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Chen XQ, Yu J. Global Demographic Characteristics and Pathogen Spectrum of Tinea Capitis. Mycopathologia 2023; 188:433-447. [PMID: 37012556 DOI: 10.1007/s11046-023-00710-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/07/2023] [Indexed: 04/05/2023]
Abstract
Tinea capitis is an important superficial fungal infection with a global distribution. It mainly affects prepubertal children and is more common in males. Anthropophilic and zoophilic dermatophytes are responsible for most infections. The pathogen spectrum of tinea capitis varies across different regions and changes over time, and is influenced by multiple factors, such as economic development, changes in lifestyle, immigration and animal distribution. This review aimed to clarify the demographic and etiological characteristics of tinea capitis worldwide and determine the common trends of causative pathogens. By mainly analyzing the literature published from 2015 to 2022, we found that the incidence and demographic characteristics of tinea capitis remained generally stable. Zoophilic Microsporum canis, anthropophilic Trichophyton violaceum and Trichophyton tonsurans were the predominant pathogens. The pathogen spectra in different countries changed in different directions. In some countries, the main pathogen shifted to an anthropophilic dermatophyte, such as T. tonsurans, Microsporum audouinii or T. violaceum; in contrast, it shifted to a zoophilic agent, such as M. canis, in some other countries. Dermatologists are advised to continue monitoring the pathogen spectrum and implement preventive measures according to the reported changes.
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Affiliation(s)
- Xiao-Qing Chen
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing, China
- Department of Dermatology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Jin Yu
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing, China.
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Powell J, Porter E, Field S, O'Connell N, Carty K, Dunne CP. Epidemiology of dermatomycoses and onychomycoses in Ireland (2001 to 2020): A single-institution review. Mycoses 2022; 65:770-779. [PMID: 35598177 PMCID: PMC9327510 DOI: 10.1111/myc.13473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/19/2022] [Indexed: 12/01/2022]
Abstract
Background Fungal skin infections are recognised as one of the most common health disorders globally, and dermatophyte infections of the skin, hair and nails are the most common fungal infections. Dermatophytes can be classified as anthropophilic, zoophilic or geophilic species based on their primary habitat association, and this classification makes epidemiological analysis useful for the prevention and control of these infections. The Irish contribution to the epidemiology of these infections has been scant, with just two papers (both reporting paediatric tinea capitis only) published in the last 20 years, and none in the last seven. Objectives To perform a comprehensive retrospective epidemiological analysis of all dermatological mycology tests performed in University Hospital Limerick over a 20‐year period. Methods All mycology laboratory test results were extracted from the Laboratory Information Management System (LIMS, iLab, DXC Technologies) from 2001 to 2020 inclusive for analysis. Specimen types were categorised according to the site of sampling. The data were analysed using Microsoft Excel. Results About 12,951 specimens of skin, hair and nails were studied. Median patient age was 42 years (IQR 26–57) with a slight female preponderance (57.2%). Two thirds of samples (67%, n = 8633) were nail, 32% were skin scrapings (n = 4118) and 200 hair samples (1.5%) were received. Zoophilic dermatophytes were more commonly present in females (38% F, 23% M, proportion of dermatophytes) and in those under 10 years of age or from 45 to 70 years (36% and 34% zoophiles, respectively, proportion of dermatophytes), although anthropophiles predominated every age and gender category. Anthropophiles had their highest prevalence in the 10–20 years age category (80% anthropophiles, proportion of dermatophytes), and yeast infections were more prevalent in older patients (29% of >60 year olds vs. 17% of <60 year olds, proportion of all fungal positives). Trichophyton rubrum was the most prevalent pathogen detected, accounting for 53% of all dermatophytes detected, 61% of those detected from nail samples and 34% from skin and hair samples. Trichophyton tonsurans was the most prevalent dermatophyte in tinea capitis, accounting for 37% of dermatophytes detected. Both of these organisms are anthropophilic, and this group showed consistently increased prevalence in proportion to all fungal isolates. The proportion of this dermatophyte class (anthropophiles) increased among both nail samples and skin/hair samples during the study period, from 55% of samples in the first 5 years of the study (2001–2005) to 88% (proportion of dermatophytes) in the final 5 years. Conversely, yeast detection decreased. Conclusions This study provides a detailed overview of the epidemiology of the fungal cultures of skin, nail and hair samples in the Mid‐West of Ireland over a 20‐year period. Monitoring this changing landscape is important in identifying likely sources of infections, to identifying potential outbreaks, and may help guide empiric treatment. To the best of our knowledge, this study provides the first detailed analysis from Ireland of fungal detections from skin, hair and nail samples, and is the first epidemiological fungal report of any kind in over 7 years.
