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Immunoprophylaxis of bovine dermatophytosis.

The literature on immunoprophylaxis as control method for ringworm in cattle is reviewed. Scientific papers on immune response to dermatophyte antigens and vaccination against ringworm were obtained from personal files and computerized search in 4 relevant databases. Vaccines with antigens of Trichophyton verrucosum stimulate a humoral and cellular immune response. In animals vaccinated with inactivated vaccines, some protection is observed after challenge. However, the protective immunity is inadequate in most cases. Vaccination with live vaccines elicits an immune response that prevents the development of clinical disease. The protective immunity is based mainly on the cellular branch of the immune system. The efficacy and safety of live dermatophyte vaccines have been demonstrated in both challenge experiments and field trials from different countries. Effective control of ringworm in cattle has been achieved in regions implementing systematic vaccination.

Animals↗

[Epidemiology of trichophytosis in fattening calves in regard to the prevention of leather defects].

During the year 1989 12,520 veal calves were visually examined for ringworm at the Zürich abattoir. The mean prevalence of ringworm amounted to 7.7% with a maximum of 12.8% in July and a minimum of 5.1% in March. Epidemiological data were collected at repeated visits from 73 calf fattening farms. Batches of calves were significantly more frequently affected in continuous management systems (51%) than in all-in all-out systems (28%). Ringworm was more prevalent in farms with large groups of calves, and where calves were shorn. Prevention of leather defects necessitates prophylactic measures. The latter are determined by the importance of animal to animal contacts for transmission of the fungus. The health status of calves at purchase and the choice of the management system are therefore of primary importance. Vaccination may be considered in problem herds. A premium for high quality skins might further stimulate the interest of the producers in leather quality.

Animals↗

[The presence of antioxidative defense enzymes in the ascarid Ascaris lumbricoides].

Superoxide dismutase, glutathione peroxidase and glutathione have been discovered in muscles of the ringworm A. lumbricoides. Superoxide dismutase activity was also revealed in eggs and larvae. Using polyacrylamide gel electrophoresis and electrofocusing, it was shown that this enzyme exists in ringworm muscles in multiple molecular forms. Oxygen poisoning of the ringworm and aerobic incubation of muscle homogenates in the presence of Fe+2 do not result in accumulation of malonyldialdehyde. Biochemical defence mechanisms are discussed against oxygen poisoning of the organisms which live under the conditions of reduced and changing pO2.

Animals↗

Arthroderma benhamiae infection in the Central African hedgehog Erinaceus albiventris, and a report of a human case.

The occurrence of ringworm caused by Arthroderma benhamiae Ajello & Cheng is reported in Central African hedgehogs (Erinaceus albiventris Wagner), caught near Nairobi, Kenya. Of the 45 animals examined, 10 were positive on culture, including a litter of 4 young. Six infected animals were without lesions, and 2 littermates showed scaly areas similar to those described in E. europaeus L. caused by Trichophyton erinacei (Smith & Marples) Padhye & Carmichael. No correlation with mite infestation or mange lesions was evident. Ringworm-like lesions were found which were repeatedly negative on culture. A human infection by A. benhamiae was contracted from the hedgehogs.

Age Factors↗

[From hedgehogs to men. Zoophilic dermatophytosis caused by Trichophyton erinacei in eight patients].

The hedgehog is an in Germany previously unrecognized source of human ringworm. Eight hedgehog caretakers from Göttingen and the surrounding area developed dermatophytosis caused by Trichophyton erinacei. Four patients who handled the animals without gloves developed lesions on the hands that were more in keeping with hand eczema, leading to a delay in diagnosis. The other caretakers who wore gloves presented with typical ringworm on the arms, the big toe, the back, the abdomen, and the thighs. Their typical clinical features led to an early diagnosis and treatment.

Adult↗

Efficacy of oral terbinafine in feline dermatophytosis due to Microsporum canis.

Microsporum canis is the dermatophyte most commonly responsible for ringworm in cats. The purpose of this paper was to evaluate the in vivo efficacy of oral terbinafine (Lamisil; Sandoz) in the treatment of feline ringworm caused by M canis, and to consider this drug as an alternative to griseofulvin or imidazoles. Fifteen cats infected with M canis were treated orally once daily with 30 mg/kg of terbinafine over a 2-week period. All treated animals were checked for dermatophytes on the last day of treatment, a month later and 3 months after the last administration of the drug. Only 12 cats could be used in the whole trial and 11 of these (92%) showed a complete cure. Terbinafine could be an effective alternative to griseofulvin when fungal resistance or idiosyncrasic intolerance are shown and, compared with griseofulvin, could give a faster rate of cure and less relapses.

Administration, Oral↗

Geographical distribution of the dermatophytes: a review.

