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PubMed2001

[Mycosis in kidney transplant patients].

Kidney transplantation therapy can be divided into two periods: the induction periods during which immunosuppressants are aggressively administered, and the maintenance periods during which treatment is continued at a maintenance dosage. During the induction periods, which usually lasts for several months after surgery, the host defense mechanism in the patient is so profoundly impaired that major infections, including deep-seated mycosis, occur in most cases. The incidence of mycosis as a result of superinfection was quite high in the l960s and l970s, when steroids and antimetabolites were the mainstay immunosuppressants, and antibacterial agents were used without any specific purpose for fear of post-transplantation infections. The new calcineurin inhibitor ciclosporin was developed around 1980 and has since become the primary immunosuppressant used to prevent graft dysfunction after transplantation. As a result of its advent, use of steroids and antimetabolites has declined. Later studies have shown that ciclosporin selectively inhibits lymphocytes and provides more information on the pattern of bacterial infections after transplantation, making it possible to optimize the use of antibacterial agents. As a result, the incidence of bacterial infections and mycosis has dramatically declined. Candida and Aspergillus are most frequently detected in post-transplantation mycosis. But Cryptococcus is also occasionally seen. Antifungal agents such as flucytosine (5-FC) and ketoconazole are effective for deep-seated mycosis such as pulmonary infections which, occurring at a relatively early stage after transplantation, threaten a patients life. However, the coadministration of ketoconazole must be carefully done because it increases blood concentrations of calcineurin inhibitors such as ciclosporin and tacrolimus by inhibiting the production of cytochrome P-450. Amphotericin B, which is effective but is associated with nephrotoxicity, is usually used in a mouthwash or inhalation therapy. Dermatomycosis such as tinea versicolor due to fragility of the skin structure is not necessarily rare even in patients with a quasi-normal host defense mechanism and good renal function at a late stage in the maintenance phase. This paper outlines change in post-transplantation mycosis in recent years and presents some case reports.

Antifungal Agents↗

PubMed2002

The first isolation of Hortaea werneckii from a household guinea pig.

Hortaea werneckii, a black yeast and the causative agent of tinea nigra (a superficial type of dermatomycosis), is a human pathogen and is also found in the environment. It is not highly pathogenic but in the last fifteen to twenty years has been isolated from various human and environmental sources in Japan. As far as we know, there has been no report on the isolation of H. werneckii from animals. Recently, we found a case of a guinea pig with dark superficial lesions on the palm and dorsal areas. Cultural and morphological studies of scrapings from the lesion showed that the causative agent was a black yeast, which was identified as H. werneckii by morphological study and molecular biological screening. D1/D2 region of the 26S large subunit rDNA gene of this isolate was identical to those of 11 other H. werneckii isolates used as reference strains in this study. This is the first case recorded of tinea nigra caused by H. werneckii in a guinea pig.

Animals↗

PubMed2005

[The pathophysiology and defense mechanism against superficial and subcutaneous fungal infection].

To determine the pathophysiology of the fungal infection and defense mechanisms against superficial dermatomycosis, two series of experimental infections of Trychophyton mentagrophytes were made on the forearm of a male volunteer. One series was applied topical steroid ointment, the other the vehicle alone. The infected sites were biopsied from each row weekly up to the 4th week, and the set of sites were studied and compared clinically, histopathologically and immunohistochemically. For the study against subcutaneous fungal infection, the same experiments were studied using the subcutaneous inoculation of Sporothrix schenckii. The pathophysiology of the superficial dermatophytosis was thought to be the same as those of the contact (allergic) dermatitis, including the physiodynamics of CD-1 cells. The principal mechanism of the defense lay in the removal of the foreign materials (fungi) together with keratinocytes whose turnover increased because of the eczematous reaction. It was proved that the topical application of steroid ointment suppressed the immune reactions locally, thus forming a paradoxical feature with little inflammatory reaction and abundant fungal elements (so-called atypical tinea). The pathophysiology of the subcutaneous fungal infection was thought to be a suppurative granulomatous reaction and pathologically showed a mixed cell granuloma. The neutrophils and macrophages engulfed and digested the fungi in the forefront, but the circumference was surrounded by epithelioid cells and/or foreign body granuloma. Transepithelial elimination also played some role in the defense. It was proved that when the defense mechanism was weakened by the topically applied steroid ointment, not only the clinical symptoms but also the fungicidal tissue reaction were subdued, and histocytes only engulfed fungi to protect them from dispersion. The trichophytin reaction turned positive on the 14th day, and the sporotrichin reaction on the 7th day.

