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Meghwal L, Mehta S, Gupta LK, Balai M, Mittal A. Trichoscopic and Clinico-Morphological Evaluation of Tinea Capitis. Indian Dermatol Online J 2024; 15:437-442. [PMID: 38845633 PMCID: PMC11152477 DOI: 10.4103/idoj.idoj_439_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 01/01/2024] [Accepted: 01/21/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Tinea capitis (TC) is a common fungal infection of the scalp, especially in children. Trichoscopy is a noninvasive technique that allows rapid and magnified in vivo observation of the hair with the visualization of morphologic features that are often imperceptible to the naked eye. Aim This study aimed to evaluate the usefulness of trichoscopy in clinical diagnosis and to study various clinico-morphological patterns of TC. Materials and Methods This cross-sectional, observational study included 140 clinically diagnosed cases of TC seen during a period of 1 year (April 2021 to March 2022). All patients were evaluated using a dermoscope (DermLite DL4 Multispectral 3 Gen, San Juan Capistrano, CA, USA,10×). Results The prevalence rate of TC in this study was 2.69 per thousand population. The most common clinical variant was gray patch followed by kerion and black dot, and the most common etiological agent was Trichophyton tonsurans. The characteristic trichoscopic features were as follows: comma hairs (80%), followed by corkscrew hairs (68.6%), bent hairs (54.2%), zigzag hairs (35.7%), and morse code-like hairs (15%). Other findings included scaling (89.2%), followed by black dot (67.1%), broken hairs (42.8%), and crusting and pustules (32.1% each). Comma and corkscrew-shaped hairs were most common in the black dot type, whereas zigzag, bent hairs, and morse code hairs were common in the gray patch type of TC. There was a significant association between trichoscopic findings and type of TC. Conclusion Trichoscopy can be considered a novel tool for rapid diagnosis and selection of the appropriate therapy and in the monitoring of treatment efficacy in TC.
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Affiliation(s)
- Lavina Meghwal
- Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India
| | - Sharad Mehta
- Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India
| | - Lalit Kumar Gupta
- Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India
| | - Manisha Balai
- Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India
| | - Asit Mittal
- Department of Dermatology, R.N.T. Medical College, Udaipur, Rajasthan, India
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Chauhan P, Behera B, Ding DD, Lallas A, Khare S, Enechukwu NA, Sławińska M, Akay BN, Ankad BS, Bhat YJ, Jha AK, Kaliyadan F, Kelati A, Neema S, Parmar NV, Stein J, Usatine RP, Vinay K, Errichetti E. Dermoscopy of Infectious Dermatoses (Infectiouscopy) in Skin of Color - A Systematic Review by the International Dermoscopy Society "Imaging in Skin of Color" Task Force. Dermatol Pract Concept 2023; 13:dpc.1304S1a309S. [PMID: 37874993 PMCID: PMC10824326 DOI: 10.5826/dpc.1304s1a309s] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/26/2023] Open
Abstract
Dermoscopy has been showed to facilitate the non-invasive recognition of several infectious disorders (infectiouscopy) thanks to the detection of peculiar clues. Although most of the knowledge on this topic comes from studies involving light-skinned patients, there is growing evidence about its use also in dark phototypes. This systematic literature review summarizes published data on dermoscopy of parasitic, bacterial, viral and fungal dermatoses (dermoscopic findings, used setting, pathological correlation, and level of evidence of studies) and provides a homogeneous terminology of reported dermoscopic features according to a standardized methodology. A total of 66 papers addressing 41 different dermatoses (14 bacterial, 5 viral, 11 fungal infections, and 11 parasitoses/bites and stings) and involving a total of 1096 instances were included in the analysis. The majority of them displayed a level of evidence of V (44 single case reports and 21 case series), with only 1 study showing a level of evidence of IV (case-control analysis). Moreover, our analysis also highlighted a high variability in the terminology used in the retrieved studies. Thus, although promising, further studies designed according to a systematic and standardized approach are needed for better characterization of dermoscopy of infectious skin infections.
