Superficial mycoses in Italy

A total of 1244 cases suspected of superficial mycoses were analysed in a period of 12 months in Italy. Dermatophytoses were found in 62.4%; the other common disease was Pityriasis versicolor (44.1%). The predominant speciesEpidermophyton floccosum (34,2%) was strickingly high in relation to other statistics; this species was commonest in tinea cruris. Among the other dermatophytesM. canis was predominant (31.3%) commonest in tinea corporis, followed byT. mentagrophytes (17,8%) andT. rubrum (10,3%). A high rate of yeasts was found in tinea manum (81.6%) and tinea pedis (47.7%).     

Dermatophytosis among the students of the elementary schools in Taipei city

Summary A survey of dermatophytosis among the students of all elementary schools in Taipei City was performed from April to June, 1957. A total of 2687 students, 1419 boys and 1268 girls, were examined as a random sample.There were 85 cases of dermatophytosis (3.16%) including 80 cases of tinea capitis (2.98 %), two cases of tinea glabrosa (0.07 %), one case of tinea pedis (0.04 %) and two cases of favus (0.07 %). Seventy eight out of 80 cases of tinea capitis were male.Mycological study of 80 cases from these patients was performed and 49 strains of the causative organisms were obtained. Among 46 strains cultured from tinea capitis, there were 39 cases (84.8 %) ofT. ferrugineum, which is the commonest species in Formosa, 6 cases (13.0 %) ofT. violaceum and one case ofT. rubrum.Favus is an endemic dermatophytosis in middle and southern China but is rare in Taipei City.The relationship between the causative dermatophytes and the clinical findings of tinea capitis were described. Clinical symptom due toT. ferrugineum was different from that due to other organisms.     

Epidemiologic study of dermatophyte infections in Nigeria (clinical survey and laboratory investigations)

The commonest dermatophyte infection among the referred dermatology cases in Nigeria is tinea pedis, whereas among the surveyed population of school children, the commonest fungal infection was tinea capitis.It was found that the most ubiquitcus causative organism for tinea pedis was E. fluccosum, that for tinea capitis was M. audouinii, while that for tinea corporis was T. soudanese.The source of infection of tinea capitis among the school children was found to be most likely the local barber who serviced the schools in all the villages, and this might explain the high incidence rate of T. soudanese in tinea capitis. Tinea pedis infection is believed to be highly favoured by the wearing of shoes among the senior students. Animals were not a major source of transmission of dermatophytes in Nigeria.No new species of dermatophytes has been identified among the cultured organisms.     

Review of dermatophytoses in Galicia from 1951 to 1987, and comparison with other areas of Spain

We have reviewed all the dermatophytoses diagnosed in Galicia during four consecutive 9-year periods 1951–86 and 1987. From 4571 patients, we isolated 3351 fungal strains belonging, in decreasing order of frequency, to the following dermatophyte species: Microsporum canis (25.5%), Trichophyton rubrum (24.6%), T. mentagrophytes (21.4%), Epidermophyton floccosum (11.8%), M. gypseum (5.2%), T. tonsurans (3.9%), T. verrucosum (3.1%), T. schoenleinii (2.5%), T. violaceum (1.2%), T. mengninii (0.3%), M. audouinii (0.2%), T. equinum (0.1%) and T. soudanense (0.1%). Tinea capitis has diminished in frequency since 1951, though there was been a slight increase since 1978; M. canis has always been the most common agent, and between 1951 and 1959 T. schoenleinii was also very frequent but is no longer found. The frequency of tinea corporis, on the other hand, has experienced a considerable increase. Its most common causal agents in the last few years have been T. mentagrophytes, M. canis and T. rubrum. Until 1977 the most common tinea cruris dermatophyte was E. floccosum, but since then it has been T. rubrum. The commonest tinea pedis dermatophytes have been T. rubrum and T. mentagrophytes. Tinea unguium and tinea barbae have been the most frequent dermatophytoses, and their commonest causal agents T. rubrum and T. mentagrophytes respectively. We have documented the distribution of the various causal agents by location of the lesions, age and source of the patients (private or National Health Service patients), and we have compared the results with those obtained in other regions of Spain.     

A study of 3891 cases of mycoses in the tropics.

