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.     

Epidemiology of the dermatophytoses in the Florence area of Italy: 1985–1990

Between 1985 and 1990 we observed 2085 cases of dermatophytoses in the Florence area of Italy.Trichophyton rubrum andMicrosporum canis were the major etiological agents. 126 cases of dermatophytoses observed during this period were caused byTrichophyton mentagrophytes. Most of the patients came from rural areas or they kept pets.Epidermophyton floccosum ranked fourth in frequency (95 cases). The patients were adults and mainly males, most of whom engaged in sports or lived in group environments.Microsporum gypseum was isolated in 31 cases. Infections occurred directly from contact with soil or domestic animals. We report the principal clinical data concerning these last three dermatophyte infections.     

Profile of Dermatophytic and Other Fungal Infections in Jaipur

The common cause of skin infections are dermatophytes and opportunistic fungi. Aim of present study is to find predominant etiological agent of dermatophytoses and to isolate various fungal agents from clinical samples of patients with different mycoses and Clinical samples from 260 patients were subjected to potassium hydroxide (KOH) examination and culture isolation; causative agents were identified macroscopically and microscopically. One hundred sixty three (62.7%) were found to be positive by KOH examination while 132 (50.8%) were culture positive. Dermatophytes were isolated in 90/140 (64.3%) specimens. Trichophyton rubrum (75.5%) was the commonest isolate among the patients suffering from dermatophytoses. Candida spp. and Malassezia furfur were isolated from patient suffering from candidiasis and pityriasis versicolor.     

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.     

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.     

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.     

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.     

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%).     

Dermatophytoses in Poona,India observations on incidence,clinical features,environmental factors and causal agents studied during 1958 to 1963 at Sassoon hospitals,Poona

Incidence of dermatophytoses in patients attending the Department of Dermatology, Sassoon Hospitals, Poona carried out over a period of six years from 1958–1963 is presented. Every year ten to fourteen per cent of skin infections were of mycotic origin.T. rubrum was the commonest causal pathogen in 65.30 per cent of the positive cases. Infections of the scalp which were thought to be rare were found in 12.97 per cent of the cases of dermatophytoses.T. violaceum andT. tonsurans var.sulfureum were the main causal organisms of ringworm of the scalp. Observations on the influence of climatic conditions on the incidence, personal habits and causal agents are also presented.This work represents a portion of the thesis of A.A.P. submitted for the degree of Doctor of Philosophy, University of Poona, India. The work was aided by a research grant from Indian Council of Medical Research, New Delhi.     

Prevalence of Dermatophytic Fungal Infections in Children: A Recent Study in Anambra State,Nigeria

We conducted a recent survey of dermatological fungal infections amongst children in both urban and rural parts of Anambra State in the south-east geographical flank of Nigeria during the period January 2003 to December 2003. Samples were collected from 1624 children with clinically suggestive lesions and also between the ages of 4 and 16. Young children aged 7–11 and 4– 6 years had significantly higher incidences (P < 0.05) than their older colleagues aged 12–16 years among samples proved to be mycologically positive by microscopy, culture or both. There was a significant difference in the incidence of dermatophytoses amongst children in urban and rural areas investigated (P < 0.05). Tinea capitis was the predominant clinical type. Trichophyton tonsurans was the most prevalent etiological agent while Microsporum audouinii was the least in occurrence. We compared our result with a recent study in the northern geographical zone and observed that although incidence of dermatophytoses is higher in northern Nigeria, tinea capitis was the predominant clinical type in both regions. In addition, the etiological agents appear to vary from time to time in their occurrence and the reasons for these observations are discussed. A regular surveillance and assessment of the etiologic agent and its prevalence by medical mycologists is strongly recommended to facilitate monitoring, reduce/prevent transmission and spread of dermatophytes in countries like Nigeria where they constitute a public health problem.     

A study of dermatophytoses in Bangkok (Thailand)

A total of 719 cases of dermatophytoses was studied in the Division of Dermatology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand, during January to December 1986. Infection caused by fungus comprises 12%, while the incidence of dermatophytoses was 5.5% of skin disorders. The age group commonly infected was 12–21 years old (mean age of 18 years); 40% was female and 47.5% was male. In the female patients the common prevalent infections were tinea corporis 29%, tinea cruris 23%, tinea pedis 16%, while in male patients it was 28%, 39% and 14% respectively. Only 4 species of dermatophytes were isolated. The prevailing ones were: Trichophyton rubrum 66%, T. mentagrophytes 15%, Epidermophyton floccorum 13% and Microsporum gypseum 6%.     

<Emphasis Type="Italic">In vitro</Emphasis> susceptibility testing of <Emphasis Type="Italic">Microsporum gypseum</Emphasis> isolated from healthy cattle and soil samples against itraconazole,terbinafine, fluconazole and topical veterinarian drugs

The present study evaluated in vitro susceptibility testing of dermatophytes isolates from healthy cattle and soil samples against three antifungal agents and three topical veterinarian drugs. Itraconazole and terbinafine showed a higher in vitro fungicidal activity than fluconazole. The veterinarian drugs LEPECID^® and iodine 5% were more active in vitro than the UNGÜENTO^® spray. All drugs showed fungicidal activity against Microsporum gypseum, and they may be considered as efficient agents for the topical treatment of dermatophytoses in cattle.     

