Surveillance of Dermatophytosis in Northeast of Iran (Mashhad) and Review of Published Studies

Dermatophytoses are considered to be one of the major public health problems in the world and are among the most commonly diagnosed skin diseases in Iran. In spite of improved personal hygiene and living environment, dermatophytosis continues to spread and persist. To determine the prevalence of dermatophytosis and their etiologic agents in Mashhad (Iran), five hundred and sixty patients suspected to have fungal infection were studied. Subjects who participated in this study were 330 males and 230 females ranged in age from 4 months to 70 years with a mean age of about 25.5 years. Clinical materials including skin scraping, hair and scalp sample, nail clipping and subungual debris were collected. All of the specimens were assessed by direct examination and culture. Of 560 patients, 166 (29.6 %) had dermatophytosis. The types of tinea according to anatomical areas were as follows: tinea corporis (33.1 %), tinea capitis (32.5 %), tinea manuum (17.5 %), tinea cruris (10.2 %), tinea pedis (5.4 %), tinea unguium (0.6 %) and tinea barbae (0.6 %). Trichophyton verrucosum was the most prevalent species followed by Trichophyton violaceum and Trichophyton mentagrophytes. The prevalence of dermatophytosis in males was higher than in females. Based on a review of published studies from different parts of Iran, there are regional differences in the incidence of dermatophytosis. Epidermophyton floccosum has been the most prevalent species, and Microsporum canis has been isolated less than from the other countries.     

Dermatophytes isolated in Hospital Universitario 12 de Octubre (Madrid, Spain).

Over a 10 year period (January 1988 - December 1997), 3,241 dermatophyte strains were isolated from 18,465 specimens from patients in whom dermatophytosis was suspected clinically. This represents a 17.5% rate of isolation. Trichophyton rubrum (38.44%), Microsporum canis (28.75%), Epidermophyton floccosum (14.5%) and Trichophyton mentagrophytes (13.5%) were the dominant species, and Trichophyton tonsurans (2.09%) has emerged, whilst in the previous decade it had virtually disappeared. Our study is basically based on an out-patient selected population, and tinea corporis (30.79%), followed by tinea cruris (16.69%) and tinea unguium (16.69%) were the most prevalent clinical forms.     

Etiologic and epidemiologic study of dermatomycoses in Navarra (Spain)

We review the etiology of the dermatophytosis in Navarra (Spain) over a 5-year period and it is compared with previous studies. We have isolated 312 strains of dermatophyte fungi in 285 patients (188 men and 97 women). Trichophyton rubrum was the most frequently isolated species (58.6%) followed by Trichophyton mentagrophytes (26.2%) and Microsporum canis (10.5%). Concerning the location of the lesions, tinea pedis was the clinical pattern found in the greatest number of patients, followed by tinea corporis, tinea unguium and tinea capitis. Twenty eight percent of the isolations were accomplished in October and November. More than half of those patients questioned had had epidemiological contact with animals or practiced sports. The rise of tinea pedis in our region is emphasised. The possible causes of this increment are analyzed and some recommendations for its control are made.     

Three years incidence of dermatophytes in a hospital in Porto (Portugal)

We evaluated the incidence of dermatophytes isolated at our hospital in the years of 1997 to 2000 and correlated it with anatomical site and age. Trichophyton rubrum was the predominant species in all anatomical sites, excluding scalp, followed by Microsporum canis, the leading agent of tinea capitis. All dermatophytosis, except tinea capitis by M. canis and Trichophyton schoenleinnii appeared mainly in adult patients. Our results revealed no substantial differences to other portuguese studies regarding the major agents. We found a relatively high incidence of T. schoenleinnii as second tinea capitis agent.     

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

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

杭州部分地区头癣73例类型及病原菌分析

目的 了解近2年来杭州部分地区头癣类型及其病原菌分布情况。方法 采用回顾性方法对2003年5月～2005年4月在杭州市第三人民医院皮肤科门诊诊治的头癣患者进行分析。结果 73例头癣患者中白癣41例（56．16％）、黑癣23例（31．5％）、脓癣9例（12．33％）,未发现黄癣。51例行真菌培养。主要病原菌为犬小孢子菌22例（43．14％）、紫色毛癣菌17例（33．33％）、须癣毛癣菌8例（15．69％）、断发毛癣菌4例（7．84％）。结论 杭州地区头癣患者中白癣发病率占首位,犬小孢子菌为主要致病菌。     

