Onychomycosis caused by Scopulariopsis brumptii

Scopulariopsis brumptii was isolated from nail lesions in left hand of a 42 year-old-farmer. The direct microscopic examination of the nail samples revealed light brown, septate, branched fungal hyphae along with thick-walled spherical cells. The histopathological examination showed involvement of internal phase of the nail plate. Amongst the antimycotics tested against S. brumptii In vitro oxiconazole was found to be the most active with MIC value of 10 g/ml^–1. This report documents the first instance of onychomycosis caused by S. brumptii.     

长脉冲1064nm激光联合酮康唑软膏封包病甲治疗甲真菌病的临床疗效观察

目的观察长脉冲1064 nm激光联合酮康唑软膏封包病甲治疗甲真菌病的临床疗效。方法 将73例甲真菌病门诊患者随机分为两组:联合组(37例,病甲75个)采用长脉冲1064 nm激光联合酮康唑软膏封包病甲治疗;对照组(36例,病甲87个)单纯使用激光治疗。每周1次,连续治疗8周,治疗6个月后随访评估。比较两种方法治疗甲真菌病的临床有效率,观察1064 nm激光联合酮康唑软膏封包病甲治疗甲真菌病患者的临床疗效。结果 联合组治疗甲真菌病的总的临床有效率(74.67%)高于对照组(63.22%),3种临床类型在联合组的临床有效率均高于对照组,尤其近端甲下型(PSO)的临床有效率明显提高,但差异无统计学意义;当9≤SCIO≤15时,联合组治疗甲真菌病的临床有效率高于对照组,差异有统计学意义。结论 对于9≤SCIO≤15的甲真菌病患者,长脉冲1064 nm激光联合酮康唑软膏封包病甲治疗甲真菌病的临床疗效显著高于单纯激光治疗。     

威海地区547例甲真菌病真菌培养结果分析

目的了解山东省威海地区甲真菌病的临床分类、菌种构成等流行情况。方法对547例镜检阳性的甲真菌病患者进行真菌培养、鉴定和临床分析。结果547例患者中真菌培养阳性423例,阳性率77.3%,远端侧位甲下型甲真菌病(DLSO)295例(53.9%),白色浅表型甲真菌病(SWO)36例(6.5%),近端侧位甲下型甲真菌病(PSO)78例(14.2%),全甲营养不良型甲真菌病(TDO)138例(25.2%)。共分离出429株真菌,其中皮肤癣菌354株(82.5%),酵母菌61株(14.2%),非皮肤癣菌霉菌14株(3.3%)。结论山东省威海地区甲真菌病病原体的分布以皮肤癣菌为主,其次为酵母菌和非皮肤癣菌霉菌,红色毛癣菌是最常见的皮肤癣菌,临床类型以DLSO型居多,其他依次是TDO、PSO、SWO。就诊人群中以20～50岁年龄段为最多见。     

Trichoderma spp. Antagonism to the Dermatophyte Trichophyton rubrum: Implications in Treatment of Onychomycosis

Onychomycosis--the dermatophytic invasion of the nail--is difficult to eradicate with drug treatment. The hyphae of the main invading pathogen, Trichophyton rubrum, are often interwoven with the nail plate, preventing effective anti-mycotic agents from reaching its growing tips. An alternative approach to treat onychomycosis may possibly be the application of a biological control agent against the pathogen. In analogy with the success of biocontrol of phytopathogenic fungi, we screened a series of commercially available Trichoderma strains for potential antagonism between Trichoderma and Trichophyton spp. A wide spectrum of antagonism capacity, ranging from effective overgrowth to no interaction was found, with Trichoderma virens NRRL 26672 being the most effective against the Trichophyton strains tested e.g. T. rubrum NCPF118. Furthermore, T. virens NRRL 26672 grown with T. rubrum NCPF118 hyphae as a carbon source, exhibited enhanced induced secretion of active extracellular chitinases and beta-glucosidases, affecting lysis and sporulation on T. rubrum NCPF118 hyphae. Growth of Trichod. virens NRRL 26672 in poor medium also resulted in secretion of antibiotics active in arresting the growth of T. rubrum NCPF118 inoculum. Our findings may open new directions for the treatment of onychomycosis, either in combination with known medications or as a new "natural" route.     

