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The persistence, development and exacerbation of chronic rhinitis and chronic rhinosinusitis all involve sensitization to respiratory allergens. The allergic response in question is the IgE-mediated mechanism of rhinitis, which often leads to a complex of etiopathophysiological malfunctions in various organs and systems. For clinical classification and further management of patients, it is important not to miss the detection of both systemic allergic sensitization to aeroallergens (which is achieved by conducting skin prick test or detecting the allergen-specific immunoglobulin E in the blood) and local sensitization (which can be confirmed by conducting nasal provocation test or detecting the nasal-specific immunoglobulin E in nasal mucosa). Before a full examination is conducted and both systemic and local sensitization are ruled out, the diagnosis of non-allergic rhinitis and the management of a patient with non-allergic nasal inflammation may be premature.

Background: Dermatophytosis is a world-wide distributed common infection. Antifungal drug resistance in dermatophytosis used to be rare, but unfortunately the current Indian epidemic of atypical widespread recalcitrant and terbinafine-resistant dermatophytosis is spreading and has sporadically been reported in Europe., Objectives: To explore the occurrence of clinical and mycological proven antifungal drug resistance in dermatophytes in Europe., Methods: A standardized questionnaire was distributed through the EADV Task Force of Mycology network to dermatologists in Europe., Results: Representatives from 20 countries completed the questionnaires of which 17 (85 %) had observed clinical and/or mycological confirmed antifungal resistance, two countries published cases of antifungal resistance and one country had no known cases., Conclusions: This pilot study confirms that both clinical and mycological antifungal resistance exist in Europe., (© 2021 European Academy of Dermatology and Venereology.)

Background: Superficial fungal infections are common. It is important to confirm the clinical diagnosis by mycological laboratory methods before initiating systemic antifungal treatment, especially as antifungal sensitivity and in vitro susceptibility may differ between different genera and species. For many years, the gold standard for diagnosis of superficial fungal infections has been direct fungal detection in the clinical specimen (microscopy) supplemented by culturing. Lately, newer molecular based methods for fungal identification have been developed., Objective: This study was initiated to focus on the current usage of mycological diagnostics for superficial fungal infections by dermatologists. It was designed to investigate whether it was necessary to differentiate between initial diagnostic tests and those used at treatment follow-up in specific superficial fungal infections., Methods: An online questionnaire was distributed among members of the EADV mycology Task Force and other dermatologists with a special interest in mycology and nail disease., Results: The survey was distributed to 62 dermatologists of whom 38 (61%) completed the whole survey, 7 (11%) partially completed and 17 (27%) did not respond. Nearly, all respondents (82-100%) said that ideally they would use the result of direct microscopy (or histology) combined with a genus/species directed treatment of onychomycosis, dermatophytosis, Candida- and Malassezia-related infections. The majority of the dermatologists used a combination of clinical assessment and direct microscopy for treatment assessment and the viability of the fungus was considered more important at this visit than when initiating the treatment. Molecular based methods were not available for all responders., Conclusion: The available diagnostic methods are heterogeneous and their usage differs between different practices as well as between countries. The survey confirmed that dermatologists find it important to make a mycological diagnosis, particularly prior to starting oral antifungal treatment in order to confirm the diagnose and target the therapy according to genus and species., (© 2018 European Academy of Dermatology and Venereology.)

Antagonistic activity of Malassezia yeast towards clinically significant yeast species was studied. Ten Malassezia strains exhibited this activity. M. furfur strain exhibited maximum activity and the least sensitivity to "foreign" metabolites. M. globosa proved to be the most sensitive and the least active. M. furfur metabolites exhibited pronounced activity towards 6 Basidiomycetes strains. This effect was significantly higher in comparison with antagonistic activity towards 13 Ascomycetes species. Studies of a complex of M. furfur antagonistic metabolites showed that it has at least two components: thermolabile proteins with molecular weights of 33 and 35 kDa and a thermostable one, proteinase-resistant. In contrast to metabolites of many other yeast species, this substance is more effective against related Basidiomycetes microorganisms (Cryptococcus albicans), while antagonistic proteins are active mainly towards Ascomycetes, such as Candida albicans. It was found that mycocin-like activity of Malassezia is encoded by chromosomes, but not plasmids.

Onychomycosis is a common disease, and there are a number of factors that may affect the duration and dosage of treatment including the type of onychomycosis, the area and thickness of nail involvement, the age of the patient, and the location of the digit that is affected. We report a composite index, the Scoring Clinical Index for Onychomycosis (SCIO) that combines these factors to give an index of the overall severity of onychomycosis. The use of the SCIO may have treatment implications; by matching patients with similar SCIO scores, it may be possible to better compare the clinical response to therapy.