scholarly journals Tinea Pseudoimbricata caused by Trichophyton rubrum

2020 ◽  
pp. 22-25
Author(s):  
Hyeong Mok Kwon ◽  
Hye Ri Kim ◽  
Dong Hoon Shin ◽  
Jong Soo Choi
Keyword(s):  
Potassium Hydroxide ◽  
Trichophyton Rubrum ◽  
Fungal Culture ◽  
Special Subset ◽  
Tinea Incognito ◽  
Polymerase Chain ◽  
Cutaneous Fungal Infection ◽  
Erythematous Plaques ◽  
Microscopic Findings ◽  
Left Abdomen

Tinea pseudoimbricata, a special subset of tinea incognito, is a cutaneous fungal infection with unusual tinea imbricata-like lesions caused by dermatophytes other than Trichophyton concentricum. Here we present a case of tinea pseudoimbricata. An 80-year-old woman presented with mildly pruritic, scaly, annular, erythematous plaques with inner small, annular, polycyclic, or arcuate plaques on the left abdomen and back for 1 month. The lesions enlarged after the application of topical corticosteroids about 2 months previously. A potassium hydroxide test performed on her lesions was positive. Fungal culture, light microscopic findings, and T. rubrum-specific real-time polymerase chain reaction confirmed the presence of T. rubrum. Thus, we diagnosed tinea pseudoimbricata caused by T. rubrum and treated successfully with oral and topical terbinafine.

Fungal Diversity and Onychomycosis

2019 ◽  
Vol 109 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Annette Joyce ◽  
Aditya K. Gupta ◽  
Lars Koenig ◽  
Randall Wolcott ◽  
Jessie Carviel
Keyword(s):  
Fungal Diversity ◽  
Potassium Hydroxide ◽  
Trichophyton Rubrum ◽  
Quantitative Polymerase Chain Reaction ◽  
Bacterial Species ◽  
The United States ◽  
Molecular Methods ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Generation Sequencing

Background: Onychomycosis is a fungal infection of the nail that is often recalcitrant to treatment and prone to relapse. Traditional potassium hydroxide and culture diagnosis is costly and time-consuming. Therefore, molecular methods were investigated to demonstrate effectiveness in diagnosis and to quantify the microbial flora present that may be contributing to disease. Methods: A total of 8,816 clinically suspicious toenail samples were collected by podiatric physicians across the United States from patients aged 0 to 103 years and compared with a control population (N = 20). Next-generation sequencing and quantitative polymerase chain reaction were used to identify and quantify dermatophytes, nondermatophyte molds, and bacteria. Results: Approximately 50% of suspicious toenails contained both fungi and bacteria, with the dermatophyte Trichophyton rubrum contributing the highest relative abundance and presence in 40% of these samples. Of the remaining 50% of samples, 34% had bacterial species present and 16% had neither. Fungi only were present in less than 1% of samples. Nondermatophyte molds contributed to 11.0% of occurrences in fungus-positive samples. All of the control samples were negative for fungi, with commensal bacterial species composing most of the flora population. Conclusions: Molecular methods were successful in efficiently quantifying microbial and mycologic presence in the nail. Contributions from dermatophytes were lower than expected, whereas the opposite was true for nondermatophyte molds. The clinical significance of these results is currently unknown.

Diagnosis of Trichophyton rubrum from Onychomycotic Nail Samples Using Polymerase Chain Reaction and Calcofluor White Microscopy

2008 ◽  
Vol 98 (3) ◽  
pp. 224-228 ◽  
Author(s):  
Aditya K. Gupta ◽  
Muhammad Zaman ◽  
Jagpal Singh
Keyword(s):  
Polymerase Chain Reaction ◽  
Fluorescence Microscopy ◽  
Polymerase Chain Reaction Assay ◽  
Potassium Hydroxide ◽  
Trichophyton Rubrum ◽  
Actin Gene ◽  
Chain Reaction ◽  
Calcofluor White ◽  
Round Polymerase Chain Reaction ◽  
Polymerase Chain

