SUPERFICIAL FUNGUS DISEASES-- DIAGNOSIS AND TREATMENT.
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Antifungal Agents↗
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TREATMENT OF FUNGUS INFECTIONS WITH MICROCRYSTALLINE GRISEOFULVIN.
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Fungi↗
[Dermatomycoses observed at the Dermatologic Clinic, Pavia University. 2) Pathology of Microsporum gypseum].
Microsporum gypseum infections are 0.4% of 4900 suspected dermatomycoses examined with direct microscopic exam and culture on Lactrimel medium or D.T.M. This geophilic dermatophyte was isolated in 20 cases (1.5% of all dermatophytes). More frequently M. gypseum caused tinea corporis (13 cases: 65%) and rarely tinea capitis (2 cases: 10%), tinea faciei (2 cases), tinea manus (2 cases) and tinea cruris (1 case). Both sexes are equally affected. Direct microscopic exam was negative in 2 cases. This dermatophyte was more frequently isolated during the summer and fall. Finally M. gypseum was not isolated in tinea pedis and tinea unguium.
Academic Medical Centers↗
Occurrence of Trichophyton tonsurans infections in the Danish island of Funen.
During the period from 1977 to 1980 eleven cases of T. tonsurans infections were diagnosed in the Mycology Laboratory, Department of Dermatology and Venereology, Odense University Hospital, Denmark. All patients were adults and none had tinea capitis. Five patients had tinea pedis, 5 tinea ungvium, 2 tinea cruris, one tinea manuum, and one tinea glabrosa.
Adult↗
Dermatophytoses among school children in Aba, Abia State--Nigeria and some physiological studies on the isolated etiologic agents.
A total of 1,136 school children comprising 433 males and 703 females, within the age groups 4 to 16 years and all resident in Aba municipal town of Abia State were examined for clinical signs of dermatophytoses. Out of this number examined 196 (17.3%), which included 108 males and 88 females, had clinical lesions on various parts of the body including the head, skin, finger nails and toe webs characteristic of dermatophytoses. While the infection occurred highest among children between the ages of 10 and 12 years, male children were significantly more infected than the females (P = 0.05). The most common type of the disease was tinea capitis (10.8%) followed by tinea corporis (5.8%). The dermatophytes identified included Trichophyton mentagrophytes (19.4%). T. tonsurans (12.3%), Microsporum audoninii (7.7%) and M. gypseum (2%). All the isolates grew well at both 25 degrees C and 37 degrees C but none survived at 45 degrees C. On solid media, all, with the exception of M. gypseum produced extracellular lipase enzyme while none produced lecithinase, deoxyribounclease and protease enzymes. Only T. tonsurans and T. mentagrophytes produced urease enzyme.
Adolescent↗
[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↗
[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↗
[Tinea faciei in a newborn].
Dermatophytosis in newborns and infants has been regarded as very unusual; a case recently observed of a 2-month-old child affected by tinea faciei is described. Twenty days before, localized erythematous infiltrated patches at the upper left eyelid and eyebrows with papules and pustules, were observed. Rarefaction of the eyebrows and partially loss of the eyelashes associated with scattered areas of erythematopapulous lesions on the face, were seen. Mycological examination was positive and trichophyton rubrum colonies grew. Tinea capitis is more common than tinea faciei in newborn and infants. Differential diagnosis includes: seborrheic dermatitis, atopic dermatitis with associated impetigo, candidiasis, bacterial folliculitis. The interhuman transmission by relatives is the most probable modality of trans-mission, as previously reported in the literature. A widespread of the dermatoses was due to previous application of topical corticosteroids. The lesions resolved completely after treatment with miconazole cream, applied twice daily for three weeks.
Age Factors↗
Common skin problems.
Dermatological problems manifesting as primary and secondary cutaneous complaints, constitute at least 30% of all outpatient visits to a pediatrician and 30% of all visits to dermatologists involve patients of pediatric age group. There is, however, a paucity of data about pediatric dermatoses in India, which has been reviewed to the extent possible. A brief account of common dermatological problems in India mainly infestations (pediculosis capitis, scabies) and infections (pyoderma, molluscum contagiosum, warts, herpes simplex infection, varicella, herpes zoster, tinea capitis and corporis, tinea versicolor, and candidiasis) has been given. At the end, common pediatric dermatological emergencies have been short-listed. Erythema multiforme and its variants and acrodermatitis enteropathica are discussed briefly.
Child↗
[Acquired effluvium of head hair: common conditions in women].
Acquired disorders of hair growth in women may present clinically either as effluvium or alopecia. The relevant pathologies include androgenetic alopecia, postpartum effluvium, tinea capitis, trichotillomania and alopecia areata.
Alopecia↗
Case report. Kerion Celsi effectively treated with terbinafine. Characteristics of kerion Celsi in the elderly in Japan.