4103 cases suspected of mycoses were analysed as to sex, age and site of disease and 3891 were proved cases. This group formed 50% of total mycoses or 13-93% of all dermatoses recorded in the Government General Hospital, Madras, during the period of study. There were 66-26% adult female, 27-6% adult male and 6-14% were below 13 years. Dermatophytoses were found in 73-5%; the other common diseases were tinea versicolor (17-68%) and candidiasis (12-43%). Multiple sites of involvement or more than 1 disease in the same individual were mostly observed. The incidence of piedra (0-1%) and deep mycoses (0-156%) was very low. Mycetoma was the common disease (5/6) in deep mycoses. In dermatophytoses, tinea corporis (49-71%) and tinea cruris (47-85%) commonest; tinea axillaris (3-42%), tinea capitis (1-72%) and tinea barbae (1-29%) were less common. The incidence of tinea manuum, tinea pedis and tinea unguium was similar (4-97%-6-38%). High temperature and humidity were related to the higher incidence of tinea corporis, tinea cruris and tinea versicolor. Mainly children suffered from tinea capitis. All other mycoses were commonly found in adults between 2nd and 3rd decades. In all mycoses but candidiasis, female predominated. Cutaneous candidiasis was mainly a problem of housewives. Among the dermatophytes Trichophyton violaceum was predominant (33-7%) followed by T. rubrum (32-6%). Trichophyton schoenleinii and M. gypseum were rarely isolated. From mycetoma, Madurella mycetomii, Nocardia braziliensis, N. asteroides and Actinomadura spp. were isolated. Demonstration of Cryptococcus laurentii in 1 case is reported in this area for the first time.     

Prevalence of Dermatophytoses in the Zarqa District of Jordan

A total of 350 clinically suspected cases of dermatomycoses were examined for causative fungi during July 1997 to September 1998. Mycotic infection was demonstrable by microscopy and culture in 199 (56.8%) cases. The most common superficial mycotic infections were tinea pedis (35.2%) followed by tinea capitis (23.1%), tinea unguium (21.6%) and tinea corporis (10.6%). Most of the infected patients were 1–9, 20–29 and 30–39 years old. Men were mainly infected with tinea cruris and tinea pedis, while women were infected with tinea pedis, tinea unguium and tinea capitis. The frequencies of etiological agents isolated from patients were as follows: Trichophyton mentagrophytes var. interdigitale (32.7%), T. rubrum (28.6%), Epidermophyton floccosum (20.1%), Microsporum canis (11.1%), T.schoenleinii (4%), T.verrucosum (2%), T.violaceum (1%), and M. gypseum (0.5%). The number of infections varied with the seasons. The highest number of cases of tinea pedis and tinea cruris occurred in the summer months, while tinea capitis, tinea corporis and tinea unguium occurred in the spring and winter months. This revised version was published online in June 2006 with corrections to the Cover Date.     

Tinea Capitis in Southeastern China: A 16-Year Survey

This survey was a retrospective of a 16-year (1993–2008) study on the incidence, clinical features, and etiological agents of tinea capitis mainly representing the Southeastern China. The diagnosis was confirmed by direct microscopic examination. Eight hundred and sixty-six patients with tinea capitis, 381 males (44%) and 485 females (56%), were enrolled in this study. Patients were between 20 days and 84 years old with an average of 10.5 years and the peak incidence was in the age group of 6–10 (48.5%). Five hundred and sixty-two patients (64.9%) were ectothrix and 303 patients (35.0%) were endothrix with only one patient was favus. The incidence of tinea capitis from 1993 was gradually increasing and reaching to its peak in 2001. Positive cultures of dermatophytes were obtained in 715 patients: Microsporum canis (62.4%) was predominant, followed by Trichophyton violaceum (19.0%), Trichophyton tousurans (9.8%). M. canis was the major pathogen for ectothrix infection, while T. violaceum and T. tousurans contributed to the most endothrix form. M. canis, T. violaceum, and T. rubrum were the major pathogens for kerion.     

