Incidence of dermatophytosis in Jordan with special reference to tinea capitis

Clinical data on 1068 cases of dermatophytosis as well as mycological data on 382 of these cases seen from March 1983 to September 1984 are reported. Tinea cruris was present in 34.1%, with Trichophyton rubrum and Epidermophyton floccosum isolated from 31% and 25% respectively. Tinea corporis was found in 17.9% of all patients of dermatophytosis with T. tonsurans responsible in 30.8%. Tinea pedis and Tinea unguium were present in 7.2% and 2% respectively, T. rubrum being the main causative agent; nail involvement was present in 27.3% of these cases. Tinea capitis was observed in 38.7% of 1068 dermatophytosis cases with T. violaceum and M. canis causing 48% and 32% of all T.C. cases respectively.The dermatophytic flora of the West Bank of Jordan apparently comprises about 14 dermatophytes, T. violaceum being the predominant agent of infection (in more than 34%). Other most common agents found in this survey were M. canis, T. rubrum, E. floccosum, T. schoenleini, T. tonsurans, and T. mentagrophytes.Formerly Assistant Professor at the Department of Internal Medicine, Faculty of Medical Sciences, University of Jordan, Amman     

Tinea capitis an endemic disease in Madras

A study ofTinea capitis in Outpatient Clinic, Skin Department, Government General Hospital, Madras during a three year period from November, 1973 to October, 1976, has shown a gradual increase in incidence of 3.56%, 5.09 % and 6.25 % respectively. Findings suggest thatTinea capitis is endemic in South India. Male children were more commonly affected than female children and the age groups chiefly affected were between 5 and 10 years. A considerable number of adults were also affected. The disease showed no correlation to environmental temperature, humidity and rainfall but was correlated to all types of mycoses and total incidence of mycoses.Among 357 isolates,Trichophyton violaceum was the commonest in 264 (73.94%) andT. tonsurans was the next common in 47 (13.16%). The other agents wereT. rubrum in 30 (8.4%),T. mentagrophytes in 11 (3.08%) andT. simii in 5 (1.4%). Noninflammatory lesions were more common than inflammatory lesions and both were produced byT. violaceum andT. tonsurans, suggesting strain differences in pathogenesis. Treatment with oral griseofulvin was satisfactory in all but had to be discontinued in 4 patients due to side effects.     

Tinea cruris in female prostitutes

Tinea cruris is a dermatophytosis that mainly affects males. Infections in females are rare, and there are no known data on the frequency of tinea cruris in female prostitutes. We describe seven female prostitutes with tinea cruris with on age range of between 19–34 years (mean 25.3). Each prostitute had a mean of 50 sexual partners per month. Four Trichophyton mentagrophytes (57.1%),2 T. rubrum (28.6%), and 1 Epidermophyton floccosum (14.3%) isolates were cultered. Tinea cruris transmission is mainly indirect, but direct contact may serve to transmit the disease in some cases, and the spread of active lesions in prostitutes through multiple contacts among with their clients is possible. This revised version was published online in June 2006 with corrections to the Cover Date.     

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.     

Epidemiology of Dermatophytes in Belgium: A 5 Years’ Survey

Dermatophytes are among the most common fungal agents causing superficial skin infections worldwide. Epidemiology of these infections is evolving and variable in every country. This report presents the Belgian epidemiological data regarding the distribution of dermatophytes species isolated by the two national reference centers for mycosis during a period of 5 years (2012–2016). Trichophyton rubrum was the most frequently isolated species, considering all sampling sites (60.3% on average between 2012 and 2016). More precisely, this dermatophyte was the major agent of Tinea unguium and Tinea corporis during this period, followed by species of the Trichophyton mentagrophytes complex. Moreover, Microsporum audouinii was the main etiological agent of Tinea capitis (TC) with a frequency of 52.5% on average between 2012 and 2016. Other African dermatophytes species such as Trichophyton soudanense and Trichophyton violaceum were also agents of TC with a respective prevalence of 11.6% and 11.5% on average. This study highlights a different dermatophyte distribution in Belgium in comparison with other European countries.

