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Martínez-Ortega JI, Ramirez Cibrian AG, Fernández-Reyna I, Atoche Dieguez CE. Tinea Capitis Kerion Type in Three Siblings Caused by Nannizzia Gypsea. Cureus 2024; 16:e55485. [PMID: 38571824 PMCID: PMC10988543 DOI: 10.7759/cureus.55485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 04/05/2024] Open
Abstract
This case report describes a rare occurrence of tinea capitis kerion type caused by Nannizzia gypsea in three siblings. The clinical presentation included pseudo-alopecic plaques with a dirty appearance, erythema, and honey-like crusts. A direct examination revealed ecto-endothrix parasitization in the hair shaft. Shared use of a comb among the siblings was suspected as the mode of transmission. Treatment with oral terbinafine resulted in a complete resolution. Systematic epidemiological surveys on N. gypsea tinea infections are scarce, and preliminary data from our center indicated a higher prevalence. The literature review identified five reported cases of N. gypsea-induced tinea capitis.
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Pendones-Ulerio J, Martins-Lopes M, García-Garrote F, Hernández-Calvo P, Yuste-Chaves M, Gutiérrez-Zufiaurre MN. Ringworm by Nannizzia nana: Clinical case and literature review. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:501-504. [PMID: 36931920 DOI: 10.1016/j.eimce.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 03/17/2023]
Abstract
INTRODUCTION Human dermatophytoses are the most widespread infections caused by fungi. These are capable of invading the keratin-containing tissues of animals. Nannizzia nana (N. nana) can cause ringworm in pigs and rarely cause infections in humans. METHODS We conducted a search using PUBMED for articles published from January 1, 1990 to March 31, 2022 to identify additional cases. The search terms used were "Microsporum nanum" and "Nannizzia nana". RESULTS After reviewing the literature, we identified a total of 16 cases of dermatophytosis due to N. nana since 1990. In most of the patients, the clinical diagnosis was tinea corporis and the most widely used antifungals were: terbinafine and griseofulvin. CONCLUSION N. nana is a dermatophyte species isolated infrequently in humans, but it represents a potential source of dermatophytosis in people who come into direct or indirect contact with animals and soil.
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Affiliation(s)
- Josué Pendones-Ulerio
- Servicio de Microbiología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
| | - Monica Martins-Lopes
- Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Fernando García-Garrote
- Servicio de Microbiología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Paula Hernández-Calvo
- Servicio de Microbiología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Manuela Yuste-Chaves
- Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
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Wu X, Shen M, Wang H, He X, Tan J, Wang R, Yang L, Yang H, Qi J, Chen Z, Zhu Q. Evaluation of the efficacy and safety of ionic liquids containing ketoconazole in patients with tinea pedis: A randomized controlled clinical trial. Bioeng Transl Med 2022; 8:e10463. [DOI: 10.1002/btm2.10463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/21/2022] [Accepted: 11/23/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Xiying Wu
- Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
- School of Pharmacy Fudan University Shanghai China
| | - Min Shen
- Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Huan Wang
- School of Pharmacy Naval Medical University Shanghai China
| | - Xue He
- Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Jingwen Tan
- Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Ruiping Wang
- Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Lianjuan Yang
- Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Hong Yang
- Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Jianping Qi
- Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
- School of Pharmacy Fudan University Shanghai China
| | - Zhongjian Chen
- Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Quangang Zhu
- Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
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Pendones-Ulerio J, Martins-Lopes M, García-Garrote F, Hernández-Calvo P, Yuste-Chaves M, Gutiérrez-Zufiaurre MN. Tiña por Nannizzia nana: caso clínico y revisión bibliográfica. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Segal E, Elad D. Human and Zoonotic Dermatophytoses: Epidemiological Aspects. Front Microbiol 2021; 12:713532. [PMID: 34421872 PMCID: PMC8378940 DOI: 10.3389/fmicb.2021.713532] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/09/2021] [Indexed: 12/30/2022] Open
Abstract