A critical survey of 1000 cases of dermatophytosis in the tel aviv area during 1970–1975

Clinical and mycological data on 1000 cases of dermatophytosis seen from 1970 to 1975 are reported. Tinea pedis was present in 44%, T. rubrum being the main causative agent; nail involvement was present in 41% of these cases. Tineainguinalis was present in 13%, 38% of them females, withT. rubrum isolated in 87% and the swimming-pool incriminated as the main source of contamination. There were various manifestations of tinea corporis in 128 patients, withT. rubrum responsible in 91%. Among the 21 cases of tinea capitis, there was one adult female with a kerion-type due toT. violaceum, 4 cases due toM. gypseum and 2 toM. canis. Tinea favosa was seen in 6 patients, all of them females and one with a spreading fungus on the soles and palms. Amonh the 10 cases with tinea barbae,T. rubrum was found in 4,T. tonsurans in 3,T. mentagrophytes in 2 andM. gypseum in one. There were widespread lesions ofT. rubrum located on large areas of the body and including the legs, arms, groins and nails, in 11 patients with other disorders, including diabetes, Cushing's syndrome and lymphoma.It was apparent that the dermatophytic flora of Israel comprises 10 dermatophytes,T. rubrum being the predominant agent of infection (in more than 80%), with a gradually increasing incidence evident. The other agents found in our survey wereT. mentagrophytes, T. violaceum, T. schoenleinii, T. tonsurans (found sporadically),E. floccosum andMicrosporum spp.M. canis andM. gypseum, the latter being reported for the first time in this country.T. verruccosum andT. megnini, mentioned in former publications, were not found in this survey.     

A study of dermatophytoses in Hamadan,the governmentship of West Iran

In order to determine the extent and causative agents of dermatophytoses in the Hamadan region of West Iran; a study was made during a 9-month period from October 1991 to June 1992. A total of 7495 individuals were studied of whom 681 (9%) were suspect of having cutaneous mycoses. Among them dermatophytoses were the commonest infections (259/681=38%). Of 259 individuals infected with dermatophytes, tinea capitis were observed in 163 (62.9%); t. corporis in 27 (10.4%); t. manuum and t. cruris in 19 (7.3%) each; t. barbae and faciei in 14 (5.4%); t. pedis in 13 (5%) and t. unguium in 4 (1.5%). A total of 144 patients yielded dermatophyte cultures. The frequency of the isolated species in decreasing order was as follows: Trichophyton verrucosum, 78 (54.1%); T. schoenleinii, 48 (33.3%); Microsporum canis, 8 (5.5%); Epidermophyton floccosum, 5 (3.5%); T. mentagrophytes and M. gypseum, 2 (1.4%) each; T. tonsurans, 1 (0.7%). In conclusion, the most prevalent dermatophytosis in this region was t. capitis with the infecting agent of T. schoenleinii.     

Prevalence of tinea pedis,tinea unguium of toenails and tinea capitis in school children from Barcelona

ObjectiveTo evaluate the prevalence of tinea capitis, tinea pedis, and tinea unguium in children from several schools of Barcelona city.MethodsDuring the period of 2003–2004, a prospective cross-sectional study was carried out in 1,305 children (9% immigrant population) between the ages 3 and 15 in 17 schools in Barcelona. A systematic examination of the feet, (including nails and scalp), was performed to identify lesions compatible with tinea. Cultures of scalp and feet samples were done and analysis of environmental samples was performed for dermatophyte isolation.ResultsDermatophytes were isolated in 2.9% of the samples with a prevalence of 2.5% in feet, 0.23% in scalp, and 0.15% in nails of the feet. The predominant etiologic agents in feet were Trichophyton mentagrophytes in 45.7% of the cases and Trichophyton rubrum in 31.4%. In the nails, T. rubrum and Trichophyton tonsurans were isolated, while T. mentagrophytes (2 cases) and Trichophyton violaceum (1 case) were identified in scalp samples. Forty-five per cent of dermatophytes were isolated from healthy feet, the majority of cases in children 13–15 years old (p<0.05). Microsporum gypseum was the only agent identified in the environmental samples, and was also found in one of the cases of tinea pedis.ConclusionThe results of this study demonstrate a low prevalence of tinea capitis and tinea unguium in school children of Barcelona. On the contrary, high prevalence of dermatophytes in feet was found. It highlights the high prevalence of healthy carriers of dermatophytes in feet.     