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Affiliation(s)
- Payal Chauhan
- Department of Dermatology, All India Institute of Medical Sciences (AIIMS), Bilaspur, Himachal Pradesh, India
| | - Biswanath Behera
- Department of Dermatology and Venereology, AIIMS, Bhubaneswar, India
| | - Delaney D Ding
- University of Florida College of Medicine, Gainesville, FL, USA
| | - Aimilios Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Soumil Khare
- Department of Dermatology, Venereology and Leprosy, AIIMS, Raipur, India
| | - Nkechi Anne Enechukwu
- Nnamdi Azikiwe University/Nnamdi Azikiwe Teaching Hospital Nnewi, Anambra State, Nigeria
| | - Martyna Sławińska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Poland
| | - Bengu Nisa Akay
- Department of Dermatology, School of Medicine, Ankara University, Ankara, Turkey
| | - Balachandra S Ankad
- Department of Dermatology, Venereology and Leprosy, SN Medical College, Bagalkot, Karnataka, India
| | - Yasmeen J Bhat
- Department of Dermatology, Venereology and Leprology, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Abhijeet Kumar Jha
- Department of Dermatology & STD, Patna Medical College & Hospital, Patna, India
| | - Feroze Kaliyadan
- Department of Dermatology, Sree Narayana Institute of Medical Sciences, Ernakulum, India
| | - Awatef Kelati
- Dermatology Department, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Shekhar Neema
- Department of Dermatology, Venereology and Leprology, Armed Force Medical College, Pune, Maharashtra, India
| | - Nisha V Parmar
- Department of Dermatology, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Jennifer Stein
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA
| | - Richard P Usatine
- Department of Dermatology and Cutaneous Surgery, Department of Family and Community Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Enzo Errichetti
- Institute of Dermatology, “Santa Maria della Misericordia” University Hospital, Udine, Italy
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3
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Shakshouk H, Tosti A. Trichoscopy beyond scalp. A narrative review. Int J Dermatol 2023; 62:416-427. [PMID: 35511549 DOI: 10.1111/ijd.16226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/03/2022] [Accepted: 03/22/2022] [Indexed: 11/28/2022]
Abstract
Dermoscopy is becoming an indispensable tool in everyday practice, with an expanding range of applications. Trichoscopy is effective not only in establishing the diagnosis of scalp disorders but also in the follow-up of treatment. The MEDLINE database was searched using the terms "dermoscopy" and "trichoscopy" in combination with each of the following: "axilla," "pubic area," "beard," "eyebrows," "eyelashes," and "body hairs." We included case reports, case series, and review articles mentioning the previous terms. By providing an updated review from the literature, we aimed to emphasize the potential uses of trichoscopy in detecting diseases in hairy locations other than the scalp. Various inflammatory conditions, infections, and infestations are discussed.
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Affiliation(s)
- Hadir Shakshouk
- Department of Dermatology, Alexandria University, Alexandria, Egypt
| | - Antonella Tosti
- Department of Dermatology, University of Miami, Coral Gables, Florida, USA
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Pakornphadungsit K, Suchonwanit P, Thadanipon K, Visessiri Y, Rutnin S. Dermoscopic Features and Their Diagnostic Values Among Common Inflammatory and Infectious Dermatoses: A Cross-Sectional Study. Clin Cosmet Investig Dermatol 2023; 16:211-220. [PMID: 36718215 PMCID: PMC9884057 DOI: 10.2147/ccid.s397212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/14/2023] [Indexed: 01/25/2023]
Abstract
Background Dermoscopy is a non-invasive tool widely used to improve the diagnostic accuracy of general dermatological conditions. Objective To determine the dermoscopic features and their diagnostic value in distinguishing common inflammatory and infectious dermatoses. Materials and Methods A cross-sectional study was conducted on patients clinically diagnosed with common inflammatory or infectious skin diseases. Baseline characteristics and clinical and dermoscopic findings were recorded. Dermoscopic variables were analyzed using a correlation matrix. A skin biopsy was performed for each patient for a definitive diagnosis. Results Of 102 patients, 43 with dermatitis, 30 with psoriasis, 14 with lichen planus (LP), 5 with pityriasis rosea (PR), and 10 with others were included. Dull red background, patchy vessels, and scales showed significant positive correlations with dermatitis (r = 0.401, 0.488, and 0.327, respectively; p < 0.01), whereas bright red background, glomerular vessels, regular vascular distribution, and diffuse scales revealed significant positive correlations with psoriasis (r = 0.412, 0.266, 0.798, and 0.401, respectively; p < 0.01). For LP, whitish reticulate structures, purplish background, and dotted vessels mixed with linear vessels in the peripheral distribution were significantly positively correlated (r = 0.831, 0.771, 0.224, and 0.558, respectively; p < 0.05). Yellowish background and peripheral scales were predictive of PR diagnosis (r = 0.254 and 0.583, respectively; p < 0.01). Conclusion Dermoscopy can be used as an adjunctive tool to differentiate conditions among common inflammatory and infectious dermatoses in order to minimize unnecessary invasive diagnostic procedures.