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Affiliation(s)
- James Powell
- Department of Microbiology, University Hospital Limerick, Limerick, Ireland.,School of Medicine and Centre for Interventions in Infection, Inflammation, and Immunity (4i), University of Limerick, Limerick, Ireland
| | - Emma Porter
- Department of Dermatology, University Hospital Limerick, Limerick, Ireland
| | - Sinead Field
- Department of Dermatology, University Hospital Limerick, Limerick, Ireland
| | - Nuala O'Connell
- Department of Microbiology, University Hospital Limerick, Limerick, Ireland.,School of Medicine and Centre for Interventions in Infection, Inflammation, and Immunity (4i), University of Limerick, Limerick, Ireland
| | - Kieran Carty
- Department of Microbiology, University Hospital Limerick, Limerick, Ireland
| | - Colum P Dunne
- School of Medicine and Centre for Interventions in Infection, Inflammation, and Immunity (4i), University of Limerick, Limerick, Ireland
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Feußner C, Karrer S, Lampl BMJ. An uncommon cause of tinea: Trichophyton violaceum in a German kindergarten - outbreak report and quantitative analysis of epidemiological data from Europe. GMS HYGIENE AND INFECTION CONTROL 2022; 17:Doc02. [PMID: 35284206 PMCID: PMC8899716 DOI: 10.3205/dgkh000405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Global mobility is increasingly associated with the emergence of "unusual" infectious agents. At the beginning of 2019, a putative outbreak of Impetigo contagiosa occurred in a kindergarten in Regensburg, Germany, that was mainly attended by children with a migrant background. After thorough examination, the outbreak was classified as infection with Trichophyton (T.) violaceum. Methods: Based on case investigations, infection control measures, disinfection, and cleaning were implemented. Microscopy of native specimens, fungal cultures, and polymerase chain reaction were used for diagnosis. Additionally, a systematic literature search in Medline, followed by a quantitative analysis of epidemiological data from Europe, were performed. Results: Between January and November 2019, 12 cases of tinea were diagnosed in 7 educators and 2 household members. Children were initially not affected. T. violaceum was only detected in 2 patients. No extensive screening measures were carried out after risk-benefit assessment. Studies on T. violaceum in Europe are heterogeneous, and the number of cases and the prevalence vary considerably. The pathogen is mainly found in children of African descent who clinically present with tinea capitis. Discussion: In the present case, the source of infection and the chain of transmission remained unclear. The pathogen could only be diagnosed in 2 cases. In Europe, the (re)emergence of pathogens such as T. violaceum is likely to be caused by increasing migration and travel. Pathogens should be identified for epidemiological reasons in all cases. In outbreaks, measures must be adapted to the dynamics of the individual outbreak after assessment of the risks, benefits, and proportionality.
