisposing to this infection are hematological malignancies and diabetes mellitus, but a significant proportion of patients are immunocompetent. The agents of mucormycosis are ubiquitous in nature and are transmitted to the skin by direct inoculation, as a result of various types of trauma. These include needle sticks, stings and bites by animals, motor vehicle accidents, natural disasters, and burn injuries. The typical presentation of mucormycosis is the necrotic eschar, but it can present with various other signs. The infection can be locally invasive and penetrate into the adjacent fat, muscle, fascia, and bone, or become disseminated. Diagnosis is difficult because of the nonspecific findings of mucormycosis. Biopsy and culture should be performed. The treatment of mucormycosis is multimodal and consists of surgical debridement, use of antifungal drugs (amphotericin B and posaconazole), and reversal of underlying risk factors, when possible. Mortality rates, although lower than in other forms of the disease, are significant, ranging from 4% to 10% when the infection is localized.
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Affiliation(s)
- Anna Skiada
- 1st Department of Propedeutic Medicine, Athens University, Laikon General Hospital, M. Asias 75, Goudi 11527, Athens, Greece.
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Trabelsi S, Aouinet A, Abderrahim E, Ben Abdallah T, Khedher A, Khaled S. First case of subcutaneous dermatomycoses in a Tunisian renal transplant patient. Tunis Med 2012; 90:196-199. [PMID: 22407643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Dermatophytes are keratinophilic and usually infect the corneal layer of the epidermis and appendages On the occasion of immunosuppression, such as solid organ transplant, they can invade deeper tissues or cause an infection of the skin and subcutaneous disseminated. AIM To report the first observation of subcutaneous dematophytosis in a Tunisian renal transplant patient. CASE REPORT A 29-year-old man had an erythematous lesion of 2 cm at the front of the left leg. He was treated with prednisone and tacrolimus. The skin lesion was has been neglected. The outcome was the occurrence of oozing whose mycological examination showed numerous hyphae and culture was positive for Microsporum canis. Initial treatment was voriconazole, but an interaction with tacrolimus has shortened the duration of treatment to 1 month. Three months later, the lesion became deeper, and then a biopsy was performed. The mycological examination showed the same appearance, previously described. The patient was put on fluconazole by adjusting the doses of tacrolimus and then underwent surgical excision of the lesions. The evolution after 4 months of antifungal treatment was favorable. CONCLUSION The increasing incidence of immunosuppressive therapy has given rise to unusual clinical forms of invasive and sometimes serious fungal agents whose pathogenicity is usually limited. Clinicians should be mindful of superficial fungal infections of the skin in a renal transplant patient.
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Affiliation(s)
- Sonia Trabelsi
- Department of Internal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
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18
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Błaszkowska J, Wójcik A. Current problems concerning parasitology and mycology with regard to diseases of the skin and its appendages. Ann Parasitol 2012; 58:111-123. [PMID: 23444796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Current issues concerning Parasitology and Mycology with regard to diseases of the skin and its appendages are presented. Aspects of diagnostics, clinical picture and therapy of skin and nail mycoses, as well as difficulties in the diagnosis and treatment of both native parasitoses (toxoplasmosis) and imported human tropical parasitoses (malaria, filariosis) have been emphasised. The clinical importance of environmental mould fungi in nosocomial infections and fungal meningitis, as well as selected properties of fungi isolated from patients with head and neck neoplasms treated by radiotherapy are discussed. Other mycological topics include the characteristics of newly-synthesized thiosemicarbazides and thiadiazoles as potential drugs against toxoplasmosis and their biological activity against Toxoplasma gondii tachyzoites, selected molecular mechanisms of resistance to azoles, Candida albicans strains and a new tool (barcoding DNA) for describing the biodiversity of potential allergenic molds. The importance of environmental factors in pathogenesis of mycoses and parasitoses is noted. The characteristics of pathogenic fungi isolated from natural ponds in Bialystok and potentially pathogenic yeast-like fungi isolated from children's recreation areas in Lodz are presented. The ongoing problem of anthropozoonoses is considered, as are the roles of stray cats and dogs in contaminating soil with the developing forms of intestinal parasites. The characteristics of the human microbiome, including population composition, activity and their importance in normal human physiology, are presented, as are the major goals of the Human Microbiome Project initiated by National Institutes of Health (NIH).