A 75-year-old non-working male living in Sagamihara, Kanagawa Prefecture, had erythematous plaques with scales associated with follicular pustules in the head area extending from the occipital to right temporal regions about 1 month prior to his initial visit, when hair loss increased. The diagnosis was kerion Celsi. Trichophyton rubrum was isolated from scales and tissues taken from lesions in the head. Histopathological examinations showed irregular epidermal thickening with dense cell infiltration from the dermis to subcutaneous adipose tissues. Granulomatous reactions involving neutrophils, histiocytes and giant cells were seen mainly in the hair follicles. Periodic acid-Schiff (PAS) and Grocott-positive microbial elements were detected in the horny layer, and inside and outside the hair follicles. Pustules disappeared 1 week after starting the oral treatment with terbinafine (125 mg day-1). A cure was achieved 2 weeks after starting the treatment, with only slight scales remaining. No recurrence has been observed to date. Terbinafine was thought to be very effective and safe for kerion Celsi. We reviewed 27 cases of kerion Celsi reported in patients, aged at least 70 years, in Japan and found that the major characteristics of this disease in Japan include the following: (1) female cases outnumber male cases; (2) the causative organism was T. rubrum in 14 of 27 patients (51.9%); and (3) topical application of steroids often induces this disease in patients with superficial tinea capitis.
Administration, Oral↗
Basal-cell carcinomas on the scalp of a black patient many years after epilation by x rays.
The development of skin cancers in areas treated with X rays for benign dermatoses has not been common. Moreover, basal-cell carcinomas in blacks are exceedingly rare. We report successive development of two basal-cell carcinomas in the hair-covered scalp of a black man three decades after he had undergone epilation of the scalp by X rays of tinea capitis while a youth.
Black People↗
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.
Adolescent↗
Kerion Celsi in a newborn due to Microsporum canis.
The present study deals with a case of a 40-day-old girl with kerion Celsi caused by Microsporum canis. The source of the infection were the parents who presented tinea corporis caused by M. canis. Systemic treatment was carried out with terbinafine and complete recovery was achieved. Tinea capitis is unusual in children during their first year of life and its evolution towards kerion is very rare in newborns.
Female↗
Diagnosing the common alopecias.
Ample scalp biopsies, including subcutaneous fat, are easily obtained by excision or punch biopsy. Using a knowledge of normal hair patterns and histologic features, the physician can identify common baldness, trichotillomania, alopecia areata, discoid lupus erythematosus, lichen planopilaris, tinea capitis and follicular mucinosis. While hair loss is usually of more psychologic than physiologic significance, accurate diagnosis can be of great importance.
Alopecia↗
White variants of Trichophyton violaceum isolated in Ethiopia.
Certain dermatophytes are geographically restricted and endemic in particular parts of the world, while other species may have a sporadic but worldwide distribution. Trichophyton violaceum is one of the most common dermatophytes causing tinea capitis, and is the predominant cause of tinea in Africa, South America and the Indian subcontinent. Among 1187 dermatophyte isolates collected from Ethiopian patients with various types of tinea, 32 isolates had uncharacteristic phenotypic features. Based on conventional methods complemented by sequence analysis of the rDNA ITS2 region, these isolates were identified as white variants of T. violaceum. This is the first time that white isolates of T. violaceum have been identified in Ethiopia.
Adolescent↗
Common hair loss disorders.
Hair loss (alopecia) affects men and women of all ages and often significantly affects social and psychologic well-being. Although alopecia has several causes, a careful history, dose attention to the appearance of the hair loss, and a few simple studies can quickly narrow the potential diagnoses. Androgenetic alopecia, one of the most common forms of hair loss, usually has a specific pattern of temporal-frontal loss in men and central thinning in women. The U.S. Food and Drug Administration has approved topical minoxidil to treat men and women, with the addition of finasteride for men. Telogen effluvium is characterized by the loss of "handfuls" of hair, often following emotional or physical stressors. Alopecia areata, trichotillomania, traction alopecia, and tinea capitis have unique features on examination that aid in diagnosis. Treatment for these disorders and telogen effluvium focuses on resolution of the underlying cause.
Alopecia↗
Optimal management of hair loss (alopecia) in children.
Hair loss in children encompasses a wide range of conditions that can be congenital or acquired. A congenital hair abnormality may be an isolated finding in an otherwise healthy child or may exist as a feature of a clinical syndrome. A thorough understanding of basic hair biology and normal hair development enables accurate assessment of the child with hair loss. Knowledge of the normal range and variation observed in children's hair additionally enhances this assessment. Social and cultural factors also influence these norms. The psychological and cosmetic importance of hair is immense in our society. The clinical presentation of pediatric hair disorders ranges from subtle to disfiguring. Management of hair disorders requires a holistic approach to the child and family. Young children usually lack self-awareness and it may be the parent who, projecting their own concerns onto the child, most acutely feels any associated anxiety. In addition, parents of a child with an inherited hair condition often feel guilt, and siblings can develop unsupported fears that they may be affected. Hair loss for the older child can lead to low self-esteem, depression and humiliation. Congenital and hereditary hypotrichosis and hair shaft abnormalities often have no effective treatment. There is a variety of treatment options for alopecia areata and telogen effluvium, but no single treatment is 100% effective. Tinea capitis is an infective condition of the hair that responds readily to the appropriate medical therapy. If no effective treatment for the hair loss exists, cosmetic camouflage with wigs is the best option.
Alopecia↗