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Background: The widespread occurrence of chronic and recurrent dermatophytosis has significantly affected the quality of life for patients in India and beyond. Identifying the causative dermatophytes and understanding their antifungal susceptibility can aid clinicians in tailoring effective antifungal therapies. Materials and Methods: Patients with chronic and recurrent dermatophytosis were enrolled, and conventional fungal cultures were conducted on skin scrapings. Identified isolates underwent antifungal susceptibility testing using the Clinical and Laboratory Standards Institute broth microdilution method (CLSI M38-A2) for common systemic antifungals, determining the minimum inhibitory concentration (MIC) range and calculating MIC 50 and MIC 90. Results: Sixty samples were tested. Tinea corporis was the most common presentation (66.6%). Trichophyton mentagrophyte species complex was the prevalent species (45, 75%), followed by Trichophyton rubrum (7, 11.7%). In Trichophyton mentagrophytes species complex, MIC range was 8-64 μg/mL for fluconazole, 0.06-0.25 μg/mL for terbinafine, and 0.125-0.5 μg/mL for griseofulvin. For Trichophyton rubrum , the MIC range was 8-64 μg/mL for fluconazole, 0.06-0.25 μg/mL for terbinafine, and 0.125-0.5 μg/mL for griseofulvin. For all species, itraconazole MIC was ≤0.125 μg/mL. Hence, itraconazole and terbinafine had the best MIC range against tested isolates in our study. Limitations: Absence of genotyping of isolate and not compared the results with studies where sequence-based identification to species level was done. Conclusion: In vitro , resistance to itraconazole for any of the four isolated agents was not seen. Terbinafine resistance appears to be an uncommon occurrence in South India. In vitro susceptibility tests shall be regularly done to design the epidemiological cutoff values. [ABSTRACT FROM AUTHOR]

Objective: In Pakistan, the real extent of fungal infection is unknown. Our objective was to estimate the burden of major fungal diseases here to emphasize their public health importance. Methods: In this retrospective study, the medical records (January 2019 December 2019) of 863 patients diagnosed with superficial fungal infection (SFI) were reviewed at the dermatology department of Aga Khan University Hospital (AKUH) Karachi. Stata 17.0 was used to analyze the data. Chi-squared test or Fisher's exact test was used to evaluate association between variables. Descriptive analyses include means, frequencies, standard deviations, and percentage tests whereas Poisson regression with robust standard error was used to examine the association of age, gender, diabetes, and type of SFI with recurrence of SFI. Results: In this study, the most common SFI was tinea cruris (234/863, 27.1%) in men (n=62, 21.7%) and females (n=172, 29.8%) followed by pityriasis versicolor (n=77, 26.9%) in males and tinea corporis (n=115, 19.9%) in females. Tinea cruris recurrence rates were similar between males and females (34/234, 14.5%). Conclusion: These findings show that fungal infections are a public health problem in Pakistan and that additional research is needed to assess their frequency in the general population. Clinicians must be taught and made aware of these infections to enhance diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: Dermatophytosis is highly prevalent in India owing to resistant and recalcitrant infection. TI (tinea incognito) is a modified form of dermatophytosis resulting from inadvertent TS (topical steroid) use. Similarly, TSDF (topical steroid-damaged face) is also caused by prolonged topical steroid use. Differentiation of TSDF and TI is difficult in face-affected cases. Dermoscopy can help in differentiating both by revealing their characteristic features. Aim: The present study aimed to assess dermoscopic and clinical features of tinea incognito affecting the face and topical steroid-damaged face. The study also observed the involvement of eyelids in tinea incognito as opposed to topical steroid-damaged face. METHODS: The present study assessed 160 subjects including 54 male and 106 female subjects with signs of tinea incognito or topical steroid-damaged face. In all the included subjects, demographic characteristics were gathered. Subjects that had applied tinea incognito or combination cream were finally included in the study. The study utilized a handheld dermoscope of 10X magnification and a potassium hydroxide mount was used for confirmation of tinea incognito diagnosis. Results: Among 160 study subjects assessed, there were 106 females and 54 male subjects where the meantime of application was 8.23±6.8 months. Clinical features seen in study subjects were burning sensation, scaling, erythema, and pruritus. Involvement of eyelids was seen in tinea incognito and was not seen in topical steroid-damaged face. On dermoscopic assessment, morphological features were dominant in tinea incognito, whereas, vascular features had dominancy in topical steroid-damaged face and white rosettes. Conclusions: The present study concludes that Dermoscopy is vital and helpful for distinguishing tinea incognito from topical steroid-damaged face comprehensively demonstrating the definitive features. In addition, the involvement of eyelids is an excellent clinical presenting sign in tinea incognito. [ABSTRACT FROM AUTHOR]

Neutrosophic environments have gained significant relevance across diverse disciplines. Neutrosophic Over Supra Exterior Modal Topological Structure is introduced, demonstrating the generation of two distinct structures through traditional Neutrosophic Over supra topological operations, denoted as ... (closure) and ... (interior), along with novel Neutrosophic Over Supra Exterior Modal Operations, expressed as ... (modal closure) and ... (modal interior). This exploration delves into the essential properties and characteristics of these structures, illuminating their behavior and implications. To illustrate the practical relevance, a numerical example is presented, demonstrating the identification of disease types using a score function. The study conclusively shows that the Neutrosophic Over Supra Exterior Modal Topological Structure effectively classifies diseases such as tuberculosis (bacterial), malaria (parasitic), swine flu (viral), and ringworm (fungal). This dual approach ensures a holistic understanding of the topic, appealing to both theoretical and practitioners seeking practical solutions in the neutrosophic over environment. [ABSTRACT FROM AUTHOR]

Background: Potential contagion and zoonotic risk make rapid diagnosis of dermatophytosis important amongst companion animals. Hypothesis/Objectives: To compare the adhesive tape impression (ATI), trichogram, Wood's lamp (WL) examination and fungal culture for diagnosis of dermatophytosis, and the ATI and trichogram for ease of use. Animals: Five dogs and 15 cats with consistent lesions, history and at least two positive dermatophyte test results. Materials and Methods: After WL examination, one representative lesion per patient was sampled for ATI, trichogram and fungal culture. Microscopic detection of fungal elements on ATI and trichogram were objectively and subjectively compared. The ability of all tests to correctly detect dermatophytosis, and the ability of ATI and trichogram to detect fungal elements in >20 high‐powered fields (HPF) were compared using Fisher's exact tests. Results: ATI, trichogram, fungal culture and WL were positive in 100% (20 of 20), 90% (18 of 20), 95% (19 of 20) and 65% (13 of 20) of patients, respectively, with a significant difference between WL and ATI (p = 0.0499). Fungal culture revealed Microsporum. canis (n = 16), Nannizzia gypsea (n = 1), Trichophyton mentagrophytes (n = 1) and T. rubrum (n = 1). Fungal elements were detected in >20 HPF more frequently with ATI (18 of 20) than trichogram (11 of 20) (p = 0.017), and detection required careful scanning to distinguish from background debris more often with trichogram. Fungal elements were located with neutrophil clusters and keratinocyte rafts in addition to abnormal hair fragments more frequently on ATI. Conclusions and Clinical Relevance: ATI had the highest ability to correctly diagnose dermatophytosis, and increased ease of detecting fungal elements compared to trichogram. [ABSTRACT FROM AUTHOR]

