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Belmokhtar Z, Djaroud S, Matmour D, Merad Y. Atypical and Unpredictable Superficial Mycosis Presentations: A Narrative Review. J Fungi (Basel) 2024; 10:295. [PMID: 38667966 PMCID: PMC11051100 DOI: 10.3390/jof10040295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/07/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
While typically exhibiting characteristic features, fungal infections can sometimes present in an unusual context, having improbable localization (eyelid, face, or joint); mimicking other skin diseases such as eczema, psoriasis, or mycosis fungoides; and appearing with unexpected color, shape, or distribution. The emergence of such a challenging clinical picture is attributed to the complex interplay of host characteristics (hygiene and aging population), environment (climate change), advances in medical procedures, and agent factors (fungal resistance and species emergence). We aim to provide a better understanding of unusual epidemiological contexts and atypical manifestations of fungal superficial diseases, knowing that there is no pre-established clinical guide for these conditions. Thus, a literature examination was performed to provide a comprehensive analysis on rare and atypical superficial mycosis as well as an update on certain fungal clinical manifestations and their significance. The research and standard data extraction were performed using PubMed, Medline, Scopus, and EMBASE databases, and a total of 222 articles were identified. This review covers published research findings for the past six months.
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Affiliation(s)
- Zoubir Belmokhtar
- Department of Environmental Sciences, Faculty of Natural Sciences, Djilali Liabes University of Sidi-Bel-Abbes, Sidi Bel Abbes 22000, Algeria;
- Laboratory of Plant and Microbial Valorization (LP2VM), University of Science and Technology of Oran, Mohamed Boudiaf (USTOMB), Oran 31000, Algeria
| | - Samira Djaroud
- Department of Chemistry, Djilali Liabes University of Sidi-Bel-Abbes, Sidi Bel Abbes 22000, Algeria
| | - Derouicha Matmour
- Central Laboratory, Djilali Liabes University of Medicine of Sidi-Bel-Abbes, Sidi Bel Abbes 22000, Algeria
| | - Yassine Merad
- Central Laboratory, Djilali Liabes University of Medicine of Sidi-Bel-Abbes, Sidi Bel Abbes 22000, Algeria
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Song G, Zhang M, Kong X, Liu W, Liang G. Tinea Capitis in Children Younger than Two Years Old: A Retrospective Study and Treatment Recommendations. Mycopathologia 2023; 188:461-478. [PMID: 36581775 DOI: 10.1007/s11046-022-00703-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Tinea capitis (TC) is a dermatophytosis of the scalp and hair, which occurs less common in children younger than two years of age, and the data of TC in this age group are still unknown. OBJECTIVES We aimed to reveal the epidemiological, clinical and mycological characteristics of TC in children under two years old. METHODS We retrospectively analyzed all reported cases of TC in children in their first two years of life from 1991 to 2022, by searching PubMed, Embase, Web of Science, CNKI, Wanfang and Weipu databases. RESULTS A total of 47 articles involving 126 cases of pediatric TC were enrolled in this study. The sex ratio (M/F) was 1.28:1. The age of the children ranged from ten days old to two years old with a median age of three months. The main clinical manifestations were alopecic patches (40 cases, 31.7%) and scaling (39 cases, 31.0%) on the scalp, and 29 infants (23.0%) appeared kerion. The most common sources of contagion were animals (35 cases, 27.78%) and humans (31 cases, 24.60%). The leading pathogens were Microsporidium canis (64 cases, 50.79%), followed by Trichophyton violaceum (13 cases, 10.32%), T. mentagrophytes complex (12 cases, 9.52%) and T. tonsurans (10 cases, 7.94%). Ninety-five children (75.40%) were treated with systemic antifungal drugs and 22 patients (17.46%) were only treated with topical therapy. Except for 10 patients with unknown final prognosis, all the other cases were cured after treatment. There was one child (0.79%) relapsed after treatment with griseofulvin and one case (0.79%) presented with gastrointestinal symptoms from griseofulvin. CONCLUSION The principal clinical symptoms of TC in children less than two years old were alopecic patches and scaling. The top four pathogens were M. canis, T. violaceum, T. mentagrophytes complex and T. tonsurans. Oral treatment for pediatric TC had achieved good therapeutic effects, and topical therapy can be an alternative choice.
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Affiliation(s)
- Ge Song
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Meijie Zhang
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Xue Kong
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Weida Liu
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China.
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China.
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China.
| | - Guanzhao Liang
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China.
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China.
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China.