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.     

甲真菌病治疗现状

甲真菌病是较常见的甲疾病,致病菌有皮肤癣菌、酵母菌和非皮肤癣菌性丝状真菌.常用治疗方法包括局部外用药治疗、系统口服药治疗,近来新型口服抗真菌药的研发以及局部治疗新技术的应用都将成为甲真菌病治疗的补充以及新的发展方向.该文就近年来甲真菌病的治疗现状进行综述.     

Identification, antifungal susceptibility and scanning electron microscopy of a keratinolytic strain of Rhodotorula mucilaginosa: a primary causative agent of onychomycosis

Onychomycosis is a dermatological problem of high prevalence that mainly affects the hallux toenail. Onychomycosis caused by the yeast Rhodotorula mucilaginosa was identified using colony morphology, light microscopy, urease and carbohydrate metabolism in a 57-year-old immunocompetent patient from Rio de Janeiro, Brazil. High-resolution scanning electron microscopy of nail fragments, processed by a noncoating method, led to the observation with fine detail of the structures of both nail and fungus involved in the infection. Yeasts were mainly found inside grooves in the nail. Budding yeasts presented a spiral pattern of growth and blastoconidia were found in the nail groove region. Keratinase assays and keratin enzymography revealed that this isolate was highly capable of degrading keratin. Antifungal susceptibility tests showed that the fungus was susceptible to low concentrations of amphotericin B and 5-flucytosine and resistant to high concentrations of fluconazole, itraconazole, voriconazole and terbinafine. These findings showed data for the first time concerning the interaction of R. mucilaginosa in toenail infection and suggest that this emerging yeast should also be considered an opportunistic primary causative agent of onychomycosis.     

An in vitro study of the photodynamic effect of rose bengal on trichophyton rubrum

Onychomycosis, a fungal infection of the finger or toenails, is predominantly caused by Trichophyton rubrum. Treatment is difficult due to high recurrence rates and problems with treatment compliance. For these reasons, alternative therapies are needed. Here we describe the photoactivation of Rose Bengal (RB) using a green laser (λ = 532 nm) at fluences of 68, 133 and 228 J/cm², and assess its fungicidal activity on T. rubrum spore suspensions. A 140 µM RB solution was able to induce a fungicidal effect on T. rubrum when photosensitized with the fluence of 228 J/cm². RB photosensitization using a green laser provides a potential novel treatment for T. rubrum infections. (© 2014 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Use of caryophyllene oxide as an antifungal agent in an in vitro experimental model of onychomycosis

Caryophyllene oxide, an oxygenated terpenoid, well known as preservative in food, drugs and cosmetics, has been tested in vitro as an antifungal against dermatophytes. Its antifungal activity has been compared to ciclopiroxolamine and sulconazole, commonly used in onychomycosis treatment and chosen because of their very different chemical structures. So, a new model has been tested, utilizing sheep hoof plates in order to simulate human nails, which are almost unobtainable for in vitro tests. Three protocols were utilized: pre-treatment. simultaneous treatment and post-treatment. Among these, the post-treatment method was the best to simulate antifungal therapy. as it permitted testing and comparing the efficiency of different antifungal drugs.This revised version was published online in October 2005 with corrections to the Cover Date.     

Onychomycosis caused by Chaetomium globosum Kunze

In this paper we report a case of onychomycosis caused by Chaetomium globosum. The patient had lesions of the fingernails of the left hand. The direct microscopical examination of the nails showed light-brown hyphae with thick-walled cells. The histopathological examination revealed thick aggregated hyphal element in the nail plate. Amongst the antimycotics tested oxiconazole with MIC values of 0.3 g/ml^–1 was found to be most effective in vitro against Chaetomium globosum.