Background: Although cutaneous mycoses are a global public health problem, very few data are available in the Democratic Republic of Congo (DRC). Objectives: This study aimed to describe the retrospective clinical epidemiology of dermatomycosis and their associated risk factors in dermatological consultations in Kinshasa, DRC. Methods: A retrospective study based on the medical records of patients seen in the departments of dermatology of 2 major hospitals in Kinshasa from March 2000 to August 2023 was carried out. The diagnosis of the various types of dermatomycoses was established based on the dermatologist's clinical examination. Patient demographic and clinical data were collected for study purposes. Results: Of 27,439 patients consulted at the two sites, 1142 were diagnosed with dermatomycosis (4.16%). Young women aged 27 (17–43) were most affected. Diagnosed patients shared a history of skin mycoses (26%), use of skin‐lightening products (19%) and diabetes mellitus (9.6%). Among these patients, 59.3% suffered from dermatophytosis (tinea), 39.1% from malassesiosis and 1.2% from candidal dermatosis. While tinea was predominantly found in children (81.88%, p < 0.001), pruritus and pain in the lesions were preferentially reported by the dermatophytosis patients [65.25% (p < 0.001) and 79.1% (p < 0.001), respectively]. Tinea corporis (45.5%), tinea capitis (20.4%), tinea pedis (19.3%) and onychomycosis (10.2%) were the main nosological entities in the dermatophytosis group, and their distribution on the body surface depended on patients' age (p < 0.001) and sex (p = 0.012). Conclusions: Dominated by dermatophytosis, dermatomycosis are frequent in dermatological consultations in Kinshasa. While clinical diagnosis remains an important element in the description of dermatomycosis, a better epidemiological understanding would also require biological identification of the fungi involved, which was lacking in this study. [ABSTRACT FROM AUTHOR]

Dermatophytosis is a superficial fungal infection involving the keratinized tissues. Limited dermatophytosis is usually treated with topical antifungals. Amorolfine and luliconazole are relatively newer and superior topical antifungals much in use in recent times. To study the therapeutic efficacy and safety of luliconazole 1% and amorolfine 0.25% cream in patients with tinea cruris. A single-center, randomized, double-blind, non-inferiority study comparing luliconazole and amorolfine was conducted on patients with localized tinea cruris. 81 patients completed the study, with 40 patients treated with luliconazole and 41 patients treated with amorolfine. Both groups of patients were followed up at the end of 2 weeks. No statistically significant difference was found between luliconazole and amorolfine regarding improvement in erythema, scaling, pruritus, and mycological cure. Both the medications were safe and well tolerated by the patients. The duration of the study was short, and there was no long-term follow-up. Amorolfine is not inferior to luliconazole in treating limited tinea cruris. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate the antifungal activity of citronellal (CIT) against clinical isolates of T. rubrum and to show the possible mechanism of action involved. The antifungal potential of CIT was evaluated from the Minimum Inhibitory Concentration (MIC), Minimum Fungicide Concentration (MFC) and assays with ergosterol and sorbitol, to elucidate the possible mechanisms of action, and molecular docking. MIC and MFC values ranged from 4 to 512 µg/mL. Regarding the mechanism of action, the monoterpene demonstrated interaction with fungal ergosterol. In addition, it is possible to observe that CIT acts on crucial enzymes for the biosynthesis and maintenance of the fungal cell membrane, due to the ability of the monoterpene to bind to CYP51. The results obtained in this research demonstrate that CIT has the potential to become, in the future, a product for the treatment of dermatophytosis. Source: Adapted from biorender.com, 2023. [ABSTRACT FROM AUTHOR]

Feline dermatophytosis is a common dermatological manifestation that carries a good prognosis once a proper diagnosis has been achieved. In rare cases, dermatophytosis can manifest as a nodular dermatosis. This condition, known as dermatophytic pseudomycetoma, can be challenging to diagnose and treat. Surgical excision and systemic antifungal therapy are the standard treatments, which generally will carry a good prognosis for the patient. This case report describes a non‐surgical dermatophytic pseudomycetoma, which failed treatment with a singular antifungal agent, but improved when multiple antifungal medications were combined. This case highlights challenges associated with treating a cat with severe dermatophytic pseudomycetoma and concurrent feline leukaemia virus. [ABSTRACT FROM AUTHOR]

A wide variety of microbial species, including Trichophyton spp., have been detected in diabetic foot ulcers (DFUs). In particular, Trichophyton spp. cause tinea pedis (i.e., athlete's foot) and onychomycosis. However, investigations regarding the correlation between Trichophyton spp. and delayed wound healing are limited to case reports. Moreover, histological changes in wounds caused by Trichophyton spp. remain unclear. In this study, we sought to confirm the delayed wound healing phenotype caused by Trichophyton mentagrophytes infection in a full‐thickness excisional wound ob/ob mouse model through histopathological analysis. The inoculation of skin wounds in ob/ob mice with T. mentagrophytes sporules resulted in significant delay on wound healing. Further histopathological analyses demonstrated that the delayed wound healing in ob/ob mice was accompanied by reduced collagen fibre formation and inhibited granulation tissue formation, with spores and elongated mycelia retained in the wound bed and along the wound edges. This suggests that T. mentagrophytes colonization of wounds potentially contributes to delayed wound healing in patients with diabetes. These results suggest that neglected tinea pedis is a potential risk factor for delayed wound healing and progression to refractory wounds in patients with DFU. [ABSTRACT FROM AUTHOR]

Background: Fungal cultures are unavailable in many hospitals. The development of an effective sample storage solution for timely transportation would improve management of patients with superficial fungal skin and nail infections. Objectives: This study aimed to evaluate the efficacy of sample storage envelopes to preserve skin and nail samples for timely microscopic examination and culture for superficial fungal infections. Methods: Patients aged 18 years and above with suspected superficial fungal infections were enrolled. The samples were divided into four envelopes. The baseline 20% potassium hydroxide (KOH) examination and fungal culture served as reference points. The stored samples were reexamined on Days 3, 7, 14, and 28. Results: The study included 90 patients with suspected superficial fungal infections (45 skin and 45 nail lesions). Reference KOH examinations showed branching septate hyphae in 36 (80.0%) for skin and 35 (77.8%) for nail infections. Reference fungal cultures were positive for the growth of dermatophyte and nondermatophyte molds in 34 (75.6%) and 28 (62.2%) in skin and nail infections, respectively. Sample storage envelopes maintained 100% sensitivity and specificity for up to 28 days with KOH examination for both skin and nail samples. On Day 28, the fungal culture sensitivity was 70.6% for the skin and 64.3% for the nail samples, with specificities of 100.0% and 88.2%, respectively. Conclusions: Sample storage envelopes effectively maintained diagnostic accuracy for up to 28 days with KOH examination for both skin and nail samples. Given the high specificity even on Day 28 for fungal culture, transferring samples within 28 days remains a reliable practice. [ABSTRACT FROM AUTHOR]