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Affiliation(s)
- Joanna Błaszkowska
- Chair of Biology and Medical Parasitology, Medical University of Lodz, 1 Hallera Square, 90-647 Lodz, Poland.
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Jidar K. [Bacterial and mycotic cutaneomucosal infections]. Rev Prat 2011; 61:989-998. [PMID: 22039746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Kaoutar Jidar
- Service de maladies infectieuses, CHU Bichat-Claude-Bernard, AP-HP, 75877 Paris Cedex 18, France.
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20
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Anan T, Shimizu F, Hatano Y, Okamoto O, Katagiri K, Fujiwara S. Paraneoplastic pemphigus associated with corneal perforation and cutaneous alternariosis: a case report and review of cases treated with rituximab. J Dermatol 2011; 38:1084-1089. [PMID: 21434987 DOI: 10.1111/j.1346-8138.2010.01192.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
| | - Fumiaki Shimizu
- Plastic Surgery, Faculty of Medicine, Oita University, Oita, Japan
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21
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Siddiqui AR, Bernstein JM, Polenakovik H. A fungus among us. Skinmed 2010; 8:291-292. [PMID: 21137640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Abdul R Siddiqui
- From the Department of Medicine, Veterans Affairs Medical Center, Dayton, OH, USA
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23
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Datsis AC, Tsintoni A, Tasoula A, Roupas N, Trahalios H, Marangos M, Leonardos P, Spiliotis J. Isolated cutaneous cryptococcosis in an immunocompromised patient cured without antifungals. Int J Dermatol 2009; 48:440-1. [PMID: 19335437 DOI: 10.1111/j.1365-4632.2009.03787.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chen CK, Wan SH, Kou SK. A rare cutaneous fungal infection complicating bacterial necrotising fasciitis. Hong Kong Med J 2008; 14:314-316. [PMID: 18685166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
We report a case of bacterial necrotising fasciitis complicated by the rare fungus Absidia corymbifera. Although this fungal infection is rare, the prognosis is poor and it therefore requires attention. Only 30 cases have been reported since 1874, and we are the first group to report this clinical scenario in our locality. Using a comprehensive journal review, we discuss the expected clinical course and optimal management.
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Affiliation(s)
- C K Chen
- Department of Orthopaedics and Traumatology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
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Peano A, Gallo MG. Management of Malassezia-related diseases in the dog. Parassitologia 2008; 50:85-88. [PMID: 18693565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Most cases of Malassezia dermatitis/otitis in the dog are associated with concurrent dermatoses or systemic diseases and recurrences are not uncommon. Recognition and control of the predisposing factors are therefore key factors for successful therapy and prevention of recurrent infections. Currently, Malassezia dermatitis/otitis is managed by the use of antifungal drugs. Systemic therapy is often necessary, in particular when clinical signs are severe and widespread. Ketoconazole and Itraconazole are the most commonly used drugs. Topical therapy is an alternative in case of localized lesions and external ear localizations. Different commercial formulations, available in clinical practice in form of creams, gels, lotions, sprays and ear drops are often used as adiuvants to systemic therapy. Topicals more frequently used are represented by imidazolic antifungals, chlorhexydine and lime sulphur. The presentation deals with more recent advances about the protocols for treatment of Malassezia-related diseases in the dog. New perspectives, as the use of natural compounds, immunotherapy and inhibitors of yeast adherence factors, are also discussed.
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Affiliation(s)
- A Peano
- Dipartimento Produzioni Animali, Epidemiologia ed Ecologia, Università degli Studi di Torino, Italy.
