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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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Hainsworth S, Kučerová I, Sharma R, Cañete-Gibas CF, Hubka V. Three-gene phylogeny of the genus Arthroderma: Basis for future taxonomic studies. Med Mycol 2020; 59:355-365. [PMID: 32640011 DOI: 10.1093/mmy/myaa057] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 01/08/2023] Open
Abstract
Arthroderma is the most diverse genus among dermatophytes encompassing species occurring in soil, caves, animal burrows, clinical material and other environments. In this study, we collected ex-type, reference and authentic strains of all currently accepted Arthroderma species and generated sequences of three highly variable loci (ITS rDNA, β-tubulin, and translation elongation factor 1-α). The number of accepted species was expanded to 27. One novel species, A. melbournense (ex-type strain CCF 6162T = CBS 145858T), is described. This species was isolated from toenail dust collected by a podiatrist in Melbourne, during an epidemiological study of four geographical regions of Eastern Australia. Trichophyton terrestre, Chrysosporium magnisporum, and Chrysosporium oceanitis are transferred to Arthroderma. Typification is provided for T. terrestre that is not conspecific with any of the supposed biological species from the former T. terrestre complex, that is, A. insingulare, A. lenticulare and A. quadrifidum. A multi-gene phylogeny and reference sequences provided in this study should serve as a basis for future phylogenetic studies and facilitate species identification in practice. LAY ABSTRACT The genus Arthroderma encompasses geophilic dermatophyte species that infrequently cause human and animal superficial infections. Reference sequences from three genetic loci were generated for all currently accepted Arthroderma species and phylogeny was constructed. Several taxonomic novelties are introduced. The newly provided data will facilitate species identification and future taxonomic studies.
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Affiliation(s)
| | - Ivana Kučerová
- Department of Botany, Faculty of Science, Charles University, Prague, Czech Republic
| | - Rahul Sharma
- Department of Botany, Mata Gujri Mahila Mahavidyalaya, Jabalpur, Madhya Pradesh, India
| | - Connie F Cañete-Gibas
- Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Vit Hubka
- Department of Botany, Faculty of Science, Charles University, Prague, Czech Republic.,Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czech Republic
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Borman AM, Szekely A, Fraser M, Lovegrove S, Johnson EM. A novel dermatophyte relative, Nannizzia perplicata sp. nov., isolated from a case of tinea corporis in the United Kingdom. Med Mycol 2019; 57:548-556. [PMID: 30329066 DOI: 10.1093/mmy/myy099] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/07/2018] [Accepted: 09/27/2018] [Indexed: 12/17/2023] Open
Abstract
A novel dermatophyte was isolated from skin scales of a female patient presenting with tinea corporis of the wrist and arm. Her principal risk factor was long-term corticosteroid use for underlying Lupus autoimmune syndrome. Microscopic examination of skin scales from lesions revealed hyphae consistent with dermatophyte infection, and a morphologically identical fungus grew in pure culture on all cultures of skin scales. Repeat isolation of the same organism from persistent lesions five months later confirmed the novel species as the causative agent. Microscopic examination revealed predominantly smooth, thin-walled macroconidia, with large numbers of unicellular aleuriospores of varied shapes and sizes. Since the isolate exhibited considerable microscopic pleomorphism, sharing morphological features consistent with several dermatophyte genera, it was subjected to multi-locus phylogenetic analyses employing a total of six different loci. Sequence analyses of all loci revealed that the isolate clustered with species within Nannizzia but diverged from all known members of the genus by 2 to 13% depending on locus analyzed. The isolate exhibited high minimum inhibitory concentrations for terbinafine in vitro, which might explain why the infection had failed to respond to two cycles of oral treatment with this antifungal agent. Interestingly, sequences in GenBank of an unnamed "Microsporum sp" isolated from leg skin of a patient in the Czech Republic showed greater than 99% identity across all of the loci analysed in common, indicating that this novel organism, which we describe here as Nannizzia perplicata sp. nov., is likely not restricted to the UK.