Dermatophyte Infections in Cairo,Egypt

In this study, we examined dermatophyte infections in patients referred to the Department of Dermatology, EL-Houd El-Marsoud Hospital, Cairo, during March 2004 to June 2005. Of 506 patients enrolled in this investigation, 403 (79.6%) were clinically diagnosed as having dermatophytoses (age range 6–70 years; males 240; females 163). Species identification determined by observation of their macroscopic and microscopic characteristics was complemented with sequencing of the internal transcribed spacer ITS1-5.8S-ITS2 rDNA region. The most common dermatophyte infection diagnosed was tinea capitis (76.4%), followed by tinea corporis (22.3%) and tinea unguium (1.2%). The most frequently isolated dermatophyte species was Trichophyton violaceum, which accounted for most (71.1%) of all the recovered dermatophytes, followed by Microsporum canis (21.09%), Trichophyton rubrum (6.2%), and Microsporum boullardii (0.49%); both Epidermophyton floccosum and Trichophyton tonsurans were each only rarely isolated (0.24%).     

15例人畜共患体癣的临床分析

目的通过对生活在同一家庭患有体癣的患者、家庭成员和所养宠物进行观察和分析,探讨人畜共患癣病的常见致病菌种以及治疗方案。方法收集2005年3月～2009年1月就诊于我院因接触宠物而致病的体癣患者,对其宠物的带菌情况进行调查,确诊后给予外用特比萘芬乳膏或联苯苄唑凝胶,未愈者给予口服伊曲康唑治疗。结果共收集15例患者,真菌培养结果显示8例为石膏样小孢子菌,4例为须癣毛癣菌,3例为犬小孢子菌。患者皮损真菌培养结果和所养宠物皮损真菌培养结果一致。按上述方法对患者及其宠物进行治疗,所有患者和10只(3只被丢弃)宠物全部治愈。结论 15例人畜共患体癣中,石膏样小孢子菌感染所致的比例最高,其次是须癣毛癣菌和犬小孢子菌,外用特比萘芬乳膏或联苯苄唑凝胶以及口服伊曲康唑胶囊可以有效治疗此类人畜共患皮肤癣菌病。     

822例浅部真菌病及其致病菌种分析

目的分析新疆乌鲁木齐市浅部真菌病病原菌的流行趋势。方法对2006年1月～2013年12月就诊于我院皮肤科门诊、有典型临床表现、真菌镜检及培养均阳性的822例患者进行致病病种及菌种分析。使用SPSS17．0统计软件对于结果进行统计分析。结果822例患者包括8个病种：体癣214例（26．0％）,足癣131例（15．9％）,头癣128例（15．6％）,甲真菌病125例（15．2％）,股癣119例（14．5％）,手癣54例（6．6％）,皮肤念珠菌病38例（4．6％）,花斑糠疹13例（1．6％）。菌种分布以须癣毛癣菌为首位,336株（40．9％）,其次为红色毛癣菌共239株（29．1％）,犬小孢子菌68株（8．3％）,铁锈色小孢子菌48株（5．8％）,念珠菌38株（4．6％）,断发毛癣菌33株（4．0％）,许兰黄癣菌23株（2．8％）,马拉色菌13株（1．6％）,疣状毛癣菌9株（1．1％）,紫色毛癣菌7株（0．9％）,支顶孢霉菌4株（0．5％）,曲霉、絮状表皮癣菌各2株（各0．2％）。统计学分析显示：不同性别足癣、股癣、甲真菌病及花斑糠疹构成比有统计学意义（P〈0．05）,除体癣及花斑糠疹外,本组其他浅部真菌病的分布在年龄方面有着明显的差别（P〈O．05）。结论乌鲁木齐市浅部真菌病发病率排在前3位的依次为体癣、足癣、头癣,致病病原菌以毛癣菌为主,须癣毛癣菌为首位致病菌,其次为红色毛癣菌。足癣及甲真菌病好发于女性,而股癣及花斑糠疹好发于男性。除体癣及花斑糠疹外,不同年龄段浅部真菌病分布有明显差异,其中头癣主要好发于青少年。     

