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PubMedDate not supplied

Treatment of dermatophytoses and pityriasis versicolor with itraconazole.

Thirty patients (18 males and 12 females) with dermatophytoses were treated with itraconazole. Twenty-eight patients received 100 mg per day for 14 days, and two patients, one with tinea pedis and one with tinea manuum, were treated for 28 days. Thirty patients (11 males and 19 females) with pityriasis versicolor were treated with 200 mg of itraconazole. for five days. Half of the patients received the 200 mg in one dose, and the other half received 100 mg twice a day. Twenty-nine of the 30 patients with dermatophytoses were clinically and mycologically cured, and one patient was improved. All 30 patients with pityriasis versicolor experienced complete clinical and mycologic cure; no difference was noted between the two groups. Ten of the 60 patients treated reported adverse reactions to therapy. The primary adverse effects were nausea and epigastric pain; one patient had diarrhea. There were no alterations in the patients' blood biochemical values. These results suggest that itraconazole is safe and effective for the treatment of dermatomycoses.

Adolescent↗

PubMedDate not supplied

Fungal infection as a cause of skin disease in the eastern province of Saudi Arabia: prevailing fungi and pattern of infection.

A total of 4,294 clinically suspected cases of dermatomycoses belonging to 26 different nationalities were examined between April 1984 and April 1988. Fungi were demonstrated in routine potassium hydroxide/dimethyl sulfoxide mount in 3,814 cases (88.8%) and the etiology was determined by culture in 2,458 cases (57.2%). Tinea versicolor was the predominant fungal infection (30.9% of all infections). Onychomycosis and paronychia ranked second in prevalence (16.8%). Candidal onychomycosis was the most common type of infection. Scalp ringworm among children ranked third (15.3%), Microsporum canis was the main etiologic agent. Tinea pedis and tinea manuum ranked fourth in prevalence (13.2%). Tinea corporis represented 10.7% of infections and M. canis was the main agent. Tinea cruris accounted for 8.7% of infections and Epidermophyton floccosum was the most common agent. Cutaneous candidosis constituted 4.3% of infections. White piedra was seen in 6 cases (0.16%). Yeasts were proved not to be unimportant as a cause of disease of skin and nail in our study.

Adult↗

PubMedDate not supplied

Fungal infection as a cause of skin disease in the eastern province of Saudi Arabia: tinea corporis and tinea cruris.

In the period between April 1984 and April 1988 a total of 4,294 clinically suspected cases of dermatomycoses were examined for causative fungi. Of these cases 768 (17.9%) were suspected as tinea corporis (427 cases) and tinea cruris (341 cases). Twenty two different nationalities were represented. Both sexes were involved and the age range was 19 days to 70 years. Of the 768 patients examined, 738 (96.1%) had their diagnosis confirmed by direct microscopy and in 631 of these positive cases the etiology was determined. Of the 408 patients who had suffered from tinea corporis, 323 isolates were obtained from 313 culturally positive cases. Microsporum canis was the main etiologic agent followed by Trichophyton violaceum, T. mentagrophytes, T. rubrum and Epidermophyton floccosum. Of the 330 patients who had suffered from tinea cruris, 388 isolates were obtained from 318 culturally positive cases and E. floccosum was the main etiologic agent. Next in frequencies were T. rubrum and T. mentagrophytes while Candida albicans was isolated from 45 of 70 patients with mixed isolates. Treatment with topical antifungal agents was effective in most of the cases. Oral griseofulvin in addition to the topical application was found necessary in extensive widespread cases.

Adolescent↗

PubMed1997

[Hormones, fungi and skin].

It is indicated by some epidemiological and clinical observations, that steroidal hormones may belong to those factors that are capable to influence the clinical courses of mycotic infections in man. Several fungal species, including pathogenic ones, are able to produce or metabolize steroidal hormones, or their growth can be affected by such hormones. Since, on the other hand, the steroid-responsive human skin is also capable to synthesize and convert steroidal hormones, the relationship between pathogenic fungi and host may be influenced by hormonal mediators in dermatomycoses.

Dermatomycoses↗

PubMed2004

Dermatophytosis in children and adolescents in Gdansk, Poland.

