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Crotti S, Cruciani D, Spina S, Piscioneri V, Natalini Y, Pezzotti G, Sabbatucci M, Papini M. A Terbinafine Sensitive Trichophyton indotineae Strain in Italy: The First Clinical Case of tinea corporis and onychomycosis. J Fungi (Basel) 2023; 9:865. [PMID: 37754973 PMCID: PMC10532841 DOI: 10.3390/jof9090865] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/18/2023] [Accepted: 08/20/2023] [Indexed: 09/28/2023] Open
Abstract
Trichophyton indotineae is an emerging dermatophyte species that plays a relevant role in human healthcare. It has been associated with severe chronic skin infections and a high level of terbinafine resistance. T. indotineae is endemic to India, Iran, and Iraq but several cases have been reported in Europe, recently. In this manuscript, the authors report the first clinical description of a tinea corporis and onychomycosis due to T. indotineae. The patient was a 42-year-old female from India that has lived in Umbria (Central Italy) for the last two years. Firstly, a dermatological examination suggested dermatophytosis: mycology isolation from cultures and macro- and microscopical features identified the colonies as belonging to the T. mentagrophytes/T. interdigitale species complex. Subsequently, ITS1/ITS4 end-point PCR and Sanger sequencing identified the strain as T. indotineae. Lastly, a DermaGenius® Resistance Multiplex real-time PCR assay was carried out, targeting the mutations in the SQLE gene to establish terbinafine resistance or susceptibility of the strain. The melting curve observed was compatible with wild-type positive control, identifying the strain as T. indotineae terbinafine-sensitive. An oral terbinafine treatment was associated with a topical ciclopirox nail solution, resulting in remission in its clinical manifestation. On 3 July 2023, the local Prevention Service notified the case to the Ministry of Health that then reported the information at national and international levels.
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Affiliation(s)
- Silvia Crotti
- Centro Specialistico Patologie Micotiche, Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati” (IZSUM), 06126 Perugia, Italy; (S.C.); (S.S.); (V.P.); (G.P.)
| | - Deborah Cruciani
- Centro Specialistico Patologie Micotiche, Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati” (IZSUM), 06126 Perugia, Italy; (S.C.); (S.S.); (V.P.); (G.P.)
| | - Sara Spina
- Centro Specialistico Patologie Micotiche, Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati” (IZSUM), 06126 Perugia, Italy; (S.C.); (S.S.); (V.P.); (G.P.)
| | - Vincenzo Piscioneri
- Centro Specialistico Patologie Micotiche, Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati” (IZSUM), 06126 Perugia, Italy; (S.C.); (S.S.); (V.P.); (G.P.)
| | - Ylenia Natalini
- Clinica Dermatologica di Terni, Università degli Studi di Perugia, 06123 Perugia, Italy; (Y.N.); (M.P.)
| | - Giovanni Pezzotti
- Centro Specialistico Patologie Micotiche, Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati” (IZSUM), 06126 Perugia, Italy; (S.C.); (S.S.); (V.P.); (G.P.)
| | - Michela Sabbatucci
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Roma, Italy;
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Pisa, 56126 Pisa, Italy
| | - Manuela Papini
- Clinica Dermatologica di Terni, Università degli Studi di Perugia, 06123 Perugia, Italy; (Y.N.); (M.P.)
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Cruciani D, Papini M, Broccatelli S, Agnetti F, Spina S, Natalini Y, Crotti S. Presumptive Zoonotic Kerion by Nannizzia gypsea: Case Report. Front Vet Sci 2021; 8:718766. [PMID: 34504889 PMCID: PMC8421798 DOI: 10.3389/fvets.2021.718766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/23/2021] [Indexed: 11/13/2022] Open
Abstract
Nannizzia gypsea (formerly Microsporum gypseum) belongs to geophilic dermatophytes, fungi involved in keratin degradation in the soil; however, they are also found in dogs and cats. Transmission to humans can occur directly by contact with soil, but indirect transmission via domestic animals is reported too. The exact source of the infection is usually difficult to assess and in most cases only hypothesised and rarely investigated. This case report describes a kerion caused by N. gypsea in a 2-year-old boy, where the contagion was probably secondary to domestic healthy carrier dogs. A “One-Health” approach involving human dermatologists and veterinarians, combined with the use of conventional and molecular-based techniques, allowed tracing of the epidemiological chain and managing of not only the treatment but also the prevention of a recurrence. The child's lesion began to regress after about 8 weeks of treatment with both systemic and topical therapy, while the dogs were given chlorhexidine and miconazole baths. No recurrences nor new infections occurred, demonstrating the effectiveness of the strategies used.