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Paul AY, Aldrich S, Scott RS, Ellis MW. Disseminated histoplasmosis in a patient with AIDS: case report and review of the literature. Cutis 2007; 80:309-312. [PMID: 18038693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Disseminated histoplasmosis was uncommon prior to the AIDS epidemic, and cutaneous eruption rarely was seen. Since the onset of the worldwide AIDS epidemic, histoplasmosis has become a more common opportunistic fungal infection and should be considered in the differential diagnosis of mucocutaneous lesions in patients with AIDS in endemic areas. We report a case of classic disseminated histoplasmosis in a patient with AIDS and discuss the epidemiology, clinical presentation, pathogenesis, laboratory and histopathologic findings, and treatment options for disseminated histoplasmosis.
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Affiliation(s)
- Amy Y Paul
- Department of Dermatology, Evans Army Community Hospital, Fort Carson, CO 80913, USA.
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Rudy SJ. Pediatric dermatology: fungal/yeast infections, viral infections, acne, and hemangiomas. Dermatol Nurs 2007; 19:507-508. [PMID: 18286865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Bowman MR, Paré JA, Sigler L, Naeser JP, Sladky KK, Hanley CS, Helmer P, Phillips LA, Brower A, Porter R. Deep fungal dermatitis in three inland bearded dragons (Pogona vitticeps) caused by the Chrysosporium anamorph of Nannizziopsis vriesii. Med Mycol 2007; 45:371-6. [PMID: 17510861 DOI: 10.1080/13693780601188610] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The Chrysosporium anamorph of Nannizziopsis vriesii (CANV), a keratinophilic fungus that naturally and experimentally causes severe and often fatal dermatitis in multiple reptile species, was isolated in pure culture from skin samples of three inland bearded dragons (Pogona vitticeps) with deep granulomatous dermatomycosis. The first animal presented with a focal maxillary swelling involving the skin and gingiva. This lizard died while undergoing itraconazole and topical miconazole therapy. The second presented with focally extensive discoloration and thickening of the skin of the ventrum and was euthanized after 10 weeks of itraconazole therapy. A third lizard presented with hyperkeratotic exudative dermatitis on a markedly swollen forelimb. Amputation and itraconazole therapy resulted in a clinical cure. Histopathology of tissue biopsies in all cases demonstrated granulomatous dermatitis with intralesional hyphae morphologically consistent with those produced by the CANV. The second lizard also had granulomatous hepatitis with intralesional hyphae. Evidence in this report suggests that the CANV is the etiologic agent of an emerging condition in captive bearded dragons that has been called 'yellow fungus disease'.
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Affiliation(s)
- Michelle R Bowman
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin - Madison, USA
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30
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Abstract
We report the case of a 56-year-old Chinese woman with phaeohyphomycosis. She presented with a 4-year history of a recurring erythematous plague initially diagnosed as chromoblastomycosis on histopathological examination. Surgical excision was performed when the lesion recurred despite intial treatment response to itraconazole. Tissue cultures of the surgical specimen grew Cladophialophora bantiana. Treatment with terbinaffine post surgery was instituted with no recurrence of the lesion to date. Cutaneous phaeohyphomycosis caused by Cladophialophora bantiana is rare and this case highlights the clinical presentation, laboratory findings and treatment of this infection.
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Affiliation(s)
- C Y Neoh
- National Skin Centre, Singapore.
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31
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Abstract
Since the mid-1990s of the last century, dermatomycological guidelines have been prepared and published in Germany. This has been achieved by a group of experts encompassing leading representatives of Deutschsprachige Mykologische Gesellschaft, Deutsche Dermatologische Gesellschaft as well as Berufsverband Deutscher Dermatologen. Preparation of guidelines is based on a defined procedure. The first draft is prepared by one to three experts and then forwarded to all members of the working group for further discussion and improvement. This can be by way of either conventional mail or electronic mail. All aspects turning up in the process are reflected by the head of the working group and these aspects are used to prepare another version, which is again distributed to all members of the working group. Following up to three or four pertinent rounds of optimisation, a final version based on general consensus will be available at the end. All guidelines are subject to adaptation in a period of 3-5 years at the latest or if needed even earlier.
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Affiliation(s)
- C Seebacher
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, München, Germany.