Background: A high rate of false-negative dermatophyte detection is observed when the most common laboratory methods are used. These methods include microscopic observation of potassium hydroxide–digested nail clippings and culture methods using agar-based media supplemented with cycloheximide, chloramphenicol, and gentamicin to isolate dermatophytes. Microscopic detection methods that use calcofluor white staining or periodic acid–Schiff staining may also be substituted for and have previously been reported to be more sensitive than potassium hydroxide–digested nail clippings. Methods: Trichophyton rubrum infections were detected directly from nails in a double-round polymerase chain reaction assay that uses actin gene–based primers. This method was compared with detection of fungal hyphae by using calcofluor white fluorescence microscopy of nail samples collected from 83 patients with onychomycosis who were undergoing antifungal drug therapy. Results: Twenty-six of 83 samples (31.3%) were found to be positive by calcofluor white fluorescence microscopy, and 21 of 83 samples (25.3%) yielded positive results for T rubrum when actin gene–based primers in a double-round polymerase chain reaction assay were used. When calcofluor white fluorescence microscopy and polymerase chain reaction assay were used, the combined detection was 46.9% compared with 31.3% when calcofluor microscopy and culture of nail samples on Sabouraud’s dextrose agar supplemented with cycloheximide, chloramphenicol, and gentamicin were used. Conclusions: These results suggest that the use of a direct DNA protocol is an alternative method for detecting Trichophyton infections. When this protocol is used, the presence of T rubrum DNA is directly detected. However, the viability of the dermatophyte is not addressed, and further methods need to be developed for the detection of viable T rubrum directly from nail samples. (J Am Podiatr Med Assoc 98(3): 224–228, 2008)

scholarly journals Majocchi’s Granuloma in a Healthy Adult Man – a Case Report

2015 ◽  
Vol 7 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Milan Bjekić ◽  
Jasna Gajica Basara
Keyword(s):  
World Literature ◽  
Trichophyton Rubrum ◽  
Topical Steroid ◽  
Skin Lesions ◽  
Hair Follicles ◽  
Fungal Culture ◽  
Direct Microscopy ◽  
Topical Corticosteroids ◽  
Tinea Incognito ◽  
Majocchi’S Granuloma

Abstract Majocchi’s granuloma was first described by Domenico Majocchi in 1883, as a deep chronic dermatophyte infection of hair follicles, in which dermatophytes penetrate the dermis through hair canals, forming granulomatous changes in the dermis and/or hypodermis. Majocchi’s granuloma has two different clinical variants: the first is a small perifollicular papular type, seen in otherwise healthy individuals, that occurs secondary to trauma (e.g. in women with chronic tinea pedis that extends to the legs and who shave their legs); the second is a type with deep plaques or nodular lesions in immunocompromised hosts. The diagnosis is primarily made using direct microscopy of unstained specimens and fungal cultures, while additional diagnostics (histology, PCR) are generally not necessary. It is most commonly caused by Trichophyton rubrum. We present a 26-year-old otherwise healthy man exhibiting blue erythematous patches over the skin of his abdomen on clinical examination, which agglomerated to form slightly raised plaques with irregular ovoid contours, spreading from umbilicus to the pubic region; they were covered with multiple red-blue, erythematous partly coalescing scales, eroded, firm papules and nodules. On pressure, some nodules excreted viscid and turbid sero-purulent content. The lesions were slightly itchy. The patient was previously unsuccessfully treated during at least 4 weeks with a topical steroid cream prescribed by his physician. Direct microscopy for fungi of skin scrapings and pus mounted in potassium hydroxide was negative. Cultures of the contents and scrapings were performed on Sabouraud’s glucose agar and Trichophyton rubrum was isolated. The diagnosis of Majocchi’s granuloma was made, and the patient was treated with itraconazole (200 mg daily) for eight weeks, when all lesions resolved and fungal culture was negative. Misapplication of topical corticosteroids over a long period, as in our case, can produce Majocchi’s granuloma. When assessing skin lesions of unusual appearance, especially if aggravated by corticosteroids, dermatologists and general practitioners should consider tinea incognito, which may appear in its invasive form of Majocchi’s granuloma. The available world literature shows that Majocchi’s granuloma presenting as tinea incognito caused by topical corticosteroids has been reported extremely rarely.