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Affiliation(s)
- Deborah Cruciani
- Centro Specialistico Patologie Micotiche, Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia, Italy
| | - Manuela Papini
- Clinica Dermatologica di Terni, Università degli Studi di Perugia, Perugia, Italy
| | - Sayra Broccatelli
- Centro Specialistico Patologie Micotiche, Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia, Italy.,Igiene degli Allevamenti e delle Produzioni Zootecniche, Dipartimento di Prevenzione, Unità Sanitaria Locale Umbria 2, Terni, Italy
| | - Francesco Agnetti
- Centro Specialistico Patologie Micotiche, Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia, Italy
| | - Sara Spina
- Centro Specialistico Patologie Micotiche, Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia, Italy
| | - Ylenia Natalini
- Clinica Dermatologica di Terni, Università degli Studi di Perugia, Perugia, Italy
| | - Silvia Crotti
- Centro Specialistico Patologie Micotiche, Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia, Italy
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Talamonti M, Malara G, Natalini Y, Bardazzi F, Conti A, Chiricozzi A, Mugheddu C, Gisondi P, Piaserico S, Pagnanelli G, Amerio P, Potenza C, Cantoresi F, Fargnoli MC, Balato A, Loconsole F, Offidani A, Bonifati C, Prignano F, Bartezaghi M, Rausa A, Aloisi E, Orsenigo R, Costanzo A. Secukinumab Improves Patient Perception of Anxiety and Depression in Patients with Moderate to Severe Psoriasis: A Post hoc Analysis of the SUPREME Study. Acta Derm Venereol 2021; 101:adv00422. [PMID: 33269404 PMCID: PMC9366680 DOI: 10.2340/00015555-3712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study evaluated whether secukinumab treatment for patients with moderate to severe plaque psoriasis correlates with improvements in symptoms of anxiety and depression. SUPREME was a 24-week, phase IIIb, multicentre, prospective study conducted across 50 centres in Italy with an extension period of up to 72 weeks. Assessments used were: Psoriasis Area Severity Index (PASI), Hospital Anxiety and Depression Scale (HADS) – Anxiety (HADS-A), and HADS – Depression (HADS-D) scores and Dermatology Quality Life Index (DLQI). Compared with baseline, a significantly greater proportion of patients who reported moderate to severe clinical symptoms of anxiety or depression (HADSA or HADS-D ≥ 11) were free of moderate to severe symptoms at weeks 16 and 48. The PASI and DLQI scores reduced over time with secukinumab treatment. Psoriasis treatment with secukinumab for 48 weeks resulted in significantly improved skin clearance and a parallel improvement in symptoms of anxiety and depression, assessed by HADS.
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Papini M, Russo A, Natalini Y, Troiani L, Cassiani L. Secukinumab is an effective and safe treatment for refractory pityriasis rubra pilaris. Ital J Dermatol Venerol 2020; 156:501-502. [PMID: 33179881 DOI: 10.23736/s2784-8671.20.06743-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Manuela Papini
- Dermatology Clinic of Terni, University of Perugia, Terni, Italy -
| | - Ada Russo
- Dermatology Clinic of Terni, University of Perugia, Terni, Italy
| | - Ylenia Natalini
- Dermatology Clinic of Terni, University of Perugia, Terni, Italy
| | - Lucas Troiani
- Dermatology Clinic of Terni, University of Perugia, Terni, Italy
| | - Lorenzo Cassiani
- Dermatology Clinic of Terni, University of Perugia, Terni, Italy
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Affiliation(s)
- Manuela Papini
- Dipartimento di Scienze Chirurgiche e Biomediche, Clinica Dermatologica di Terni, Università degli Studi di Perugia, Perugia, Italy
| | - Ylenia Natalini
- Dipartimento di Scienze Chirurgiche e Biomediche, Clinica Dermatologica di Terni, Università degli Studi di Perugia, Perugia, Italy
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Abstract
Fournier's gangrene is a rare polymicrobial necrotising soft tissue infection affecting the perineum and scrotum. It is rapidly progressive, destructive and associated with high morbidity and mortality. Management protocol includes prompt diagnosis, early institution of antibiotic therapy and adequate wound debridement, usually requiring multiple operations. Rapid accurate diagnosis is crucial for successful outcome, while early aggressive surgical intervention together with fluid, hemodynamic and nutritional support and broad-spectrum antibiotics are essential to reduce mortality. Dermatologists are often the first specialist consulted. Two cases of Fournier's gangrene are reported in this report. The aim of the report is to underline the importance of an immediate diagnostic approach to save patients, favoured by a close collaboration among dermatologist, surgeon and urologist.
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Affiliation(s)
- Pietro Rubegni
- Department of Clinical Medicine and Immunological Sciences, Dermatology Section, University of Siena , Italy
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