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32
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Faucher N. [6/5--Irritant dermatitis and mycoses]. Soins Gerontol 2007:47. [PMID: 17708506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Abstract
Zygomycosis, often referred to as ''mucormycosis'' or ''phycomycosis,'' is a rapidly progressive fungal infection which usually occurs in immunocompromised individuals, and is characterized by soft tissue destruction and invasion of blood vessels. The rare and easily misdiagnosed primary cutaneous form may present as a superficial erosion with a painless, gradual onset and slow progression of symptoms or a gangrenous, necrotic ulceration due to rapid tissue and vascular invasion. With the latter form, the mortality rate among affected individuals is high even after aggressive surgical debridement and amphotericin B administration, emphasizing the importance of early recognition and proper diagnosis. We present two instances of gangrenous cutaneous zygomycosis in immunocompromised children and review the literature with regard to etiology, diagnosis and treatment, highlighting the pediatric population.
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Swick BL, Walling HW. Papular eruption in an HIV-infected man. Disseminated histoplasmosis with cutaneous and gastrointestinal involvement. ACTA ACUST UNITED AC 2007; 143:255-60. [PMID: 17310009 DOI: 10.1001/archderm.143.2.255-b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Nakamura Y, Xu X, Saito Y, Tateishi T, Takahashi T, Kawachi Y, Otsuka F. Deep cutaneous infection by Fusarium solani in a healthy child: successful treatment with local heat therapy. J Am Acad Dermatol 2006; 56:873-7. [PMID: 17147970 DOI: 10.1016/j.jaad.2006.10.960] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2006] [Revised: 10/31/2006] [Accepted: 10/31/2006] [Indexed: 10/23/2022]
Abstract
We describe a 6-year-old boy with a granulomatous lesion on the upper aspect of his left arm. Fusarium solani infection was confirmed by biopsy studies and cultures. The biopsy specimen showed an unusually extensive dermal invasion with fungal hyphae. This is an uncommon clinical presentation for deep cutaneous infection caused by F solani in a healthy child. Local heat therapy with a chemical pocket warmer led to dramatic healing of the lesion.
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Affiliation(s)
- Yasuhiro Nakamura
- Department of Dermatology at Hitachi Ltd, Taga General Hospital, Hitachi, Ibaraki 316-0035, Japan.
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Héliot-Hosten I, Boralevi F, Taïeb A. [Bacterial and mycotic cutaneomucosal infections]. Rev Prat 2006; 56:1817-25. [PMID: 17315510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Affiliation(s)
- Isabelle Héliot-Hosten
- Service de dermatologie et dermatologie pédiatrique, centre de référence pour les maladies rares de la peau, hôpital Saint-André, CHU de Bordeaux, 33075 Bordeaux Cedex
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Ara M, Aspiroz C, Zaballos P, Alcalde V, Alvarez R, Rezusta A, Giménez JA. Relapse of cutaneous alternaria infectoria in a renal transplant recipient after 2 years. Acta Derm Venereol 2006; 86:154-5. [PMID: 16648921 DOI: 10.2340/00015555-0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Dulak SB. Stop the assault on skin in HIV. RN 2006; 69:25-9; quiz 30. [PMID: 16796269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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Abstract
AIMS The increasing resistance to antifungal compounds and the reduced number of available drugs led us to search therapeutic alternatives among aromatic plants and their essential oils, empirically used by antifungal proprieties. In this work the authors report on the antifungal activity of Juniperus essential oils (Juniperus communis ssp. alpina, J. oxycedrus ssp. oxycedrus and J. turbinata). METHODS AND RESULTS Antifungal activity was evaluated by determination of MIC and MLC values, using a macrodilution method (NCCLS protocols), on clinical and type strains of Candida, Aspergillus and dermatophytes. The composition of the oils was ascertained by GC and GC/MS analysis. All essential oils inhibited test dermatophyte strains. The oil from leaves of J. oxycedrus ssp. oxycedrus is the most active, with MIC and MLC values ranging from 0.08-0.16 microl ml(-1) to 0.08-0.32 microl ml(-1), respectively. This oil is mainly composed of alpha-pinene (65.5%) and delta-3-carene (5.7%). CONCLUSIONS J. oxycedrus ssp. oxycedrus leaf oil proved to be an emergent alternative as antifungal agent against dermatophyte strains. delta-3-Carene, was shown to be a fundamental compound for this activity. SIGNIFICANCE AND IMPACT OF THE STUDY Results support that essential oils or some of their constituents may be useful in the clinical management of fungal infections, justifying future clinical trials to validate their use as therapeutic alternatives for dermatophytosis.