Introduction Dermatophytes are a group of molds characterized by the ability to produce keratinases, thereby carving out for themselves specific ecological niches. Their traditional division into three genera, Trichophyton, Microsporum, and Epidermophyton has been expanded to nine and the species in each genus were modified. Dermatophytes are among the most prevalent causes of human and animal mycoses. Their epidemiology is influenced by various factors. These factors may be evolutive such as the predilected environment of the fungus, namely, humans (anthropophilic), animals (zoophilic), or environment (geophilic), is evolutionary and thus may require centuries to develop. Many other factors, however, result from a variety of causes, affecting the epidemiology of dermatophytoses within a shorter time frame. Objective This review aims at summarizing the factors that have modified the epidemiology of dermatophytoses during the last decades. Results Geographic and climatic conditions, demography such as age and gender, migration, socio-economic conditions, lifestyle, and the environment have had an impact on changes in the epidemiology of dermatophytoses, as have changes in the pattern of human interaction with animals, including pets, farm, and wild animals. A typical example of such changes is the increased prevalence of Trichophyton tonsurans, which spread from Latin America to the United States and subsequently becoming a frequent etiological agent of tinea capitis in Africa, Middle East, and other areas. Conclusion The comprehension of the epidemiology of dermatophytoses has a major bearing on their prevention and treatment. Since it is undergoing continuous changes, periodic assessments of the most recent developments of this topic are required. This article aims at providing such an overview.
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Affiliation(s)
- Esther Segal
- Sackler School of Medicine, Department of Clinical Microbiology and Immunology, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Elad
- Department of Clinical Bacteriology and Mycology, Kimron Veterinary Institute, Bet Dagan, Israel
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Santana AE, Sellera FP, de Oliveira Costa M. Letter in response to the article: "Nannizzia incurvata as a rare cause of favus and tinea corporis in Cambodia and Vietnam". Indian J Dermatol Venereol Leprol 2021; 87:530-531. [PMID: 34219439 DOI: 10.25259/ijdvl_984_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Aline Elisa Santana
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Fábio Parra Sellera
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Matheus de Oliveira Costa
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Sharma B, Nonzom S. Superficial mycoses, a matter of concern: Global and Indian scenario-an updated analysis. Mycoses 2021; 64:890-908. [PMID: 33665915 DOI: 10.1111/myc.13264] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 01/19/2023]
Abstract
Superficial mycoses of skin, nails and hair are among the common fungal infections. They are caused by dermatophytes, non-dermatophyte moulds, yeasts and yeast-like fungi. Such fungal infections are widespread all over the world and are predominant in tropical as well as subtropical regions. Environmental factors, such as warm, humid and pitiable hygienic conditions, are conducive for their growth and proliferation. Although it does not cause mortality, it is known to be associated with excessive morbidity which may be psychological or physical. This affects the quality of life of the infected individuals which leads to a negative impact on their occupational, emotional and social status. Such infections are increasing on a global scale and, therefore, are of serious concern worldwide. This review article covers the global and Indian scenario of superficial mycoses taking into account the historical background, aetiological agents, prevalence, cultural and environmental factors, risk factors, pathogenesis and hygienic practices for the prevention of superficial mycoses.
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Affiliation(s)
- Bharti Sharma
- Department of Botany, University of Jammu, Jammu, Jammu and Kashmir, India
| | - Skarma Nonzom
- Department of Botany, University of Jammu, Jammu, Jammu and Kashmir, India
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Porras-López C, Martínez-Herrera E, Frías-De-León MG, Moreno-Coutiño G, Del Rocío Reyes-Montes M, Arenas R, González-Cespón JL, Rodríguez-Cerdeira C. Dermatophytosis caused by Nannizzia nana. J Mycol Med 2020; 31:101047. [PMID: 33087307 DOI: 10.1016/j.mycmed.2020.101047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE In this paper, we reported three distinct cases of tinea, including tenia ungulum, tenia pedis, and tenia cruris caused by the infection of Nannizzia nana in the immunocompetent patients who were also the residents of Guatemala. Dermatophytes were identified phenotypically and genotypically. Thereafter, DNA was extracted from the fungal isolates and a fragment of the ITS1-5.8S-ITS2 region was amplified and sequenced. The direct visual examination revealed the presence of fungal hyphae and arthroconidia. These characteristic morphological features resembled with the general features of the species, Nannizzia nana. Furthermore, nucleotide sequences that were amplified from the fungal isolates, confirmed the species identification. Thereafter, all the patients were treated with Terbinafine (250mg) through oral route for two weeks, except the patient with onychomycosis, who received the same treatment but for an extended period of three months. All the patients showed complete recovery from dermatophytosis. This study contributes to a better understanding of the epidemiology of human infections that are caused by dermatophytes, often misdiagnosed. Dermatophytes are currently less known but are now being more frequently identified due to the improvements in the diagnostic techniques.