During a 3-year period (1999-2001) a total of 94 cases of dermatophytosis were seen in patients from 0 to 18 years of age attending the Department of Dermatology, Venerology and Allergology of Gdańsk Medical University. Mycoses were diagnosed on the basis of clinical picture and direct microscopy and were confirmed by positive cultures. The most frequent pathogens were Microsporum canis (62%) and Trichophyton rubrum (12%). The most often forms of dermatophytosis in children were tinea cutis glabrae (42%) and tinea capitis (30%). Microsporum canis predominated in both locations. Glabrous skin lesions were the most frequent in children aged 8-15 years; the peak of scalp lesions was observed mainly in children aged 4-7 years. Tinea pedis occurred more frequently than suspected. Tinea pedis was observed mainly in adolescents (above the age of 12 years)--the majority of cases were caused by T. rubrum and T. mentagrophytes var. granulosum. Onychomycosis was highly uncommon, caused mainly by T. rubrum. Dermatomycoses in general were most frequent in October and November.

Adolescent↗

PubMed2004

Itraconazole corneofungimetry bioassay on Malassezia species.

Yeasts of the genus Malassezia are part of the normal skin biocenosis and are involved in a series of distinct skin disorders and specific dermatomycoses in man and animals. Several species are currently distinguished. Their relative in vitro susceptibility to antifungals appears different according to the species and to the nature and route of administration of the drug. Corneofungimetry is an ex vivo bioassay allowing to test the fungal response on human stratum corneum following oral intake of a given antifungal by volunteers. Two series of cyanoacrylate skin surface strippings (CSSS) were harvested from the volar forearm of 30 volunteers before and after a 2-week treatment with itraconazole 200 mg daily. They were coated by olive oil and inoculated with suspensions of seven different Malassezia spp. After a 1-week culture on CSSS, the amount of viable yeasts was assessed using neutral red staining assisted by computerized image analysis. Growth of the seven species was not similar on the CSSS from untreated stratum corneum. The ranking order from the most proliferative to the least was M. restricta, M. sympodialis, M. globosa, M. furfur, M. obtusa, M. slooffiae and M. pachydermatis. Their growth was abated to almost the same level after itraconazole treatment. It is concluded that in vivo treatment with itraconazole is highly active against all Malassezia spp. colonizing the human stratum corneum.

Administration, Oral↗

PubMed2001

Rapid discrimination among dermatophytes, Scytalidium spp., and other fungi with a PCR-restriction fragment length polymorphism ribotyping method.

Dermatomycoses are very common infections caused mainly by dermatophytes. Scytalidiosis is a differential mycological diagnosis, especially in tropical and subtropical areas. Since a culture-based diagnosis takes 2 to 3 weeks, we set up a PCR-restriction fragment length polymorphism (RFLP) method for rapid discrimination of these fungi in clinical samples. The hypervariable V4 domain of the small ribosomal subunit 18S gene was chosen as the target for PCR. The corresponding sequences from 19 fungal species (9 dermatophytes, 2 Scytalidium species, 6 other filamentous fungi, and 2 yeasts) were obtained from databases or were determined in the laboratory. Sequences were aligned to design primers for dermatophyte-specific PCR and to identify digestion sites for RFLP analysis. The reliability of PCR-RFLP for the diagnosis of dermatomycosis was assessed on fungal cultures and on specimens from patients with suspected dermatomycosis. Two sets of primers preferentially amplified fungal DNA from dermatophytes (DH1L and DH1R) or from Scytalidium spp. (DH2L and DH1R) relative to DNA from bacteria, yeasts, some other filamentous fungi, and humans. Digestion of PCR products with EaeI or BamHI discriminated between dermatophytes and Scytalidium species, as shown with cultures of 31 different fungal species. When clinical samples were tested by PCR-RFLP, blindly to mycological findings, the results of the two methods agreed for 74 of 75 samples. Dermatophytes and Scytalidium spp. can thus be readily discriminated by PCR-RFLP within 24 h. This method can be applied to clinical samples and is suited to rapid etiologic diagnosis and treatment selection for patients with dermatomycosis.

Ascomycota↗

PubMed2002

Euclidean and fractal computer-assisted corneofungimetry: a comparison of 2% ketoconazole and 1% terbinafine topical formulations.

