Dermatophytosis in northern Greece during the decade 1981-1990

Changing Epidemiology of Tinea Capitis in Athens, Greece: The Impact of Immigration and Review of Literature

Mass population movements have altered the epidemiology of tinea capitis (TC) in countries receiving refugees. Periodic monitoring of the local pathogen profiles may serve as a basis for both the selection of appropriate empirical antifungal therapy and the implementation of preventive actions. Therefore, we investigated the impact of an unprecedented immigration wave occurring in Greece since 2015 on the epidemiological trends of TC. All microbiologically confirmed TC cases diagnosed during the period 2012-2019 in a referral academic hospital for dermatological disorders in Athens, Greece, were retrospectively reviewed. A total of 583 patients were recorded, where 348 (60%) were male, 547 (94%) were children and 160 (27%) were immigrants from Balkan, Middle Eastern, Asian as well as African countries. The overall annual incidence of TC was 0.49, with a significant increase over the years (p = 0.007). M. canis was the predominant causative agent (74%), followed by T. violaceum (12%), T. tonsurans (7%) and other rare dermatophyte species (7%). M. canis prevalence decreased from 2014 to 2019 (84% to 67%, p = 0.021) in parallel with a three-fold increase in T. violaceum plus T. tonsurans rates (10% to 32%, p = 0.002). An increasing incidence of TC with a shift towards anthropophilic Trichophyton spp. in Greece could be linked to the immigration flows from different socioeconomic backgrounds.

Epidemiology of Dermatophytoses in Crete, Greece

Dermatophytoses are among the most frequently diagnosed skin infections worldwide. However, the distribution of pathogenic species and the predominating anatomical sites of infection vary with geographical location and change over time. The aim of this study was to determine the epidemiological and aetiological factors of dermatophytoses in Crete, Greece over the last 5-year period (2011-2015) and their incidence in relation to the gender and the age of the patients. We compared our findings with those previously reported from the same area and from other parts of the world. A total of 2,910 clinical specimens (skin scrapings, nail clippings, and hair specimens) obtained from 2,751 patients with signs of dermatomycoses were examined using direct microscopy and culture. Overall, 294 specimens (10.1%) were proved mycologically positive for dermatophytes. The age of the patients ranged from 2 to 86 years (mean age, 37 years). Tinea corporis was the predominant clinical type of infection, followed by tinea unguium, tinea pedis, tinea capitis, tinea faciei, tinea cruris and tinea manuum. Among dermatophytes, eight species were isolated: Microsporum canis (35.8%), Trichophyton rubrum (35.1%), Trichophyton mentagrophytes (23.3%), Epidermophyton floccosum (2.5%), Microsporum gypseum (1.8%), Trichophyton violaceum (0.7%), Trichophyton verrucosum (0.4%), and Trichophyton tonsurans (0.4%). In our area, the most common dermatophyte was M. canis followed by T. rubrum. Increased migration, mass tourism, and climate changes will contribute to further changes in the epidemiology of dermatophytoses in our area. Continuing studies are necessary for determining the new epidemiological trends and to implement the appropriate control measures.

Prevalence of Dermatophytic Infection and the Spectrum of Dermatophytes in Patients Attending a Tertiary Hospital in Addis Ababa, Ethiopia

Background. Dermatophytosis is common worldwide and continues to increase. Objective. This study was undertaken to determine the prevalence of dermatophytosis and the spectrum of ringworm fungi in patients attending a tertiary hospital. Methods. Samples were collected from 305 patients. A portion of each sample was examined microscopically and the remaining portion of each sample was cultured onto plates of Sabouraud's dextrose agar containing chloramphenicol with and without cycloheximide. Dermatophyte isolates were identified by studying macroscopic and microscopic characteristics of their colonies. Result. Of 305 samples, fungi were detected in 166 (54.4%) by KOH of which 95 were dermatophytes while 242 (79.4%) samples were culture positive of which 130 isolates were dermatophytes. Among dermatophyte isolates T. violaceum was the most common (37.7%) cause of infection. Tinea unguium was the predominant clinical manifestation accounting for 51.1% of the cases. Patients with age group 25–44 and 45–64 years were more affected. T. violaceum was the most common pathogen in tinea unguium and tinea capitis, whereas T. mentagrophytes was the most common pathogen in tinea pedis. Conclusion. Further intensive epidemiological studies of ring worm fungus induced dermatophytosis which have public health significance are needed.

Dermatophyte infections in the Ljubljana region, Slovenia, 1995-2002

We studied dermatophyte infections in patients, examined in the Mycological Laboratory of the Department of Dermatology, University Medical Centre Ljubljana during the period 1995-2002. A total of 42,494 samples were collected from 33,974 patients suspected to have dermatomycosis. Dermatophytes were identified in 8286 (71.2%) positive cultures. Microsporum canis was the most frequent dermatophyte isolated (46.8%), followed by Trichophyton rubrum (36.7%), T. mentagrophytes var. interdigitale (7.9%) and T. mentagrophytes var. mentagrophytes (4.9%). Less frequently isolated were M. gypseum, T. verrucosum, Epidermophyton floccosum, T. tonsurans and T. violaceum. The most common dermatophyte infections included tinea corporis, onychomycosis, tinea pedis and tinea faciei. Zoophilic dermatophytes were most commonly recovered from children and adolescents with tinea capitis, tinea corporis and tinea faciei. Anthropophilic species were identified mostly in adults with tinea pedis, onychomycosis and tinea inguinalis. During the period studied, we recorded a decline in the rate of M. canis infections, while infections produced by T. rubrum increased in frequency.