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Affiliation(s)
- Kallapan Pakornphadungsit
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kunlawat Thadanipon
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Yingluck Visessiri
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthinee Rutnin
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand,Correspondence: Suthinee Rutnin, Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, Thailand, 10400, Tel +66-2-2011141, Fax +66-2-201-1211 ext 4, Email
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Litaiem N, Mnif E, Zeglaoui F. Dermoscopy of Onychomycosis: A Systematic Review. Dermatol Pract Concept 2023; 13:dpc.1301a72. [PMID: 36892372 PMCID: PMC9946122 DOI: 10.5826/dpc.1301a72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Onychomycosis represents a global burden accounting for about 50% of nail consultations. Several studies have tried to assess the dermoscopic features of onychomycosis. With the multiplication of papers, several "new" dermoscopic signs keep being added leading to some inconsistency in onychoscopic terminology. OBJECTIVE This study aimed to summarize the existing literature on the dermoscopic features of onychomycosis and propose a unified onychoscopic terminology. METHODS The literature search was performed using PubMed and Scopus databases up to October 30, 2021 to identify eligible contributions. In total, 33 records (2111 patients) were included. RESULTS The main dermoscopic signs of onychomycosis are "ruin appearance", "longitudinal striae" and "spikes" on the proximal margin of onycholytic areas, with a specificity of 99.38%, 83.78%, and 85.64% respectively. The "aurora borealis" sign had the highest sensitivity and specificity. CONCLUSIONS The current review provides a framework for issues related to the onychoscopic terminology of onychomycosis and is intended to serve as an aid for students, teachers, and researchers. We proposed a unifying terminology to describe dermoscopic signs of onychomycosis. Dermoscopic signs of onychomycosis show good specificity and are useful in distinguishing nail psoriasis, trauma, and onychomycosis. It helps differentiate fungal melanonychia from nail melanoma, nevi, and melanocytic activation.
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Affiliation(s)
- Noureddine Litaiem
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,University of Tunis El Manar, Faculté de Médecine de Tunis, Tunisia
| | - Emna Mnif
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Faten Zeglaoui
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,University of Tunis El Manar, Faculté de Médecine de Tunis, Tunisia
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Bosseila M, Okail A, Sayed S, Saleh MA. Comparison of vascular endothelial growth factor expression between lesional and non-lesional skin in patients with morphea: a dermoscopy-guided immunohistochemical study. Arch Dermatol Res 2023; 315:61-66. [PMID: 35064289 DOI: 10.1007/s00403-021-02315-x] [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: 04/05/2021] [Revised: 09/18/2021] [Accepted: 12/07/2021] [Indexed: 01/12/2023]
Abstract
Morphea is an inflammatory fibrosing disease, initiated by vascular injury resulting in increased collagen formation and decreased collagen degradation. This study was designed to evaluate the role of angiogenic vascular endothelial growth factor (VEGF) in the vascular changes which are dermoscopically evident in morphea lesions, compared with that in non-lesional skin, by assessing its expression immunohistochemically on tissue blood vessels. Twenty patients with morphea were subjected to clinical and dermoscopic examinations. Two skin biopsies from lesional and non-lesional skin were obtained and stained with hematoxylin and eosin (H&E) and immunohistochemically with VEGF. Dermoscopic examination showed linear blood vessels in 90% of the lesions. No significant difference in the number of VEGF-stained and unstained blood vessels, was observed between the lesional and non-lesional skin (p = 0.475 and 0.191, respectively). A weak inverse correlation was found between the total number of blood vessels positive for VEGF and the disease duration, (r = - 0.48; p = 0.032). Significant differences were found between different stages of morphea and total number of blood vessels negative for VEGF, (p = 0.017). In conclusion, VEGF immunostaining, which represents the newly formed blood vessels, showed no difference between lesional and non-lesional skin in patients with morphea. Thus, the dermoscopically observable blood vessels in lesions compared with non-lesional skin are not due to angiogenesis, but rather due to the thinning and atrophy of the overlying epidermis in morphea cases, rendering the blood vessels more obvious.
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Affiliation(s)
- Manal Bosseila
- Department of Dermatology, Faculty of Medicine, Cairo University School of Medicine, Kasr Al Ainy Hospital, Cairo, PO 11956, Egypt
| | - Amira Okail
- Department of Dermatology, Faculty of Medicine, Cairo University School of Medicine, Kasr Al Ainy Hospital, Cairo, PO 11956, Egypt
| | - Safinaz Sayed
- Department of Histology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwah Adly Saleh
- Department of Dermatology, Faculty of Medicine, Cairo University School of Medicine, Kasr Al Ainy Hospital, Cairo, PO 11956, Egypt.
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Varsha MG, Shilpa K, Revathi TN, Shanmukhappa AG, Loganathan E. Telltale signs of skin trespassers: Clues to superficial mycosis. Indian J Dermatol Venereol Leprol 2023; 89:144-148. [PMID: 35146987 DOI: 10.25259/ijdvl_105_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 08/01/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Manche Gowda Varsha
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Kanathur Shilpa
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - T N Revathi
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Asha Gowrappala Shanmukhappa
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Eswari Loganathan
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
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8
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Dermoscopy of Bacterial, Viral, and Fungal Skin Infections: A Systematic Review of the Literature. Dermatol Ther (Heidelb) 2022; 13:51-76. [PMID: 36417086 PMCID: PMC9823193 DOI: 10.1007/s13555-022-00855-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022] Open
Abstract
Over the last three decades, the use of dermoscopy has been extended to inflammatory and infectious dermatoses. Regarding the latter, while the first applications concerned skin parasitoses, there has been a significant increase in the publication trend regarding nonparasitic dermatoses over recent years, yet data on this topic are sparse and often lack a standardized analytical approach. This systematic literature review summarizes published data on dermoscopy of bacterial, viral, and fungal dermatoses (dermoscopic findings, used setting, pathological correlation, and level of evidence of studies) and provides a homogeneous terminology of reported dermoscopic features according to a standardized methodology. A total of 152 papers addressing 43 different dermatoses and describing 184 different dermoscopic findings were included in the analysis. The majority of them displayed a level of evidence of V (107 single case reports and 40 case series), with only 5 studies showing a level of evidence of IV (case-control studies). Moreover, our analysis also underlined a high variability in the terminology used in published articles (even for the same dermatosis). Therefore, despite significant potential, future studies designed according to a systematic and standardized approach are required for a better characterization of dermoscopy of nonparasitic skin infections.
