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.     

Epidemiology of dermatophytoses: retrospective analysis from 2005 to 2010 and comparison with previous data from 1975

Dermatophyte infections are extremely frequent worldwide and their epidemiological features vary according to the geographical area and have changed in the last decades. We studied the spectrum of dermatophytoses by means of a retrospective analysis involving 6,133 patients referred to the Mycology Service of the Dermatology Clinic of Policlinico Hospital - University of Bari, Italy during the period 2005-2010. The most frequent clinical forms were tinea unguium (39.2% of the total dermatophytoses), tinea corporis (22.7%) and tinea pedis (20.4%). There was a predominance of women for tinea unguium and corporis and of men for tinea pedis and especially tinea cruris. T. rubrum was the prevalent causative agent, implicated in 64% of total cases, followed by M. canis (14%) and T. mentagrophytes (10%). The retrospective evaluation of epidemiological data collected at our Clinic since 1975 showed a gradual decrease in the frequency of tinea cruris, tinea corporis, and tinea capitis over time. On the contrary, during the past two decades, there has been a progressive increase in the frequency of tinea pedis and especially of tinea unguium. In parallel with this changing pattern, the frequency of isolation of T. rubrum has shown a continuous increase during the last 35 years, whereas a progressive decline of the etiological role of T. violaceum, M. canis and even more of E. floccosum has been noted.     

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.     

2%硝酸舍他康唑乳膏治疗体股癣和足癣疗效和安全性评价

目的 评价2％硝酸舍他康唑乳膏治疗足癣和体、股癣的疗效及安全性,并与2％硝酸咪康唑乳膏对照。方法 采用多中心随机双盲对照试验。试验组及对照组分别外用2％硝酸舍他康唑乳膏和2％硝酸咪康唑乳膏,每天2次,疗程4周。在治疗开始及治疗2周、4周、6周时进行观察。结果 足癣试验组61例,对照组58例;体、股癣试验组56例,对照组55例完成了观察。足癣在4周时,临床有效率试验组98．36％,对照组93．10％,在6周时分别为100％和98．28％;在4周和6周时真菌学清除率试验组均为95．1％,对照组均为100％;在4周时总有效率试验组98．36％,对照组93．10％,在6周时分别为100％和98．28％。体、股癣在4周时,临床有效率试验组98．21％,对照组92．73％,在6周时分别为100％和98．18％;在4周和6周时真菌学清除率试验组和对照组均为100％;在4周时总有效率试验组98．21％,对照组92．73％,在6周时分别为100％和98．18％。药物不良反应发生率试验组1．7％,对照组0．9％,表现为局部刺激。结果 显示2％硝酸舍他康唑乳膏治疗足癣和体、股癣的疗效及安全性与2％硝酸咪康唑乳膏相似（P〉0．05）。结论 2％硝酸舍他康唑乳膏治疗足癣和体、股癣有效、安全。     

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.     

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.     

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。     

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.     

Update in Antifungal Therapy of Dermatophytosis

Treatment of dermatophyte infection involves primarily oral and/or topical formulations of azoles or allylamines, particularly itraconazole and terbinafine. Topical medications applied once or twice daily are the primary treatment indicated for tinea corporis/cruris, and tinea pedis/manuum. Use of oral antifungals may be practical where the tinea involvement is extensive or chronic, or where application of a topical is not feasible. For tinea unguium (onychomycosis) and tinea capitis, oral therapies are the primary treatments provided. Recently, topical amorolfine and ciclopirox formulations have been approved for use in milder onychomycosis cases, and their role in the treatment of the different clinical forms of onychomycosis is currently being defined. Relapse of infection remains a problem, particularly with tinea pedis/unguium. Appropriate follow-up duration and education of patients on proper foot hygiene are also important components in providing effective therapy.     

亚热带地区部队皮肤真菌病及其病原菌的调查研究

亚热带地区是皮肤真菌病的高发地区,据报道,云南边防某部皮肤真菌病发病率为57.8％,占皮肤病发病率的第一位,美军在越南战争期间,发生的所有皮肤病中,最常见的是皮肤真菌感染,而且造成了非战斗减员。战争后期,美军把皮肤病的防治作为其疾病防治的重点。因此,我们于1992年10月底对海南地区部队皮肤真菌病的发病情况进行了流行病学凋查,并对皮肤真菌病的病原菌进行了分离鉴定,现报告如下。     

Epidemiology of superficial mycosis (tinea pedis, onychomycosis) in elementary school children in Istanbul, Turkey