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Affiliation(s)
- C Porras-López
- Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala; Psychodermatology task force of the Ibero-Latin American College of Dermatology (CILAD), Buenos Aires, Argentina
| | - E Martínez-Herrera
- Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Mexico; Psychodermatology task force of the Ibero-Latin American College of Dermatology (CILAD), Buenos Aires, Argentina; European Women's Dermatologic and Venereologic Society (EWDVS), Tui, Spain
| | - M G Frías-De-León
- Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Mexico; European Women's Dermatologic and Venereologic Society (EWDVS), Tui, Spain
| | - G Moreno-Coutiño
- Psychodermatology task force of the Ibero-Latin American College of Dermatology (CILAD), Buenos Aires, Argentina; Sección de Micología, Hospital General "Dr. Manuel Gea González" Ciudad de México, Mexico
| | | | - R Arenas
- Psychodermatology task force of the Ibero-Latin American College of Dermatology (CILAD), Buenos Aires, Argentina; Sección de Micología, Hospital General "Dr. Manuel Gea González" Ciudad de México, Mexico; Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Health Research Institute, SERGAS-UVIGO, Vigo, Spain
| | - J L González-Cespón
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Health Research Institute, SERGAS-UVIGO, Vigo, Spain
| | - C Rodríguez-Cerdeira
- Psychodermatology task force of the Ibero-Latin American College of Dermatology (CILAD), Buenos Aires, Argentina; European Women's Dermatologic and Venereologic Society (EWDVS), Tui, Spain; Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Health Research Institute, SERGAS-UVIGO, Vigo, Spain; Dermatology Department, Hospital do Meixoeiro and University of Vigo, 36200 Vigo, Spain.
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Leung AK, Lam JM, Leong KF, Hon KL. Tinea corporis: an updated review. Drugs Context 2020; 9:dic-2020-5-6. [PMID: 32742295 PMCID: PMC7375854 DOI: 10.7573/dic.2020-5-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/18/2020] [Accepted: 06/25/2020] [Indexed: 02/07/2023] Open
Abstract
Background Tinea corporis is a common fungal infection that mimics many other annular lesions. Physicians must familiarize themselves with this condition and its treatment. Objective This article aimed to provide a narrative updated review on the evaluation, diagnosis, and treatment of tinea corporis. Methods A PubMed search was performed with Clinical Queries using the key term ‘tinea corporis.’ The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies, and reviews. The search was restricted to the English language. The information retrieved from the mentioned search was used in the compilation of the present article. Results Tinea corporis typically presents as a well-demarcated, sharply circumscribed, oval or circular, mildly erythematous, scaly patch or plaque with a raised leading edge. Mild pruritus is common. The diagnosis is often clinical but can be difficult with prior use of medications, such as calcineurin inhibitors or corticosteroids. Dermoscopy is a useful and non-invasive diagnostic tool. If necessary, the diagnosis can be confirmed by microscopic examination of potassium hydroxide wet-mount preparations of skin scrapings from the active border of the lesion. Fungal culture is the gold standard to diagnose dermatophytosis especially if the diagnosis is in doubt and results of other tests are inconclusive or the infection is widespread, severe, or resistant to treatment. The standard treatment of tinea corporis is with topical antifungals. Systemic antifungal treatment is indicated if the lesion is multiple, extensive, deep, recurrent, chronic, or unresponsive to topical antifungal treatment, or if the patient is immunodeficient. Conclusion The diagnosis of tinea corporis is usually clinical and should pose no problem to the physician provided the lesion is typical. However, many clinical variants of tinea corporis exist, rendering the diagnosis difficult especially with prior use of medications, such as calcineurin inhibitors or corticosteroids. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made and appropriate treatment initiated.