Dermatitis, Contact↗

PubMed2000

[Experimental Trichophyton rubrum infection in animals].

The objective of the work was to induce experimental infection with the anthropophil dermatophyte Trichophyton rubrum in animals and to confirm it by clinical, mycological and histopathological examination. For preparation of the inoculum the authors used a T. rubrum culture isolated from patients suffering from dermatomycosis. The inoculum was cultivated under conditions of intensive aeration (shaking). Its density was 2.0 x 10(6)/ml of germinative spores and hyphal fragments. On the animal's back shoved and irritated by scarification (area 4 cm2) 2 ml inoculum were rubbed in. Experimental mycotic infection was induced in one of four guinea pigs and one of two domestic rabbits. The first clinical manifestations of mycotic infection were found on the 6th and 9th day after inoculation. From the focus T. rubrum was cultivated. From the unaffected hair in the close vicinity and at more remote sites numerous contaminants were isolated, other fungi as well as dermatophytes. In the histopathological material the authors found in the shed layers of the stratum corneum PAS positive septate fibres. Numerous PAS positive septate fibres were found also in the hair follicles. In the corium a mixed inflammatory infiltration was present with a predominance of histiocytes and polymorphonuclear leukocytes. No morphological changes were found after passaging the dermatophyte T. rubrum via animals. Guinea pigs and the domestic rabbit are useful animals for inducing experimental infection with the dermatophyte Trichophyton rubrum.

Animals↗

PubMed1979

[Preventive and therapeutic efficacy of the vaccine against trychophytosis in cattle].

The effectiveness of vaccine against dermatomycosis, caused by Trichophyton verrucosum, was studied in young cattle in three herds. The vaccines of Czechoslovak and Soviet production had almost the same effectiveness in prevention. In healthy calves without clinical signs of trichophytosis vaccinated at an age of one to three months with a dose of 2.5 to 5.0 ml, applied intramuscularly, and revaccinated with due respect to the rules of hygiene in the calf-houses, an incidence of 0 to 13% in the three- to five-month period of study was observed. In the non-vaccinated control groups, the incidence under the same infection conditions and in the same period was 36.3 to 100.0%. At the early stage of vaccination--during the inoculation of the animals suspected of being infected--the incidence of the disease was 50.0 to 68.8% and mostly showed no difference from incidence observed in the nonvaccinated control cattle. The therapeutic effect of the vaccine and Mykolastanox F is characterized by the fact that zero prevalence was obtained in the animals ten weeks after vaccination. Animals treated locally with Mykolastanox F showed zero prevalence 12 weeks after the beginning of treatment.

Animals↗

PubMed2001

Once daily treatment with terbinafine 1% cream (Lamisil) for one week is effective in the treatment of tinea corporis and cruris. A placebo-controlled study.

Duration of therapy is an important factor in determining patients' compliance in dermatomycosis. Terbinafine (Lamisil) is an allylamine antifungal agent. Its fungicidal properties against dermatophytes should allow physicians to reduce treatment duration without affecting the cure rate. This study was carried out to determine the efficacy and tolerability of terbinafine 1% cream, applied once daily for 7 days, in adult patients with tinea corporis/cruris. In a multicentre, randomized, double-blind, parallel-group study, patients with a clinical diagnosis of tinea corporis/cruris confirmed by microscopy and culture received treatment with either terbinafine 1% cream (n = 57) or placebo cream (n = 60). The patients applied the cream once daily for 7 days, and were then observed for a further 7 weeks. The efficacy was assessed at the end of the study by comparing the rates of mycological cure in the two treatment groups. Total clinical signs and symptoms scores, clinical response, and overall treatment efficacy were also measured and compared between the two groups. A 7-day once-daily course of terbinafine was significantly more effective than placebo in achieving and maintaining mycological cure (84.2 versus 23.3%, P< 0.001). Terbinafine was also significantly more effective than placebo in terms of clinical response, reduction in signs and symptoms scores, and overall efficacy. The short treatment regimen and the sustained high cure rate should contribute to making terbinafine a valuable treatment option in tinea corporis/cruris.