Diagnostic Accuracy of a Direct Panfungal Polymerase Chain Reaction Assay Performed on Stained Cytology Slides

2021 ◽  
pp. 030098582199156
Author(s):  
Alexandra N. Myers ◽  
Unity Jeffery ◽  
Zachary G. Seyler ◽  
Sara D. Lawhon ◽  
Aline Rodrigues Hoffmann
Keyword(s):  
Polymerase Chain Reaction ◽  
Diagnostic Accuracy ◽  
Molecular Techniques ◽  
Fungal Culture ◽  
Chain Reaction ◽  
Identification Of Fungi ◽  
Fungal Dna ◽  
Polymerase Chain ◽  
Panfungal Pcr ◽  
Pcr Targeting

Molecular techniques are increasingly being applied to stained cytology slides for the diagnosis of neoplastic and infectious diseases. Such techniques for the identification of fungi from stained cytology slides have not yet been evaluated. This study aimed to assess the diagnostic accuracy of direct (without nucleic acid isolation) panfungal polymerase chain reaction (PCR) followed by sequencing for identification of fungi and oomycetes on stained cytology slides from dogs, cats, horses, and other species. Thirty-six cases were identified with cytologically identifiable fungi/oomycetes and concurrent identification via fungal culture or immunoassay. Twenty-nine controls were identified with no cytologically or histologically visible organisms and a concurrent negative fungal culture. Direct PCR targeting the internal transcribed spacer region followed by sequencing was performed on one cytology slide from each case and control, and the sensitivity and specificity of the assay were calculated. The sensitivity of the panfungal PCR assay performed on stained cytology slides was 67% overall, 73% excluding cases with oomycetes, and 86% when considering only slides with abundant fungi. The specificity was 62%, which was attributed to amplification of fungal DNA from control slides with no visible fungus and negative culture results. Direct panfungal PCR is capable of providing genus- or species-level identification of fungi from stained cytology slides. Given the potential of panfungal PCR to amplify contaminant fungal DNA, this assay should be performed on slides with visible fungi and interpreted in conjunction with morphologic assessment by a clinical pathologist.

Detection of Aspergillus fumigatus by Polymerase Chain Reaction (PCR)

2019 ◽  
Vol 10 (04) ◽  
pp. 655-661
Author(s):  
Zainab H Abood AL-Asadi
Keyword(s):  
Polymerase Chain Reaction ◽  
Aspergillus Fumigatus ◽  
Oligonucleotide Primer ◽  
Rrna Gene ◽  
Fungal Culture ◽  
Chain Reaction ◽  
Isolation And Identification ◽  
Internal Transcribed Spacer Region ◽  
Polymerase Chain ◽  
The Impact

Aspergillosis refers to fungi infections of the respiratory tract caused by Aspergillus species, especially Aspergillus fumigatus. Infection of A. fumigatus was increased in the last few years due to either resistances to antibiotics or the influence of other factors such as other fungal infections. The present study aimed to review the impact of Aspergillus fumigatus in Aspergillosis cases, and study the role of Singleplex PCR for amplification of ITS1, ITS4 of rRNA gene in the detection of fungal isolate. In this study, One hundred sputum samples were collected from patients admitted to the specialize chest and respiratory diseases center / Baghdad who were suffering from respiratory problems. During these studied, molds were isolation and identification based on Conventional method (Direct microscopy by using 10% KOH, and fungal culture was done on Sabouraud Dextrose agar supplemented with chloramphenicol and on Czapek-Dox agar incubated at 37°C and examined for 3-7 days then macroscopic, microscopic examination of the colony by(lactophenol cotton blue stain )and molecular methods by using Polymerase chain reaction (PCR)technique for identification. The 10% KOH examination was positive for 35 cases, while laboratory culturing was positive for 53 cases. Aspergillus sp were isolated from 44(83%) patients; A. fumigatus was isolated in 23 (42. 4%) patients while A. flavus, A. niger, and A. terreus were isolated from 11 (20. 08%), (13. 2%) and 3 (5. 7%) patients respectively, also isolated Penicillium spp. at percentage 1(1. 9%). In this study. The ages of participants ranged from 10-70years with a mean age of 34years, the males were more susceptible to fungal infection, were recorded 35/53 (66. 3), compared to females were 18/53 (33. 96). The infection of fungi was more prevalent in ages 30-40recorded 26(53. 06%) followed by ages 40-50, 13(26. 5), while the lowest infection recorded in the age group 10- 20 years was 2(2. 04%). DNA isolated from twenty-three A. fumigatus isolates was used as a template, and the specific of oligonucleotide primer sequences were used in conventional PCR to detect the presence of internal transcribed spacer region ( ITS) region of the rRNA gene for Aspergillus fumigates. The results of the PCR amplification of the rRNA gene showed that this gene was present in 19 samples out 23 positive samples which isolation with a PCR product size of approximated 385 bp, while 4 samples out 23 positive samples showed negative results for the presence of this gene as indicated by the absence of the PCR products in their relevant lanes. Statistical analysis revealed that the PCR to have a sensitivity of 95. 1% in the detection of Aspergillus fumigatus in Aspergillosis cases. Polymerase chain reaction (PCR) is a rapid, specific, and sensitive method to detect Aspergillus fumigatus in aspergillosis cases of humans.