Miconazole in the treatment of superficial mycoses

Miconazole nitrate (2%) cream was evaluated in the treatment of superficial mycoses. Out of 116 patients having multiple clinical diagnoses, 66 cases were found to be positive by culture. Species of Trichophyton were the predominant etiological agents (in over 60%) followed by Candida species (20%) and Epidermophyton floccosum (15%). All the cases selected for study were followed up to a period of 4–18 months. A cure rate of 94.6 per cent was observed in all the cases where causal organisms were isolated. Significantly high cure rate (66%) was also seen in cases where causal organisms could not be isolated, including cases of tinea versicolor. Results of mycological examination were in confirmity with the clinical results. Read at the Symposium on Human Mycoses and Miconazole held in New Delhi, India, February, 1975.     

Some data on the occurrence of trichophyton tonsurans in Romania

Summary During the last 12 years,T. tonsurans has been isolated from 250 cases of various mycotic infections, 80% in the adults, the rest in children. The age of infected patients varied from 1 to 66 years, the female being represented by 10%.Most of the cases (93%) involved the hair follicles, 45 of them affecting the bearded area, in which 4 clinical types could be distinguished: the superficial form, the kerion type (in 11% of the cases) and 2 intermediate forms.In 16% of cases,T. tonsurans attacked the scalp, simulating various nonmycotic dermatoses as impetigo, seborrheic dermatitis, tinea amiantacea etc. 5 cases of the scalp infection were found in the adults (3 of black-dot type, the other 2 of superficial tinea capitis). The same variety of clinical manifestations was observed in the glabrous skin, which this species affected in 7% of the cases. It also involved the nails in 2 cases only. T. tonsurans is in continuous decrease in Romania for the last ten years (4% of all the dermatophytes). This dermatophyte remained, till now, the main agent of tinea barbae in Romania. Community epidemics as those caused byM. audouinii andM. ferrugineum have not yet occurred in this country.     

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.     

A prospective epidemiologic survey on the prevalence of onychomycosis and dermatophytosis in male boarding school residents

Dermatophyte infections and onychomycosis are not usually serious in term of mortality; however, they may have significant clinical consequences such as secondary bacterial infections, chronicity, therapeutic difficulties and esthetic disfigurement in addition to serving as a reservoir of infection. Our aim was to determine the prevalence of onychomycosis and dermatophytosis in a selected high risk group, consisting of male boarding school residents. A total of 410 males inhabiting two houses were evaluated by two dermatologists. In cases of clinical suspicion, appropriate samples were taken for direct microscopy and culture. The results showed that the prevalences of tinea pedis (athletes foot) and pure pedal onychomycosis were 51.5% (n:211) and 4.4% (n:18), respectively. Thirty cases of those with tinea pedis were complicated by toenail onychomycosis. Tinea cruris was present only in five cases with tinea pedis. Interestingly 71.1% of those with tinea pedis and 45.8% of those with onychomycosis, associated with or without tinea pedis were unaware of their diseases. The most common fungal isolate was Trichophyton rubrum (76.6%) followed by Epidermophyton floccosum (11.6%), T. interdigitale (10.55%). Approximately one third of the cultures from nail specimens yielded pure growths of nondermatophyte moulds or Candida albicans. In conclusion, we found unexpectedly high prevalences of occult athletes foot and toenail onychomycosis among the male residents of student houses. Our results indicate that health-care workers of such common boarding-houses should be more aware of clinical and subclinical dermatophyte infections and onychomycosis, and have more active approaches to educational measures and management strategies to prevent further infections. To our knowledge, this is the first epidemiologic study on the prevalences of dermatophytosis and onychomycosis in boarding-houses from Turkey.     

Analysis of Dermatomycoses in Lanzhou District of Northwestern China

The skin mycoses, perticularly dermatophytoses, in Lanzhou district, Northwestern China, was investigated during July 2002–June 2003. The specimens from patients suspected of having dermatomycoses were examined microscopically in KOH preparations and cultured on Sabouraud dextrose agar (SDA). Among 1443 suspected cases, 594 were KOH positive and 221 cultures of fungi were isolated. The most frequently isolated fungi were Trichophyton rubrum (43.9%) Trichophyton mentagrophytes (29.4%) and Candida species (14.0%). The frequency of tinea pedis, onychomycosis and tinea manuum were 38.7, 27.8 and 13.5%, respectively. In Lanzhou district, tinea pedis is the most commonly seen dermatophytoses, and T. rubrum is the most frequent etiologic agent.     

