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Gangneux JP, Miossec C, Machouart M, Gits-Muselli M, Benderdouche M, Ranque S, Botterel F, Brun S. Epidemiology and management of tinea capitis in France: A 6-year nationwide retrospective survey. Med Mycol 2024; 62:myae047. [PMID: 38653717 DOI: 10.1093/mmy/myae047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/10/2024] [Accepted: 04/22/2024] [Indexed: 04/25/2024] Open
Abstract
Tinea capitis (TC) is still a frequent dermatophytosis in France, both autochthonous and imported. A nationwide retrospective survey was performed and a total of 4395 TC cases were recorded within 36 French mycology laboratories during a 6-year period. TC is a disease that occurs in childhood with 85% of the cases occurring before 10 years old and 94% before the age of 15. Anthropophilic origin was predominant with 779 cases of Trichophyton tonsurans (32.6%), 738 cases of Trichophyton soudanense/T. violaceum (31%), and 445 cases of Microsporum audouinii (19.2%). Of note, T. tonsurans represents more than 80% of the cases in the French West Indies (Martinique and Guadeloupe). By contrast, zoophilic species were less prevalent with mainly M. canis (10.3%) confirming the shift from zoophilic to anthropophilic species observed in many centers during the last decades. During this survey, diagnosis methods were also collected. Most labs had a classical process for the diagnosis: microscopic direct examination associated to cultures on Sabouraud and Sabouraud-cycloheximide media (incubated between 25 ± 5°C for at least 3 weeks) in all laboratories. Identification of the causal dermatophyte was performed by microscopic and macroscopic examination of the cultures in 100% of the labs, with various specific culture media available when fructification was insufficient (mainly malt or potato-dextrose agar, or Borelli medium). New techniques were also implemented with the introduction of MALDI-TOF mass spectrometry identification in more than two third of the labs, and molecular identification available if necessary in half of the labs.
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Affiliation(s)
- Jean-Pierre Gangneux
- Department of Parasitology-Mycology, Excellence Center in Medical Mycology (ECMM EC), Rennes University Hospital, Rennes, France
| | - Charline Miossec
- Department of Parasitology-Mycology, Fort-de-France University Hospital, Martinique, France
| | - Marie Machouart
- Department of Parasitology-Mycology, Nancy University Hospital, Nancy, France
| | - Maud Gits-Muselli
- Department of Parasitology-Mycology, Saint-Louis University Hospital, AP-HP, Paris, France
| | - Mazouz Benderdouche
- Department of Parasitology-Mycology, Saint-Louis University Hospital, AP-HP, Paris, France
| | - Stéphane Ranque
- Department of Parasitology-Mycology, Marseille University Hospital, Marseille, France
| | - Françoise Botterel
- Unit of Parasitology-Mycology, Henri Mondor University Hospital, AP-HP, Dynamyc research group, UPEC, Créteil, France
| | - Sophie Brun
- Department of Parasitology-Mycology, Avicenne Hospital, AP-HP, Sorbone Paris Nord University, Bobigny, France
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Hill RC, Caplan AS, Elewski B, Gold JAW, Lockhart SR, Smith DJ, Lipner SR. Expert Panel Review of Skin and Hair Dermatophytoses in an Era of Antifungal Resistance. Am J Clin Dermatol 2024; 25:359-389. [PMID: 38494575 PMCID: PMC11201321 DOI: 10.1007/s40257-024-00848-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 03/19/2024]
Abstract
Dermatophytoses are fungal infections of the skin, hair, and nails that affect approximately 25% of the global population. Occlusive clothing, living in a hot humid environment, poor hygiene, proximity to animals, and crowded living conditions are important risk factors. Dermatophyte infections are named for the anatomic area they infect, and include tinea corporis, cruris, capitis, barbae, faciei, pedis, and manuum. Tinea incognito describes steroid-modified tinea. In some patients, especially those who are immunosuppressed or who have a history of corticosteroid use, dermatophyte infections may spread to involve extensive skin areas, and, in rare cases, may extend to the dermis and hair follicle. Over the past decade, dermatophytoses cases not responding to standard of care therapy have been increasingly reported. These cases are especially prevalent in the Indian subcontinent, and Trichophyton indotineae has been identified as the causative species, generating concern regarding resistance to available antifungal therapies. Antifungal-resistant dermatophyte infections have been recently recognized in the United States. Antifungal resistance is now a global health concern. When feasible, mycological confirmation before starting treatment is considered best practice. To curb antifungal-resistant infections, it is necessary for physicians to maintain a high index of suspicion for resistant dermatophyte infections coupled with antifungal stewardship efforts. Furthermore, by forging partnerships with federal agencies, state and local public health agencies, professional societies, and academic institutions, dermatologists can lead efforts to prevent the spread of antifungal-resistant dermatophytes.