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Affiliation(s)
| | - Sigrid Karrer
- Department of Dermatology, University Medical Center Regensburg, Regensburg, Germany
| | - Benedikt M. J. Lampl
- Regensburg Department of Public Health, Regensburg, Germany,Department of Epidemiology and Preventive Medicine, Faculty of Medicine, University of Regensburg, Regensburg, Germany,*To whom correspondence should be addressed: Benedikt M. J. Lampl, Regensburg Department of Public Health, Division of Infection Control and Prevention, Altmühlstr. 3, 93059 Regensburg, Germany, Phone: +49 941 4009 523, E-mail:
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Nowicka D, Nawrot U. Tinea pedis-An embarrassing problem for health and beauty-A narrative review. Mycoses 2021; 64:1140-1150. [PMID: 34145648 DOI: 10.1111/myc.13340] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 05/31/2021] [Indexed: 12/19/2022]
Abstract
Fungal infections present with a broad spectrum of diseases in humans (from relatively mild superficial infections of the skin and mucous membranes to the invasive or chronic infections of internal organs, which have a high mortality rate). Globally, up to 1.6 million people die each year as a result of various types of mycoses. Currently, many scientific studies focus on the best possible understanding of the aspects of the epidemiology and pathogenesis of invasive mycoses and effective methods to combat them. However, mycoses of the skin and its appendages remain a relatively less explored area. In some communities, superficial mycoses are a frequent problem as they affect nearly 70% of the population, an example of which is the athlete's foot. It involves the nails (onychomycosis) and skin (tinea pedis). It is mainly caused by keratin-decomposing dermatophyte fungi. Less often, infections are caused by non-dermatophyte moulds (Fusarium, Aspergillus, Scopulariopsis) or yeasts. Several factors have been listed as having substantial influence on the development of dermatophytosis, including those related to climate, season, geographical region, as well as to demography, socioeconomic and cultural customs, professions or contact with animals. In this review, we summarise the current knowledge about aetiology, epidemiology, diagnostics and therapy of tinea pedis with a special focus to the role of podologic management in spreading, prevention and therapy of mycoses. The article presents up-to-date knowledge on the management of the patient from the diagnosis, treatment and skincare, to counselling on how to prevent fungal skin infections in the long term.
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Affiliation(s)
- Danuta Nowicka
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
| | - Urszula Nawrot
- Department of Pharmaceutical Microbiology and Parasitology, Wroclaw Medical University, Wrocław, Poland
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Petrucelli MF, de Abreu MH, Cantelli BAM, Segura GG, Nishimura FG, Bitencourt TA, Marins M, Fachin AL. Epidemiology and Diagnostic Perspectives of Dermatophytoses. J Fungi (Basel) 2020; 6:E310. [PMID: 33238603 PMCID: PMC7712040 DOI: 10.3390/jof6040310] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 10/27/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022] Open
Abstract
Dermatophytoses affect about 25% of the world population, and the filamentous fungus Trichophyton rubrum is the main causative agent of this group of diseases. Dermatomycoses are caused by pathogenic fungi that generally trigger superficial infections and that feed on keratinized substrates such as skin, hair, and nails. However, there are an increasing number of reports describing dermatophytes that invade deep layers such as the dermis and hypodermis and that can cause deep infections in diabetic and immunocompromised patients, as well as in individuals with immunodeficiency. Despite the high incidence and importance of dermatophytes in clinical mycology, the diagnosis of this type of infection is not always accurate. The conventional methods most commonly used for mycological diagnosis are based on the identification of microbiological and biochemical features. However, in view of the limitations of these conventional methods, molecular diagnostic techniques are increasingly being used because of their higher sensitivity, specificity and rapidity and have become more accessible. The most widely used molecular techniques are conventional PCR, quantitative PCR, multiplex PCR, nested, PCR, PCR-RFLP, and PCR-ELISA. Another promising technique for the identification of microorganisms is the analysis of protein profiles by MALDI-TOF MS. Molecular techniques are promising but it is necessary to improve the quality and availability of the information in genomic and proteomic databases in order to streamline the use of bioinformatics in the identification of dermatophytes of clinical interest.
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Affiliation(s)
- Monise Fazolin Petrucelli
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Mariana Heinzen de Abreu
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Bruna Aline Michelotto Cantelli
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Gabriela Gonzalez Segura
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Felipe Garcia Nishimura
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Tamires Aparecida Bitencourt
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto SP 14049-900, Brazil
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto SP 14049-900, Brazil
| | - Mozart Marins
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
| | - Ana Lúcia Fachin
- Biotechnology Unit, Unaerp, Av. Costábile Romano, 2201, Ribeirão Preto SP 14096-900, Brazil; (M.F.P.); (M.H.d.A.); (B.A.M.C.); (G.G.S.); (F.G.N.); (T.A.B.); (M.M.)