广州地区70例儿童头癣病原学分析

目的 了解6a来广州地区头癣类型及病原菌分布特点.方法 采用病例回顾性分析,对2007年7月～2013年9月来广州市中山大学附属第三医院皮肤科门诊就诊的头癣患儿（平均为6.0±3.6岁）真菌直接镜检、培养及分离鉴定的结果进行分析.结果 70例头癣患儿真菌镜检阳性为69例,阳性率为99％,真菌培养阳性为47例,阳性率为81％.白癣为52例,占74％.病原菌包括犬小孢子菌19例（40％）、须癣毛癣菌13例（28％）、紫色毛癣菌5例（11％）,石膏样小孢子菌3例（6％）,其他病原菌为7例（15％）.其中,4～7岁的头癣患儿为35例,占50％.结论 儿童头癣的主要临床类型为白癣.致病菌以亲动物性犬小孢子菌为主.患儿的主要年龄段为4～7岁.     

Epidemiology of Dermatophytoses in an Area South of Tehran,Iran

Dermatophyte infections have been considered to be a major public health problem in many parts of the world. The aim of this study was to identify the etiological and epidemiological factors of dermatophyte infections in an area south of Tehran. A total of 1254 patients suspected to have dermatophytic lesions were examined over a period of three years (1999-2001). Material collected from skin, hair, and nails was submitted to direct microscopic examination using KOH, cultured in Sabouraud dextrose agar and microscopically examined for colony morphology, in order to the identify the 169 dermatophytes isolated. The prevalence of dermatophytoses was 13.5% (95% CI: 11.7-15.5%). Their incidence was 10.6 per 100,000 person-years (95% CI: 8.5-13.2). Epiderophyton floccosum was the most frequent dermatophyte isolated (31.4%) followed by Trichophyton rubrum (18.3%), T. mentegrophytes (17.2%), T. violaceum (16.6%), Microsporum canis (6.5%), T. verrucosum (4.7%) and M. gypseum (4.1%). Epidermophytes floccosum was found to be the most common isolated dermatophyte in age groups 20-29 (30.2%). Tinea corporis (31.4%) was the most common type of infection, followed by tinea cruris (20.7%), tinea manuum (15.4%), tinea capitis (12.4%), tinea pedis (10.6%), tinea faciei (7.1%), and tinea unguium (2.4%). The frequency rate of all of the types of tinea was higher in males than in females. The anthrophilic species E. floccosum was the most common dermatophyte as a causative agent of tinea. The most prevalent fungal infection was tinea corporis caused by E. floccosum.     

Dermatophyte and non dermatophyte fungi in Riyadh City,Saudi Arabia

BackgroundDermatophytes are a scientific label for a group of three genera (Microsporum, Epidermophyton and Trichophyton) of fungus that causes skin disease in animals and humans. Conventional methods for identification of these fungi are rapid and simple but are not accurate comparing to molecular methods.ObjectiveThis study aimed to isolate human pathogenic dermatophytes which cause dermatophytosis in Riyadh City, Saudi Arabia and to identify these fungi by using conventional and molecular methods.MethodsThe study was conducted in Medical Complex, Riyadh and King Saud University. Samples of infected skin, hairs and nails were collected from 112 patients. Diagnosis of skin infections, direct microscopic test, isolation and identification of dermatophytes by conventional and molecular methods were carried out.ResultsThe results indicated that the tinea capitis infection had the highest prevalence among the patients (22.3%) while Tinea barbae had the lowest. In this study the identified dermatophyte isolates belong to nine species as Trichophyton violaceum, Trichophyton verrucosum, Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton schoenleinii, Trichophyton concentricum, Microsporum canis, Microsporum audouinii and Epidermophyton floccosum which cause skin infections were isolated during this study. Non dermatophyte isolates included 5 isolates from Aspergillus spp. 4 isolates from Acremonium potronii and 15 isolates from Candida spp. M. canis were the most common species (25% of isolated dermatophytes). Out of the 52 dermatophyte isolates identified by conventional methods, there were 45 isolates identified by the molecular method.ConclusionsThe results concluded that approximately M. canis caused a quarter of dermatophyte cases, tinea capitis infection was prevalent and the molecular method was more accurate than conventional methods.     