Clinico-epidemiological study and microbiological correlation of tinea incognito at a tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 212-216
Author(s):  
Monisha K ◽  
Jagannath Kumar V
Keyword(s):  
Tertiary Care ◽  
Fungal Culture ◽  
Care Hospital ◽  
Diagnostic Dilemma ◽  
Steroid Abuse ◽  
Systemic Corticosteroids ◽  
Study Population ◽  
Tinea Incognito ◽  
General Physical ◽  
Systemic Examination

Tinea incognito also known as steroid-modified tinea are dermatophytic infections modified by the use of topical or systemic corticosteroids. Dermatophytic infection being very common and very simple to diagnose, is a diagnostic dilemma due to steroid abuse. Hence making a simple curable infection into a chronic persistent dermatological condition. As a treating doctor it’s important to recognize and educate the patients regarding the tinea infections and steroid abuse. To study the various morphological presentations, epidemiology and etiological agent of tinea incognito. An observational study was performed with 100 cases from 2017 to 2019 in the department of Dermatology & Venerology, SS Institute of Medical Sciences and Research, Davangere, Karnataka, India. The baseline data, thorough general physical, local, and systemic examination were done with reference to clinical features of tinea incognito. Skin scraping were collected and subjected to potassium hydroxide (KOH) preparation. The part of the sample was inoculated into Sabouraud’s Dextrose Agar (SDA) media for fungal culture. Later the fungus was identified by standard techniques. The mean age of study population was 32.83 years. The males outnumbered females in our study. Almost 29% cases remain asymptomatic followed by 34% itching and 37% burning sensation. The source of drug responsible for tinea incognito were highly suggested by friends (29%) with the combination use of drugs account for 35% of study population. 77% cases showed erythema followed by 48% of hypopigmentation. The scraping of lesion showed positive KOH mount in 71% and T.mentagrophytes were the most common dermatophyte grown in SDA medium. Misuse of steroid formulations in dermatophytic infections may lead to adverse effect as well as chronicity. Awareness of this problem is needed for prevention of steroid modified dermatophytosis, which is a rising menace.

PAS stain based histological classification and severity grading of toenail onychomycosis

2019 ◽  
Vol 58 (4) ◽  
pp. 453-459
Author(s):  
Xingpei Hao ◽  
Joon Yim ◽  
David Freedman ◽  
Sarwat Siddiqui ◽  
David Levine ◽  
...  
Keyword(s):  
Potassium Hydroxide ◽  
Detection Rate ◽  
World Wide ◽  
Response To Treatment ◽  
Fungal Culture ◽  
Histological Classification ◽  
Depth Level ◽  
Severity Grading ◽  
Severe Infections ◽  
Common World

Abstract Onychomycosis is a common world-wide health issue. Accurate detection is essential for treatment. Multiple studies have shown that PAS-stain based histological visualization of fungal elements is superior to either direct microscopy with 20% potassium hydroxide, or fungal culture. However, PAS stain based histological classification and severity grading of onychomycosis are lacking in the literature. Here we reported a fungal detection rate of 47.87% based on an analysis of 13,805 toenails processed for H&E and PAS stains over a three year period. Based on the analysis of fungal density, distribution and infiltrating depth level in 858 PAS-positive toenails, we created a novel PAS stain based histological classification system to classify onychomycosis as occult onychomycosis (OO), focal or diffuse subungual onychomycosis (FSO or DSO), focal or diffuse plate onychomycosis (FPO or DPO), focal or diffuse subungual and plate onychomycosis (FSPO or DSPO) and superficial onychomycosis (SO). The severities of OO, FSO and FPO were graded as mild, DSO and DPO as moderate, FSPO and DSPO as severe infections, which revealed that more than 75% PAS positive toenails were severe infections. Evaluation of 97 paired toenails biopsied pre- and post-treatment from 47 patients demonstrated that the severity of infection was significantly reduced from severe to mild and moderate levels. These data indicate that the current histological classification evaluates not only the severity of the fungal infection but also the response to treatment. We further propose a guideline for treatment of onychomycosis based on the histological classification and severity.