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Affiliation(s)
| | - Avrom S Caplan
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USA
| | - Boni Elewski
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeremy A W Gold
- Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, GA, USA
| | - Shawn R Lockhart
- Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, GA, USA
| | - Dallas J Smith
- Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, GA, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, 1305 York Avenue, New York, NY, 10021, USA.
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Truong A, Miller A, Asch S. Pediatric Sports Dermatology. Pediatr Rev 2024; 45:271-284. [PMID: 38689113 DOI: 10.1542/pir.2023-006040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Affiliation(s)
- Andrew Truong
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | - Allison Miller
- Department of Dermatology, University of Wisconsin, Madison, WI
| | - Sarah Asch
- Department of Dermatology, University of Minnesota, Minneapolis, MN
- Hometown Pediatric Dermatology PLLC, North Oaks, MN
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Chen X, Liang Y, Guo Z, Huang R, Zheng W, Wu W, Li W. Photodynamic therapy combined with antifungal drugs against kerion: A report of six cases and literature review. Photodiagnosis Photodyn Ther 2024; 46:104039. [PMID: 38452908 DOI: 10.1016/j.pdpdt.2024.104039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
Kerion, a severe manifestation of tinea capitis caused by dermatophytes, is a fungal skin disease primarily affecting children. This report discusses six cases of pediatric kerion that were successfully treated with a combination of photodynamic therapy (PDT) and antifungal agents. Additionally, we conducted a literature review, identifying and analyzing six published reports on kerion and tinea capitis. The characteristics and efficacies of these cases are summarized. In summary, early combination therapy and proactive pre-treatment interventions proved effective in maximizing therapeutic outcomes, reducing disease duration and minimizing adverse reactions such as cicatricial alopecia. This approach has emerged as a favorable choice for the treatment of kerion.
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Affiliation(s)
- Xiaoli Chen
- Department of Plastic and Dermatologic Surgery, The Fifth People's Hospital of Hainan Province, Haikou, Hainan, China; Department of Plastic and Dermatological Surgery, Affiliated Dermatology Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Yujia Liang
- Department of Plastic and Dermatologic Surgery, The Fifth People's Hospital of Hainan Province, Haikou, Hainan, China; Department of Plastic and Dermatological Surgery, Affiliated Dermatology Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Ziyu Guo
- Department of Plastic and Dermatologic Surgery, The Fifth People's Hospital of Hainan Province, Haikou, Hainan, China; Department of Plastic and Dermatological Surgery, Affiliated Dermatology Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Ruiye Huang
- Department of Plastic and Dermatologic Surgery, The Fifth People's Hospital of Hainan Province, Haikou, Hainan, China; Department of Plastic and Dermatological Surgery, Affiliated Dermatology Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Wenai Zheng
- Department of Laboratory Medicine, The Fifth People's Hospital of Hainan Province, Haikou, Hainan, China
| | - Weiwei Wu
- Department of Plastic and Dermatologic Surgery, The Fifth People's Hospital of Hainan Province, Haikou, Hainan, China; Department of Plastic and Dermatological Surgery, Affiliated Dermatology Hospital of Hainan Medical University, Haikou, Hainan, China.
| | - Wen Li
- Department of Plastic and Dermatologic Surgery, The Fifth People's Hospital of Hainan Province, Haikou, Hainan, China; Department of Plastic and Dermatological Surgery, Affiliated Dermatology Hospital of Hainan Medical University, Haikou, Hainan, China.
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Gurnani P, Monir RL, Schoch JJ. Diagnosis and Management of Common Pediatric Cutaneous Infections. Pediatr Ann 2024; 53:e138-e145. [PMID: 38574073 DOI: 10.3928/19382359-20240205-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Dermatologic concerns are common in the general pediatrician's practice. Herein, we review the most commonly encountered cutaneous bacterial, viral, and superficial fungal infections in the pediatric population. We describe clinical presentation, pathogenesis, and current treatments. The goal of this guide is to increase pediatricians' comfort in diagnosing and managing common skin infections, as well as determining when a dermatology referral may be necessary. [Pediatr Ann. 2024;53(4):e138-e145.].