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Das A, Madke B, Jakhar D, Neema S, Kaur I, Kumar P, Pradhan S. Named signs and metaphoric terminologies in dermoscopy: A compilation. Indian J Dermatol Venereol Leprol 2022; 88:855-866. [PMID: 35146985 DOI: 10.25259/ijdvl_1047_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 06/01/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Bhushan Madke
- Department of Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India
| | - Deepak Jakhar
- Department of Dermatology, North DMC Medical College and Hindu Rao Hospital, New Delhi, India
| | - Shekhar Neema
- Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ishmeet Kaur
- Department of Dermatology, North DMC Medical College and Hindu Rao Hospital, New Delhi, India
| | - Piyush Kumar
- Department of Dermatology, Katihar Medical College, Katihar, Bihar, India
| | - Swetalina Pradhan
- Department of Dermatology, All India Institute of Medical Sciences, Patna, Bihar, India
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Moskaluk AE, VandeWoude S. Current Topics in Dermatophyte Classification and Clinical Diagnosis. Pathogens 2022; 11:pathogens11090957. [PMID: 36145389 PMCID: PMC9502385 DOI: 10.3390/pathogens11090957] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/28/2022] Open
Abstract
Dermatophytes are highly infectious fungi that cause superficial infections in keratinized tissues in humans and animals. This group of fungi is defined by their ability to digest keratin and encompasses a wide range of species. Classification of many of these species has recently changed due to genetic analysis, potentially affecting clinical diagnosis and disease management. In this review, we discuss dermatophyte classification including name changes for medically important species, current and potential diagnostic techniques for detecting dermatophytes, and an in-depth review of Microsporum canis, a prevalent zoonotic dermatophyte. Fungal culture is still considered the “gold standard” for diagnosing dermatophytosis; however, modern molecular assays have overcome the main disadvantages of culture, allowing for tandem use with cultures. Further investigation into novel molecular assays for dermatophytosis is critical, especially for high-density populations where rapid diagnosis is essential for outbreak prevention. A frequently encountered dermatophyte in clinical settings is M. canis, which causes dermatophytosis in humans and cats. M. canis is adapting to its primary host (cats) as one of its mating types (MAT1-2) appears to be going extinct, leading to a loss of sexual reproduction. Investigating M. canis strains around the world can help elucidate the evolutionary trajectory of this fungi.
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Lamie C, Elmowafy E, Ragaie MH, Attia DA, Mortada ND. Assessment of antifungal efficacy of itraconazole loaded aspasomal cream: comparative clinical study. Drug Deliv 2022; 29:1345-1357. [PMID: 35506466 PMCID: PMC9090397 DOI: 10.1080/10717544.2022.2067601] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Topical conveyance of antifungal agents like itraconazole ITZ has been giving good grounds for expecting felicitous antifungal medicines. The defiance of topical delivery of this poorly water soluble and high-molecular-weight drug, however, mightily entail an adequate vehiculation. ITZ aspasomes, newer antioxidant generation of liposomes, have been designed and enclosed in a cream to ameliorate skin deposition. The proposed creams containing non-formulated ITZ or encapsulated in aspasomes (0.1% or 0.5%) were topically applied in patients with diagnosed diaper dermatitis complicated by candidiasis, tinea corporis (TC), and tinea versicolor (TVC). Placebos (void aspasomal cream and cream base) were also utilized. The obtained results for diaper rash revealed that aspasomal cream (0.5% ITZ) was eminent with respect to complete cure and negative candida culture after 10-day therapy relative to counterparts containing 0.1% ITZ aspasomes or non-formulated ITZ (0.1% and 0.5%). For tinea, the same trend was manifested in terms of ‘cleared’ clinical response in 90% of patients and absence of fungal elements after 4-week treatment. Relative to non-formulated ITZ, ITZ aspasomal cream was endorsed to be auspicious especially when ITZ concentration was lowered to half commercially available cream concentration (1%), pushing further exploitation in other dermal fungal infections.