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Rodríguez‐Cerdeira C, Martínez‐Herrera E, Szepietowski J, Pinto‐Almazán R, Frías‐De‐León M, Espinosa‐Hernández V, Chávez‐Gutiérrez E, García‐Salazar E, Vega‐Sánchez D, Arenas R, Hay R, Saunte D. A systematic review of worldwide data on tinea capitis: analysis of the last 20 years. J Eur Acad Dermatol Venereol 2020; 35:844-883. [DOI: 10.1111/jdv.16951] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 09/03/2020] [Indexed: 12/18/2022]
Affiliation(s)
- C. Rodríguez‐Cerdeira
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD) Health Research InstituteSERGAS‐UVIGO Vigo Spain
- Dermatology Department Hospital do Meixoeiro and University of Vigo Vigo Spain
- Psichodermatology Task for (CILAD) Buenos Aires Argentina
| | - E. Martínez‐Herrera
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD) Health Research InstituteSERGAS‐UVIGO Vigo Spain
- Psichodermatology Task for (CILAD) Buenos Aires Argentina
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - J.C. Szepietowski
- Department of Dermatology, Venereology and Allergology Wroclaw Medical University Wroclaw Poland
| | - R. Pinto‐Almazán
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - M.G. Frías‐De‐León
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - V.M. Espinosa‐Hernández
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - E. Chávez‐Gutiérrez
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - E. García‐Salazar
- Psichodermatology Task for (CILAD) Buenos Aires Argentina
- Unidad de Investigación Hospital Regional de Alta Especialidad de Ixtapaluca Ixtapaluca México
| | - D.C. Vega‐Sánchez
- Psichodermatology Task for (CILAD) Buenos Aires Argentina
- Sección de Micología Hospital General ‘Dr. Manuel Gea González’ Ciudad de México México
| | - R. Arenas
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD) Health Research InstituteSERGAS‐UVIGO Vigo Spain
- Psichodermatology Task for (CILAD) Buenos Aires Argentina
- Sección de Micología Hospital General ‘Dr. Manuel Gea González’ Ciudad de México México
| | - R. Hay
- St Johns Institute of Dermatology King's College London London UK
| | - D.M. Saunte
- Department of Dermatology Zealand University Hospital Roskilde Denmark
- Health Sciences Faculty University of Copenhagen Copenhagen Denmark
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Wang X, Ding C, Xu Y, Yu H, Zhang S, Yang C. Analysis on the pathogenic fungi in patients with superficial mycosis in the Northeastern China during 10 years. Exp Ther Med 2020; 20:281. [PMID: 33209125 PMCID: PMC7668139 DOI: 10.3892/etm.2020.9411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 09/25/2020] [Indexed: 12/15/2022] Open
Abstract
This study analyzed the infection of superficial mycosis and the relationship between the distribution characteristics of pathogenic fungi and age, time and sex in Northeast China in the past 10 years. We would like to provide a theoretical basis for the diagnosis and treatment of related diseases. From December 2008 to December 2018, 5,374 superficial mycoses from Northeast China were selected. The fungal species were identified by fungal microscopy, fungal culture, and species identification. Besides, the relationship between sex, age, time and the distribution of superficial mycosis and pathogenic fungi was analyzed. Among the 5,374 patients, the top three infections were tinea pedis (n=1,538, 28.62%), tinea cruris (n=1,018, 18.94%) and tinea corporis (n=938, 17.45%). The top three pathogens were Trichophyton rubrum (n=2,849, 48.65%), Trichophyton mentagrophytes (n=947, 16.14%) and Candida spp. (n=804, 13.70%). The main pathogenic fungi were dermatophytes. The age group with the highest incidence of tinea capitis was children (n=372, 6.92%). The highest incidence rate of tinea pedis was in 31-69-year adults (n=905, 16.84%); Malassezia mainly affects young people aged 15-30. Yeast and mold mostly invade the elderly patients >60 years old. The incidence of tinea cruris, tinea pedis and tinea corporis in male patients was higher than that in female patients. The incidence of onychomycosis in female patients was higher than that in male patients (P<0.05). The isolation rate of Candida, Mold, Microsporum canis, Malassezia and Sporothrix increased year by year, while that of Trichophyton rubrum, Trichophyton mentagrophyte, Trichophyton schoenleinii and Epidermophyton floccosum decreased. From December 2008 to December 2018, dermatophytes were the main pathogens of superficial mycosis in Northeast China. The distribution of disease species and pathogenic fungi varied in different gender, age and time.
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Affiliation(s)
- Xiufen Wang
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
| | - Changrui Ding
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
| | - Yulong Xu
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
| | - Haomiao Yu
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
| | - Songdi Zhang
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
| | - Cuiyun Yang
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang 161041, P.R. China
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