     

Incidence of Tinea capitis in São Paulo, Brazil

To determine the incidence of tinea capitis in São Paulo, Brazil, an investigation was performed in Private and Public Pediatrics Service involving 4,500 children from 0 to 15 years old during 5 years (1996–2000). Samples were taken from 132 children with suspected fungal infection of the scalp, for direct microscopy and culture. Tinea of scalp was mycologically confirmed in 112 patients (85%). Males were more affected than females in all age groups. Children below 8 years old accounted for more than 75% of the occurrences. Only three cases of tinea capitis were diagnosed in children from 12 to 15 years of age. Tinea capitis was prevalent in 103 cases (91.96%); inflammatory kerion type lesions were diagnosed in 9 patients (8.04%). Microsporum canis (70.5%) and Trichophyton tonsurans (23.2%) were the most common agents followed by T. mentagrophytes (3.6%), M. gypseum (1.8%) and T. rubrum (0.9%).     

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.     

Epidemiology of dermatophytoses in a rural community in Eastern Nigeria and review of literature from Africa

A total of 4,287 primary school children, comprising 1,740 males and 2,547 females in Arochukwu local government area of Abia state Nigeria were examined for clinical signs of dermatophytoses. About 873 (20.4%), consisting of 505 males and 368 females had lesions consistent with dermatophytoses. The disease was more prevalent in males (29%) than females (14.4%) in a ratio of approximately 2:1 (P < 0.05). The infection rate increased from 16.8% in the 4–6 year age group to a peak of 28.1% in the 10–12 year age bracket and dropped sharply to 5.6% in the 16–18 year group. The highest prevalence (39%) was observed among males aged 10–12 years while females 16–18 years had the lowest prevalence (2.5%). Tinea capitis was the predominant clinical type of dermatophytoses, and occurred in 13.7% of the total population studied and 67% of lesion positive cases. Trichophyton soudanense and Trichophyton tonsurans the predominant aetiological agents of dermatophytoses with a prevalence of 26.2% and 21.6%, respectively. Others include Trichophyton mentagrophytes (18.8%), Epidermophyton floccosum (8.3%), Microsporum audouinii (6.4%), Microsporum gypseum (6.0%), Trichophyton rubrum (5.5%) and Microsporum ferrugineum (7.3%), which was isolated for the first time in Nigeria.     

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.     

Tinea capitis in adults in southern Spain. A 17-year epidemiological study

BackgroundTinea capitis is an infection of the hair due to keratinophilic fungi, known as dermatophytes. Although the disease is common in children, several studies have also shown that it is far from unusual in adults, especially in post-menopausal women and immunocompromised persons.AimsTo determine the incidence of tinea capitis in adults in our area, as well as the predisposing factors (gender, immunity), and causative species.Materials and methodsA retrospective study was conducted over a period of 17 years, from 1995 to 2011, collecting data on cases of tinea capitis diagnosed in our dermatology department. Information collected for all patients included age, gender, location of the lesions, results of direct examination and culture, immune status, cause of immunosuppression, and the prescribed treatment.ResultsThirty-three cases (11.4%) out of 289 cases of tinea capitis occurred in adults. Most of these adults (72%) were immunocompetent, and the rest were immunocompromised for different reasons. Three of the patients were men and 30 women, with 70% of the latter being post-menopausal. Trichophyton species were isolated in 76% of these adult patients, with Trichophyton violaceum being the most common. Treatment with oral terbinafine was successful in all these cases. Microsporum species were responsible for the other cases, all treated successfully with oral griseofulvin.ConclusionsThis series of tinea capitis in adults is one of the largest to date. It shows that tinea capitis is not uncommon among the immunocompetent adult population. In our geographical area, except for prepubescent patients, most cases affecting the adult population were caused by species of the genus Trichophyton. In these cases the treatment of choice was oral terbinafine, which considerably shortened the treatment time, and was associated with fewer side effects than the classical griseofulvin.     

Tinea Capitis in the Paediatric Population in Milan, Italy: The Emergence of Trichophyton violaceum

Tinea capitis (TC) is the most common type of dermatophytosis in children. The epidemiology of TC depends on the geographical areas, and it changes over time. The aim of the study is to determine the incidence of TC and to identify the causative species in children observed at Dermatology Outpatient Department of the University of Milan, Italy, between January 2004 and December 2011. Four hundred and eighty-six children with suspected dermatomycosis were observed; TC was the most prevalent dermatomycoses with 86 cases. The most common isolated dermatophyte in scalp lesions was Trichophyton violaceum with 33 cases. The most recent epidemiological Italian studies still show zoophilic fungi as primary cause of TC. We are the first medical team in Italy to demonstrate a dominance of anthropophilic fungi, in particular T. violaceum.     

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.     