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Shakeel CS, Khan SJ. Machine learning (ML) techniques as effective methods for evaluating hair and skin assessments: A systematic review. Proc Inst Mech Eng H 2024; 238:132-148. [PMID: 38156410 DOI: 10.1177/09544119231216290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
Machine Learning (ML) techniques provide the ability to effectively evaluate and analyze human skin and hair assessments. The aim of this study is to systematically review the effectiveness of applying Machine Learning (ML) methods and Artificial Intelligence (AI) techniques in order to evaluate hair and skin assessments. PubMed, Web of Science, IEEE Xplore, and Science Direct were searched in order to retrieve research publications between 1 January 2010 and 31 March 2020 using appropriate keywords such as "hair and skin analysis." Following accurate screening, 20 peer-reviewed publications were selected for inclusion in this systematic review. The analysis demonstrated that prevalent Machine Learning (ML) methods comprised of Support Vector Machine (SVM), k-nearest Neighbor, and Artificial Neural Networks (ANN). ANN's were observed to yield the highest accuracy of 95% followed by SVM generating 90%. These techniques were most commonly applied for drafting framework assessments such as that of Melanoma. Values of parameters such as Sensitivity, Specificity, and Area under the Curve (AUC) were extracted from the studies and with the help of comparisons, relevant inferences were also made. ANN's were observed to yield the highest sensitivity of 82.30% as well as a 96.90% specificity. Hence, with this systematic review, a summarization of the studies was drafted that encapsulated how Machine Learning (ML) techniques have been employed for the analysis and evaluation of hair and skin assessments.
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Affiliation(s)
| | - Saad Jawaid Khan
- Department of Biomedical Engineering, Ziauddin University (ZUFESTM), Karachi, Pakistan
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7
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Ricciardo BM, Kessaris HL, Nannup N, Tilbrook D, Farrant B, Michie C, Hansen L, Douglas R, Walton J, Poore A, Whelan A, Barnett TC, Kumarasinghe PS, Carapetis JR, Bowen AC. Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project. Pilot Feasibility Stud 2024; 10:6. [PMID: 38200545 PMCID: PMC10782716 DOI: 10.1186/s40814-023-01428-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Indigenous children in colonised nations experience high rates of health disparities linked to historical trauma resulting from displacement and dispossession, as well as ongoing systemic racism. Skin infections and their complications are one such health inequity, with the highest global burden described in remote-living Australian Aboriginal and/or Torres Strait Islander (hereafter respectfully referred to as Aboriginal) children. Yet despite increasing urbanisation, little is known about the skin infection burden for urban-living Aboriginal children. More knowledge is needed to inform service provision, treatment guidelines and community-wide healthy skin strategies. In this pilot study, we aimed to test the feasibility and design of larger multi-site observational studies, provide initial descriptions of skin disease frequency and generate preliminary hypotheses of association. METHODS This project has been co-designed with local (Noongar) Elders to provide an Australian-first description of skin health and disease in urban-living Aboriginal children. In collaboration with an urban Aboriginal Community Controlled Health Organisation (Derbarl Yerrigan Health Service), we conducted a week-long cross-sectional observational cohort study of Aboriginal children (0-18 years) recruited from the waiting room. Participants completed a questionnaire, skin examination, clinical photos, and swabs and received appropriate treatment. We assessed the feasibility and impact of the pilot study. RESULTS From 4 to 8 October 2021, we recruited 84 Aboriginal children of whom 80 (95%) were urban-living. With a trusted Aboriginal Health Practitioner leading recruitment, most parents (or caregivers) who were approached consented to participate. Among urban-living children, over half (45/80, 56%) of parents described a current concern with their child's skin, hair and/or nails; and one-third (26/80, 33%) reported current itchy skin. Using a research-service model, 27% (21/79) of examined urban-living participants received opportunistic same-day treatment and 18% (14/79) were referred for later review. CONCLUSIONS This co-designed pilot study to understand skin health in urban-living Aboriginal children was feasible and acceptable, with high study participation and subsequent engagement in clinical care observed. Co-design and the strong involvement of Aboriginal people to lead and deliver the project was crucial. The successful pilot has informed larger, multi-site observational studies to more accurately answer questions of disease burden and inform the development of healthy skin messages for urban-living Aboriginal children.