Trichophyton (T.) mentagrophytes ITS genotype VIII, also known as Trichophyton indotineae, is a new species of the T. mentagrophytes/T. interdigitale complex and its first records, albeit under a different species name, are from the Indian subcontinent, Middle Eastern Asia, and West Asia. T. mentagrophytes genotype VIII (T. indotineae) has spread globally and has now been documented in over 30 countries. The aim of this study was to investigate the occurrence and proportion of terbinafine- and itraconazole-resistant isolates of T. mentagrophytes ITS genotype VIII (T. indotineae) in Bangladesh. This was part of an official collaborative project between IADVL (Indian Association of Dermatologists, Venereologists, and Leprologists) and Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. Over a period of 6 months, ninety-nine patients of chronic recalcitrant tinea corporis were recruited from BSMMU hospital. Species identification was performed by fungal culture and morphological observation of the upper and lower surfaces of fungal colonies, as well as by using fluorescent microscopy. In addition, a PCR (polymerase chain reaction)-ELISA was performed to group the patients into those with the T. mentagrophytes/T. interdigitale complex. The internal transcribed spacer (ITS) gene was sequenced. Samples were tested for resistance to terbinafine and itraconazole by mutational analyses of the squalene epoxidase (SQLE) and the ergosterol 11B (ERG11B) genes. A total of 79/99 samples showed a positive culture. In 76 of these isolates, T. mentagrophytes ITS genotype VIII (T. indotineae) could be reliably identified both by culture and molecular testing. Resistance testing revealed terbinafine resistance in 49 and itraconazole resistance in 21 patients. Among these, 11 patients were resistant to both the antifungal agents. Mutations L393S, L393F, F397L, and F397I of the SQLE gene were associated with terbinafine resistance. Resistance to itraconazole could not be explained by mutations in the ERG11B gene. Infections with T. mentagrophytes ITS genotype VIII (T. indotineae) have become a public health issue with potentially global ramifications. About 62% of samples from Bangladesh showed resistance to terbinafine, making oral itraconazole the most effective drug currently available, although resistance to itraconazole and both terbinafine and itraconazole also exists. [ABSTRACT FROM AUTHOR]

Background: Dermatophytosis is widespread in India due to recalcitrant and resistant infection. Tinea incognito (TI) is modified dermatophytosis due to the inadvertent use of topical steroids (TS). Similarly, topical steroid-damaged face (TSDF) is caused by prolonged use of TS. Distinction of TI and TSDF is difficult when the face is affected. Dermoscopy can assist in the differentiation of both by revealing characteristic features. We evaluated the dermoscopic features in TI affecting the face and TSDF. Aims and Objectives: To evaluate the clinical and dermoscopic features of TI affecting the face and TSDF. To observe the involvement of eyelids in TI as opposed to TSDF. Materials and Methods: The study was conducted in a tertiary hospital after obtaining ethical clearance and informed consent. Patients with signs of TI or TSDF were enrolled and demographic data were collected. Patients who had applied TS/combination creams were included. A handheld dermoscope with 10x magnification was used. A potassium hydroxide mount was used to confirm the diagnosis of TI. Results: Out of 80 patients, 27 males and 53 females were present. The mean duration of application was 8.25 ± 7 months. Clinical features were pruritus, erythema, scaling, and burning sensation. Eyelid involvement was noted in TI while it was spared in TSDF. On dermoscopy, morphological features were predominant in TI whereas vascular structures were found in TSDF in addition to white rosettes. Conclusion: Dermoscopy distinguishes TI from TSDF comprehensively by demonstrating definitive features. In addition, the involvement of the eyelid is an excellent clinical sign of TI. [ABSTRACT FROM AUTHOR]

Background: Trichophyton indotineae, a newly defined species within the T. mentagrophytes/T. interdigitale complex, has emerged as an epidemiological concern worldwide. However, owing to the limitations of commonly applied fungal identification techniques, T. indotineae remains underreported. In addition, T. indotineae's response to treatment has been described in only a few studies. Objective: To investigate the prevalence, clinical characteristics and treatment outcomes of terbinafine‐resistant T. mentagrophytes/T. interdigitale complex infections, as well as to detect T. indotineae cases. Patients and Methods: A retrospective cohort study was conducted on 22 patients with T. mentagrophytes/T. interdigitale complex infections between 2019 and 2023, using either culture or commercial polymerase chain reaction methods. Patient demographics, disease characteristics and treatment responses were recorded. Patients non‐responsive to oral terbinafine underwent further analyses, including DNA sequencing of the internal transcribed spacer region for accurate species identification and mutational analysis of the squalene epoxidase (SQLE) gene. Results: The mean age of the patients was 49.7 years (±18.2), with 54.5% men. Terbinafine‐resistant T. mentagrophytes/T. interdigitale complex infections were reported in 46.2% of the cohort (n = 6/13 patients; 9 lost to treatment response follow‐up), all of whom exhibited extensive dermatophytosis. Among the terbinafine‐resistant T. mentagrophytes/T. interdigitale isolates, all five isolates available for fungal analysis were identified as T. indotineae, harbouring SQLE single‐point mutations (Phe397Leu and Leu393Ser). Only three of the terbinafine‐resistant cases responded to oral itraconazole 200 mg/day, with two responding only to oral voriconazole and one to oral itraconazole 400 mg/day. Conclusion: All cases of T. mentagrophytes/T. interdigitale assessed in this study were identified as T. indotineae, which exhibits SQLE gene mutations. This underscores the importance of integrating methods to detect T. indotineae in routine clinical practice. [ABSTRACT FROM AUTHOR]

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Copyright of Microbes & Infectious Diseases is the property of Microbes & Infectious Diseases and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Kerion, a severe inflammatory type of tinea capitis, presents with purulent, boggy swelling and alopecia. Few articles in the literature provide information on this uncommon manifestation of tinea capitis (TC). This study aimed to determine the epidemiological and clinical characteristics of patients with Kerion over an 11-year period in an inpatient setting. Methods In this retrospective cross-sectional study, we enrolled all the admitted patients with inflammatory TC in the dermatology department of Shahid Faghihi referral hospital during 2011–2022. The data included demographic factors, animal contact, treatment, outcome, and past medical profiles. We used STATA 14.2 to analyze the data. Results One hundred and thirty-two patients with Kerion were enrolled in to the study. the mean age of patients was 7.6 ± 5.8 years. Boys (82.5%, n = 109) significantly outnumbered girls (17.5%, n = 23), and 82.2% of patients were under 11 years of age. Eight patients were one to two years old, two were infants under one year old, and five were adults. More than half (52.2%) of the patients were from rural areas. Most of the cases had heavily utilized systemic antifungal therapy, antibiotics, and corticosteroids. In addition, 43 patients reported positive animal contact. Over the course of an eleven-year period, there was a downward trend in the number of hospitalized patients. Conclusion We report one of the largest studies on Kerion patients over an eleven-year period. We have expanded the information on Kerion patients’ epidemiology, transmission mode, and clinical outcomes. To develop preventative strategies for Kerion, future studies should focus on additional risk factors and individual susceptibilities.