Genes coding for LysM domains in the dermatophyte Trichophyton rubrum: A transcription analysis

2019 ◽  
Vol 58 (3) ◽  
pp. 372-379 ◽  
Author(s):  
Lúcia Lopes ◽  
Tamires A Bitencourt ◽  
Elza A S Lang ◽  
Pablo R Sanches ◽  
Nalu T A Peres ◽  
...  
Keyword(s):  
Catalytic Domain ◽  
Trichophyton Rubrum ◽  
Carbohydrate Binding ◽  
Biological Functions ◽  
Chain Reaction ◽  
Transcription Analysis ◽  
Lysm Domain ◽  
Genes Encoding ◽  
Polymerase Chain ◽  
In Silico Analyses

Abstract The filamentous fungus Trichophyton rubrum is a pathogen that causes superficial mycoses in humans, predominantly in keratinized tissues. The occurrence of dermatophytoses has increased in the last decades, mainly in immunocompromised patients, warranting research on the mechanisms involved in dermatophyte virulence. The genomes of dermatophytes are known to be enriched in genes coding for proteins containing the LysM domain, a carbohydrate-binding module, indicating the possible involvement of these genes in virulence. Although the LysM domains have already been described in other fungi, their biological functions in dermatophytes are unknown. Here we assessed the transcription of genes encoding proteins containing the LysM domains in T. rubrum grown on different substrates using quantitative real-time polymerase chain reaction. Some of these genes showed changes in transcription levels when T. rubrum was grown on keratin. In silico analyses suggest that some of these proteins share features, namely, they are anchored in the plasma membrane and contain the catalytic domain chitinase II and signal peptide domains. Here we show a detailed study of genes encoding the proteins with LysM-containing domains in T. rubrum, aiming to contribute to the understanding of their functions in dermatophytes.

Clinical Study of various Nail Disorders presenting to Dermatology Outpatient Department

2017 ◽  
Vol 2 (3) ◽  
pp. 125-129
Author(s):  
Praveen K Rathore ◽  
Sapna Goyal ◽  
Anuj Kumar ◽  
Parul Garg
Keyword(s):  
Clinical Study ◽  
Potassium Hydroxide ◽  
Outpatient Department ◽  
Fungal Culture ◽  
Nail Bed ◽  
Nail Psoriasis ◽  
Medical College ◽  
Gram Staining ◽  
Nail Discoloration ◽  
Pachyonychia Congenita

ABSTRACT Aims and objectives To study the clinical spectrum of nail disorders including congenital, developmental, infectious, neoplastic, degenerative, dermatological, and systemic diseases affecting the nail unit. Materials and methods A total of 100 consecutive cases of nail disorders reporting to the dermatology outpatient department in Rohilkhand Medical College & Hospital were examined. Complete dermatological, systemic, hematological examinations, Gram staining, scraping for fungus, nail clipping for potassium hydroxide mount, fungal culture, biopsy from nail bed were undertaken in doubtful cases. Observations and results Among 100 cases, the most common was onychomycosis — 28 cases, followed by nail psoriasis — 13 cases, pitting — 10 cases, paronychia — 9 cases, trachyonychia — 5 cases, onycholysis — 4 cases, clubbing — 3 cases, koilonychia — 3 cases, ingrow toenail — 3 cases, pterygium — 3 cases, onychogryphosis — 2 cases, subungual wart — 2 cases, half and half nail — 2 cases, anonychia — 2 cases, longitudinal grooves — 2 cases, clubbing with resorption of fingers — 2 cases, onychomadesis — 1 case, nail discoloration — 1 case, melanonychia — 1 case, pachyonychia congenita — 1 case, beau's line — 1 case, racket nail — 1 case, transverse groove — 1 case. Conclusion Among examined cases, onychomycosis was most common followed by another nail disorders. How to cite this article Garg P, Kumar A, Rathore PK, Goyal S. Clinical Study of various Nail Disorders presenting to Dermatology Outpatient Department. Int J Adv Integ Med Sci 2017;2(3):125-129.

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