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Xiao YY, Zhou YB, Chao JJ, Ma L. Successful treatment of tinea capitis caused by Microsporum canis in a 23-day-old newborn with itraconazole pulse therapy and a review of the literature. Dermatol Ther 2021; 34:e15078. [PMID: 34327790 DOI: 10.1111/dth.15078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/06/2021] [Accepted: 07/26/2021] [Indexed: 12/01/2022]
Abstract
Although tinea capitis is common in children, but it is rare in newborns. It should be differentiated with neonatal lupus erythematosus, nummular eczema, psoriasis, seborrheic dermatitis, erythema annular centrifugum, annular urticaria, and annular erythema of infancy. Tinea capitis usually needs oral antifungal therapy, but the data of use in newborn is limited. Here, we report a case of tinea capitis caused by Microsporum canis in a 23-day-old female newborn. The patient was given itraconazole oral solution pulse therapy with an excellent outcome. Itraconazole oral solution pulse therapy may be a promising therapy for tinea capitis in infants, especially in newborns.
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Affiliation(s)
- Yuan Yuan Xiao
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ya Bin Zhou
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jin Jing Chao
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lin Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Lozano-Masdemont B, Carrasco-Fernández B, Polimón-Olabarrieta I, Durán-Valle M. Microsporum audouinii: un dermatofito causante de una tiña reemergente. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:785-787. [DOI: 10.1016/j.ad.2018.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 11/12/2018] [Accepted: 11/15/2018] [Indexed: 11/16/2022] Open
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Lozano-Masdemont B, Carrasco-Fernández B, Polimón-Olabarrieta I, Durán-Valle M. Microsporum audouinii: Re-Emergence of Ringworm Due to the Dermatophyte. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2018.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Brito-Santos F, Figueiredo-Carvalho MHG, Coelho RA, Sales A, Almeida-Paes R. Tinea Capitis by Microsporum audouinii: Case Reports and Review of Published Global Literature 2000-2016. Mycopathologia 2017; 182:1053-1060. [PMID: 28736794 DOI: 10.1007/s11046-017-0181-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/16/2017] [Indexed: 11/28/2022]
Abstract
Tinea capitis caused by Microsporum audouinii is reported herein from two Brazilian schoolchildren, which are brothers. Arthroconidia were evidenced on direct examination of scalp hair, and a fungus of the genus Microsporum was isolated from cultures of each patient. The isolated fungi were classified as M. audouinii by visualization of species-specific structures, including: pectinate hyphae, chlamydospores, and fusiform macroconidia, sterile growth with characteristic brown pigment in rice grains, and through DNA sequencing of the internal transcriber spacer region. Patients were refractory to ketoconazole, but the two cases had a satisfactory response to oral terbinafine. All M. audouinii infections described in this century were reviewed, and to our knowledge, this is the first literature description of this species from South America. Misidentification of M. audouinii with Microsporum canis can occur in this area, leading to erroneous data about the occurrence of this species.
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Affiliation(s)
- Fábio Brito-Santos
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Av. Brazil 4365 - Manguinhos, 21045-900, Rio de Janeiro, RJ, Brazil
| | | | - Rowena Alves Coelho
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Av. Brazil 4365 - Manguinhos, 21045-900, Rio de Janeiro, RJ, Brazil
| | - Anna Sales
- Souza Araujo Outpatient Clinics, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Rodrigo Almeida-Paes
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Av. Brazil 4365 - Manguinhos, 21045-900, Rio de Janeiro, RJ, Brazil.
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Zampella JG, Kwatra SG, Blanck J, Cohen B. Tinea in Tots: Cases and Literature Review of Oral Antifungal Treatment of Tinea Capitis in Children under 2 Years of Age. J Pediatr 2017; 183:12-18.e3. [PMID: 28088394 DOI: 10.1016/j.jpeds.2016.12.042] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/10/2016] [Accepted: 12/14/2016] [Indexed: 12/21/2022]
Affiliation(s)
- John G Zampella
- Department of Dermatology, Johns Hopkins University, Baltimore, MD.
| | - Shawn G Kwatra
- Department of Dermatology, Johns Hopkins University, Baltimore, MD
| | - Jaime Blanck
- Welch Library, Johns Hopkins University, Baltimore, MD
| | - Bernard Cohen
- Department of Dermatology, Johns Hopkins University, Baltimore, MD; Department of Dermatology, Division of Pediatric Dermatology, Johns Hopkins University, Baltimore, MD
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Fernandes S, Amaro C, da Luz Martins M, Inácio J, Araújo T, Vieira R, Silvestre MJ, Cardoso J. Kerion caused by Microsporum audouinii in a child. Med Mycol Case Rep 2013; 2:52-4. [PMID: 24432216 DOI: 10.1016/j.mmcr.2013.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 02/04/2013] [Accepted: 02/04/2013] [Indexed: 10/27/2022] Open
Abstract
Kerion celsi is rarely associated with Microsporum audouinii infection. We report the case of a 3-year-old girl with a kerion celsi caused by M. audouinii and successfully treated with oral terbinafine. Fungi identification was made by macro and microscopical colony morphology analyses and molecular (genotypic) studies.