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Affiliation(s)
- Caroline Lamie
- Pharmaceutics and Pharmaceutical Technology, The British University in Egypt, Cairo, Egypt
| | - Enas Elmowafy
- Pharmaceutics and Industrial Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Maha H Ragaie
- Department of Dermatology, STD's and Andrology, Faculty of Medicine, Minia University, Al Minya, Egypt
| | - Dalia A Attia
- Pharmaceutics and Pharmaceutical Technology, The British University in Egypt, Cairo, Egypt
| | - Nahed D Mortada
- Pharmaceutics and Industrial Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
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Albash R, Ragaie MH, Hassab MAE, El-Haggar R, Eldehna WM, Al-Rashood ST, Mosallam S. Fenticonazole nitrate loaded trans-novasomes for effective management of tinea corporis: design characterization, in silico study, and exploratory clinical appraisal. Drug Deliv 2022; 29:1100-1111. [PMID: 35373684 PMCID: PMC8986243 DOI: 10.1080/10717544.2022.2057619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The current investigation aimed for loading fenticonazole nitrate (FTN), an antifungal agent with low aqueous solubility, into trans-novasomes (TNs) for management of tinea corporis topically. TNs contain Brij® as an edge activator besides the components of novasomes (cholesterol, Span 60, and oleic acid) owing to augment the topical delivery of FTN. TNs were fabricated applying ethanol injection method based on D-optimal experiment. TNs were evaluated with regard to entrapment efficiency percent (EE%), particle size (PS), polydispersity index (PDI), and zeta potential (ZP). Further explorations were conducted on the optimum formulation (F7). F7 showed spherical appearance with EE%, PS, PDI, and ZP of 100.00 ± 1.10%, 358.60 ± 10.76 nm, 0.51 ± 0.004, and −30.00 ± 0.80 mV, respectively. The in silico study revealed the ability of the FTN–cholesterol complex to maintain favorable interactions throughout the molecular dynamics simulation (MDS) study. Moreover, Trichophyton mentagrophytes growth was inhibited effectively by F7 than by FTN suspension applying 2,3-bis(2-methyloxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) reduction assay. Furthermore, a clinical appraisal on patients with tinea corporis fungal lesions confirmed the superiority of F7 compared to Miconaz® cream in the magnitude of clinical cure of tinea corporis. Thereby, TNs could be considered as promising vesicles for enhancing the antifungal potential of FTN for the topical management of tinea corporis.
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Affiliation(s)
- Rofida Albash
- Department of Pharmaceutics, College of Pharmaceutical Sciences and Drug Manufacturing, Misr University for Science and Technology, Giza, Egypt
| | - Maha H Ragaie
- Department of Dermatology, STD's and Andrology, Faculty of Medicine, Minia University, Al-Minya, Egypt
| | - Mahmoud A El Hassab
- Department of Medicinal Chemistry, Faculty of Pharmacy, King Salman International University (KSIU), South Sinai, Egypt
| | - Radwan El-Haggar
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Helwan University, Cairo, Egypt
| | - Wagdy M Eldehna
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Kafrelsheikh University, Kafr el-Sheikh, Egypt
| | - Sara T Al-Rashood
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Shaimaa Mosallam
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, October 6 University, Giza, Egypt
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13
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Lim SS, Shin K, Mun JH. Dermoscopy for cutaneous fungal infections: A brief review. Health Sci Rep 2022; 5:e464. [PMID: 35024456 PMCID: PMC8733849 DOI: 10.1002/hsr2.464] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 01/22/2023] Open
Abstract
Background Fungal dermatological diseases are significant public health issues. Dermoscopy is a useful bedside assessment tool that helps clinicians diagnose various skin neoplasms and general dermatological diseases. Aim This brief review aims to update clinicians on the dermoscopic features of cutaneous fungal infections such as tinea capitis, tinea corporis, tinea incognito, onychomycosis, and pityrosporum folliculitis. Methods The PubMed database was searched using the terms “dermoscopy” or its synonyms, “tinea capitis”, “tinea corporis”, “tinea incognito”, “onychomycosis” and “pityrosporum folliculitis”. Results The diagnostic value of dermoscopy is well‐recognised in the evaluation of tinea capitis and onychomycosis. There are fewer studies investigating the dermoscopic features of tinea corporis, tinea incognito and pityrosporum folliculitis, but the current data suggest that dermoscopy can aid clinical evaluation of these diseases. Understanding dermoscopic features of cutaneous fungal infection has the potential to increase diagnostic accuracy. Conclusion Dermoscopy in the evaluation of fungal dermatological diseases has the potential to optimize diagnostic accuracy, reduce unnecessary testing, and, consequently, improve clinical practice.