Administration, Cutaneous↗

PubMedDate not supplied

[Epidemiologic characteristics of onychomycosis--results of a retrospective study].

INTRODUCTION: The term onychomycosis is used for fungal infections of the nail unit. Tinea unguium is defined as a dermatophyte nail infection. The aim of this study was to determine the epidemiological characteristics of onychomycoses. MATERIAL AND METHODS: Ambulatory patients of the policlinic department of the Clinic of Dermatovenereology in Novi Sad were included in this study. Every patient with clinically suspected nail changes was examined. Direct microscopy of nail clippings and isolation of fungi on Sabouraud agar were performed. The results were evaluated using standard statistic methods. RESULTS: During a one-year-period (1995-1996) 70 cases of onychomycoses were registered that is 1.07% of the total number of patients examined in this period (N = 6535). The vast majority of observed patients were females (N = 47-67.14%), and male patients were significantly less frequent (N = 23-32.86%, p < 0.01). The most frequent type was dermatophyte onychomycosis (N = 39-55.71%), and the most often isolated agent was Trichophyton mentagrophytes (N = 38-54.29%). Manual workers were most often affected (N = 18-25.71%). Most patients were in the 41-50 year age group (N = 23-32.86%). The mean age of patients was X = 47.64 years (SD = 15.39). Table 4 shows the clinical duration of different types of onychomycoses. The longest clinical course was in the group of dermatophyte onychomycosis (20 years, one case). The mean clinical duration of the whole group was 26.81 months (SD = 40.04). Table 5 shows presence of other dermatomycoses associated with onychomycoses. Tinea pedis was the most frequently observed dermatomycosis (N = 9-60.00%). DISCUSSION: The incidence (1.07%) is something less than usual, and other findings are compatible with standard results. A lower incidence could be the result of the fact that children under 17 years are managed at the Institute of Mother and Child Health Care in Novi Sad. CONCLUSION: This study is a contribution to epidemiological investigations of onychomycoses. This disorder, with its social and medical importance and dubious treatment results, puts onychomycoses on high level of interest in modern dermatovenereology.

Adolescent↗

PubMed2002

[Epidemiology of dermatomycoses in Slovakia].

The authors analyze the incidence of dermatomycoses in the Slovak Republic in 1994-1999. They found an increase of these infections in particular epidermophytoses, trichophytoses and candidoses. From 25,762 examined subjects with suspicion of dermatomycosis they isolated in 1990 till 1999 8,237 cultures of dermatophytes. The most frequent causal agent was Trichophyton rubrum (81.61%). In the conclusion the authors draw attention to the inevitability of introduction of effective preventive measures.

Dermatomycoses↗

PubMed1992

[The effect of occupational environment on the development of skin lesions in workers at a tableware porcelain plant].

This work reports on the skin diseases which occur among the workers of the ceramic industry. The most frequently observed diseases were: dermatomycosis, eczema as a result of wear, and allergic diseases. Nickel, and also cobalt, turpentine, paraphenyldiamine and detergents were the main allergens. Mycotic infection was observed primarily among the workers using common bathrooms.

Adult↗

PubMed2003

Study of solar photosensitization processes on dermatophytic fungi.