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Affiliation(s)
- Andrew M Borman
- Public Health England UK National Mycology Reference Laboratory, Bristol
| | - Adrien Szekely
- Public Health England UK National Mycology Reference Laboratory, Bristol
| | - Mark Fraser
- Public Health England UK National Mycology Reference Laboratory, Bristol
| | - Simon Lovegrove
- West Suffolk NHS Foundation, Bury St Edmonds, United Kingdom
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Walser M, Bosshard P. Development and evaluation of a pan‐dermatophyte polymerase chain reaction with species‐level identification using sloppy molecular beacon probes. Br J Dermatol 2019; 180:1489-1497. [DOI: 10.1111/bjd.17512] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2018] [Indexed: 11/29/2022]
Affiliation(s)
- M. Walser
- Institute of Molecular Life Sciences University of Zurich Winterthurerstr. 190 CH‐8057 Zurich Switzerland
| | - P.P. Bosshard
- Department of Dermatology University Hospital Zurich Gloriastrasse 31 CH‐8091 Zurich Switzerland
- Faculty of Medicine University of Zurich Gloriastrasse 31 CH‐8091 Zurich Switzerland
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Hayette MP, Sacheli R. Unusual Species of Dermatophytes: Rarely Identified or New? Mycopathologia 2016; 182:203-213. [PMID: 27640161 DOI: 10.1007/s11046-016-0066-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 09/05/2016] [Indexed: 12/14/2022]
Abstract
Dermatophytes are causing superficial mycosis in animals and humans. Depending on the geophilic, zoophilic or anthropophilic origin of the fungus but also on the immunological status of the patient, symptomatology can widely differ. Nevertheless, each species is currently associated with typical clinical manifestations, even if atypical localizations and/or clinical pictures are sometimes also reported. Diagnostic tools applied to species identification have been changing since the last two decades with the more frequent use of molecular methods currently considered nowadays as reference methods for species identification. It becomes obvious that the algorithm used for the distinction of closely related species needs to combine phenotypic and genomic methods. All these different points are discussed, and the most recent novel species causing or involved in human dermatophytosis are reported.
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Affiliation(s)
- Marie-Pierre Hayette
- Department of Clinical Microbiology, National Reference Centre for Mycosis, University Hospital of Liège, Domaine du Sart Tilman B23, Avenue de l'Hôpital, 1, 4000, Liège, Belgium.
| | - Rosalie Sacheli
- Department of Clinical Microbiology, National Reference Centre for Mycosis, University Hospital of Liège, Domaine du Sart Tilman B23, Avenue de l'Hôpital, 1, 4000, Liège, Belgium
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Tsang CC, Chan JFW, Pong WM, Chen JHK, Ngan AHY, Cheung M, Lai CKC, Tsang DNC, Lau SKP, Woo PCY. Cutaneous hyalohyphomycosis due to Parengyodontium album gen. et comb. nov. Med Mycol 2016; 54:699-713. [PMID: 27161787 DOI: 10.1093/mmy/myw025] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/10/2016] [Indexed: 11/14/2022] Open
Abstract
"Engyodontium album" is an environmental saprobic mould and an emerging opportunistic pathogen able to cause both superficial and systemic infections. In this study, we isolated a mould from the skin lesion biopsy specimen of the right shin in a patient who received renal transplantation for end-stage renal failure with prednisolone, tacrolimus, and azathioprine immunosuppressant therapy. Histology of the skin biopsy showed mild squamous hyperplasia and neutrophilic infiltrate in the epidermis, active chronic inflammation in the dermis, and fat necrosis in the subcutis, with numerous fungal elements within the serum crusts. On Sabouraud glucose agar, the fungus grew as white, cobweb-like, floccose colonies. Microscopically, conidiogenous cells were arranged in whorls of one to seven at wide angles, with zigzag-shaped terminal fertile regions and smooth, hyaline, oval, apiculate conidia. DNA sequencing showed the mould isolate belonged to "E. album" but matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF MS) failed to identify the isolate. Phylogenetic analyses based on the internal transcribed spacer region, 28S nuclear ribosomal DNA, and β-tubulin gene and MALDI-TOF MS coupled with hierarchical cluster analysis showed that "E. album" is distantly related to other Engyodontium species and should be transferred to a novel genus within the family Cordycipitaceae, for which the name Parengyodontium album gen. et comb. nov. is proposed. Three potential cryptic species within this species complex were also revealed. Antifungal susceptibility testing showed posaconazole and voriconazole had high activities against all clinical P. album isolates and may be better drug options for treating P. album infections.
