Superficial mycosis, at the site or distant to the surgical site, appears to predispose patients to bacterial periprosthetic joint infections

Background: It is traditionally believed that presence of fungal infection in the nail or skin of patients is a risk factor for subsequent infection. The literature is devoid of any evidence to confirm or refute this belief. This study examined a possible relationship between the presence of superficial skin or nail mycoses and subsequent periprosthetic joint infection (PJI) in patients undergoing total joint arthroplasty (TJA). Methods: This is a single-centre, retrospective study of patients who underwent primary TJA between 2000 and 2018. 55 patients with superficial mycoses of skin or nail, at the time of arthroplasty were identified and a variable number matching with up to a 1:5 ratio was performed with 182 patients undergoing TJA who had no superficial mycosis. The groups were further divided into knee and hip TJA. The outcome of TJA in the cohorts was compared. Results: Preoperative demographics were similar between the 2 groups. The incidence of PJI in patients undergoing TKA within a year was significantly higher in patients with superficial mycosis at 8.6% (3/35) compared to 0% (0/120) in patients without mycosis. However, all infections were caused by bacterial species and none were fungal. Multiple regression analysis demonstrated that the presence of superficial mycosis had a strong correlation with development of PJI postoperatively in our TKA cohort. Conclusions: Identification of fungal infection (mycosis) of skin and nail in patients awaiting TJA is important. These patients appear to have a higher risk for developing bacterial PJI than those without fungal infections. Further study is needed to determine if treatment of these patients prior to arthroplasty stands to reverse the high risk for PJI that these patients carry.

Isolation and Identification of Candida Species and Some Superficial Mycosis Associated with Diaper Dermatitis in Erbil City

Diaper dermatitis (DD) is the most common cutaneous diagnosis in infancy that affects almost every child during the early months of their life time; most cases are associated with the yeast colonization of Candida or DD candidiasis and some dermatophytes. It is an irritating and inflammatory acute dermatitis in the perineal and perianal areas resulting from the occlusion and irritation caused by diapers. The study aimed to assess the association between Candida species and some dermatophytes in infants with napkin dermatitis and determine the prevalence of DD in relation with yeast (Candida) colonization and identify common Candida spp. which is responsible for Candida (fungal) DD among infants. Data from 210 infants aged between (0 and 18) months are collected from January to August 2018 in Raparin Hospital in Erbil City. The cases include 113 (53.80%) male infants and 97 (46.19%) female infants and diagnosed with DD. Results of 210 infant with diaper rash participated in this study. 188 (89.52%) were positive for Candida spp. and Dermatophytes (molds). From the total yeast number, Candida albicans was the most predominant species accounting 128 (84.21%), while 24 (15.78%) were non-albicans and dermatophyte molds among which Malassezias spp that accounted 26 (13.83%) and 10 (5.32%), respectively. The percentage of misdiagnosed cases was 9 (4.28%). Infants at age group 6–12 months showed high frequency with diaper rash 127 (60.47%). The prevalence of DD is higher in urban 120 (57.14%) than rural area 90 (42.85%). Furthermore, high prevalence DD found in hot season than colds was 121 (64.36%) and 67 (35.63%), respectively. In conclusion, I found that there are high association between DD with Candida spp. and dermatophytes and Candida albicans is a common invader of all types of napkin eruption.

Clinico-Mycological Study of Superficial Mycoses in a Tertiary Health Care Centre of Southern Assam

Background-Superficial Mycosis, which is the most common fungal infection affecting human beings, includes Dermatophytosis and Dermatomycoses, which are the infections of superficial keratinized layer of skin, nail & hair by Dermatophytes and non Dermatophytic moulds or yeasts respectively. This clinical entity is very common in hot, humid tropical climate of India with prevalence ranging from 30-60% but its precise case magnitude and epidemiology in North eastern India cannot be stated as there are only few studies conducted. So, this study is undertaken to 1) Find the prevalence of Superficial Mycosis in a tertiary health care centre of Southern Assam. 2) Study the clinical profile of the cases 3) Isolate and identify the causative agents of Superficial mycosis. Materials & Method- The study has been conducted on 250 samples from clinically suspected and untreated cases of superficial mycosis from Aug 2017 to Dec 2018. 2 separate sets of samples from edge of skin lesion/nail /hair were collected, of which 1 sample was subjected to direct microscopy with (10-40) % KOH and the other part was subjected to 2 sets of fungal culture in SDA tubes at 25°C and 37°C & followed for 3 weeks. In Culture positive cases, fungal identification was based on colony morphology, pigment production & LPCB mount. For confirmation of isolates, Slide Culture and biochemical tests were done. Result-Out of total 250 samples,115 samples (46%) showed presence of fungal elements in KOH examination, of which 73 were culture positive and of the KOH negative samples 10 samples were culture positive, thus making the prevalence 33.2% (83/250). Clinically, Tinea corporis was the most common form of both superficial mycosis & Dermatophytosis and Pityriasis Versicolor has been found the most common Dermatomycosis. Males(21-50yrs) were affected by superficial mycosis more than Females(16-30yr). Trichophyton mentagrophyte was the mostly isolated agent causing superficial mycosis. Keywords: Superficial mycoses, prevalence, Assam, Slide Culture, Urease.

