A Case of Terbinafine-Resistant Tinea Cruris Caused by Trichophyton tonsurans

A 26-year-old male patient referred to our center with a history of extremely itchy crusted skin lesions in his groins for one year. Moreover, his friend, a 25-year-old male, also developed similar lesions in the groin after using the shared pool, whose condition also did not improve with similar treatment. A regular mycology test (direct and culture test) was performed, as well as molecular examination. The antifungal susceptibility assay to terbinafine, itraconazole, posaconazole, fluconazole, and voriconazole was conducted according to the Clinical and Laboratory Standards Institute M38 third ed. The sequencing study identified T. tonsurans as the causative organism in both patients. The abovementioned organism isolated from both patients displayed resistance against terbinafine and fluconazole (MIC ≥ 4 µg/ml and MIC ≥ 8 µg/ml, respectively). Moreover, the susceptibility of both subjects to posaconazole (0.313 µg/ml), voriconazole (0.25–0.0625 µg/ml), and (1 µg/ml) itraconazole increased. The present report aimed to emphasize the increase in antifungal resistance and a demand for antifungal stewardship, to control this public health threat.

Trichophyton Species Isolated from Asymptomatic Patients of the Pet-owner Pair in Mexico

Background and Purpose: Superficial mycoses are the fourth most common cause of disease worldwide. It is not surprising that zoonotic transmission occurs to humans due to close contact with different animals, be it companion or farm animals. Therefore, the objective of this study was to determine the presence of asymptomatic dermatophyte carriers in the owner-pet pairs, identify the most common etiologic agents, and find the likely connection between the carrier status of an owner and the presence of dermatophytes in their pets. Materials and Methods: From May 2019 to January 2020, 21 cats and 115 dogs with their respective owners were selected for dermatophyte culture. All the dogs and cats included in the study were from the communities of southeastern Mexico. The samples were taken with a cotton swab, which was vigorously rubbed and twisted on the scalp or body of the pet four times and grown on Mycosel Agar. The isolates were identified based on macroscopic and microscopic characteristics. The prevalence of the binomial ranged from 0.73% in pet skin and human hands to 2.2% in human scalp. In humans, the agents were Trichophyton tonsurans and Trichophyton verrucosum, while in pets, a strain of Trichophyton sp was found. Conclusion: Different species of dermatophytes were found in the owner/pet pairs, which denotes that coexistence is not related in asymptomatic cases.

Human and Zoonotic Dermatophytoses: Epidemiological Aspects

IntroductionDermatophytes are a group of molds characterized by the ability to produce keratinases, thereby carving out for themselves specific ecological niches. Their traditional division into three genera, Trichophyton, Microsporum, and Epidermophyton has been expanded to nine and the species in each genus were modified. Dermatophytes are among the most prevalent causes of human and animal mycoses. Their epidemiology is influenced by various factors. These factors may be evolutive such as the predilected environment of the fungus, namely, humans (anthropophilic), animals (zoophilic), or environment (geophilic), is evolutionary and thus may require centuries to develop. Many other factors, however, result from a variety of causes, affecting the epidemiology of dermatophytoses within a shorter time frame.ObjectiveThis review aims at summarizing the factors that have modified the epidemiology of dermatophytoses during the last decades.ResultsGeographic and climatic conditions, demography such as age and gender, migration, socio-economic conditions, lifestyle, and the environment have had an impact on changes in the epidemiology of dermatophytoses, as have changes in the pattern of human interaction with animals, including pets, farm, and wild animals. A typical example of such changes is the increased prevalence of Trichophyton tonsurans, which spread from Latin America to the United States and subsequently becoming a frequent etiological agent of tinea capitis in Africa, Middle East, and other areas.ConclusionThe comprehension of the epidemiology of dermatophytoses has a major bearing on their prevention and treatment. Since it is undergoing continuous changes, periodic assessments of the most recent developments of this topic are required. This article aims at providing such an overview.

Molecular Characterisation and Phylogenetic Analysis of Dermatophytic Fungi Isolated from Tinea Capitis in Northwest Nigeria Using Sequence of the 28S rRNA

The detection and identification of fungal DNA from clinical samples is one of the fundamental approaches in biomedicine. The incidence, distribution, and control of dermatophytes has progress significantly and the use of phylogenetic species concepts based on rRNA regions have enhanced the taxonomy of dermatophyte species; however, the use of 28S rDNA genes has certain limitations. This gene has been used in dermatophyte taxonomy with limited enumeration; we appraised the sequence disparity within and among groups of the species, the gene ranking in identification, phylogenetic analysis, and taxonomy of 32 strains of eight dermatophyte species. In this study, a set of primers was adopted to amplify the target followed by a partial sequencing of the rDNA. The utilization of a pairwise nucleotide differentiation, an affinity was observed among eight dermatophyte species, with disparity among species ranging from 0 to 197 base pair (bp). Intra-species bp differences were found within strains of Trichophyton eriotrephon, Trichophyton bullosum, Trichophyton simii (Trichophyton genus), Microsporum audouinii, and Trichophyton tonsurans (Microsporum and Trichophyton genus, respectively); however, only some strains of Trichophyton eriotrephon were found to be invariant having three genotypes. Trichophyton tonsurans exhibited most intra-species variability. The characterization and construction of a phylogenetic tree of 28S rDNA gene on dermatophyte species provide a bedrock of an additional finding of connections between species. However, 28S rRNA capture provides a novel method of effective and sensitive detection of dermatophytes lodged in human skin scale. We report for the first time the emergence of T. eriotrephon, T. bullosum, T. simii, T. benhamiae, and Ctenomyces serratus dermatophytes from Tinea capitis in Nigeria.