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Affiliation(s)
| | - Jasper F W Chan
- Department of Microbiology.,State Key Laboratory of Emerging Infectious Diseases.,Research Centre of Infection and Immunology.,Carol Yu Centre for Infection, the University of Hong Kong, Hong Kong
| | - Wai-Mei Pong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong
| | | | | | - Mei Cheung
- Department of Microbiology.,Department of Pathology, Queen Elizabeth Hospital, Hong Kong
| | | | | | - Susanna K P Lau
- Department of Microbiology.,State Key Laboratory of Emerging Infectious Diseases.,Research Centre of Infection and Immunology.,Carol Yu Centre for Infection, the University of Hong Kong, Hong Kong.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China
| | - Patrick C Y Woo
- Department of Microbiology.,State Key Laboratory of Emerging Infectious Diseases.,Research Centre of Infection and Immunology.,Carol Yu Centre for Infection, the University of Hong Kong, Hong Kong.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China
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Hubka V, Nissen CV, Jensen RH, Arendrup MC, Cmokova A, Kubatova A, Skorepova M, Kolarik M. Discovery of a sexual stage inTrichophyton onychocola, a presumed geophilic dermatophyte isolated from toenails of patients with a history ofT. rubrumonychomycosis. Med Mycol 2015; 53:798-809. [DOI: 10.1093/mmy/myv044] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 05/12/2015] [Indexed: 11/13/2022] Open
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Hubka V, Dobiašova S, Dobiaš R, Kolařik M. Microsporum aenigmaticum sp. nov. from M. gypseum complex, isolated as a cause of tinea corporis. Med Mycol 2014; 52:387-96. [PMID: 24625678 DOI: 10.1093/mmy/myt033] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
An undescribed Microsporum species was isolated from skin scales recovered from a 40-mm large, annular, scaling lesion on the wrist of a 46-year-old woman. The risk factors for dermatophyte infection in the patient were frequent work in the garden, hunting, and contact with dogs and horses. Direct microscopic examination of the scales revealed the presence of dermatophyte hyphae; when the samples were cultured, a morphologically similar fungus grew on all slants in pure culture. Both of these findings strongly suggested that the isolate was the true causal agent of infection. The possible geophilic nature of the species was based on phylogenetic analysis (internal transcribed spacer region of rDNA and β-tubulin gene) that placed it in between species of the M. gypseum complex. However, its divergencies from all other Microsporum species exceeded 4% base pairs. Based on β-tubulin phylogeny, the isolated species is a sister to M. gypseum. The species produces abundant chlamydospores and clumps of hyphae similar to those of ascomatal primordia but no conidia and ascospores. The species was unable to grow at 37°C and does not grow on T6 basal medium, which is unlike other Microsporum species; hair perforation and urease tests were positive. The addition of histidine to the T6 medium resulted in rapid growth of the fungus. The phylogenetic evidence, morphology, growth parameters, and physiology justified the proposal that the isolate is a new species, M. aenigmaticum, sp. nov.
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Affiliation(s)
- Vit Hubka
- Department of Botany, Faculty of Science, Charles University in Prague, Czech Republic
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Hubka V, Cmokova A, Skorepova M, Mikula P, Kolarik M. Trichophyton onychocola sp. nov. isolated from human nail. Med Mycol 2014; 52:285-92. [DOI: 10.1093/mmy/myt010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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