Preparation of Topical Itraconazole with Enhanced Skin/Nail Permeability and In Vivo Antifungal Efficacy against Superficial Mycosis

In this study, a stable and highly skin-permeable topical delivery system for itraconazole (ITZ) was designed to provide effective treatment against superficial mycosis. Herein, ITZ was incorporated into a solution composed of ethanol, benzyl alcohol, hydrochloric acid, Transcutol P, and cyclomethicone as a delivery vehicle, solubilizer, protonating agent, permeation enhancer, and spreading agent, respectively. At 72 h, the optimal topical ITZ formulation (ITZ–TF#11) exhibited 135% enhanced skin permeability, which led to increases in drug deposition in the stratum corneum, epidermis, and dermis of 479%, 739%, and 2024%, respectively, compared with the deposition of 1% ITZ in ethanol (control). Moreover, on day 7, ITZ–TF#11 demonstrated 2.09- and 2.30-fold enhanced nail flux and drug deposition, compared with the control. At a dose of 40 mg/kg/day, ITZ–TF#11 showed 323% greater lesion recovery, a 165% lower mean erythema severity score, and a 37% lower mean logarithm of viable fungal cells in skin in the treated area, compared with mice that received oral ITZ at the same dose. Overall, the findings imply that ITZ–TF#11 is a superior alternative to oral ITZ for treatment of superficial mycosis.

New Record of Bipolaris cynodontis: An Emerging Human Pathogen Causing Superficial Mycosis in North India

Superficial mycosis, a common fungal infection affecting people worldwide are prevalent in the tropical and subtropical countries, mostly caused by the dermatophytes but nowadays, there is an increase in the incidence of these infections being caused by non-dermatophytic fungi and yeasts. Among non-dermatophytes, Bipolaris species, usually known to cause diseases in plants, have also emerged as potent human pathogens in the past years. Reports on Bipolaris species associated with clinical human skin samples are rare worldwide with no reports on B. cynodontis as a causal agent of superficial human skin mycoses from India. We report the first case of superficial mycosis caused by B. cynodontis that affected the feet of a 19-year-old female student from Jammu district, Jammu and Kashmir, India. Thus, the causal agent described in the research communication constitutes a new addition to the list of pathogenic non-dermatophytes associated with human skin.

A clinical and mycological study of superficial mycosis

<p><strong>Background: </strong>Superficial mycosis is among the most frequent forms of human infection affecting more than 20-25% of world’s population. Current study aims at assessing the clinical profile of dermatophytic infection and to identify the fungal species responsible. <strong></strong></p><p><strong>Methods: </strong>A prospective study conducted on 100 patients with clinically suspected dermatophytosis presenting to Skin OPD in a tertiary hospital in north Karnataka. A detailed clinical history, general physical examination and systemic examination routine lab investigations were done. Sample collection for mycological examinations was done for direct microscopy in 10% KOH (40% KOH for nail) and fungal culture an SDA with 0.5% chloramphenicol and 0.5% cyclohexidine was done in every case.<strong></strong></p><p><strong>Results: </strong>A total of 100 patients were included in the study. Male:female ratio was approximately 3:2. Maximum numbers of cases were in the age groups of 16-30 years (46 cases). 46% patients had multiple site involvement followed by tinea corporis in 20 (20%), tinea cruris in 18 (18%), tinea unguium (8%), tinea manuum (3%), tinea pedis (3%), tinea barbae (1%), and tinea faciei (1%). Potassium hydroxide examination was positive for fungal elements in 88(88%) patients and 35(35%). The most common species identified were. <em>Trichophyton rubrum</em> in 60% samples, followed by <em>Trichophyton mentagrophytes </em>in 20%.</p><p><strong>Conclusions:</strong> Present clinical and mycological study showed tinea corporis as the most common clinical pattern followed by tinea cruris and <em>T. rubrum</em> as the most common causative agent.</p>

Superficial mycosis profile in the Tertiary Hospital Dr. Moh. Hoesin Palembang: retrospective research

Background Superficial mycoses is a fungal infection of the skin, nails and hair thatcaused by dematophytes, yeast and mold. Superficial mycoses infections are commonlyfound in high temperature and humidity area such as Indonesia. Palembang is one ofregions in Indonesia has a high temperature and humidity, considered the incidenceof this disease is high. A retrospective study of new cases of superficial mycoses, datataken from medical records and register book at Policlinic of Dermatology andVenereology Dr. Moh. Hoesin Palembang during 5 years from January 2014-December2018. There were 1,236 (17.1%) new cases of superficial mycoses. Incidence ofsuperficial mycoses varies with range 6.9%-23%. The most common superficialmycoses is dermatophytes (38,3%). Microsporum canis, Trichophyton rubrum danTricophyton hmentagrophytes are frequent isolates in this study. The most age groupis 36-45 years (17.6%) with male more than female. Superficial mycoses are often foundin students (26.9%), followed by unskilled workers (20.8%). Of the 1,236 new cases,125 patients had comorbidities, such as malignancy 21 (16.8%) patients,cerebrovascular disease and diabetes mellitus each 16 patients (7.4%). Inguinal andabdomen are the most commonly infected regions. 656 (53.1%) patients was giventopical antifungal. The most common topical antifungal was ketoconazole 2% cream(62%) and systemic antifungal was itraconazole (55,3%).Conclusion: Cases ofsuperficial mycoses, especially dermatophytosis and Malassezia were still commonlyfound, especially in Palembang.