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Affiliation(s)
- C Cavaleiro
- Laboratory Pharmacognosy, Faculty of Pharmacy/CEF, University of Coimbra, Coimbra, Portugal.
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41
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Abstract
UNLABELLED Fungal infections are common in tropical countries and can have an important impact on public health. Lobomycosis is a common fungal infection in the tropical rain forest of South America, and paracoccidioidomycosis (South American blastomycosis) is a widespread and sometimes severe illness. Penicilliosis marneffei is an opportunistic infection of AIDS patients in southeast Asia. Chromoblastomycosis and mycetomas are causes of morbidity around the world. Sporotrichosis is a worldwide subcutaneous mycosis with a high incidence in tropical countries and is an important illness in immunocompromised patients. Rhinosporidiosis was classed as a fungal infection but is now considered a protistan parasite that belongs to the class Mesomycetozoea. It is included in this review because of its historical classification. In the past, most of these mycoses were restricted to specific geographic areas and natural reservoirs. There are, however, situations in which people from other regions come in contact with the pathogen. A common situation involves an accidental contamination of a traveler or worker who has contact with a tropical mycosis. Even minor trauma to the skin surface or inhalation of the fungal conidia can infect the patient. Thus recognition of the clinical symptoms and the dermatologic findings of the diseases, as well as the geographic distribution of the pathogens, can be critical in diagnosis of the tropical mycoses. This review discusses some of the more common tropical subcutaneous and systemic mycoses, as well as their signs, symptoms, methods of diagnosis, and therapies. LEARNING OBJECTIVE At the completion of this learning activity, participants should be able to recognize the clinical and histologic presentations of tropical fungal diseases with cutaneous manifestations and be familiar with the appropriate therapies.
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Affiliation(s)
- Omar Lupi
- Department of Medical Clinics (Dermatology), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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42
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Abstract
Molds are quite more often suspected as pathogens by the public than by the medical care community. Molds may, however, cause serious medical problems, and mold infections can develop incognito. Among the mycoses caused by opportunistic molds, alternariosis and fusariosis together with aspergillosis are of particular importance. They are more common than other groups with pathological characteristics. The aim of our presentation is to demonstrate the important role of common molds as causative agents in skin and ear infections. The clinical picture, etiology and pathogenesis, diagnosis and treatment, and course and prognosis of cutaneous infections will be given. The spectrum of clinical symptoms ranges from eczemalike lesions to chronic erythematous, verrucous lesions of the skin or multiple acute infiltrations of the dermis, occasionally forming abscesses. The mycologic direct preparation of the specimens, particularly with optical brighteners, and a histological examination of a skin biopsy are strongly recommended. The outbreak of cutaneous infections is triggered by weakened host defense mechanisms. A review of the literature regarding immunosuppressed and immunocompetent patients will be given.
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Affiliation(s)
- Irina Vennewald
- Institute of Laboratory Medicine, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
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43
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Abstract
Childhood acne has different clinical expressions which may be present from birth or manifest within the first weeks of life or after the third to sixth month of life. The condition may occur as a physiological phenomenon or may be pathological and require endocrinologic evaluation and treatment. It may be induced by drugs or ointments or due to intoxication. Severe courses with a tendency to scarring in childhood may be observed. Childhood acne may persist and develop into juvenile acne. It is likely that childhood acne may represent a risk factor for the development of severe acne in puberty.
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Affiliation(s)
- T Jansen
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie der Universität Essen.