Dermatophytoses are infectious skin diseases of public health importance because of their transmissibility and high prevalence, especially among children. This is the first study aiming to estimate and report the burden of dermatophytoses on school-age children on the island of Santiago in Cape Verde, an African country that is an archipelago. A total of 249 students attending the afternoon shift of three elementary schools in the city of Achada Igreja were examined. Of these, 60 had suspected lesions of dermatophyte infection. However, from the samples collected from these 60 students, including hair, nails, and skin scrapings, only 18 dermatophyte isolates were obtained, corresponding to a point prevalence of 7.2%. Morphological species identification demonstrated three different species: Trichophyton soudanense, Trichophyton rubrum, and Trichophyton violaceum; re-identification by sequencing the internal transcribed spacer (ITS) 1 and 2 regions of ribosomal DNA, and the 5.8S rDNA encoding gene (ITS-5.8S region), revealed T. soudanense as the most prevalent species, with only one case of T. rubrum. This is the first epidemiological data describing dermatophytoses and dermatophytes in Cape Verde among school-age children on one of the archipelago islands. It reinforces the need of using culture and accurate identification methodologies when gathering epidemiological data on dermatophytoses. [ABSTRACT FROM AUTHOR]

Microsporum canis is considered one of the filamentous fungi that cause surface fungal contagion in the humans and animals. The present study aimed to diagnose M. canis via the molecular method and differentiating its local Iraqi isolates from global isolates. Microscopic examination showed 55 specimens with M. canis from 130 specimens collected from children aged between 4-10 years suspected of dermatophytes who attended Medical City Laboratories and Baghdad Hospital in Baghdad city from 1/12/2022 to 1/3/2023. The results showed that the frequency of M. canis infections was 55/130 (42.31%). The results demonstrated significant differences in the animals' contact (p <0.0001), lesions (0.03) and habitation area (p =0.002). Whilst the ages appeared with non-significant differences (p =0.6). In order to confirm the microscopic examination and compare the Iraqi isolates with other global ones, the 55 positive results with M. canis were further diagnosed by using internal transcribed spacer (ITS) 1 and 4 universal primers with a size of 550 bp for PCR amplicons. PCR amplicons sequencing showed only one isolate of M. Canis that differed from global isolates registered in the database of NCBI. The Iraqi local isolate of M. canis was registered with accession number: OM185328. In conclusion, the PCR technique using ITS rDNA aided in confirming the detection of dermatophytes. [ABSTRACT FROM AUTHOR]

Background: Dermatophytosis are a group of superficial fungal infection of keratinized tissues, such as the epidermis, hair, and nails.1 Dermatophytosis causes 16–75% of all the mycological infections worldwide and severe diseases in immunocompromised patients. Frequency, distribution, and their etiologic agents of dermatophytosis vary based on the age, topography, socioeconomic status, climate, and domestication of animals.2 It is more prevalent in tropical countries such as India, due to climate & living condition. 3. Method: It was a cross-sectional study of 110 patients attending the Dermatology outpatient of the Tertiary care center for 18months from March 2021 to September 2022. Clinically suspected cases of dermatophytosis with informed consent were included in the study. A pre structured proforma was used to collect data on history, clinical examination, KOH Mount, SDA Culture & Calcoflour stain. Patients on antifungals for >4 weeks & whose KOH or Culture showed organisms other than dermatophytes were excluded. Result: Among 110 patients of the study population, mean age group affected was 34.2 years. Males are more affected than females (54.55%) who were daily wage workers from lower socioeconomic strata. [Table 1]. Most common site of infection was Groin (54.54%) followed by buttocks (44.54%). The risk factors associated are poor hygiene & fomites among subjects [Table 2]. Most common clinical variant of dermatophytosis was Tinea corporis with cruris (42.73%). (Figure 1) Commonest organism isolated from the culture was Trichophyton mentagrophytes (24.55%) [Figure 3], followed by Trichophyton rubrum (22.73%) [Figure 4]; Trichophyton tonsurans (2.73%) and Trichophyton violaceum (1.81%) [Figure 5] with average time taken for the culture to grow was around 14 to 21 days. KOH & Calcofluor positivity was seen in 84 (98.82%) whereas KOH & culture positive was seen in 43 (75.43%). We found calcofluor with KOH could pick up faint fungal elements which was missed in culture. Conclusion: The study highlights Tinea corporis and Tinea cruris as the predominant clinical variant, with Trichophyton mentagrophytes emerges as the most frequently isolated organism, emphasizing its significance rampant & resistant dermatophytosis in this topography. Furthermore, the findings suggest Calcofluor staining as a superior method for microscopy in diagnosing dermatophytosis compared to KOH, potentially due to its enhanced sensitivity in detecting fungal elements. These observations provide valuable insights into the epidemiology and diagnostic methods of dermatophytosis but also emphasize the importance of accurate and efficient diagnostic techniques in clinical practice. This contributes to understanding of dermatophytosis & associated risk factors aiding in improved management of these infections. [ABSTRACT FROM AUTHOR]

Background: Tinea capitis is an infectious dermatosis frequent in children, causative fungi variable over time and space. The risk factors associated with this disease are still poorly understood. The objective of this study was to estimate the prevalence of tinea capitis among schoolchildren in Lomé (Togo), identify the fungal species involved and assess the associated risk factors. Patients and Methods: It was a cross‐sectional and case–control study conducted in primary schools in Lomé from November 2020 to April 2021. All pupils presenting tinea capitis suspected lesions have been sampled, and the scraping and hair were examined by direct microscopy in KOH solution and cultured in Sabouraud dextrose agar with chloramphenicol and cycloheximide. Positive children were matched by age and sex with those without symptoms for case–control study. Results: Out of the 15,087 pupils enrolled, 465 had positive cultures for dermatophytes, corresponding to the tinea capitis prevalence of 3.08% (95% CI [2.59–3.57]). Trichophyton mentagrophytes (81.86%) and Trichophyton soudanense (13.12%) were the majors isolated dermatophytes. The risk factors were mostly living in households with domestic animals, showering less than twice a day, having a history of ringworm, having similar lesions in the same household and sharing personal hygiene items. Conclusion: This study highlights the low prevalence of tinea capitis in schoolchildren in Lomé (Togo), the causative species dominated by T. mentagrophytes and emphasises the importance of environmental and behavioural factors in the mycosis transmission. Implementing preventive measures addressing the identified factors could help to reduce the prevalence of this disease. [ABSTRACT FROM AUTHOR]

Background: Dermatophytosis, caused by dermatophytes, affects up to 25% of people globally, with higher rates observed in Africa and Asia. While these infections are usually superficial, they can become severe in immunocompromised individuals. Despite their high prevalence, scientific research on dermatophytes is limited and the epidemiological data available are insufficient. In addition, diagnostic methods are not standardised and there are challenges with resistance to antifungals. Objectives: This study aimed to conduct a bibliometric analysis of scientific publications related to dermatophytes and dermatophytosis to assess research output and trends. Methods: A bibliometric analysis of publications from 2000 to 2023 in Web of Science and Scopus examined trends, citation counts, publication types, key journals, top authors and institutions and funding sources. Results: The analysis revealed a significant increase in dermatophyte‐related publications, with 15,868 articles retrieved from the Web of Science and 23,189 from Scopus. Research articles dominated the output, constituting 76.2% in Web of Science and 80% in Scopus. Peak publication years were 2019, 2021 and 2022 in Web of Science, and 2020, 2021 and 2023 in Scopus, with lower output between 2000 and 2002. The United States and India were the leading contributors, followed by Brazil and China, though citation metrics varied. Although there has been a rise in the number of publications, the amount of research conducted on dermatophytes is still very limited in comparison with other types of fungal diseases. Conclusions: Dermatophyte‐related research has increased over the past 2 decades. However, research gaps remain, particularly compared with other fungal diseases. Advances in diagnostics, antifungal testing and taxonomic classification are urgently needed. The study underscores the need for continued research and global collaboration to address these issues. [ABSTRACT FROM AUTHOR]