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Affiliation(s)
- Bernadette M Ricciardo
- University of Western Australia, Crawley, WA, Australia.
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia.
- Fiona Stanley Hospital, Murdoch, WA, Australia.
- Perth Children's Hospital, Nedlands, WA, Australia.
| | - Heather-Lynn Kessaris
- Fiona Stanley Hospital, Murdoch, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Noel Nannup
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Dale Tilbrook
- Telethon Kids Institute, Nedlands, WA, Australia
- Maalingup Aboriginal Gallery, Caversham, WA, Australia
| | - Brad Farrant
- University of Western Australia, Crawley, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Carol Michie
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Lorraine Hansen
- Derbarl Yerrigan Health Services Aboriginal Corporation, East Perth, WA, Australia
| | - Richelle Douglas
- Derbarl Yerrigan Health Services Aboriginal Corporation, East Perth, WA, Australia
| | - Jacinta Walton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Ainslie Poore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Alexandra Whelan
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Timothy C Barnett
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
| | | | - Jonathan R Carapetis
- University of Western Australia, Crawley, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Asha C Bowen
- University of Western Australia, Crawley, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
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8
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Montaño JI, Pineda CA, Apráez G. An outbreak of trichophytic tinea capitis in a group of schoolchildren in a rural area of the department of Cauca, Colombia. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:534-537. [PMID: 38109135 DOI: 10.7705/biomedica.7247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Affiliation(s)
| | | | - Giovanny Apráez
- Secretaría Departamental de Salud, Gobernación del Cauca, Popayán, Colombia; Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
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Gheisari M, Zahedi K, Al‐Zubaidi N. Tinea capitis caused by Trichophyton violaceum in an immunocompetent elderly patient: A case report and review of literature. Clin Case Rep 2023; 11:e8205. [PMID: 38028093 PMCID: PMC10661301 DOI: 10.1002/ccr3.8205] [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] [Received: 08/17/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
Tinea capitis is a common dermatophyte infection of the scalp in children. It is an uncommon infection in adults and usually affects postmenopausal women and immunocompromised patients. We report an immunocompetent elderly female with inflammatory tinea capitis caused by Trichophyton violaceum and review the literature for the past 5 years to describe the disease, its epidemiologic characteristics, dermatophyte species involved and treatment options used. The total number of cases was 11, including 8 women and 3 men, with an average age of 48.36. The most commonly isolated dermatophyte was Trichophyton tonsurans, and most cases were treated successfully with oral terbinafine with no side effects. In our case, the diagnosis was established by direct examination, culture and histological examination. Remedy with itraconazole and prednisolone was very successful. Early diagnosis of tinea capitis in adults is necessary to provide early treatment and minimize sequelae of the disease.
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Affiliation(s)
- Mehdi Gheisari
- Skin Research CenterShahid Beheshti University of Medical SciencesTehranIran
- Department of Dermatology, Loghman Hakim HopsitalShahid Beheshti University of Medical SciencesTehranIran
| | - Khatere Zahedi
- Skin Research CenterShahid Beheshti University of Medical SciencesTehranIran
- Department of Dermatology, Loghman Hakim HopsitalShahid Beheshti University of Medical SciencesTehranIran
| | - Nabaa Al‐Zubaidi
- Skin Research CenterShahid Beheshti University of Medical SciencesTehranIran
- Department of Dermatology, Loghman Hakim HopsitalShahid Beheshti University of Medical SciencesTehranIran
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Barbosa V, Hight R, Grullon K. Scalp Infection, Inflammation, and Infestation. Dermatol Clin 2023; 41:539-545. [PMID: 37236720 DOI: 10.1016/j.det.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Tinea capitis, folliculitis, seborrheic dermatitis, and pediculosis capitis are four common scalp conditions. Although tinea capitis and seborrheic dermatitis are found more commonly in patients with skin of color and highly textured hair, all of these conditions have special diagnostic or management considerations in these populations. This article reviews the diagnosis and management of these common scalp conditions.
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Affiliation(s)
- Victoria Barbosa
- University of Chicago Medicine Section of Dermatology, 5841 South Maryland Avenue, MC5067, L518B, Chicago, IL 60637, USA.
| | - Robert Hight
- University of Chicago Pritzker School of Medicine, 121 West Central Avenue, Maywood, NJ 07607, USA
| | - Karina Grullon
- University of Chicago Pritzker School of Medicine, 121 West Central Avenue, Maywood, NJ 07607, USA
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