In these days of rapid transit from continent to continent, and the increasing mobility of people, agents of disease are no longer geographically restricted. Disease contracted half way across the world may become manifest in a country in which the pathogen is not normally found. Thus knowledge of the geographical distribution of pathogens becomes increasingly important when a diagnosis is being made. This is as true of ringworm fungi as of any other group of microorganisms. In the last 12 years, in the Mycological Reference Laboratory, an increasing number of exotic dermatophytes have been seen, related in part at least to the great increase in the number of non-British residents. Not all species of dermatophytes are cosmopolitan in their distribution throughout the world. While some have been recorded from every continent, others have geographically limited areas of greater or lesser extent. Surveys taken at intervals in a country may show a rise and fall in occurrence of several species as habits change, populations move and medical facilities became increasingly well-distributed. There have been few geographical surveys of ringworm fungi that have covered the world. Ajello (1960, 1974) has reviewed the individual species with regard to geographical location, while Vanbreuseghem & de Vroey (1970) attempted to estimate the relative importance of the various species in terms of numbers of isolations reported. This paper therefore reviews the world dermatophyte flora in terms of the dominant agents in the various countries, and some of the changes that have been recorded.

Africa↗

Erythema multiforme ID reaction in atypical dermatophytosis: a case report.

BACKGROUND: Erythema multiforme (EM) is an uncommon mucocutaneous disorder, characterized by widespread erythematous-oedematous targetoid lesions, considered as a reaction pattern to many different stimuli. OBSERVATION: Presentation is made of a classical EM eruption concomitant to an inflammatory, atypical dermatophytosis of the ala nasi, observed in a 37-year-old male at the Dermatology Department of Cagliari, Italy. METHODS: Laboratory investigations revealed normal complete blood count and biochemistry profile. A direct microscopic examination with 20% potassium hydroxide of the nasal skin scales and of the vibrissae indicated the presence of dermatophyte hyphae and spores invading the rhinothrix. Culture confirmed a Trycophyton mentagrophytes infection. Specific determination of antiviral immunity in the blood (TORCH) was negative for recent infections, while the cell-mediated response, investigated with a delayed skin multitest, showed a marked positivity for the tricophyton antigen. Systemic therapy with terbinafine (250 mg/day) led to complete clinical and mycological recovery of the atypical ringworm in 30 days. Multiforme lesions rapidly improved and completely disappeared in 7 days. CONCLUSIONS: ID reaction to a distant focus of dermatophyte infection very rarely presents as EM. The presented case fits all the essential criteria required for the diagnosis of an ID reaction. The atypical clinical presentation of the ringworm infection, with marked involvement of the intranasal hairs, seems to have induced an inflammatory allergic response, similar to that evoked by sycosis.

Adult↗

Tinea capitis in adults.

Scalp ringworm is unusual after puberty. Etiological, epidemiological and clinical data regarding cases of tinea capitis in the elderly observed over a period of 15 years are discussed and some explanations are given for the conditions which favoured the mycotic infection of the scalp in adults. This study underlines that tinea capitis in the elderly is usually characterized by very variable and often atypical lesions and that female preponderance in adult cases of scalp ringworm is striking and unexplained. Moreover, all the dermatophytes we isolated from scalp lesions in children can cause tinea capitis in adults.

Adolescent↗

Superficial mycoses in the west of Scotland.

Ringworm formed almost 70 per cent of all superficial mycoses diagnosed. The feet and nails were most frequently affected and a single species, Trichophyton rubrum was responsible for the majority of infections that required specialist attention. Scalp ringworm which, until the middle of this century, was the most common form of the disease now constitutes only 5 per cent of infections and the majority of these are caused by the zoophilic fungus Microsporum canis. The anthropophilic dermatophytes which were once so prevalent as the cause of scalp infections are now rarely encountered. Yeasts, especially Candida albicans were most frequently encountered as a cause of mucosal infections but were not unimportant as a cause of disease of skin and nail.

Aged↗

Tinea gladiatorum: wrestling's emerging foe.