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Affiliation(s)
| | - Kihyuk Shin
- Department of Dermatology, College of Medicine Pusan National University Busan South Korea.,Department of Dermatology Pusan National University Yangsan Hospital Yangsan South Korea.,Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan South Korea
| | - Je-Ho Mun
- Department of Dermatology Seoul National University Hospital Seoul Republic of Korea.,Department of Dermatology Seoul National University College of Medicine Seoul Republic of Korea
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Bakos RM, Leite LL, Reinehr C, Escobar GF. Dermoscopy of skin infestations and infections (entomodermoscopy) - Part II: viral, fungal and other infections. An Bras Dermatol 2021; 96:746-758. [PMID: 34620527 PMCID: PMC8790190 DOI: 10.1016/j.abd.2021.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/31/2021] [Accepted: 04/17/2021] [Indexed: 02/03/2023] Open
Abstract
In addition to the infestations and bacterial infections reported in part I, the study of entomodermoscopy also involves descriptions of dermoscopic findings of a growing number of viral and fungal infections, among others. In this article, the main clinical situations in viral infections where dermoscopy can be useful will be described, that is in the evaluation of viral warts, molluscum contagiosum, and even in recent scenarios such as the COVID-19 pandemic. As for fungal infections, dermoscopy is particularly important, not only in the evaluation of the skin surface, but also of skin annexes, such as hairs and nails. The differential diagnosis with skin tumors, especially melanomas, can be facilitated by dermoscopy, especially in the evaluation of cases of verruca plantaris, onychomycosis and tinea nigra.
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Affiliation(s)
| | - Leandro Linhares Leite
- Dermatology Service, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Clarissa Reinehr
- Postgraduation in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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15
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Sethi S, Chauhan P, Jindal R, Bisht YS. Dermoscopy of topical steroid-dependent or damaged face: A cross-sectional study. Indian J Dermatol Venereol Leprol 2021; 88:40-46. [PMID: 34379967 DOI: 10.25259/ijdvl_11_2020] [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: 01/01/2020] [Accepted: 04/01/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Topical corticosteroid (TCS) abuse is rampant and results in steroid addiction labeled as topical steroid-dependent or damaged face (TSDF). Indian market is replete with triple combination creams containing TCS sold as over-the-counter products at low cost, luring people to use them without prescription. The resultant damage if detected late is irreversible and difficult to treat. Dermoscopy can help in the early identification of features of TSDF at a preclinical stage resulting in better prognosis. However, the literature on the same is limited. AIMS This study is undertaken to characterize dermoscopic features of TSDF and to correlate them with potency and duration of application of the TCS. METHODS One hundred and thirty-two patients aged 18 years or above, with clinical symptoms and signs suggestive of TSDF and with history of application of TCS on the face for a period of more than one month, were enrolled in the study. Their demographic details, clinical features, and dermoscopy findings were recorded using a predesigned structured format. Comparison of dermoscopic findings with clinical examination, gender, potency of TCS, and duration of TCS use was done using Chi-square test, Fisher's exact test, and one-tailed Z-test. RESULTS Mean age of the patients was 31.7 ± 8.1 years. Male to female ratio was 2:9. Sixty-nine (52.3%) patients abused TCS for more than one year. Clinical findings noted in the patients were erythema (81.1%), hyperpigmentation (80.3%), and hypertrichosis (68.2%). The most common dermoscopy findings seen were brown globules (96.2%), red diffuse areas (92.4%), vessels (87.1%), white structureless areas (86.4%), and hypertrichosis (80.3%). Red diffuse areas, vessels, brown globules, white structureless areas, and white hair were observed in a statistically higher proportion of cases dermoscopically. Y-shaped vessels and brown globules were seen in significantly higher number of patients, using TCS for more than three months and in those continuing it beyond six months, polygonal vessels were predominant. LIMITATIONS Lack of histopathological correlation is the limitation of our study. Furthermore, brown globules seen in 96.2% patients of TSDF on dermoscopy may have been over-estimated and not always signify TSDF; instead, it could represent melasma for which patient applied TCS. CONCLUSION Dermoscopy in TSDF can help dermatologists in a multitude of ways from confirming the diagnosis to differentiating from other causes of red face and predicting the approximate duration of TCS abuse.
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Affiliation(s)
- Sheenam Sethi
- Department of Dermatology, Venereology and Leprosy, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Payal Chauhan
- Department of Dermatology, Venereology and Leprosy, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Rashmi Jindal
- Department of Dermatology, Venereology and Leprosy, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Yashwant Singh Bisht
- Department of Dermatology, Venereology and Leprosy, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
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16
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Kumar P, Pandhi D, Bhattacharya SN, Das S. Trichoscopy as a monitoring tool in assessing treatment response in 98 children with tinea capitis: A prospective clinical study. Dermatol Ther 2021; 34:e15010. [PMID: 34041831 DOI: 10.1111/dth.15010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/24/2021] [Indexed: 12/01/2022]
Abstract
Tinea capitis (TC) is the most common dermatophyte infection in children. Fungal culture the gold standard diagnostic method takes several weeks and has poor yields. Trichoscopy helps in rapid diagnosis and could work as a monitoring tool during antifungal therapy. Our main objective is to document the evolution of trichoscopic features with treatment and their correlation with clinical parameters in patients of TC. Forty-six and 52 children with clinically diagnosed TC that was confirmed by potassium hydroxide microscopy, received griseofulvin and terbinafine, respectively. Recruited children were subjected to clinical and trichoscopic assessment by calculation of CASS (clinical assessment severity score) and counting of TAHC (Total Altered hair count; negative and positive), respectively, at baseline and follow-up at 2, 4, and 6 weeks. McNemar, Wilcoxon singed ranked test and Spearman-rho correlation of various parameters was evaluated. Follow-up trichoscopy revealed significant (p < 0.009) disappearance of negative TAHC like black dot (second week onward), corkscrew, horseshoe and zigzag hair at 4 weeks and short broken hair, erythema telangiectasia hemorrhage (ETH) resolved at 6 weeks. Positive TAHC (regrowing hair) shows significant increase at 6 weeks (p < 0.001). CASS and negative TAHC showed significant difference at 4 weeks (p < 0.001) by analyzing boxplot graph. Therefore, trichoscopic resolution occurred before the clinical cure. Terbinafine subjects showed a higher clinical cure rate at 4 weeks (p = 0.02) as compared to griseofulvin. To conclude, trichoscopy is a good monitoring tool that could document the disappearance of almost all dystrophic hair at 4 to 6 weeks and is a more sensitive tool than microscopic examination. Regrowing hair and perifollicular scaling are markers of recovery.