The purpose of this study is to determine the prevalence of tinea pedis and onychomycosis in children of elementary school age and to examine the socio-demographic attributes that may be effective in correlation of both mycoses. 3,390 female and 3,768 male children between ages 6-14 have been examined in seven schools. Skin scrapings and nail samples were taken from 13 students who were suspected to have tinea pedis and from 49 students who were suspected to have onychomycosis. According to direct microscopy (10-15% KOH+calcofluor white) and culturel examination (Sabouraud dextrose agar and dermatophyte test medium) 11 students were diagnosed as tinea pedis and 24 were diagnosed as onychomycosis. Trichophyton rubrum was isolated in 3 students with tinea pedis whose culture was positive and five Candida albicans, five Candida glabrata and one Candida tropicalis cases were isolated from 11 samples with onychomycosis. Tinea pedis prevalence has been found to be 3.3%0. Differences between onychomycosis prevalence based on age have been found to be significant (p < 0.001). In conclusion, it has been determined that the prevalence of tinea pedis and onychomycosis among children is low. Candida spp. was isolated from all of the 14 samples diagnosed as onychomycosis. Our study shows similar results with previous studies done in Turkey and that Trichophyton rubrum continues to be the most isolated agent.     

Clinical and epidemiological survey of dermatophytoses in Jaen (Spain)

Prevalence of dermatophytosis, with respect to age and sex and dermatophyte species, in Jaen was investigated during a period of three years (1996-1999). The prevalence of dermatophytosis over three years was 4.48 cases / 1000 inhabitants. The isolated species were: Microsporum canis (48.6%), Trichophyton mentagrophytes (27.1%), Epidermophyton floccosum (10%), Trichophyton rubrum (8.6%), Trichophyton violaceum (4.3%), and Microsporum gypseum (1.4%). The most frequently observed dermatophytoses were tinea corporis (62.8%), followed by tinea capitis (12.8%); other clinical forms encountered were, in decreasing order of frequency, tinea cruris, tinea pedis and tinea unguium, tinea faciei and tinea barbae. Men were more affected than women.     

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.     

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.     

The Epidemiology of Tinea Manuum in Nanchang Area, South China

Tinea manuum is a common superficial fungal infection which is usually coexistent with tinea pedis; there are few studies available on the epidemiology of tinea manuum at present. This study aims to investigate the epidemiology of tinea manuum and its correlation with tinea pedis in south China. A total of 280 patients with tinea manuum were recruited. The epidemiological and clinical data were analyzed, and causative agents were isolated and identified mycologically. Totally, 84.3 % patients with tinea manuum had co-occurrence of tinea pedis, among which 88.4 % patients had experience of scratching their feet. There was a significant relationship between the touch habits and the hand infection (χ² = 65.451, P = 0.000). More than 90 % patients had quite the same species of isolates from multiple infected sites in one patient. Therefore, it seems that transmission of dermatophytes from the feet to hand by scratching might be a most common way. As for tinea manuum, whether “unilateral” or “bilateral” is just the result that pathogens spread from feet to hand(s), which is only a special clinical presentation of tinea.     

趾间型足癣患者细菌菌种分布特征

目的了解趾间型足癣患者趾间和健康志愿者趾间细菌菌种分布特征。方法对37例经临床和真菌镜检确诊的趾间型足癣患者的趾间进行细菌培养,然后给予1%联苯苄唑霜1次/d外用治疗4周,在治疗后的第1、2、4周分别对趾间再进行细菌培养。33例健康志愿者作为对照。结果健康志愿者趾间细菌培养葡萄球菌属占92.5%,其中表皮葡萄球菌占32.5%,未分离到金黄色葡萄球菌。趾间型足癣患者细菌培养葡萄球菌属占74.4%,其中金黄色葡萄球菌占27.9%,表皮葡萄球菌仅占2.3%,还分离到化脓性链球菌、粪肠球菌、屎肠球菌、奇异变形杆菌、铜绿假单胞菌等。经过4周的外用联苯苄唑霜治疗,金黄色葡萄球菌消失,表皮葡萄球菌又成为优势菌（37.5%）。结论趾间型足癣患者趾间金黄色葡萄球菌的分离率明显高,此乃足癣继发细菌感染的主要致病菌,因此积极治疗足癣对预防足癣合并症有非常重要的意义。     

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.     

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.     

Epidemiologic study of dermatophytoses in Salamanca (Spain)

An epidemiologic study of the dermatophytoses in Salamanca (Spain) from 1973 to 1976 was performed. Dermatophyte species were identified in 224 patients with clinical tinea infections; 31 bovines, 18 rodents and 70 soil samples. The prevalence of Trichophyton verrucosum and Epidermophyton floccosum was strikingly high in relation to other statistics. The most common clinical forms were tinea corporis and tinea cruris. Tinea capitis by anthropophilic species was uncommon.     

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%).