Griseofulvin in the treatment of dermatomycoses and onychomycoses produced by dermatophytes of the Trichophyton group

Summary Based on observations on the therapy of 128 patients affected with tinea unguium, tinea manus et pedis, tinea granulomatosa nodularis (Granuloma Majocchi), tinea cruris, tinea corporis, tinea barbae and tinea capitis due to infection with dermatophytes of theTrichophyton group, determinations were made for the absolute and relative indication of griseofulvin in the treatment of these mycoses. For each affection, comparisons were made between the therapeutic results obtained by combined therapy with oral griseofulvin (uniform daily dose 1 g for each case) and local therapy with 1 % water solution organic dyes, coal tar on the one hand, and mere local therapy as described above, on the other. For treatment, griseofulvin of different production was available: British Grisovin, Likuden and Likuden M from West-Germany, and Griseofulvin produced in the German Democratic Republic. No essential differences were found in the therapeutic effect of the individual preparations, the tolerance, however, was found to be best with Likuden. On the basis of comparisons made for the results of the individual methods of treatment, griseofulvin therapy was found to be an absolute indication of the mycotic diseases as follows: tinea capitis, tinea cruris follicularis trichophytica and tinea unguium. A relative indication was found to be tinea corporis, tinea barbae, tinea cruris, and tinea manus et pedis.All patients were subjected to microscopic and culture examination. The frequency of the individual dermatophytes was as follows:Trichophyton rubrum in 56 cases,Trichophyton verrucosum in 19 cases,Trichophyton mentagrophytes in 16 cases, andTrichophyton violaceum in 1 case. Thirty six cases showed negative cultures.In conclusion, the author recommends individual selection of patients for the griseofulvin therapy.     

Trichophyton violaceum is the dominant cause of tinea capitis in children in Tripoli,Libya: Results of a two year survey

The causative agents of tinea capitis in Libyan nationals attending the out patient Dermatology Clinic of the Tripoli Medical Centre over the period December 1997 to December 1999 were investigated. Samples (hair and scalp scrapings) were taken from 940 patients who presented with suspected tinea capitis. The etiological agents were identified in 584 cases. Trichophyton violaceum was found to be the most prevalent organism isolated being responsible for 64.4% (376/584) of culture positive cases, followed by Microsporum canis at 24.7% (144/584) and T. mentagrophytes at 5.5% (32/584). The majority of infections (380/584) occurred in females and in children with ages less than 12 years (554/584). This revised version was published online in June 2006 with corrections to the Cover Date.     

Causative Agents of Superficial Mycoses in Istanbul,Turkey: Retrospective Study

The aim of the present study was to determine the percentage of agents, which can give rise to superficial fungal infections in Istanbul, Turkey. Between 2000 and 2007, the clinical samples collected from 8,200 patients attending the outpatient Dermatology Clinic at Mihrimahsultan Medical Center were examined by direct microscopy and culture. Pathogen fungi were detected in 5,722 of the patients. Of the isolates were 4,218 (74%) dermatophytes, 1,196 (21%) Candida sp., 170 (3%) Malassezia furfur, and 138 (2%) Trichosporon sp. Among the dermatophytes, Trichophyton sp. was the most common isolate followed by Epidermophyton floccosum (243) and Microsporum sp. Among the Candida species, C. albicans (549) was also frequently found. Onychomycosis was the most prevalent type of infection, followed by tinea pedis, tinea cruris, tinea corporis, and tinea capitis. In conclusion, our study showed that the most common isolated agents from superficial infections were T. rubrum being Candida sp. the second most prevalent.     

Tinea cruris epidemiology (São Paulo,Brazil)

In order to determine the epidemiology of tinea cruris in São Paulo, Brazil, an investigation was carried out from April 95 to March 1997. A total of 2000 individuals were studied, of whom 105 were suspected of having tinea cruris infection. Direct microscopy and/or culture were positive in 66 [62.8%] of the cases. Erythematous-scale plaques and erythematous-liquenificated plaques were the most frequently found clinicaltypes. T. rubrum was the prevalent dermatophyte in 90% of the cases, followed by T. tonsurans (6%) and T. mentagrophytes (4%).     

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.