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Affiliation(s)
- Pradeep Kumar
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Deepika Pandhi
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Sambit Nath Bhattacharya
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Shukla Das
- Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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17
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Starace M, Carpanese MA, Alessandrini A, Piraccini BM, Patrizi A, Neri I. Tinea corporis incognito due to Microsporum Gypseum: Report of eight cases in children. Pediatr Dermatol 2021; 38:652-654. [PMID: 33709430 DOI: 10.1111/pde.14573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/02/2021] [Accepted: 02/18/2021] [Indexed: 01/25/2023]
Abstract
Microsporum gypseum is a geophilic saprophyte for which soil is the natural habitat. Tinea corporis caused by Microsporum gypseum is rare and usually occurs after direct contact with the soil or healthy carrier animals. We present a case series of eight children with tinea corporis caused by M gypseum, with unusual clinic presentations mimicking dermatitis.
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Affiliation(s)
- Michela Starace
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Miriam Anna Carpanese
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Aurora Alessandrini
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Iria Neri
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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18
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Verma SB, Panda S, Nenoff P, Singal A, Rudramurthy SM, Uhrlass S, Das A, Bisherwal K, Shaw D, Vasani R. The unprecedented epidemic-like scenario of dermatophytosis in India: II. Diagnostic methods and taxonomical aspects. Indian J Dermatol Venereol Leprol 2021; 87:326-332. [PMID: 33871195 DOI: 10.25259/ijdvl_302_20] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
Abstract
Trichophyton (T.) mentagrophytes now accounts for an overwhelming majority of clinical cases in India, a new "Indian genotype" (T. mentagrophytes ITS genotype VIII) having been isolated from skin samples obtained from cases across a wide geographical distribution in this country. The conventional diagnostic methods, like fungal culture, are, however, inadequate for diagnosing this agent. Thus, molecular methods of diagnosis are necessary for proper characterization of the causative agent. The shift in the predominant agent of dermatophytosis from T. rubrum to T. mentagrophytes, within a relatively short span of time, is without historic parallel. The apparent ease of transmission of a zoophilic fungus among human hosts can also be explained by means of mycological phenomena, like anthropization.
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Affiliation(s)
| | - Saumya Panda
- Department of Dermatology, Belle Vue Clinic, Kolkata, West Bengal, India
| | - Pietro Nenoff
- Department of Dermatology and Laboratory Medicine, Laboratory of Medical Microbiology, Moelbis, Germany
| | - Archana Singal
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Shivaprakash M Rudramurthy
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Silke Uhrlass
- Department of Dermatology and Laboratory Medicine, Laboratory of Medical Microbiology, Moelbis, Germany
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Kavita Bisherwal
- Department of Dermatology, Venereology and Leprosy, Lady Harding Medical College and SSK Hospital, Delhi, India
| | - Dipika Shaw
- Department of Medical Microbiology, PGI, Chandigarh, India
| | - Resham Vasani
- Department of Dermatology, Bhojani Clinic, Mumbai, Maharashtra, India
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19
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Verma SB, Panda S, Nenoff P, Singal A, Rudramuruthy SM, Uhrlass S, Das A, Bisherwal K, Shaw D, Vasani R. The unprecedented epidemic-like scenario of dermatophytosis in India: I. Epidemiology, risk factors and clinical features. Indian J Dermatol Venereol Leprol 2021; 87:154-175. [PMID: 33769736 DOI: 10.25259/ijdvl_301_20] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/01/2020] [Indexed: 12/21/2022]
Abstract
Dermatophytosis has attained unprecedented dimensions in recent years in India. Its clinical presentation is now multifarious, often with atypical morphology, severe forms and unusually extensive disease in all age groups. We hesitate to call it an epidemic owing to the lack of population-based prevalence surveys. In this part of the review, we discuss the epidemiology and clinical features of this contemporary problem. While the epidemiology is marked by a stark increase in the number of chronic, relapsing and recurrent cases, the clinical distribution is marked by a disproportionate rise in the number of cases with tinea corporis and cruris, cases presenting with the involvement of extensive areas, and tinea faciei.