<Emphasis Type="Italic">Trichophyton rubrum</Emphasis> and <Emphasis Type="Italic">Trichophyton interdigitale</Emphasis>: Genetic Diversity Among Species and Strains by Random Amplified Polymorphic DNA Method

Onychomycosis is a common condition that represents up to 50% of all nail problems and 30% of all cases of dermatophytoses. Trichophyton rubrum and Trichophyton interdigitale are the most common agents involved in this condition. In cases of recurrent post-treatment onychomycosis, strain fingerprinting could reveal whether the original isolate is responsible, a new strain has been acquired or if multiple strains are involved. The aim of this study was to evaluate the efficacy of the RAPD method for species and strain differentiation of T. rubrum and T. interdigitale obtained from patients with subungeal distal-lateral onychomycosis. A set of 86 strains of onychomycosis causative dermatophytes were submitted to species differentiation and strain typing by RAPD method with two previously described primers. Both primers proved capable of strain differentiation when tested for each species. Nineteen molecular profiles were configured for T. rubrum isolates with primers 1 and 6. For T. mentagrophytes, ten molecular profiles were configured with primer 1 and twenty-one with primer 6. We found that T. interdigitale and T. rubrum species were grouped in different clusters when both primers were analyzed together. This study shows that these primers are valuable tools for strain differentiation with T. rubrum and T. intedigitale.     

Epidemiology of dermatophytosis in the metropolitan area of Turin

The study here presented deals with the problem of the dermatophytoses in Piedmont, with regard to their etiologic and, more generally, their epidemiologic aspects. From 586 patients who presented themselves at the Dermatology Clinic of the University of Turin, for mycological examinations, between the period of March–November 1979, 100 positive cases were selected. The study was set under way with the filling in of special forms for the epidemiologic investigation and with the classification of some species of fungi which had been isolated beforehand, using the methods of Ajello, Rebell and Taplin (1, 12). From the data collected, it was ascertained that the principal etiologic agents isolated were, in order of frequency: Microsporum canis, Tricophyton rubrum, Epidermophyton floccosum and T. mentagrophytes. The subjects that were affected most by these dermatophytes were the young (babies and schoolchildren) with the location of the infections being mostly in the scalp. As regards the period of manifestation, May–June and September–October were the periods with the highest incidence. It is noteworthy that the diffusion of the principal dermatophytes could be attributed to domestic animals such as cats and dogs.     

A Clinico-Mycological Study of Dermatophytoses in Goa,India

The study was a clinico-mycological approach to find out the various clinical types of dermatophytoses and as well as the species of dermatophytes in Goa. Various socio-demographic and host factors were assessed to determine the predisposing factors for dermatophytoses. A detailed clinical history of the patients was recorded. Samples were collected aseptically in sterile black paper envelopes. The material was subjected to microscopy using potassium hydroxide mount. Culture was done by inoculating the material in Sabouraud’s peptone glucose agar slants. Tinea corporis was found to be the most common clinical presentation (44.2 %). Among the dermatophytes, Trichophyton rubrum predominated (38.2 %), followed by Trichophyton mentagrophytes (27.2 %). Dermatophytoses was more common among the lower and upper lower strata of society. Majority of the patients were in the 21–40 years age group (62 %) with males predominating women in ratio 2.4:1.     

Extensive dermatophytoses caused by Trichophyton mentagrophytes and Microsporum canis in a patient with AIDS

Retrospective studies have shown the occurrence of episodes of deep or superficial fungal infections in 58 to 81% of HIV/AIDS patients as a result of impairment of cell immunity. We describe a case of disseminated cutaneous dermatophytoses caused by Trichophyton mentagrophytes and Microsporum canis in a patients with AIDS. Diagnostic and therapeutic problems in relation to this unsual presentation are emphasized as well as the importance of an early mycologic diagnosis to prescribe antifungal therapy.     

Diagnostic significance of the coagglutination reaction in patients with the diarrhoea syndrome

Specific soluble Shigella, Salmonella and Yersinia enterocolitica antigens were determined in biological fluids (saliva, urine, coprofiltrate) from 268 patients with the diarrhoea syndrome using the coagglutination reaction. The findings suggest that the coagglutination reaction (COA) is a simple and efficient method suitable for the fast diagnosing of acute intestinal infection (AII) in the early days from the onset of the disease. COA enables the identification of specific antigens associated with the causative agents of intestinal infections in 79-54% of patients with shigellosis and salmonellosis. COA was shown to possess a high diagnostic potential in AII of unknown etiology. Shigella, Salmonella and Yersinia antigens were determined in 47.7, 23.4 and 10.8% of cases respectively where no bacterial excretion could be confirmed. Two and less frequently three antigens being identified simultaneously in 10.8% cases. The identification of opportunistic microorganisms in AII using the COA does not appear to be sufficient to confirm their etiological significance as Shigella and Salmonella antigens were simultaneously determined in most patients.     

Isolation of keratinophilic fungi from the floor dust of Arab kindergarten schools in the West Bank of Jordan

The keratinophilic mycoflora of floor dust of seventy two classrooms in 24 kindergarten schools (children aged 2–5) in the city of Nablus was studied using a hair-baiting technique. The study was aimed at the evaluation of extent of diffusion of keratinophilic fungi in this environment in relation to human presence and the age of children in order to determine their role and impact in the epidemiology of human dermatophytoses. Thirty three species were isolated. A large proportion of these species are either well-known human and animal mycotic agents or have been isolated frequently from human and animal lesions. These pathogenic and potentially pathogenic fungi comprised about 85.8% of all keratinophilic fungal isolates found in the classroom dust.The results of this investigation have also been discussed in respect to previous studies on human dermatophytoses in the West Bank of Jordan.     

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.     

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.