Dermatophytosis is distributed worldwide, with a global prevalence of 20%-25%, while allergic diseases have a high prevalence of 10%-45% in the global population. In recent years, research on the correlation between dermatophytosis and allergic diseases such as allergic rhinitis, atopic dermatitis, and asthma has been reported successively, highlighting a previously overlooked relationship between dermatophytes and allergic diseases. This review summarizes the research progress on fungal allergens, the correlation between dermatophytosis and allergic diseases, as well as the mechanisms of interaction, aiming to provide insights for the clinical diagnosis and treatment of dermatophytosis and allergic diseases. [ABSTRACT FROM AUTHOR]

The patient was a girl (case 1) and her mother (case 2). The family had purchased a domestic cat five months previously. Three months later, both patients developed eruptions. Mycological examinations were positive in both cases, and the cat tested positive on the hairbrush test. The macroconidia were thick only in the cat strain, and drug susceptibility testing showed mildly low levels of terbinafine and itraconazole. However, a molecular biological analysis of these three strains showed 100% identity with reference strains of Microsporum canis. Since there have been recent reports of drug-resistant dermatophytosis, drug-susceptibility testing is considered necessary. [ABSTRACT FROM AUTHOR]

Background: Dermatophytosis has lately become widespread in India. The presence of dermatophytosis for six months or more is described as chronic dermatophytosis. Chronic dermatophytosis may significantly affect one's quality of life. The aim of this study was to determine the impact of chronic dermatophytosis on quality of life. Materials and Methods: A total of 220 cases of chronic dermatophytosis were included in the study for the Dermatology Life Quality Index questionnaire. Statistical analysis was done using univariate/multivariate and regression analysis to analyze the effect of chronic dermatophytosis on quality of life. p < 0.05 was considered statistically significant. Results: Among the total 220 cases, 47.27% were males (mean age: 30.53 yrs.), and 52.72% were females (mean age: 36.24 yrs.). The mean DLQI score was 11.054. DLQI was significantly (p < 0.05) influenced by duration of illness and body surface area of the patient. Conclusion: Dermatophytosis is known to affect the quality of life of all patients, whereas chronic dermatophytosis causes a remarkably negative outcome on quality of life. Hence, reassurance and counseling of patients suffering from chronic disease is required along with timely and precise treatment. [ABSTRACT FROM AUTHOR]

Background: The most common superficial fungal infections are tinea corporis, tinea cruris, tinea capitis, tinea pedis, tinea unguium, and tinea facie and cutaneous Candida albicans infections such as oral thrush, oropharyngeal candidiasis, vaginal candidiasis, and onychomycosis. Aims and Objectives: (i) Analysis of prescription pattern of antifungal drugs and (ii) to study common adverse effects. Materials and Methods: A retrospective, observational study conducted in B. K. L. Walawalkar Hospital, Sawarde, Ratnagiri. A total of 993 case papers were analyzed after getting approval from the institutional ethics committee and permission from dermatology department. The frequency with percentage was used for the analysis of data. Results: In 993 patients with superficial fungal infections, 523 (52.7%) were males and 470 (47.3%) were females. Majority of patients were belonged to 21-40-year age group, i.e., 439 (44.2%) followed by 41-60 years, i.e., 244 (24.6%). Our study shows that the most common superficial fungal infections with single lesion were tinea corporis (22.3%), tinea cruris (14.6%), and pityriasis versicolor (13.9%). In Candida albicans, the most common infection was onychomycosis 14 (1.4%). The most common antifungal prescribed was luliconazole (20.84%) followed by itraconazole (20.58%). The most common route was topical route (68.26%). Combination of drugs was not prescribed. Different prescription indicators were that the average number of drugs prescribed per encounter was 3.4 and average number of drugs prescribed per encounter was 2.7. Conclusion: Most commonly prescribed newer antifungal was luliconazole. Next most commonly prescribed by oral route was itraconazole. In our study prescription pattern were rational approach in two points, they are no use of combination of drugs and many drugs were selected from essential medicinal list. [ABSTRACT FROM AUTHOR]

Dermatomycoses are the most widespread fungal skin infections worldwide and directly affect patients' quality of life. They are challenging to manage because of the need for prolonged treatment and the development of resistance to antifungal agents. This article studies the antifungal activity of trifluoromethylthiolated cinnamate derivatives on Candida species and dermatophytes as well as possible mechanisms of action, irritability, and cytotoxicity tests. These molecules show activity against dermatophyte fungi with minimum inhibitory concentrations (MIC) as low as 0.39 μg mL−1. In particular, chloroaromatic derivatives demonstrated the best inhibition profile (1.56–6.25 μg mL−1). Importantly, our series of molecules were not active against Candida spp., being selective for dermatophytes. A study of the mechanism of action suggests that our SCF3 cinnamates do not bind directly to ergosterol or the cell wall. The physicochemical parameters and the absence of irritability resulting from the HET‐CAM test demonstrate that compound 8 can be considered a future candidate for the therapy of dermatophytosis. [ABSTRACT FROM AUTHOR]

Background: In recent decades, globalization and international migration have increased the spread of infectious agents, including dermatophytes. Although considered minor infections, dermatophytoses are highly contagious, and they significantly reduce the quality of life, inducing itching, burning, sleep disturbances, and even depressive states. Moreover, the increasing resistance to antifungals threats the public health and burdens the costs for the healthcare system. Methods: DermaGenius® Resistance Multiplex real-time PCR assay allowed to analyze the terbinafine susceptibility/resistance of 172 Trichophyton strains, which were isolated from human and animal samples collected from 2016 to May 2024 and previously identified by Sanger sequencing. Results: All the 11 animal strains belonged to the T. interdigitale/T. mentagrophytes complex and tested terbinafine sensitive. Out of 161 human strains, 9 (5.6%) showed terbinafine resistance and 7 (4.3%) were identified as T. indotineae. Conclusions: This study provides preliminary data about behavior toward antifungals in animals and finalizes the scientific information currently available about human strains, highlighting the importance of the One Health concept. Moreover, it supports the relevant role of T. indotineae as an emerging dermatophyte with high proportion of terbinafine resistance. [ABSTRACT FROM AUTHOR]

Chronic mucocutaneous candidiasis (CMC) is characterized by recurrent infections with Candida spp., often linked to primary immunodeficiencies. We report a case of two 8‐year‐old monozygotic twin brothers presenting with extensive dermatophytosis, later diagnosed with autoimmune polyendocrinopathy, candidiasis, and ectodermal dystrophy (APECED) syndrome due to a homozygous p.M1V mutation in the AIRE gene. The twins exhibited widespread skin and nail infection, along with malabsorption, dental caries, and other autoimmune manifestations. This case highlights the novel presentation of extensive dermatophytosis in APECED, underscoring the variability in clinical expression even within a single family. [ABSTRACT FROM AUTHOR]

Introduction: Eosinophilic skin diseases encompass a broad spectrum, including Wells syndrome, which is characterized by histological findings of eosinophilic infiltration in the dermis. The etiology and pathogenesis of Wells syndrome are still unknown, but it has been reported that insect bites, infections, and medications can act as triggers. Fungal infections are common in clinical practice; however, when they are recurrent, have atypical characteristics, or are resistant to treatments, they must be recognized as potential triggers for hypersensitivity reactions such as Wells syndrome. Case Presentation: We present the clinical and histopathological characteristics of a case in which Wells syndrome was associated with a fungal infection. Conclusions: Wells syndrome is a rare skin disorder with polymorphic manifestations, making diagnosis challenging in clinical practice. Therefore, a high index of suspicion is required, and blood tests and skin biopsy are necessary to confirm the diagnosis. [ABSTRACT FROM AUTHOR]