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Affiliation(s)
| | - Saumya Panda
- Department of Dermatology, Belle Vue Clinic, Kolkata, West Bengal, India,
| | - Pietro Nenoff
- Department of Dermatology and Laboratory Medicine, Laboratory of Medical Microbiology, Moelbis, Germany
| | - Archana Singal
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India,
| | - Shivprakash M. Rudramuruthy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Silke Uhrlass
- Department of Dermatology and Laboratory Medicine, Laboratory of Medical Microbiology, Moelbis, Germany
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India,
| | - Kavita Bisherwal
- Department of Dermatology, Venereology and Leprosy, Lady Hardinge Medical College and SSK Hospital, Delhi, India,
| | - Dipika Shaw
- Department of Medical Microbiology, PGI, Chandigarh, India,
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20
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Arammehr A, Dehghan P, Chadeganipour M, Katoueezadeh M, Shadzi S. Detection of Dermatophytes from Dermatophytosis-Suspected Cases in Iran, Evaluation of Polymerase Chain Reaction-Sequencing Method. Adv Biomed Res 2021; 9:56. [PMID: 33457339 PMCID: PMC7792868 DOI: 10.4103/abr.abr_21_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/25/2020] [Accepted: 08/05/2020] [Indexed: 11/04/2022] Open
Abstract
Background Dermatophytosis is mostly caused by dermatophytes species, and the diagnosis of disease is very important for early treatment. The aim of this study was to identify the commonly dermatophytes species isolated directly from the clinical samples, using the polymerase chain reaction (PCR) and evaluate both conventional and molecular methods. Materials and Methods This study was performed on 115 clinical samples. Dermatophyte isolates were initially identified by conventional method and confirmed by the sequencing molecular method. In this study, the molecular technique is implemented directly on clinical samples. Statistical analysis of the information was performed by the SPSS software, and the results were statistically analyzed. Results Our findings demonstrated that the most abundant dermatophyte species by PCR-sequencing were Trichophyton mentagrophytes (20%), followed by Trichophyton tonsurans (10%), Trichophyton rubrum (6.7%), T. interdigital (6.7%), Arthroderma otae, and Arthroderma vanbreuseghemii, (3.3%) for each one. Conclusion For medical laboratories, routine procedures are still preferred because of their lower cost, and the results are almost the same as the molecular methods. The sensitivity and specificity values for PCR under our laboratory condition were 60% and 87%, respectively. This study shows that molecular results performed better in nails than other samples, by culture results.
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Affiliation(s)
- Akbar Arammehr
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvin Dehghan
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Chadeganipour
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Katoueezadeh
- Department of Hematology and Medical Laboratory Science, Faculty of Allied Medicine, Kerman university of Medical Sciences, Kerman, Iran
| | - Shahla Shadzi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Leung AK, Lam JM, Leong KF, Hon KL. Tinea corporis: an updated review. Drugs Context 2020; 9:dic-2020-5-6. [PMID: 32742295 PMCID: PMC7375854 DOI: 10.7573/dic.2020-5-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/18/2020] [Accepted: 06/25/2020] [Indexed: 02/07/2023] Open
Abstract
Background Tinea corporis is a common fungal infection that mimics many other annular lesions. Physicians must familiarize themselves with this condition and its treatment. Objective This article aimed to provide a narrative updated review on the evaluation, diagnosis, and treatment of tinea corporis. Methods A PubMed search was performed with Clinical Queries using the key term ‘tinea corporis.’ The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies, and reviews. The search was restricted to the English language. The information retrieved from the mentioned search was used in the compilation of the present article. Results Tinea corporis typically presents as a well-demarcated, sharply circumscribed, oval or circular, mildly erythematous, scaly patch or plaque with a raised leading edge. Mild pruritus is common. The diagnosis is often clinical but can be difficult with prior use of medications, such as calcineurin inhibitors or corticosteroids. Dermoscopy is a useful and non-invasive diagnostic tool. If necessary, the diagnosis can be confirmed by microscopic examination of potassium hydroxide wet-mount preparations of skin scrapings from the active border of the lesion. Fungal culture is the gold standard to diagnose dermatophytosis especially if the diagnosis is in doubt and results of other tests are inconclusive or the infection is widespread, severe, or resistant to treatment. The standard treatment of tinea corporis is with topical antifungals. Systemic antifungal treatment is indicated if the lesion is multiple, extensive, deep, recurrent, chronic, or unresponsive to topical antifungal treatment, or if the patient is immunodeficient. Conclusion The diagnosis of tinea corporis is usually clinical and should pose no problem to the physician provided the lesion is typical. However, many clinical variants of tinea corporis exist, rendering the diagnosis difficult especially with prior use of medications, such as calcineurin inhibitors or corticosteroids. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made and appropriate treatment initiated.
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Affiliation(s)
- Alexander Kc Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Joseph M Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kin Fon Leong
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong
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