Kerion Celsi in a Nepalese Boy: An Underdiagnosed Cause of Scalp Swelling

Tinea capitis (TC) is an infection of the scalp and hair caused by a dermatophyte fungus. Typically caused by the zoophilic and geophilic species of Microsporum and Trichophyton, it remains the commonest cutaneous fungal infection in children. A 9-year-old Nepalese boy was evaluated in outpatients for multiple boggy scalp lesions for two months. Suspecting a bacterial etiology, the lesions were excised and sent for cultures. While bacterial cultures failed to grow, endothrix spores were readily detected in potassium hydroxide preparation and histopathology. Trichophyton tonsurans was identified by the phenotype method and later confirmed by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF). Systemic antifungal therapy for 6 weeks along with local wound dressings resulted in complete recovery. At 2-year follow-up, focal alopecia was seen; however, no recurrence was noted.

IDENTIFIKASI JAMUR PENYEBAB TINEA MANNUM PADA PEDAGANG IKAN DI PASAR KODIM KOTA PEKANBARU

Tinea mannum merupakan infeksi jamur dermatofitosis yang terjadi pada kulit tangan. Penyakit ini umumnya menginfeksi pada pekerja yang lingkungan bekerjanya basah dan lembab termasuk pedagang ikan. Data tentang infeksi Tinea mannum masih sedikit di Indonesia, khususnya pada pedagang ikan di Pasar. Tujuan dari penelitian ini adalah untuk mengidentifikasi jamur penyebab Tinea mannum pada pedagang ikan di pasar Kodim Kota Pekanbaru. Penelitian ini merupakan suatu studi deskriptif dengan metode purposive sampling yang melibatkan 12 pedagang ikan yang menderita infeksi tinea mannum. Diagnosis ditegakkan berdasarkan pemeriksaan langsung secara makroskopis dan mikroskopis. Pemeriksaan mikroskopis langsung dengan menggunakan larutan KOH 10% dari kerokan kulit tangan, dan juga dilakukan kultur jamur pada media SDA. Hasil penelitian ini menunjukkan semua pedagang ikan terinfeksi Tinea mannum. Dua kelompok jamur yang ditemukan yaitu dermatofita seperti Trichophyton tonsurans sebanyak 5 jamur (6)% dan non dermatofita seperti Aspergillus sebanyak 6 jamur (30%), Yeast sebanyak 4 jamur (20%), Penicilium sebanyak 2 jamur (10%) dan Trichoderma sp., Basidiobolus sp., Fusarium sp., masing – masing sebanyak 1 jamur (5%).

A Case of Tinea Pseudoimbricata by Trichophyton tonsurans

Tinea imbricata is a unique dermatophytosis caused by Trichophyton concentricum, observed endemically in subtropical to torrid zones. It is characterized by development of impressive concentric rings on the trunk or limbs. And few dermatophytosis cases mimicking this disease are reported as "tinea pseudoimbricata". Herein, we report a case of tinea pseudoimbricata caused by T. tonsurans with multiple concentric annular erythemas. The common clinical manifestations of T. tonsurans infection are tinea capitis and tinea corporis. However, tinea imbricate-like lesions are very rare. Fungal culture and microscopic findings confirmed a T. tonsurans infection in this case. The patient was treated with topical isoconazle and additional oral terbinafine.

Tinea gladiatorum due to Trichophyton tonsurans in a school wrestling team in Mexico: A case series

Background and Purpose: Tinea gladiatorum is a type of dermatophytosis that occurs in combat athletes, such as wrestlers and judo fighters, as a result of Trichophyton species. Herein, we aimed to present a small outbreak of tinea gladiatorum in a high school in Mexico. Materials and Methods: Seven individuals belonging to the school fighting team were mycologically studied with direct examinations and cultures. In four cases, T. tonsurans was isolated and identified by morphological and proteomic methods (Matrix-assisted laser desorption/ionization- time-of-flight mass spectrometry). Out of the four subjects, two cases had clinical lesions presented as tinea corporis, and two cases were healthy carriers. Trichophyton tonsurans was also isolated from one of the four training mats (25%). All positive patients were treated with systemic or topical antifungals and achieved clinical and mycological cure. Conclusion: We report the first outbreak of tinea gladiatorum caused by T. tonsurans among a group of high school wrestlers in Mexico.