126例面癣临床因素及病原菌分析

目的探讨面癣的致病菌种、临床特点及发病相关因素。方法对126例面癣患者进行真菌分离培养鉴定及流行病学分析。结果面癣见于各年龄段,以11～30岁最多见。患病动物接触史、合并其他部位浅部真菌病史及糖皮质类固醇激素类药物外用史是面癣发病的重要危险因素。分离出皮肤癣菌108株,包括红色毛癣菌63株（58．3％）、犬小孢子菌25株（23．1％）、须癣毛癣菌18株（16．7％）和石膏样小孢子菌2株（1．9％）。结论面癣的发病没有年龄差异,患者可见于各个年龄阶段;面癣的常见致病真菌绝大多数为红色毛癣菌和犬小孢子菌,其发病可能与患者自体接种或接触患病动物相关。面癣容易被误诊,及时进行真菌镜检和培养是降低面癣误诊率的关键。     

阴囊皮肤癣菌病患者临床及 真菌学分析

目的探讨阴囊皮肤癣菌病患者的致病菌、临床特征、易感因素及治疗转归等相关因素。方法回顾性分析2007-2017年广州市中山大学附属第三医院经真菌学检查确诊的24例阴囊癣病例,分析患者一般资料、临床特征、发病相关因素、合并其他部位浅部真菌病情况、病原菌及治疗转归等情况。结果 24例阴囊癣患者均为青少年,平均年龄19.6岁,平均病程2.9个月。患者分离皮肤癣菌24株,其中石膏样小孢子菌15株(62.50%)、红色毛癣菌7株(29.17%)和絮状表皮癣菌2株(8.33%)。石膏样小孢子菌主要引起阴囊单纯性感染,临床表现为特征性的白色伪膜样斑片,而红色毛癣菌多引起阴囊及其他部位皮肤癣菌病。结论阴囊癣多见于青少年,石膏样小孢子菌为主要病原菌,其临床表现具有一定特征性。     

A survey of dermatophytes isolated from human patients in the United States from 1979 to 1981 with chronological listings of worldwide incidence of five dermatophytes often isolated in the United States

A survey of dermatophytes isolated from patients seeking medical advice was made from 1979 to 1981 in the United States. The survey included 54 locations with data from 40 cities and 2 states. Correlations of these data with that of the other localities of the world were made to illustrate the dynamic epidemiology of several common dermatophytes. The most often isolated dermatophyte in this survey was Trichophyton rubrum having 53.66% of the total for these three calendar years. In a chronological listing of ringworm infections caused by this organism, many areas of the world have reported similar increased incidence of this pathogen. Trichophyton tonsurans was isolated 27.85% of the total. A dramatic increase of this pathogen as a cause of tinea capitis has been observed in most cities of the United States. It has been isolated in 25 different countries of the world. The percentage of isolation of Trichophyton mentagrophytes was 8.56%. This percentage may not be near the true incidence of infection by this dermatophyte because the infections are mild and respond to treatment without the individual seeking medical advice. Since the 1950s the percentage of isolations of the total has dropped for T. mentagrophytes in the United States. Epidermophyton floccosum accounted for 4.36% of the total. In a few areas of the world it causes over 30% of the total of dermatophytoses. Microsporum canis was isolated 3.72% of the total in the United States. It has recently been reported to be the dominant agent of tinea capitis in several South American countries, Tucson, Arizona and Kuwait. Once the dominant pathogen of tinea capitis in children in the United States, it was replaced by Microsporum audouinii before 1960. Today in the United States, M. audouinii only accounts for 0.30% of the total. It is considered eliminated as a pathogen in England. In this survey, isolated less than 1.0% of the total were Microsporum gypseum, Microsporum ferrugineum, Microsporum nanum, Microsporum fulvum and Trichophyton schoenleinii. Trichophyton meginii and Trichophyton terrestre were reported isolated but no numerical data were available.     