The antifungal activity of solar simulator was evaluated in presence of haematoporphyrin derivative (HPD), methylene blue (MB) and toluidine blue O (TBO) as photosensitizers. Seven dermatophytes were used as test fungi. The solar simulator at fluence rate 400 W/m2 for 30 minutes induced marked inhibition for spore germination of the photosensitized fungi. The rate of inhibition varied according to the fungal species and concentration of the photosensitizer. There was an increase in percentage inhibition of spore germination as the concentration of HPD or MB increased. Complete inhibition for spore germination of Trichophyton. verrucosum, T. mentagrophytes, and Miccrosporum canis was induced when these species were pretreated with 10(-3) M of HPD or MB before irradiation. Epidermophyton floccosum, T. rubrum, M. gypseum and T. violaceum were less sensitive to irradiation when pretreated with HPD or MB. On contrary, the maximum reduction in percentage spore germination was induced at the lowest concentration (10(-7) M) of TBO. The tested dermatophytes were mostly capable of producing different enzymes (keratinase, phosphatases, amylase, lipase). The separate application of radiation or photosensitizer was ineffective or exerted slight inhibition on enzyme production. However, the activity of the enzymes was drastically inhibited when the fungi were irradiated after their treatment with photosensitizer. T. verrucosum and T. mentagrophytes were the most sensitive. In a trail to apply a control measure against dermatomycosis using solar simulator radiation, the results revealed that the radiation was successful in curing the MB-photosensitized guinea pigs, artificially infected with T. verrucosum, T. mentagrophytes or M. canis. The percentage of recovery reached 100% in some treatments.

Amylases↗

PubMed1977

[Long-term observation of fungal and other skin disorders after renal transplantation (author's transl)].

All of 68 renal transplant recipients (mean observation time 28.4 months after transplantation) showed skin complications. In these subjects fungal infection was found in 51, viral disease in 45 and bacterial infection in 36 cases. Of fungal manifestations candidiasis, onychomycosis, and dermatomycosis were most commonly observed. The most important viral disease was herpes simplex. The main part of bacterial infections was either caused by surgical complications or by super-infection (impetigo) of steroid acne. Non infectious dermatological disorders were usually due to immunosuppressive therapy.

Acne Vulgaris↗

PubMed1992

[Loss of taste sensation in terbinafine administration].

Terbinafine is a new antifungal agent for oral treatment of dermatomycosis. Seven patients are reported who developed taste loss after treatment with terbinafine. In four of them, taste loss was complete while one patient was still able to taste sweet products, and a second and third patient no longer tasted salty and sweet products, respectively. In all patients, the onset of the adverse reaction occurred 4-8 weeks after starting treatment. As far as known, taste loss is a transient effect which disappears within 3-6 weeks after discontinuation of terbinafine.

Adult↗

PubMed1992

[Mycotic diseases in patients with AIDS].

The author analyzes factors influencing the occurrence of mycoses in AIDS-patients with different stages of the disease. The clinical picture, the diagnosis and sources of common as well as uncommon mycoses accompanying AIDS are given in detail. Candidosis, cryptococcosis, histoplasmosis and dermatomycosis complicate AIDS frequently most. The course of all mycoses in AIDS patients is quite different from the course of the same mycoses complicating other diseases.

Acquired Immunodeficiency Syndrome↗

PubMed1978

[Dermatoses in tapestry workers].

From among 810 persons subjected to a medical examination, skin lesions were found in 33.3%. These were mostly: seborrhea (89 cases), occupational naevi (55 cases), dermatomycosis (49 cases), urticaria (21 cases), eczema (12 cases). Other dermatoses were found in 44 workers, however, in a small percentage, not greater than in other non-industrial populations. No occupational dermatoses resulting from exposure to fundamental materials or dyes used in production were found.

Adolescent↗

PubMed2004

Evaluation of valuation of toxicity profile of an alkaloidal fraction of the stem bark of Picralima nitida (fam. Apocynacaes).

Dermal and acute toxicity evaluation of the basic alkaloidal fraction of the stem bark of Picralima nitida, which has been shown to have pronounced activity against causative organisms of dermatomycosis in man, was carried out in animals. Acute intraperitoneal toxicity tests showed a dose-dependent toxicity. There was inflammation and necrosis of liver hepatocytes accompanied by reduction in neutrophilic count and a corresponding increase in lymphocytic count. There was no sign of reddening or irritation when applied into the eye conjunctiva. Dermal tests also showed that the fraction caused no sensitization, inflammation or death in the animal models used.

Alkaloids↗

PubMed1992

In vivo activity of sertaconazole in experimental dermatophytosis in guinea pigs.