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Affiliation(s)
- Sónia Fernandes
- Hospital Curry Cabral, Department of Dermatology and Venereology, Rua da Beneficência no. 8, Lisbon 1069-166, Portugal
| | - Cristina Amaro
- Hospital Curry Cabral, Department of Dermatology and Venereology, Rua da Beneficência no. 8, Lisbon 1069-166, Portugal
| | - Maria da Luz Martins
- Laboratório de Micologia, Medical Microbiology Unit, Instituto de Higiene e Medicina Tropical/CREM-Universidade Nova de Lisboa, Rua da Junqueira, Lisbon 1149-008, Portugal
| | - João Inácio
- Laboratório de Micologia, Medical Microbiology Unit, Instituto de Higiene e Medicina Tropical/CREM-Universidade Nova de Lisboa, Rua da Junqueira, Lisbon 1149-008, Portugal
| | - Teresa Araújo
- Hospital Curry Cabral, Clinical Pathology Department, Rua da Beneficência no. 8, Lisbon 1069-166, Portugal
| | - Raquel Vieira
- Hospital Curry Cabral, Department of Dermatology and Venereology, Rua da Beneficência no. 8, Lisbon 1069-166, Portugal
| | - Maria José Silvestre
- Hospital Curry Cabral, Clinical Pathology Department, Rua da Beneficência no. 8, Lisbon 1069-166, Portugal
| | - Jorge Cardoso
- Hospital Curry Cabral, Department of Dermatology and Venereology, Rua da Beneficência no. 8, Lisbon 1069-166, Portugal
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Zaraa I, Hawilo A, Aounallah A, Trojjet S, El Euch D, Mokni M, Ben Osman A. Inflammatory Tinea capitis: a 12-year study and a review of the literature. Mycoses 2012; 56:110-6. [PMID: 22757767 DOI: 10.1111/j.1439-0507.2012.02219.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Inflammatory Tinea capitis (TC) is a rare form of TC. The aim of this study was to review epidemiological, clinical and mycological profile of inflammatory TC. We present a retrospective study (1999-2010), enrolled all the cases of inflammatory TC observed at a referral hospital in the northern Tunisia. One hundred and twenty-one patients with inflammatory TC, 83 male patients (68.6%) and 38 female patients (31.4%) were enrolled. The mean age was about 8 years. A majority of TC (71.9%) were in patients lesser than 10 years of age. Positive family history and contact with animals were noted in seven and 35 cases respectively. Direct examination was positive in 110 cases (59 ectothrix, 51 endothrix) and positive cultures were obtained in 105 patients (49 Trichophyton violaceum, 31 Microsporum canis, 13 Trichophyton interdigitale complex, 12 Trichophyton verrucosum). Systemic treatment was carried out in 115 patients with griseofulvin, in one with terbinafine. A complete recovery was noted in 88 cases; and persistent alopecia in 28 cases. The inflammatory TC is rare, but more common in rural families. The disease mostly affected male genders (68.6%) and T. violaceum remains the common pathogen of inflammatory TC in northern Tunisia.
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Affiliation(s)
- Inès Zaraa
- Department of Dermatology, La Rabta Hospital Tunis, Tunisia University of Medicine, El Manar Faculty Tunis, Tunis, Tunisia.
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Atanasovski M, El Tal AK, Hamzavi F, Mehregan DA. Neonatal dermatophytosis: report of a case and review of the literature. Pediatr Dermatol 2011; 28:185-8. [PMID: 21504448 DOI: 10.1111/j.1525-1470.2010.01318.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Tinea capitis is a common fungal infection in children but rare among neonates. We present a case of a 3-week-old infant with multiple scalp lesions for 1 week. A diagnosis of tinea capitis due to Microsporum canis was made based on clinical morphology, Wood's lamp, and biopsy with a positive PAS stain. She was effectively treated with oral griseofulvin and ketoconazole shampoo.
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Rezusta A, Gilaberte Y, Betran A, Gene J, Querol I, Arias M, Revillo MJ. Tinea nigra: a rare imported infection. J Eur Acad Dermatol Venereol 2010; 24:89-91. [DOI: 10.1111/j.1468-3083.2009.03300.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Alopecia areata, the alleged autoimmune process leading to nonscarring hair loss, is not uncommon. It has been classified as an acquired cause of alopecia; however, recently it has been reported in the neonatal period. We report 4 cases of congenital alopecia areata with follow-up from 3 to 5 years. The diagnosis was made clinically in all cases. All patients had prolonged periods of quiescence of hair loss ranging from 6 to 24 months. Treatments used included minoxidil 2% and a range of topical steroids including hydrocortisone 1%, betamethasone valerate 0.05%, fluocinonide 0.05%, and clobetasol propionate 0.05%. The best regrowth observed resulted from the use of clobetasol propionate 0.05%, giving full regrowth in 50% of those treated. Alopecia areata can occur at all ages and, thus, can be classified as both an acquired and a congenital disorder resulting in hair loss.
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Affiliation(s)
- Patsy Lenane
- Dermatology Department, The Hospital for Sick Children, Toronto, Ontario, Canada
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