Antifungal‐resistant dermatophytes (ARD) infection is a hotspot issue in clinical microbiology and the dermatology field. Trichophyton indotineae as the dominant species of dermatophyte with terbinafine‐resistance or multidrug resistance, is easy to be missed detection clinically, which brings severe challenges to diagnosis and treatment. ARD infection cases have emerged in China, and it predicts a risk of transmission among human. Based on the existing medical evidence and research data, the Mycology Group of Combination of Traditional and Western Medicine Dermatology and Chinese Antifungal⁃Resistant Dermatophytoses Expert Consensus Group organized experts to make consensus on the management of the infection. Here, the consensus formulated diagnosis and treatment recommendations, to raise attention to dermatophytes drug resistance problem, and expect to provide reference information for the clinical diagnosis, treatment, prevention and control. [ABSTRACT FROM AUTHOR]

Background: A common superficial illness called dermatophytosisis brought on by dermatophytes, a genus of keratinophilic, pathogenic fungi. In addition to invading the epidermal barrier, host immunological reactions to dermatophytes may partially cause tissue injury and pathologic inflammation. Understanding the pathophysiology of dermatophytosis, including fungal virulence factors and immune responses against pathogens, is therefore very beneficial. Dermatophytes are classified into nine genera based on the characteristics of their asexual spores, or macroconidae. This study aimed to detect the prevalence of dermatophytes in Egypt with mycological assessment before and after oral itraconazole therapy for chronic, recurrent, and recalcitrant dermatophytosis. Patients and methods: This study included 75 patients with different clinical types of chronic, recurrent, and/or recalcitrant dermatophytosis. All patients were subjected to adequate dermatological examination as regarding site and size of the lesions, the presence of associated papules, vesicles and/or pustules, lesion distribution, morphological variants, duration, and the presence of inflammation and scaling at each follow-up visit. All patients received oral itraconazole at a dose of 200mg/day for 6 weeks. Results: T.mentagrophytes was the most common isolated dermatophyte in patient with recalcitrant dermatophytosis (28%), followed by T.rubrumwhich represents (20%) of the recalcitrant tinea cases. as regarding Therapeutic response after end of itraconazole therapy, complete mycological cure was observed in (66.7%) of cases and complete clinical cure (69.3%) of cases. Recurrence after end of itraconazole therapy was detected in 13 cases (17%). Conclusion: T. mentagrophytesis the most common fungal isolates in patients with recalcitrant dermatophytosis. [ABSTRACT FROM AUTHOR]

This document explores the use of UVF-dermoscopy, a new imaging technique, in diagnosing and distinguishing between Microsporum and Trichophyton infections of the skin. The study found that polarized dermoscopy alone may not be enough to accurately differentiate between these two types of infections, particularly in cases involving glabrous skin. However, UVF-dermoscopy, which reveals green fluorescence, showed potential in distinguishing between the two types of infections. The study acknowledges its limitations and suggests that more research is necessary to validate these findings. [Extracted from the article]

Objective: To study the pattern of skin diseases in our population with respect to different age groups, gender and seasonal variations. Study Design: Observational Retrospective study. Setting: Department of Dermatology, Lahore General Hospital, a tertiary care referral hospital situated in second big city of Pakistan i.e Lahore. Period: July 2021 to June 2022. Methods: A total of 65284 patients presenting to skin OPD were studied. Demographic details were noted and diagnosis was made after detailed history, examination and appropriate investigations like scraping or smears. Data was analyzed for various age groups, gender distribution and effect of variables on diagnosis. Results: Out of 65284 patients, 38 %were male & 62% were female. Most of the patients (43%) were in age group of 21-40 years. Scabies was the most prevalent dermatosis and affected 27% of study population. Three most common dermatosis were tinea, scabies and acne. The maximum number of dermatosis was seen in the months of summer. Conclusion: Infectious diseases pose a major burden to skin health of most of the population suffering from dermatological problem. Fungal infections and scabies are treatable but very common diseases contributing in burden of dermatological disorder in population presenting to hospitals. [ABSTRACT FROM AUTHOR]

Background: The most typical dermatologic disorders worldwide include tinea infections. Skin ringworm infections, such as tinea corporis and tinea cruris, are caused by Trichophyton rubrum, Epidermophyton, and Microsporum canis. These are the main dermatophytes responsible for tinea. Red, scaly, itchy, and growing lesions should be tinea. It is most seen in males compared to females. All skin illnesses are categorized in Ayurveda as Kushta Roga (skin diseases), while Dadru Kushta (tinea) has a connection to the diseases caused by fungi. The illness has aggravated Pitta and Kapha dosha. The line of treatments for these illnesses includes palliative, purificatory intervention, and peripheral biocleansing procedures. However, in this case, we utilize palliative, mild laxative, and peripheral biocleansing procedures. Here, mild laxatives act as purificatory therapy to treat the illness. Purpose: To study the effect of Ayurvedic intervention in the management of tinea (Dadru). Methods: In this case report, a 41-year-old male patient receives Ayurveda treatment after 2 months of experiencing relief from ring-like patches, discoloration, and itching in the groin, upper back, and upper and lower thighs. He is diagnosed by presenting clinical symptoms, and pathological examination is the specific tool for diagnosis of fungal infection. Results: Significant improvements were seen in the parameters, including increased circular skin lesions, eruptions, erythema, and itching. He experienced 70% relief. Conclusion: Treated with the Ayurveda line of treatment is the best tinea infection treatment. [ABSTRACT FROM AUTHOR]

Background: Dermatophytosis, a prevalent fungal infection, often exhibits treatment failure. It poses ongoing public health concerns, urging exploration of alternative treatment strategies. This study examines eucalyptol's in vitro activity and its interaction with antifungal agents against dermatophyte isolates. Methods: Overall, 489 patients clinically suspected of dermatophytosis were investigated, and the causative agents were molecularly identified. The antifungal activity of eucalyptol, itraconazole, terbinafine, and griseofulvin was assessed according to the guideline of the Clinical and Laboratory Standards Institute (CLSI M38 ed3). The interaction between eucalyptol and the aforementioned antifungals was determined using a checkerboard method. Results: Dermatophytosis was confirmed in 30 out of 489 (6.13%) patients, with a female-to-male ratio of 3:2 and an age range of 8–67 years. The most commonly observed clinical manifestation was tinea corporis (34.21%), and Trichophyton indotineae (n = 14, 46%) was the most common causative agent. Antifungal susceptibility testing revealed that eucalyptol exhibited antidermatophyte properties with minimum inhibitory concentrations (MIC) ranging from 0.78 to 25 mg/mL. Itraconazole demonstrated the lowest geometric mean (GM) value (MIC range: 0.0019–0.25 µg/mL, GM: 0.015 µg/mL), while griseofulvin exhibited the highest GM value (MIC range: 0.125–8 µg/mL, GM: 2.37 µg/mL). The in vitro interaction of eucalyptol with antifungal drugs, except for its combination with terbinafine against two Trichophyton tonsurans isolates resulting in synergistic effects, showed indifference (n = 70, 77.77%) and antagonistic types (n = 18, 20%). Conclusion: Among the evaluated antifungals, itraconazole demonstrated the highest effectiveness against clinical isolates, while eucalyptol alone exhibited a more pronounced effect than when combined with antifungal agents. [ABSTRACT FROM AUTHOR]