Tinea corporis, or ringworm, has become a common nuisance in competitive wrestling. Although it is a fairly benign infectious skin disease, it has significant effects on the ability of a wrestler to compete because of infection control issues. Very little has been published in the medical literature describing this problem. The majority of the literature has described outbreaks in an isolated group of wrestlers. One must examine ringworm infections in wrestlers as an entity distinct from tinea corporis infections typically seen in the paediatric population, thus the term 'tinea gladiatorum'. Tinea gladiatorum outbreaks have been caused by the dermatophyte, Trichophyton tonsurans. The epidemiology and microbiology point to person-to-person contact as the main source of transmission in wrestlers. The clinical features of tinea gladiatorum may or may not be consistent with those found in the general population. Ancillary tests, including potassium hydroxide preparations and fungal cultures may have to be done to confirm the diagnosis. Treatment guidelines for tinea corporis have failed to produce the desired goals in this particular population. More research studying different treatment regimens in the wrestling environment is needed to define the optimal treatment to return wrestlers to competition quickly without putting other wrestlers at risk for infection. Intuitive hygiene practices have been suggested to prevent spread of the infection, but they have not been substantiated. Anecdotal reports suggest that hygiene practices fall short of producing adequate primary or secondary prevention. Pharmaceutical prophylaxis has been effective, but universal drug prophylaxis carries risks including drug adverse effects and potential drug resistance. The role of potential asymptomatic carriers of dermatophytes has yet to be elucidated in the origin and/or perpetuation of tinea gladiatorum outbreaks. There are many unanswered questions about tinea gladiatorum. Sports medicine professionals must work to define this entity more completely before making recommendations about treatment, prevention and infection control. The ultimate goal is the eradication of tinea infections from the wrestling world. Energy should be focused on primary and secondary prevention, as well as treatment. Without a thorough knowledge of tinea gladiatorum as a distinct disease entity, wrestling has been losing its battle with this formidable opponent.

Humans↗

Skin infections in eastern Panama. Survey of two representative communities.

A skin infection survey of 1,084 people was carried out in two jungle villages in eastern Panama. Bacterial pyoderma was the most prevalent infection, affecting 25% of boys, 15% of girls, and 11% of those over 10 years of age. Streptococcus pyogenes and Staphylococcus aureus were recovered from 84% of pyodermas cultured. Nearly 60% of the cutaneous staphylococcal isolates were resistant to penicillin. Hippelates flies were seen feeding on purulent skin lesions and may have been important in transmission. Scabies, ringworm, candidiasis, and cutaneous leishmaniasis were in comparison with pyoderma involving less than 1% of the population each. All of the ringworm infections were caused by Trichophyton rubrum.

Adolescent↗

[Allergic phenomena in the course of dermatomycoses].

Fungi, well known as infectious factors so far, are important allergens too. A fungal id reaction is defined as a distant skin manifestation of an established fungal infection. The most typical setting is in association with tinea of the feet. The main id reactions are well established. A widespread lichen trichophyticus--eruption of small follicular papules grouped or diffuse. The eruption is symmetrical, usually pronounced on the trunk but in severe cases extending down to the lower limbs, even sometimes involving the face. The common cause of this type of id reaction is scalp ringworm of kerion type, caused typically by Trichophyton verrucosum. The treatment of the original ringworm lesion may play a role in initiation of the process. A pompholyx-like id affecting the interdigital spaces and palmar surfaces of the fingers, the palms and sometimes the dorsal surfaces of the hands. This eruption is associated with an acute inflammatory tinea of the feet and may develop spontaneously or as a result of inappropriate treatment. The palmar and web space skin may be covered with papules or vesicles. Sometimes blisters or pustules may occur. Other varieties of mycides include eczematous eruptions, erysipelas-like dermatitis, psoriasiform dermatitis, erythema multiforme, erythema annulare centrifugum, erythema nodosum, and urticaria. Adequate antifungal therapy is recommended as the treatment of allergic diseases caused by superficial fungi.

Candida↗

[Update on the diagnosis of dermatomycosis].

Dermatomycosis are mycotic diseases of skin caused by a few mycetes: dermatophytes, and some opportunistic fungi as Malassezia, Candida (not C. albicans), Trichosporon, Rhodutorula, Cryptococcus or Aspergillus, Geotrichum, Alternaria, etc. Dermatophytes are a group of closely related filamentous fungi that invade keratinized tissue (skin, hair, nails) of humans and other animals and produce infection called dermatophytosis or ringworm or "tinea". The etiological agents of dermatophytosis are classified in three genera: Microsporum, Trichophyton and Epidermophyton (Deuteromycetes). On the basis of their primary habitat dermatophytes are divided in Anthropophilic dermatophytes (parasitic organisms that infect humans), Zoophilic dermatophytes (parasitic organisms that infect animals, but also humans: agents of zoonosis) and Geophilic dermatophytes (saprobic fungi associated with keratinous materials in soil). In the soil there are also structure associated with contagion, ("spore", "arthroconidium", or "clamydospore") of anthropophilic and zoophilic dermatophytes that may persist for years, in the environment, in hair or skin scales. Since on the skin of animals there are many saprobic organisms (Malassezia) and many fungi may infect the fur, it is important to make an accurate diagnosis. Dermatophytosis are communicable diseases acquired from infected animals or from fomites. Infections caused by dermatophytes is a ringworm. These infections may range from mild and superficial, almost subclinical, to a few areas of scaling to a highly inflammatory reaction with extensive areas of scarring and alopecia. Granuloma formations (mycetoma-like) may occur especially in cats. Dermatophytes, as filamentous fungi, undergo radial fungi: collection of skin material is best made by collecting the scales near the edges of the rings. Hairs are best sampled by plucking; a scalpel may be used to scrape scales; brushes have also been used. Sample materials are best transported in dry packet. The Wood's light may be used to identify infected fluorescent hairs. Direct microscopy, although false negative up to 50% of cases, is a highly efficient screening technique. Scraping and hairs should mixed to 10-15% KOH. Culture is a valuable adjunct to direct microscopy and is essential to identify more dermatophytes. A medium selective against most nondermatophytic moulds and bacteria is used as a primary isolation medium. Many typical isolates of common dermatophytes can be identified directly from primary isolation media. Identification characters include: colony pigmentation, texture, morphological structure (macroconidia, microconidia, spirals, pectinate branches, etc). Nutritional requiment, growth in special media, "in vitro" perforation, mating studies are procedures used to identify atypical isolates. Serological approaches have revealed difficulties. Many kinds of molecular biologic techniques have been made available for clinical diagnosis recently; almost all of these techniques involve the polymerase chain reaction (PCR).