BACKGROUND: The corneofungimetry bioassay was designed as a unique model predicting the efficacy of topical and oral antifungals in dermatomycoses. OBJECTIVE: In this 2-step study performed in two groups of 15 volunteers, corneofungimetry was used to compare the effect of 5-day b.i.d. treatments with 2% ketoconazole and 1% terbinafine creams. METHODS: The bioassay was performed using 10 isolates of each of the 3 fungi Trichophyton rubrum, T. mentagrophytes var. interdigitale and Candida albicans put to grow on human stratum corneum. Controls were stratum corneum either untreated or enriched in propylene glycol contained in an unmedicated vehicle. Quantitative assessments were made using both Euclidean and fractal geometry parameters. RESULTS: In comparison with untreated stratum corneum, the fungitoxic activity of the 2% ketoconazole and 1% terbinafine formulations was obvious and similar against dermatophytes. By contrast, 2% ketoconazole was significantly more active against C. albicans than 1% terbinafine. The propylene-glycol-containing vehicle did not exhibit a significant effect upon the dermatophyte growth. Positive linear correlations were yielded between the extent area and the fractal dimension D of dermatophyte mycelia. By contrast, D appeared unrelated to the relative area of dermatophyte growth compared to controls. CONCLUSION: The combination of Euclidean and fractal analyses improves the information provided by the corneofungimetry bioassay. Creams containing 2% ketoconazole and 1% terbinafine appear equally effective against dermatophytes while the former is more potent against Candida albicans.

Administration, Topical↗

PubMed1980

Follow-up study after more than one year including 100 patients treated for superficial mycoses.

A total of 100 patients with dermatomycoses were treated with econazole nitrate 1% or with the same compound combined with triamcinolone acetonide 0.1%. The patients were supposed to undergo clinical and mycological follow-up examinations at an average of 15 months after cure had been obtained. Of the 100 patients, 83 were followed up: 78 (95%) reported neither relapses nor reinfections; 4 (5%) presented with clinical symptoms and positive mycological examination and in 1 patient the mycological examination was positive but no clinical symptoms were present. Generally speaking, the results can be considered excellent.

Adolescent↗

PubMed1995

Amorolfine. A review of its pharmacological properties and therapeutic potential in the treatment of onychomycosis and other superficial fungal infections.

Amorolfine is a structurally unique, topically active antifungal agent, which possesses both fungistatic and fungicidal activity in vitro. Its spectrum of in vitro activity includes dermatophyte, dimorphic, some dematiaceous and filamentous fungi, and some yeasts. In clinical trials, application of amorolfine 5% nail lacquer once or twice weekly for up to 6 months produced mycological and clinical cure in approximately 40 to 55% of patients with mild onychomycosis 3 months after cessation of therapy. Overall cure and improvement was observed in approximately 85 to 90% of patients with superficial dermatomycoses following treatment with amorolfine 0.25% cream for up to 6 weeks. However, few controlled, comparative trials are available for these different mycoses, and only small numbers of patients have been evaluated to date. Both preparations appear to be well tolerated; only minor localised adverse events have been reported in clinical trials. At present, the major potential indication for topical amorolfine appears to be onychomycosis. Within this clinical setting, amorolfine should be reserved for patients with mild infection without nail matrix involvement. Systemic therapy, however, remains essential for patients with severe intractable onychomycosis involving the nail bed. Evidence to date does not clarify whether the use of adjuvant topical amorolfine reduces the need for systemic therapy in patients with severely infected nails, or whether amorolfine is beneficial in individuals unresponsive to other treatment options.

Animals↗

PubMed2000

Use of lufenuron for treating fungal infections of dogs and cats: 297 cases (1997-1999).

OBJECTIVE: To evaluate use of lufenuron for treating cutaneous fungal infections in dogs and cats. DESIGN: Retrospective study. ANIMALS: 156 dogs and 201 cats with dermatophytosis or superficial dermatomycoses. PROCEDURE: Medical records were reviewed for dogs and cats that had been treated for dermatophytosis or other fungal infections by administration of lufenuron and 18 dogs and 42 cats that were not treated and served as a control group. RESULTS: Dogs were treated once by oral administration of lufenuron tablets at doses ranging from 54.2 to 68.3 mg/kg (24.6 to 31.0 mg/lb) of body weight. Samples of skin, scrapings, and hair were obtained daily from 14 dogs with dermatophytosis; mean durations from time of treatment to time of negative fungal culture results and resolution of gross lesions were 14.5 and 20.75 days, respectively. In all treated dogs, gross lesions resolved within approximately 21 days. Cats were treated once by oral administration of lufenuron suspension in doses ranging from 51.2 to 266 mg/kg (23.3 to 120.9 mg/lb). Samples were obtained daily from 23 cats; mean durations from time of treatment to time of negative fungal culture results and resolution of gross lesions were 8.3 and 12 days, respectively. Time to resolution of lesions in most untreated control animals was approximately 90 days. Adverse effects of treatment were not detected. CONCLUSIONS AND CLINICAL RELEVANCE: Results of this study suggest that lufenuron provides an effective, convenient, and rapid method for treating fungal infections in dogs and cats.

Administration, Oral↗

PubMed2001

[1997 Epidemiological survey of dermatophytoses in Japan].