The comparative curative effect of 7-chloro-3-[1-(2,4-dichlorophenyl)-2-(1H- imidazol-1-yl)ethoxy-methyl]benzo [b]thiophene (sertaconazole, FI-7045, CAS 99592-32-2) (SZ) and miconazole (MZ) 2% creams in a model of dermatomycosis caused by Trichophyton mentagrophytes in guinea pigs was studied. Two treatments of different duration (12 and 3 days) were applied, and their efficacy versus infected and untreated animals (control group) was evaluated according to clinical parameters (degree of alopecia and lesion) and microbiological healing (recovery of T. mentagrophytes from hair pulled from the infected site). The therapeutic effect resulting from the application of the creams for 12 days was excellent and similar for both test creams; however, the application of SZ cream for 3 days had greater therapeutic effect than MZ cream according to the improvement of clinical symptoms and microbiological healing.

Alopecia↗

PubMed1992

[Natural history of HTLV-I infection].

Adult T-cell leukemia (ATL), a disease entity first described by Takatsuki et al., is endemic in southwestern Japan, the Caribbean Islands, and in some parts of Africa. ATL patients are classified into four subtypes according to the clinical picture: acute, chronic, smoldering, and lymphoma type. The diagnosis of ATL is made from the characteristic clinical findings, the detection of serum antibodies to HTLV-I, and when necessary, the confirmation of monoclonal integration of HTLV-I proviral DNA in cellular DNA of ATL cells. Recently, diagnostic criteria for clinical subtypes of ATL were proposed by the Lymphoma Study Group in Japan: 1) smoldering type, normal lymphocyte level, no hypercalcemia, lactate dehydrogenase (LDH) value 1.5 times the upper limit of normal or lower, no lymphadenopathy, no involvement of liver, spleen, central nervous system (CNS), bone or gastrointestinal tract, and no ascites or pleural effusion: 2) chronic type, absolute lymphocytosis with T-lymphocytosis of greater than 3 x 10(9)/1, LDH value twice the upper limit of normal or lower, no hypercalcemia, no involvement of CNS, bone, or gastrointestinal tract, and no ascites or pleural effusion: 3) lymphoma type, no lymphocytosis, 1% or less abnormal lymphocytes, and histologically-proven lymphadenopathy: 4) acute type, remaining ATL patients who are not classified as any of the above types. Infection with HTLV-I is a direct cause of ATL. Furthermore, infection with this virus can indirectly cause many other diseases via the induction of immunodeficiency, such as chronic lung diseases, opportunistic lung infections, cancer of other organs, monoclonal gammopathy, chronic renal failure, strongyloidiasis, non-specific dermatomycosis, non-specific lymph node swelling, HTLV-I associated myelopathy (HAM/TSP), and HTLV-I uveitis.(ABSTRACT TRUNCATED AT 250 WORDS)

CD4-CD8 Ratio↗

PubMed2006

[Harmful impact of biological agents released at metalworking].

In metalworking, the temperature of the cutting edge can reach 700 degrees C, which can adversely affect either the surface of the metal processed or the cutting edge itself. To reduce the heat and friction, the metalworking fluids and coolants are used. The most common are the oil-in-water emulsions, which are a mixture of concentrated mineral oils, different additives, and water. The presence of water and organic substrates generates conditions for microbial growth. Bacterial endotoxins can also be frequently detected in metalworking fluids. Rapid rotation of the metalworking tools makes various biological agents to be released as droplet bioaerosols that can be inhaled by the workers, thus producing adverse health effects, mainly on the respiratory system. More than 130 species of bacteria (including pathogens), moulds and yeasts have so far been found in the metalworking fluids and coolants. This paper summarizes the outcomes of projects on the impact of biological agents present in metalworking fluids. Exposure to oil mist, bacteria and endotoxins as well as the variety of health effects resulting from that exposure have been discussed. The findings indicate that the most frequent symptoms reported by the workers include cough with phlegm, wheezing breath, chest tightness and throat irritation. The most common among the diagnosed diseases are chronic allergic bronchitis, asthma, hypersensitivity pneumonitis and acute respiratory dysfunction indicated by decreased FEV1 values. The main skin diseases include oil acne, bacterial infections, dermatomycosis and allergic reactions. The review made the authors conclude that the problem of occupational exposure to biological agents released with coolants during metalworking has not been well recognized in Poland.

Air Microbiology↗