Dermatophytoses in Prague, Czech Republic, between 1987 and 1998

Over a 12-year period, from 1987 to 1998, the spectrum of aetiological agents isolated from 11208 patients (6265 females and 4943 males) suspected of having dermatomycosis was analysed in the mycological laboratory of the Department of Dermatology, Charles University, Prague. The most frequently examined locations were toenails (34.9%), feet (15.6%), fingernails (12.8%), toe webs (11%), trunk (10%) and hands (8.7%). Dermatophytes were isolated from 5605 (30.2%) of all 18528 samples examined. Among dermatophytes, the most common infectious agent was Trichophyton rubrum (90.2%) followed by Trichophyton mentagrophytes (6.6%), Microsporum canis (1.8%) and Epidermophyton floccosum (1.4%). Trichophyton verrucosum, Microsporum persicolor and Microsporum gypseum were rare. During this 12-year period the pattern of aetiological agents of dermatomycoses in Prague was relatively stable.

The aetiological agents of tinea capitis in Zaragoza (Spain)

Between 1977 and 1997, 190 cases of tinea capitis were observed. The age groups most commonly infected were 1-10 years old. The following dermatophytes were isolated: Microsporum canis (119), Trichophyton mentagrophytes (57), Trichophyton tonsurans (seven), Trichophyton verrucosum (three), Trichophyton violaceum (one), Trichophyton schoenleinii (one), Trichophyton soudanense (one) and Microsporum audouinii (one).

The frequency of tinea pedis in patients with tinea cruris in Tehran, Iran

The objective of this study is to define the frequency of tinea pedis in patients with tinea cruris. Sixty patients (46 males and 14 females) entered our study. Epidermophyton floccosum was the most frequently isolated fungus in tinea cruris. Four patients (6.4%) had concurrent tinea pedis and the only isolate from the foot was Trichophyton mentagrophytes. In three of them, the corresponding dermatophyte in the groin was E. floccosum.

Survey on the epidemiology of Microsporum canis infections in Crete, Greece over a 5-year period

BACKGROUND

Microsporum canis is a frequent cause of tinea capitis and tinea corporis in Europe and especially in the Mediterranean area. Objective This study was undertaken to examine the epidemiologic features of all cases of M. canis infections recorded in Crete, Greece, during a 5-year period (1994-1998).

METHODS

The epidemiology of 111 cases of dermatophytoses due to M. canis was analyzed according to the sex, age, origin of the infection, place of residence, body site affected, and seasonal progression.

RESULTS

M. canis constituted 24.5% of all dermatophytes isolated during the study period. Women were more frequently affected than men (54%), and infections were most prevalent in patients up to the age of 9 years (46.8%). Cats were identified as the commonest source of the infection (82%). As regarding the place of residence, most of the infected patients came from rural areas (64.9%). The commonest sites of M. canis infection (in decreasing order of frequency) were: the head, the lower extremities, the trunk, and the upper extremities. The greatest number of cases were seen in September and December.

CONCLUSIONS

The findings of the present study indicate that M. canis infections have gradually decreased in recent years in this geographic area. Eradication requires elimination of the natural source of the infection, represented mainly by stray animals.

A review of the epidemiology of tinea unguium in the community

Tinea unguium is a common, chronic fungal infection of the nails. Many epidemiological studies have looked at the frequency with which this condition is seen in hospital outpatients clinics or mycological laboratories along with other dermatomycoses. Only recently have studies begun to emerge looking at the prevalence of this condition in populations. Hospital and mycological laboratory-based studies give valuable information about tinea unguium prevalence in a particular clinic, but cannot be compared with other studies due to confounding factors inherent in the different people attending individual clinics. From population-based studies the prevalence of tinea unguium lies between 2 and 8%. Tinea unguium increases steadily with age. It is infrequent but definitely found in children. With the increasing life expectancy in the Western world the prevalence of tinea unguium is likely to increase further without adequate prevention and treatment.

Dermatophytoses in Crete, Greece, between 1992 and 1996

Pathological specimens from 1361 patients with clinical manifestations of dermatophytosis from the island of Crete, Greece, were examined for dermatophytes during a 5-year period (1992-96). Dermatophytes of the genus Trichophyton, Microsporum and Epidermophyton were isolated from 327 (24%) of the patients. Trichophyton rubrum was the most frequently isolated dermatophyte accounting for 44.4% of the strains, followed by M. canis (25%), T. mentagrophytes var. interdigitale (14.4%) and E. floccosum (7.6%). Less frequent isolates included T. mentagrophytes (3.4%), T. violaceum (3.1%), T. verrucosum (1.8%) and M. gypseum (0.3%). An analysis of the distribution and frequency of the dermatophytes according to the cutaneous area affected and the sex of the patients is also reported.

The spectrum of dermatophytes in northern Malawi (Africa)

Between 1.5% and 2.5% of the population in Karonga District, northern Malawi (Africa), were diagnosed as having tinea faciei, corporis, inguinalis or cruris in the course of a total population survey carried out between 1987 and 1989. With regard to the relative frequency distribution of dermatophytes, the main findings were the rarity of Trichophyton rubrum (around 1%) and the predominance of Microsporum audouinii (57%) in this part of Africa. In the genital area Epidermophyton floccosum was the most common isolate (56%).