An epidemiological investigation on dermatophytoses in Japan for the year 1997 was carried out with the following results. The number of dermatomycoses patients visiting the fourteen cooperating institutes that year was 8,284. New outpatients with this condition accounted for 13.3% of all new outpatients in these institutes. Dermatophytoses patients numbered 7,314 and were composed of: tinea pedis 4,901 (63.8%), tinea unguium 1,592 (20.7%), tinea corporis 557 (7.2%), tinea cruris 395 (5.1%), tinea manuum 215 (2.8%), tinea capitis 12, kerion celsi 3, tinea barbae 1 and granuloma trichophyticum 1. Of these, 117 were children under 15 years of age. Species and incidences of the 2,273 strains isolated from the patients with dermatophytoses were as follows: Trichophyton (T.) rubrum 1,628 (71.6%), T. mentagrophytes 617 (27.2%), Epidermophyton floccosum 9 (0.4%), Microsporum (M.) canis 2, M. gypseum 2, T. glabrum 1, and 15 undetermined strains. Candidiasis was found in 714 individuals: intertrigo 302, erosio interdigitalis 108, erythema infantum 85, oral candidiasis 51, paronychia et onychia 51, genital candidiasis 50, onychomycosis 15 and other atypical forms of candidiasis 39. Patients with tinea versicolor numbered 242 and those with malassezia folliculitis 15. There were nine cases of deep dermal mycoses. The results of superficial dermatophytoses for the year 1997 differed from those of 1991-92 in the following points: tinea corporis and tinea cruris were lower in number, while tinea unguium had increased in ratio and number continuously. M. canis infection tended to decrease. In the age distribution of tinea, in every clinical form the peak of distribution curve gradually shifted to a more elderly age group.

Adolescent↗

PubMed2002

[Dermatophyte flora at the dermatology clinic of Kimitsu Chuo Hospital from 1994 through 1999].

Kimitsu Chuo Hospital is located in the middle of Chiba Prefecture along Tokyo Bay. An epidemiological survey of dermatophytosis was made at the dermatology clinic of the hospital from January 1994 through December 1999. Dermatophytosis patients numbered 2,580 and disease types were composed of: tinea pedis 1,656 (64.2%), tinea unguium 377 (14.6%), tinea corporis 308 (11.9%), tinea cruris 139 (5.4%), tinea manuum 92 (3.6%), tinea capitis 6 (0.2%) and tinea profunda 2 (0.1%). Species frequencies in the 1,610 strains isolated from these patients were as follows: 929 (57.7%) of Trichophyton rubrum, 651 (40.4%) of T. mentagrophytes, 9 (0.6%) of Microsporum gypseum, 8 (0.5%) of M. canis, 8 (0.5%) of Epidermophyton floccosum and 5 (0.3%) of T. violaceum. The ratio of T.R/T.M was 1.43 in all the isolates, and 0.81 in the isolates from tinea pedis. These ratios were lower than those of the epidemiological survey of dermatomycoses in Japan in 1997. T. mentagrophytes was characteristically dominant in this hospital and resulted from a drastic increase in tinea pedis caused by this species in the summer season.

Adolescent↗

PubMed1979

[Seasonal dynamics in the occurrence of bovine trichophytosis and human dermatomycosis in Czechoslovakia].

The occurrence of the outbreaks of bovine trichophytosis and numbers of people affected by this disease in the Czech Socialist Republic were studied in 1966 to 1977. The effectiveness of the preventive and therapeutic measures against the causative agents of the disease is proved by a marked drop of the number of outbreaks in all months in the mentioned period. The greatest drop was in March (74.9) and April (70.1 annually) and lowest in June to August (24.6 to 27.8 annually). Despite the drop of the number of trichophytosis outbreaks, the number of ill animals slightly rose (+402 heads). The slow decrease of the number of trichophytosis outbreaks in summer requires more intensive therapeutic and preventive activity. Summer emptying of stables, supporting the devitalization of dermatophytes, should be used in the sanitation of the houses. The highest monthly seasonal indices of bovine trichophytosis were found in May and April (more than 13% above the annual average), and the lowest in December (23% below the average) and in November (12.5% below the average). The seasonal occurrence of dermatomycoses in man does not coincide with the seasonal occurrence of the disease in cattle. The seasonal index is at its maximum in winter (January-March), reaching 13-15% above the average. The lowest value of the seasonal index was found in August (20% below the long-term average).

Animals↗

PubMed2000

[1996 epidemiological survey of dermatophytoses in Japan. Epidemiological Investigation Committee for Human Mycoses in the Japanese Society for Medical Mycology].

