An overview: the changing face of cutaneous infections and infestations

Tinea capitis by Microsporum canis in a 3-year-old girl with palmoplantar pustular id reaction

Dermatophytid skin eruption involving a delayed hypersensitivity reaction. It is triggered by a distant dermatophyte infection. It is most frequent in adult tinea pedis but also occurs in tinea corporis and tinea cruris. Tinea capitis, one of the most frequent pediatric skin infections, is rarely reported to cause an id reaction. Herein, we describe a case of palmoplantar, pustular dermatophytid associated with kerion caused by Microsporum (M.) canis.

The changing face of Microsporum spp infections

Significant changes in epidemiology, etiology, and the clinical pattern of mycotic infections caused by Microsporum spp have been observed in recent years. Fungal infections caused by M canis, followed by M gypseum and M hominis, involving skin and its appendages, represent one of the most common diseases worldwide and a recalcitrant problem in dermatology that demands appropriate diagnostic and treatment strategies. The most striking clinical phenomena of superficial and kerion and other forms of tinea, such as tinea capitis, fungal infections of the glabrous skin (tinea pedis, manus, cruris et corporis), and even onychomycosis due to Microsporum spp are described, with emphasis on the changes that have occurred in the last decade. The data on significant differences in the prevalence and clinical pattern of the fungal skin infections caused by Microsporum spp today compared with the data at the beginning of the epidemic breakout might still be rather controversial, depending also on the patients' lifestyle and geography. In general, physicians should be aware of the clinical spectrum of mycotic infections due to Microsporum spp to avoid mistakes in identifying the fungal etiology and to provide patients with the proper therapy.