Alopecia↗

[New studies on the characterization of virulence factors in Microsporum canis].

Microsporum canis is a worldwide distributed zoophilic and zoonotic dermatophyte which is responsible for most cases of feline ringworm. Its prevalence is on the rise in developed countries. Since 1995, the author and his Laboratory have developed a research programme to better understand the pathogenesis of M. canis dermatophytosis. Both the potential fungal virulence factors and the host immune response were investigated. A 31.5 kDa keratinolytic subtilase (SUB) and a 43.5 kDa keratinolytic metalloprotease (MEP) were purified from a crude exoantigen consisted in a mixture of inducible proteins secreted by the fungus in a medium enriched with keratin. Additionally, two gene families encoding respectively 3 SUBs and 3 MEPs, including the 2 keratinases previously purified (called SUB3 and MEP3), were characterized. The genes encoding several MEPs and SUBs were shown to be transcribed in vivo during infection by nested RT-PCR. Finally, we demonstrated that a specific cellular immune response towards the crude exoantigen, MEP3 and SUB3 was induced in experimentally infected guinea pigs. This indicates that the potential immunoprotective properties of these antigens are interesting to evaluate in the frame of the development of an efficient vaccine against feline ringworm.

Animals↗

The low income preschools in Benin City: some health aspects of the children.

Forty-three proprietors of the low-income preschools in Benin City and 353 mothers of children attending such groups were asked to give information pertaining to the common health problems and immunization status of the children. Information was obtained by interviews and self-administered questionnaires. Moreover, 415 children were examined to determine the incidence of head lice, scabies, ringworm and catarrh - conditions which had been found to be common among children in the low-income group. The results revealed that malaria and catarrh were the commonest conditions according to the parents and proprietors while the physical examination established catarrh and ringworm as very common. The immunization status was unsatisfactory. Recommendations are made for the upgrading of these preschool groups for better health and early childhood education.

Child Day Care Centers↗

[Reflections on dermatophytes].

In light of his experiences especially in tropical regions, the author makes some remarks about dermatophytes and dermatophytia, which they cause. The following main items are: 1. The dermatophytes lead a saprophytic life. 2. Exceptionally, they can invade nonkeratinized tissue and cause "dermatophytic disease", perhaps mycetomas. 3. 45 percent of the ringworm of the scalp heal before puberty. 4. In the tropical regions, trichophytosis caused by endothrix-species are often of inflammatory nature, the favus appears often without scutula formation (afavic). 5. One can heal a substantial percentage of the ringworm of the scalp with a single dosis of 12 tablets (125 mg each) of fine particle griseofulvin. 6. Athlete's foot has also other causes than only dermatophytes.

Adolescent↗

Paroxysmal pruritus. Its clinical characterization and a hypothesis of its pathogenesis.

In dermatologic literature generally, itching, that familiar sensation that evokes a desire to rub or scratch, has been attributed almost without exception to something occurring in the skin: e.g., an insect bite, ringworm, contact dermatitis, urticaria, lymphoma, provocation by bile salts in jaundice. Itching in such instances is almost invariably relieved quite promptly, even if only temporarily, by rubbing or scratching with only moderate vigor, not enough to damage the skin, or at most to damage it only superficially. No one scratches a mosquito bite, hives, ringworm, or even lichen planus to the point of bleeding and scarring. Winkelmann and Muller suggested in 1964, "In rare instances, the itching response does not reside in the skin...but may be analogous to phantom limb sensations." I believe that this is a common phenomenon that is characteristic of several familiar, common skin disorders, that can be readily identified from the patient's history, and that serves to explain some otherwise mysterious clinical features of those disorders; in particular, why they are regularly scratched to the point of oozing, bleeding, scarring, or lichenification.

Adult↗