Background: In a small state like Tripura, a surge in prevalence of superficial dermatophytosis has been observed from April to September among the population of both tribal and non-tribal groups having different lifestyle, different food habit, and different socioeconomic status. Studies from different region reveal varying pattern of etiological distribution of the disease. But till date no research study has been initiated in Tripura on clinicomycological profile of dermatophytosis. Objectives: This study was undertaken with the objectives to estimate the proportion of different fungal species associated with dermatophytosis among the patients attending Dermatology Outpatient Department of a Tertiary care hospital of Tripura and also to determine possible association of different clinical parameters with fungal species if any. Materials and Methods: A total of three hundred and ninety-one (391) new cases of dermatophytosis attending Dermatology Outpatient Department of a Tertiary care teaching hospital of Tripura were included in this study from June, 2021 to May, 2022. All the specimens were assessed by direct microscopic examination and in vitro culture. Fungi were identified on the basis of their macroscopic and microscopic features with the help of lactophenol cotton blue staining and urease test. Results: There was a male preponderance among cases and maximum patients belonged to 21-40 years age group. Trichophyton schoenleinii was the most common fungal species (52.1%) grown in culture followed by Trichophyton rubrum (26.9%). Conclusion: In contrast to previous study results from different parts of India, Trichophyton schoenleinii was the most common isolated fungal species from this part of northeast India, and Tinea corporis (41.3%) was the most prominent clinical manifestation of dermatophytosis. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is an etiological factor of tinea pedis (TP) which can increase the risk of diabetes-related foot complications. There is scarce research investigating the epidemiology of TP among patients with diabetes and this study contributed to filling this gap. Objective: To identify the prevalence and the associated factors of TP among patients with diabetes in Jordan. Methods: A total of 375 patients with diabetes were recruited in a cross-sectional study at the National Centre for Diabetes, Endocrinology and Genetics in Amman, Jordan. TP was examined by a specimen culture and microscopic study. Several independent variables were collected, including sociodemographic, clinical, and foot self-care variables. Multivariant logistic regression was conducted to test independent factors associated with the prevalence of TP. Results: Positive TP was present in 211 participants with a prevalence of 56.3%. Multiple logistic regression resulted in four significant associated factors; being highly educated (β = 1.69, p = 0.03), presence of onychomycosis (β = 4.48, p < 0.01), wearing socks as a daily habit (β = 2.30, p < 0.01), and frequency of feet washing (1–2 times\day) (β = 2.54, p = 0.04). Conclusion: Patients with diabetes in Jordan have a high prevalence of TP. Factors including educational level, onychomycosis infection, and self-care activities (i.e., socks wearing habits and foot hygiene) were found to be associated with the prevalence of TP. [ABSTRACT FROM AUTHOR]

Dermatological condition caused by dermatophyte fungi, affects the superficial keratinized structures of the skin. The primary etiological agents include the genera Microsporum, Trichophyton, and Epidermophyton. This study examines the incidence and characteristics of dermatophytosis lesions in domestic cats (Felis catus) at Go Pet Care Animal Clinic from 2020 to 2022. The research utilized secondary data from the clinic's medical records, which is a significant reference institution in Kabupaten Bandung Barat, to assess the prevalence and features of dermatophytosis within this population. The findings revealed a prevalence of 7.5% in 2020, 11.3% in 2021, and 3.7% in 2022. The incidence was highest in cats under 1 year of age, with a notable frequency in Persian breed cats and males. Common lesions identified included localized alopecia primarily in the ear region, alopecia in the back region, and crust formation also in the back area. This study provides critical insights into the epidemiology and clinical presentation of dermatophytosis in domestic cats, offering guidance for improved diagnosis and management of the condition. [ABSTRACT FROM AUTHOR]

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Introduction: There is an increasing number of reports of Trichophyton indotineae infections. This species is usually poorly responsive to terbinafine. Areas covered: A literature search was conducted in May 2024. T.indotineae infections detected outside the Indian subcontinent are generally associated with international travel. Reports of local spread are mounting. As a newly identified dermatophyte species closely related to the T. mentagrophytes complex with limited genetic and phenotypic differences, there is an unmet need to develop molecular diagnosis for T. indotineae. Terbinafine has become less effective as a first-line agent attributed to mutations in the squalene epoxidase gene (Leu393Phe, Phe397Leu). Alternative therapies include itraconazole for a longer time-period or a higher dose (200 mg/day or higher). Generally, fluconazole and griseofulvin are not effective. In some cases, especially when the area of involvement is relatively small, topical non-allylamine antifungals may be an option either as monotherapy or in combination with oral therapy. In instances when the patient relapses after apparent clinical cure then itraconazole may be considered. Good antifungal stewardship should be considered at all times. Expert Opinion: When both terbinafine and itraconazole are ineffective, options include off-label triazoles (voriconazole and posaconazole). We present four patients responding to these newer triazoles. Plain Language Summary: Ringworm (dermatophytosis, tinea) is a fungal infection of the skin, hair and nails that is commonly seen by primary and secondary healthcare providers. An estimated 20–25% of the global population is affected by this condition. In Europe and the United States, tineas are often treated empirically using over-the-counter medications, which can increase the risk of resistance development. While antifungal resistance is not a new problem, this topic has garnered the attention of physicians and researchers in recent years due to an outbreak from South Asia caused by a new pathogen known as Trichophyton indotineae. In this review, we summarize the global prevalence, diagnosis methods, antifungal resistance profile and treatment options for T. indotineae. Currently, most cases outside of South Asia are linked to international travel, there is evidence suggesting local person-to-person transmission and transmission via animal contact. One hurdle to surveilling the spread of this pathogen is the requirement of complex molecular diagnosis, tackling this challenge will require the development of newer assays. Terbinafine, a widely available antifungal drug, is becoming less effective owing to resistance mutations of the squalene epoxidase gene. Itraconazole has shown effectiveness, especially with a higher dose and a longer treatment duration. There is a significant risk of T. indotineae infections becoming chronic with episodes of relapse. When both terbinafine and itraconazole fail, newer agents such as posaconazole and voriconazole can be considered. Combination therapy using oral and topical medications should also be considered. [ABSTRACT FROM AUTHOR]

Background: Dermatophytosis is a common skin infection of cats and many other animals. A reliable diagnosis is crucial because of the zoonotic potential of dermatophytes. The routine mycological diagnostic procedures for dermatophytosis are widely known, but in the case of some isolates, identification based on phenotypic characteristics may be incorrect. Infections caused by Chrysosporium spp. are usually described in reptiles, but in other animals they are uncommon. Case presentation: This study presents a description of a cat with dermatological lesions, that was mistakenly diagnosed with Trichophyton spp. dermatophytosis. Clinical material for mycological examination was collected from alopecic areas on the back of the neck, the ventral abdomen, and the hindlimbs. The initial identification based on phenotypic properties indicated Trichophyton spp. The result of the MALDI-ToF MS allowed the exclusion of the Trichophyton genus. Ultimately, the correct identification as Chrysosporium articulatum was obtained based on the sequencing of ribosomal genes. Conclusions: Interpretation of the results of the mycological examination of samples collected from animals' skin or hair shafts is always challenging. Thus, careful consideration of the primary cause of the clinical lesions observed on the skin is mandatory, and the culture results are worth supporting by molecular methods. [ABSTRACT FROM AUTHOR]