Frequency and aetiology of dermatophytosis in children age 12 and under in the state of Amazonas,Brazil

BackgroundFew scientific studies have evaluated dermatophytosis among children in the state of Amazonas or in the greater northern region of Brazil.AimsThe aim of this study was to research the frequency and aetiology of dermatophytosis in children age 12 and under, who were seen between March 1996 and November 2005 at the Mycology Laboratory of the National Institute of Amazonian Research.MethodsFor mycological diagnoses, epidermal scales and/or hairs were used. A portion of this material was treated with potassium hydroxide for direct examination, and another portion was cultivated in Mycobiotic Agar for the isolation of dermatophytes.ResultsOf the 590 samples analysed, 210 showed positive diagnoses by direct examination and cultivation. Tinea capitis (153 cases) was the most frequent type of dermatophytosis, and Trichophyton tonsurans (121 cases) was the most frequently isolated fungal agent. Tinea corporis was observed in 48 cases where the most frequently isolated fungal agent was also T. tonsurans (17 cases), and the corporal regions most affected were the face, arms and trunk. The laboratory confirmed tinea pedis in 6 cases, and the principal fungal agents isolated were Trichophyton rubrum (3) and Trichophyton mentagrophytes (3). The presence of tinea cruris was confirmed in 3 cases, and T. rubrum, T. tonsurans and Epidermophyton floccosum were isolated from these cases.ConclusionsThe children examined were primarily affected by tinea capitis, and the main fungal agent for this dermatophytosis was T. tonsurans.     

A short review on the onychomycoses by dermatophytes in Romania

In 525 patients with onychomycoses by dermatophytes, collected in Bucharest (45% of the cases being females), the toe-nails were found to be affected in 65% of the cases, while the finger-nails only in 20%. In order of frequency, the following agents were isolated:T. rubrum (55%),T. mentagrophytes (interdigitale — 26%),T. violaceum (12%),E. floccosum (3%),T. schonleinii (1.3%). Only sporadically were found other species, viz.:M. canis (4),T. tonsurans (3),T. verruccosum (2),T. quinckeanum (1) andM. audouinii (1). Tinea pedis was the main manifestation associated with the respective cases.     

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.     

Molecular confirmation of a Trichophyton violaceum isolate from human black-dot ringworm

A clinical isolate from a black-dot ringworm lesion of a 28-year-old female Japanese was investigated by morphological and biochemical analyses as well as molecular analyses. The isolate grew well onthiamine enriched agar and did not produce violetpigment, macroconidia or microconidia on Sabouraud's dextrose agar. Approximately 620-bp genomic DNA fragments of the CHS1 gene were amplified from Trichophyton mentagrophytes, T. rubrum, T. tonsurans and T. violaceum by polymerase chain reaction (PCR) and sequenced. The chitin synthase 1 (CHS1) nucleotide sequences of the clinical isolate showed more than 97% similarity to that of T. violaceum and less than 96% similarity to that of T. mentagrophytes, T. rubrum and T. tonsurans. The phylogenetic analysis of their sequences revealed that the clinical isolate was genetically close to T. violaceum and distinct from T. mentagrophytes, T. rubrum and T. tonsurans. Therefore, the isolate was confirmed as T. violaceum by mycological examination and molecular analyses. This revised version was published online in June 2006 with corrections to the Cover Date.     

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.     

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.     

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.     

Microbiology of siljo,a traditional Ethiopian fermented legume product

Siljo was prepared by thoroughly cooking powdered horsebean (Vicia faba) in safflower (Carthamus tinctorius) extract into a semi-solid slurry and then adding to it untreated black mustard (Brassica nigra) powder after cooling to 50°C. The black mustard powder was the source of starter microorganisms, with Lactobacillus acidophilus, L. plantarum and L. delbruekii initiating and later dominating the fermentation process. The pH of the fermenting mass dropped to 4.5 within 36 h and reached 4.0 at 168 h. Aerobic mesophilic bacteria and lactic acid bacteria were each present at about 1×10¹⁰ c.f.u./ml after 36 h of fermentation but Enterobacteriaceae were never detected. The dominant aerobic mesophilic flora consisted of Micrococcus, Bacillus and Lactobacillus spp. Crude protein, crude fat and ash increased slightly during the fermentation, with final values of around 28%, 25% and 7%, respectively, but there was a marked increase in protein availability and concentration during the fermentation.T. Mehari is with the Department of Biochemistry, Physiology and Pharmacology, Faculty of Veterinary Medicine, Addis Ababa University, P.O. Box 32, Debre-Zeit, Ethiopia, M. Ashenafi is with the Department of Basic Sciences, Awassa College of Agriculture, Addis Ababa University, P.O. Box 5, Awassa, Ethiopia.