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44
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Shah A, Lagvankar S, Shah A. Cutaneous mucormycosis in children. Indian Pediatr 2006; 43:167-70. [PMID: 16528115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Cutaneous mucormycosis is a rare fungal infection in children. It is commonly found in immunocompromised children. Early diagnosis is difficult and requires a very high degree of suspicion. Recommended mainstay of treatment has been amphotericin B and extensive surgical debridement which may at times require amputation if limb is involved. The authors share their experience of two cases of successfully treated cutaneous mucormycosis.
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Affiliation(s)
- Amar Shah
- Amardeep Multispeciality Childrens Hospital and Research Center, Gujarat College Cricket Ground Road, Ellisbridge, Ahmedabad 380 006, Gujarat, India.
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Abstract
Atopic eczema (AE) is a chronic relapsing, highly pruritic inflammation of the skin with a worldwide prevalence of 10-20% in children and of 1-3% in adults. Malassezia sympodialis has been reported as the most frequent skin-colonizing yeast in both AE patients and healthy individuals. Approximately 50% of the AE patients show immediate-type skin reactions or have specific serum IgE against M. sympodialis. Sensitization to the yeast occurs almost exclusively in AE patients. The main cause for this specific sensitization may be the disrupted skin barrier facilitating allergen uptake. So far thirteen allergens of Malassezia have been cloned produced, characterized and partly studied in vitro and in vivo. Phylogenetically conserved allergen structures, such as manganese superoxide dismutase, may play a role as cross-reactive allergens in a subset of AE patients as a result of molecular mimicry and cross-reactivity with structurally related human proteins and might contribute to the perpetuation of the inflammatory skin reactions. The use of recombinant Malassezia allergens will contribute to elucidate the pathways of sensitization occurring in AE, the underlying immunological mechanisms governing IgE- and T-cell-mediated responses and may provide new therapeutic options to alleviate Malassezia-related symptoms in AE.
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Marques SA, Camargo RMP, Summerbell RC, De Hoog GS, Ishioka P, Chambô-Cordaro LM, Marques MEA. Subcutaneous phaeohyphomycosis caused byPhaeoacremonium parasiticumin a renal transplant patient. Med Mycol 2006; 44:671-6. [PMID: 17071564 DOI: 10.1080/13693780600895181] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
A 49-year-old renally transplanted man, under a five-year course of immunosuppressive therapy with prednisone and cyclosporine A, experienced a subcutaneous phaeohyphomycosis caused by Phaeoacremonium parasiticum. The clinical presentation consisted of impressive, large, inflammatory and draining cystic tumors on the left foot that had been present for one year. A significant improvement was obtained with itraconazole plus intralesional injection with amphotericin B. Drug interaction was observed between itraconazole and cyclosporine A causing a severe hypertensive crisis and requiring a temporary sharp reduction in cyclosporine administration. Subcutaneous phaeohyphomycosis caused by P. parasiticum is uncommon among major organ transplant patients but several cases have previously been published and some patterns are emerging, e.g., limbs are generally involved but no known traumatic event has preceded lesion development. The identification of the case isolate was confirmed using a recently published online system based in part on beta-tubulin sequence comparison.
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Affiliation(s)
- S A Marques
- Departamento de Dermatologia e Radioterapia, Faculdade de Medicina de Botucatu-Universidade Estadual Paulista/Unesp, Sao Paulo, Brazil.
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Woodward L. Skin infection with Fusarium. Dermatol Nurs 2005; 17:455. [PMID: 16463929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- Linda Woodward
- The University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA
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Meads SB, Ramos-Ceballos FI, Ramos-Caro FA. Nonhealing verrucous plaque on the forearm. ACTA ACUST UNITED AC 2005; 141:1457-62. [PMID: 16301395 DOI: 10.1001/archderm.141.11.1457-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Shanna B Meads
- University of Florida College of Medicine, Gainesville, Fla, USA
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Torres-Rodríguez JM, González MP, Corominas JM, Pujol RM. Successful Thermotherapy for a Subcutaneous Infection Due to Alternaria alternata in a Renal Transplant Recipient. ACTA ACUST UNITED AC 2005; 141:1171-3. [PMID: 16172326 DOI: 10.1001/archderm.141.9.1171-b] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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