Changes of Dermatophytoses in Southwestern Greece: An 18-Year Survey

The isolation and distribution rate of dermatophytes as causative agents of superficial mycoses of skin, hair, and nails during an 18-year period (1991–2008) at a university hospital are presented. A comparative analysis of epidemiological differences within the first (1991–1999) and the second 9-year period (2000–2008) was performed. Skin scrapings, nail, and hair specimens were examined by a direct microscopic examination and culture. Identification of dermatophyte species was based on macroscopic and microscopic characteristics of colonies. During the complete period (18 years), 5,971 patients with suspected dermatophytosis were examined. Seven hundred and sixty-nine patients (12.8%) were found positive. Among them, 495 cases (64.3%) were of skin dermatophytoses, 91(11.8%) of hair, and 183 (23.7%) of nails. The most frequent etiological agents were Microsporum canis (54%), Trichophyton rubrum (38%), and T. mentagrophytes (6%). Epidermophyton floccosum, T. tonsurans, T. violaceum, and M. gypseum were responsible only for 16 cases (2%) of dermatophytoses. The prevalence of dermatophytoses seems to decrease significantly from 16.2% (1991–1999)–9.6% during the last 9-year period. The most frequent dermatophyte, M. canis, shows decreasing trends during the last period (from 58.5 to 45.7%), whereas T. rubrum shows an increasing isolation rate (from 35 to 43.6%), respectively. The most common form of dermatophytosis among children remains tinea capitis due to M. canis. The most frequent etiological agent of tinea unguium (81%) is T. rubrum.     

Protein profiles of Malassezia pachydermatis isolated from dogs

Chronic dermatophytosis was observed in 2276 (10.02%) of 22 692 patients with dermatophytosis during a period of 5.5 years. Males were affected at least 3 times more frequently than females. The age group most commonly affected was between 20 and 40 years of age. Females were affected more between the ages of 30 to 40 years. Tinea cruris and tinea corporis were the most common clinical types and tinea pedis was the least common type observed. The most frequent isolate was Trichophyton rubrum followed by T. mentagrophytes and T. violaceum. Ichthyosis vulgaris was the most common cutaneous association whereas atopy and diabetes mellitus were the most common systemic associations. This revised version was published online in August 2006 with corrections to the Cover Date.     

Dermatophytosis due to Trichophyton rubrum. Ten-year period (1996-2006) data collection in a Dermatology Department in Mexico City

Dermatophytosis is the most common mycosis in the world up to 80% caused by Trichophyton rubrum. The aim of the present study was to describe the clinical characteristics of the dermatophytosis caused by T. rubrum in a dermatological outpatient clinic during a ten years period, from 1996 to 2005. We collected the data from patients with a dermatophytosis from which we have isolated T. rubrum. A total of 776 patients with dermatophytosis caused by T. rubrum were found. A slight predominance of female patients (56.2%) was observed. The most commonly affected age group was those in the third to the fifth decade of life, and house working women (33.5%) were predominant. Onychomycosis was found in 63% of the cases, tinea pedis in 22.7%, tinea corporis in 5.2% and tinea cruris in 2.8%. In onychomycosis, the first toe nail was the most commonly affected (58.9%) and the dystrophic type was seen in 50.7% of them.     

儿童头癣33例临床分析

目的 观察姜堰地区儿童头癣流行病学、传播方式、病原菌及治疗结果.方法 对我科2006年8月～ 2013年5月诊治的33例儿童头癣病例进行总结分析.结果 33例儿童头癣中白癣24例、黑癣5例、脓癣4例;男19例、女14例;犬小孢子菌22例、紫色毛癣菌2例、须癣毛癣菌3例、断发毛癣菌3例、红色毛癣菌1例、石膏样小孢子菌2例.患者中有动物接触史的占42.42％ （14/33）.经口服特比萘芬或伊曲康唑6～8周,每日用硫磺皂洗头,局部外用萘替芬酮康唑乳膏均取得满意疗效.8周时治愈率分别为87.50％和88.24％,真菌清除率分别为100％和94.12％.结论 近年来本病增多的原因与喂养猫、犬等宠物有关,主要病原菌是亲动物的犬小孢子菌,经综合治疗,疗效满意.     

Animal dermatophytosis. Recent advances

The proportion of positive samples in relation to the number of samples examined from cases of dog and cat dermatophytosis varies considerably from one investigation to another. In dogs, it ranges between 4% and 10% and few studies show higher prevalences. On the other hand, the percentages of positive cultures cited in the reviewed literature from dogs with or without suspected dermatophytosis are quite similar. In dogs with suspected lesions of dermatophytosis, with few exceptions, Microsporum canis is the most common species isolated. Trichophyton mentagrophytes and Microsporum gypseum are less frequently isolated. In cats the prevalence of dermatophytes is usually higher than in dogs, and it is usually higher than 20%. However the frequency of positive findings is higher in cats with suspected dermatophytosis than in cats without visible lesions, with the exception of asymptomatic infected cats and transient carrier cats. Cats are accepted as the principal reservoir for M. canis. Griseofulvin is the drug of choice in canine and feline dermatophytosis.