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Affiliation(s)
- Alexander Kc Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Joseph M Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kin Fon Leong
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong
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Gnat S, Łagowski D, Nowakiewicz A, Dyląg M. Unusual dermatomycoses caused by Nannizzia nana: the geophilic origin of human infections. Infection 2020; 48:429-434. [PMID: 32232786 PMCID: PMC7256082 DOI: 10.1007/s15010-020-01416-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/23/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fungal infections of the skin, hair, and nails are the largest and most widespread group of all mycoses. Nannizzia nana is a relatively rare etiological factor of dermatomycosis in humans, as it usually affects animals, e.g. pigs and boars. In addition to the zoophilic nature, there are also reports of the geophilic reservoir of this dermatophyte species. OBJECTIVE In this study, we present symptomatic infections with N. nana aetiology in humans reported recently in Poland. Interestingly, these cases had a non-specific clinical picture and occurred as skin lesions on the neck and foot as well as onychomycosis of the toenails. From the medical history, the patients had no contact with pigs. METHODS Diagnostics of these infections was performed with a combination of classical phenotypic and molecular genomic methods. The genomic diversity of the isolates was determined using the MP-PCR method. In vitro antifungal susceptibility tests against itraconazole, ketoconazole, terbinafine and naftifine hydrochloride were also performed. RESULTS Nannizzia nana has been identified as an etiological factor of dermatomycosis. Moreover, heterogeneity of the genomes was revealed for the obtained strains. In vitro activities of antifungal agents showed that isolates were susceptible to all tested drugs. The patients were treated with oral terbinafine and topical ketoconazole cream, which led to a complete recovery. CONCLUSIONS In conclusion, the cases studied by us may indicate that the infrequency of N. nana infections may not necessarily be related to the low infectivity of this fungal agent, but they are rather associated with misdiagnosis. Furthermore, N. nana reservoirs should also be sought in soil.
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Affiliation(s)
- Sebastian Gnat
- Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Institute of Biological Bases of Animal Diseases, University of Life Sciences in Lublin, Akademicka 12, 20-033, Lublin, Poland.
| | - Dominik Łagowski
- Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Institute of Biological Bases of Animal Diseases, University of Life Sciences in Lublin, Akademicka 12, 20-033, Lublin, Poland
| | - Aneta Nowakiewicz
- Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Institute of Biological Bases of Animal Diseases, University of Life Sciences in Lublin, Akademicka 12, 20-033, Lublin, Poland
| | - Mariusz Dyląg
- Department of Mycology and Genetics, Faculty of Biological Sciences, Institute of Genetics and Microbiology, University of Wroclaw, Przybyszewskiego 63/77, 51-148, Wroclaw, Poland
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Metin B, Heitman J. She Loves Me, She Loves Me Not: On the Dualistic Asexual/Sexual Nature of Dermatophyte Fungi. Mycopathologia 2019; 185:87-101. [PMID: 31578669 DOI: 10.1007/s11046-019-00390-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/23/2019] [Indexed: 12/17/2022]
Abstract
Dermatophytes are ascomycetous fungi whose sexuality is greatly influenced by their ecology. Sexual reproduction is ubiquitous among soil-related geophiles and some animal-associated zoophiles. In contrast, anthropophiles are generally present as a single mating type in the population and appear to reproduce asexually. In this article, the current knowledge on the sexuality of dermatophytes including reproduction modes, mating conditions, mating type distributions and the mating type (MAT) locus is presented in the context of revised taxonomy and discussed from an evolutionary perspective.
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Affiliation(s)
- Banu Metin
- Department of Food Engineering, Faculty of Engineering and Natural Sciences, Istanbul Sabahattin Zaim University, Halkali Cad, No: 2, Halkali, Kucukcekmece, 34303, Istanbul, Turkey.
| | - Joseph Heitman
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, 27710, USA
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