An epidemiological investigation on dermatophytoses in Japan for the year 1996 was carried out with the following results. The number of dermatomycoses patients visiting the fifteen cooperating institutes that year was 8,402. New outpatients with this condition accounted for 13.1% of all new outpatients in these institutes. Dermatophytoses patients numbered 7,395 and were composed of: tinea pedis 4,764 (64.4%), tinea unguium 1,487 (20.1%), tinea corporis 558 (7.5%), tinea cruris 369 (5.0%), tinea manuum 195 (2.6%), tinea capitis 11, kerion Celsi 7, tinea barbae 1 and other forms 3. Of these, 113 were children under 15 years of age. Species and incidences of the 2,615 strains isolated from the patients with dermatophytoses were as follows: Trichophyton (T.) rubrum 1,828 (69. 9%), T. mentagrophytes 743 (28.4%) Epidermophyton floccosum 20 (0. 8%), Microsporum (M.) canis 13 (0.5%), M. gypseum 5, T. violaceum 2, and 4 undetermined strains. Candidiasis was found in 722 individuals: intertrigo 299, erosio interdigitalis 95, erythema infantum 89, oral candidiasis 63, paronychia et onychia 56, genital candidiasis 56, onychomycosis 24, chronic mucocutaneous candidiasis 1 and other atypical forms of candidiasis 39. Patients with tinea versicolor numbered 265 and those with Malassezia folliculitis 15. There were five cases of deep dermal mycoses: three of sporotrichosis, one of chromomycosis and one of aspergillosis. The results of superficial dermatophytoses for the year 1996 differed from those of 1991-92 in the following points: Tinea corporis and tinea cruris were lower in number, while tinea unguium had increased in ratio and number. M. canis infection tended to decrease gradually. In the age-distribution of tinea, in every clinical form the peak of distribution curve shifted to a more elderly age group.

Adolescent↗

PubMed2000

[Molecular biological methods and their consequences in taxonomy and diagnosis of dermatophytes].

Trichophyton rubrum, T. mentagrophytes, T. verrucosum, Microsporum canis, M. gypseum and Epidermophyton flocoosum represent the cause of human dermatomycoses isolated most often at the University Hospital of Dermatology in Graz, Austria, between 1991 and 1998. So far, identification was mainly based on the cultivation of fungal isolates on special media as well as on the analysis of their microscopic characters. Restriction enzyme length polymorphisms (RFLPs) were now used to identify these human fungal parasites. For this purpose, internal transcribed spacers (ITS) which are located between ribosomal RNA genes have been amplified by using PCR and have afterwards been used to generate species specific RFLP patterns. By this method, a fast and reliable identification of these species was made possible. Nucleotide sequence data of this region not needed for identification have been worked out to show RFLPs in more detail.

Arthrodermataceae↗

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↗

PubMed2006

Mycetes and urban areas.

Mycetes are ubiquitous organisms that can cause mycoses in human and animals. The role of animals in the epidemiology of human mycoses in urban areas is multiform, but here will be discuss only two features: A) animals as vectors of mycoses and B) animal substrates as growth factor of pathogenic fungi. A) Animals as vectors of mycoses: this role is important as zoofilic dermatophytes are very important agents of zoonosis; the urban dermatophytozoonoses are prevalent caused by Microsporum canis which is prevalent in cats and dogs. Cats are often asymptomatic carriers. The pattern of human dermatomycoses has changed in Italy during the past century: at the beginning of the century anthropophilic fungi were prevalent while at present the zoophilic fungi are the most important causes. B) Animal substrata as growth factor of pathogenic fungi: soil "animalization" (i.e., the addition of such debris as hair, skin scales, dropping and other organic matters) creates an optimal substratum for the growth and the multiplication of geophilic or saprophyitic fungi, such as Microsporum gypseum and Cryptococcus neoformans. The present human lifestyle, which favours a an overpopulation of birds, wild animals, domestic mammals and sinanthropic together with man in crowded areas seems to favour the formation of environments adapted to the abundant growth of some pathogenic fungi with consequent infection for man and animals. Finally, an environment heavily populated by fungi can cause allergic pulmonary reactions as well as reactions in other organs and tissues. The control of human and animal fungi, and the efficient use of a monitoring system require ample knowledge of mycological problems both in human and veterinary medicine and of efficient laboratories capable of resolving the needs of both disciplines. Close collaboration between veterinarians, doctors and mycologists is necessary in order to resolve health problems linked to mycosis.

Animals↗