Background: Over the past decades, the increasing incidence of recurrent dermatophytosis associated with terbinafine‐resistant Trichophyton has posed a serious challenge in management of dermatophytosis. Independent reports of failure of treatment and high minimum inhibitory concentrations (MIC) of antifungals are available, but data correlating MIC and clinical outcomes is still sparse. Therefore, the present study was conducted to evaluate the outcomes of systemic treatment of dermatophytosis and its correlation with MIC of the etiological agents isolated from such patients. Methods: Retrospective analysis of 587 consecutive patients with dermatophytosis was done from March 2017 to March 2019. Demographic and clinical details of the patients were noted, along with the results of direct microscopy and fungal culture. The isolates were identified by sequencing the internal transcribed spacer region of rDNA. Antifungal susceptibility testing was performed following the CLSI M38 protocol. Mutation in the squalene epoxidase (SE) gene was detected by DNA sequencing and ARMS‐PCR. Based on the culture‐positivity and prescribed systemic antifungal, patients were categorised into Group I culture‐positive cases treated with systemic terbinafine and Group II culture‐positive cases treated with systemic itraconazole, each for a total period of 12 weeks. Results: In the present study, 477 (81.39%) were culture‐positive; however, 12 weeks follow‐up was available for 294 patients (Group I‐157 and Group II‐137) who were included for statistical analysis. In both groups [Group I‐37/63 (51.4%) and Group II‐14/54 (58.3%)], a better cure rate was observed if the initiation of therapy was performed within <6 months of illness. Treatment outcome revealed that if therapy was extended for 8–12 weeks, the odds of cure rate are significantly better (p <.001) with either itraconazole (Odd Ratio‐15.5) or terbinafine (Odd Ratio‐4.34). Higher MICs for terbinafine were noted in 41 cases (cured‐18 and uncured‐23) in Group I and 39 cases (cured‐16 and uncured‐23) in Group II. From cured (Group I‐17/18; 94.4% and Group II‐14/16; 87.5%) and uncured (Group I‐20/23; 86.9% and Group II‐21/23; 91.3%) cases had F397L mutation in the SE gene. No significant difference in cure rate was observed in patients with Trichophyton spp. having terbinafine MIC ≥ 1or <1 μg/mL (Group I‐p =.712 and Group II‐p =.69). Conclusion: This study revealed that prolonging terbinafine or itraconazole therapy for beyond 8 weeks rather than the standard 4 weeks significantly increases the cure rate. Moreover, no correlation has been observed between antifungal susceptibility and clinical outcomes. The MIC remains the primary parameter for defining antifungal activity and predicting the potency of antifungal agents against specific fungi. However, predicting therapeutic success based solely on the MIC of a fungal strain is not always reliable, as studies have shown a poor correlation between in vitro data and in vivo outcomes. To address this issue, further correlation of antifungal susceptibility testing (AFST) data with clinical outcomes and therapeutic drug monitoring is needed. It also highlights that initiation of the treatment within <6 months of illness increases cure rates and reduces recurrence. Extensive research is warranted to establish a better treatment regime for dermatophytosis. [ABSTRACT FROM AUTHOR]

Background: Dermatophytosis impacts a significant portion of the global population. Recent shifts in the disease's presentation, severity and response to treatment, primarily due to emerging drug resistance, underscore the need for reliable assessment tools. The Dermatophytosis Severity Score (DSS) aims to standardise the evaluation of the disease's severity and monitor therapeutic responses. Methods: In a cross‐sectional pilot study, 25 adults with clinically diagnosed dermatophytosis were evaluated using the DSS. The study also aimed to establish the correlation of DSS with different stages of treatment, dermatophyte species and patient‐reported outcomes. Participants were recruited from a dermatology outpatient clinic, and the DSS was applied at baseline, Weeks 4 and 8. The validity and reliability of the DSS were assessed using statistical measures, including Cronbach's alpha and intraclass correlation coefficient. Results: The study comprised of a near‐equal distribution of male (52%) and female (48%) patients, primarily within the age group of 20–39 years. A high recurrence rate of dermatophytosis (60%) was noted, and more than half of the patients (56%) had used topical steroids before presentation. The mean DSS significantly decreased from baseline to the final visit, mirroring the substantial reduction in the 5D itch scale and Dermatology Life Quality Index, with strong positive correlations observed between these measures. Conclusion: The DSS demonstrated high inter‐rater reliability and internal consistency, indicating its utility as a reliable clinical tool for assessing dermatophytosis severity. The strong correlation of DSS with itch intensity and quality of life validates its role in patient‐centered care. Continued use and further validation of the DSS are recommended to enhance dermatophytosis management and treatment outcomes. [ABSTRACT FROM AUTHOR]

Caffeine affords several beneficial effects on human health, acting as an antioxidant, anti-inflammatory agent, and analgesic. Caffeine is widely used in cosmetics, but its antimicrobial activity has been scarcely explored, namely against skin infection agents. Dermatophytes are the most common fungal agents of human infection, mainly of skin infections. This work describes the in vitro effect of caffeine during keratinocyte infection by Trichophyton mentagrophytes, one of the most common dermatophytes. The results show that caffeine was endowed with antidermatophytic activity with a MIC, determined following the EUCAST standards, of 8 mM. Caffeine triggered a modification of the levels of two major components of the fungal cell wall, β-(1,3)-glucan and chitin. Caffeine also disturbed the ultrastructure of the fungal cells, particularly the cell wall surface and mitochondria, and autophagic-like structures were observed. During dermatophyte–human keratinocyte interactions, caffeine prevented the loss of viability of keratinocytes and delayed spore germination. Overall, this indicates that caffeine can act as a therapeutic and prophylactic agent for dermatophytosis. [ABSTRACT FROM AUTHOR]

Background Dermatophytosis is a common fungal infection of the skin and nails. Insufficient data exist regarding the clinico-epidemiological profile of dermatophytosis and the usefulness of individualized homeopathic medicines (IHMs) for patients visiting a homeopathy outpatient department (OPD). Objectives This article undertakes a clinico-epidemiological profiling of dermatophytosis and the usefulness of IHMs in its management. Methods This open-label, pre–post, comparative observational study was conducted in a homeopathy OPD from November 2018 to February 2020. IHMs were prescribed based on symptom totality and repertorization. A numeric rating scale (NRS) and the Dermatology Life Quality Index (DLQI) patient questionnaires were used, and results were analyzed using SPSS-IBM version 20. Results Data from a total of 103 patients, mean age 29.65 ± 15.40 years, were analyzed. Tinea cruris was the most common infection (29.1%), followed by tinea corporis (13.6%). After 3 months of treatment, significant reductions in NRS and DLQI scores were observed (8.51 ± 1.24 to 0.59 ± 0.83, p < 0.001, and 16.28 ± 5.30 to 1.44 ± 1.56, p < 0.001, respectively), with Sepia (15.5%), Sulphur (14.6%), Calcarea carbonica (11.7%), Natrum muriaticum (9.7%) and Bacillinum (8.7%) being the most frequently prescribed medicines. There was no significant correlation between occupation, sex, home location or marital status and the clinical types of dermatophytosis. No adverse events were reported. Conclusion T. cruris and T. corporis were prevalent dermatophytic infections. The decrease in NRS and DLQI scores associated with homeopathy indicates its usefulness as an integrative treatment option for dermatophytosis. Further research in larger and more diverse population samples is needed. [ABSTRACT FROM AUTHOR]