Common Superficial Fungal Infection Research Articles

Dermoscopic Perspective of Pityriasis Versicolor in a Cross-Sectional Study.

Pityriasis versicolor is a common superficial fungal infection which is usually easily diagnosed with Wood's lamp examination and 10% potassium hydroxide mount. However, these modalities have varying sensitivity and specificity. This study aimed to ascertain the dermoscopic features of pityriasis versicolor lesionally as well as perilesionally using dermoscopy, a non-invasive diagnostic tool. In this cross-sectional study, consecutive patients with pityriasis versicolor underwent dermoscopic examination of lesions and 2 cm around lesions, noting lesional and perilesional features. Semi-objective grading of pigmentation, scaling, and vascularity was done. The association between parameters was determined using heat maps and violin plots with Kolmogorov-Smirnov test. Lesional analysis was performed since lesions at different sides showed disparate features. A total of 353 lesions from 233 patients (males = 150/233; 64.38% and females = 84/234; 36.05%) were studied. On lesional dermoscopy, pigmentary and scaling abnormalities were universal. 258/353 (73.1%) of lesions showed vascular abnormalities. Perilesionally, scaling (223/353; 63.17%) followed by pigmentation (205/353; 58.07%) and vascular changes (111/353; 31.44%) constituted the most common dermoscopic abnormalities and were noted in 294/353 (83.29%) of lesions overall. Increased disease duration corresponded with increased intensity of perilesional pigmentation alterations, perifollicular (P = 0.04), and follicular scales (P = 0.02). Awareness of dermoscopic features could improve the diagnostic accuracy in doubtful cases of pityriasis versicolor. Vascular findings are common and may point to an underlying inflammatory pathogenesis. Perilesional findings constitute early dermoscopic features of pityriasis versicolor and hint at the need for treatment beyond the confines of lesions. Larger follow-up studies and research into immunopathogenesis may be of further benefit.

Comprative Study of two Different Microscopic Techniqes and Fungal Culture for Isolation of Dermatophytes

Introduction: Fungal infections are very common in man. They are assuming greater significance both in developed & developing countries due to advent of immunosuppressive drugs & disease hot & humid climate in tropical & subtropical countries like India makes dermatophytosis or ringworm a very common superficial fungal skin infection. Dermatophytosis is caused by dermatophytes, a group of keratinophilic fungi that require long incubation period to grow. The clinical presentation, though very typical of ringworm infection, is very often confused with other skin disorder particularly due to rampant application of broad – spectrum steroid containing skin ointments and cream leading to further misdiagnosis and mismanagement. Materials and Methods: Cross sectional lab based investigational study was conducted and skin, hair, nail sample from 110 clinically suspected cases of dermatophytosis were taken from OPD of district hospital of central India and were screened by direct microscopicexamination using 10% potassium hydroxide (KOH) with and without 40% dimethyl sulphoxide (DMSO) mount. 10% potassium hydroxide (KOH) with 40% Dimethyl sulphoxide mount (DMSO) mixed in equal proportion. Results: Direct microscopy using KOH mount is simple, rapid and easy method to visualize fungal elements. Many modification have been evolved to increase the specificity & sensitivity of KOH microscopy results like use of 5% glycerol, addition of 36% DMSO, and addition of parker’s blue(4) in this study we compered the results of conventional KOH mount and a modified technique (40%KOH with DMSO)(5). When doing direct microscopic. Conclusion: The modified KOH with DMSO mount had allowed fastest and better visualization of fungal elements at 10 minutes instead of routine 30 minutes.

Pityriasis Versicolor-A Narrative Review on the Diagnosis and Management.

This narrative review presents a comprehensive overview of the diagnosis and management of pityriasis versicolor (PV), a common superficial fungal infection caused by the yeast Malassezia. PV is characterised by scaly hypopigmented or hyperpigmented patches, primarily affecting the upper trunk, neck, and upper arms. Regarding commensal interactions, Malassezia utilises nutrient sources without affecting the human host. In cases of pathogenicity, Malassezia can directly harm the host via virulence factors or toxins, or indirectly by triggering damaging host responses. The diagnosis typically relies on recognising characteristic clinical features. Due to the wide variability in its clinical presentation, recognising the differential diagnosis is critical. In this paper, we discuss the clinical differentials, with their dermatoscopic presentation, but also describe a range of helpful diagnostic techniques (microscopy, conventional and ultraviolet-induced fluorescence dermatoscopy, and confocal microscopy). Topical therapies are the primary treatment for PV, encompassing non-specific antifungal agents like sulphur with salicylic acid, selenium sulphide 2.5%, and zinc pyrithione. Additionally, specific topical antifungal medications with either fungicidal or fungistatic properties may also be incorporated into the topical treatment regimen, such as imidazoles, allylamines, and ciclopirox olamine. Systemic therapies might occasionally be used. Patient education and the promotion of good personal hygiene are pivotal to reduce the risk of recurrence. In recurrent cases, particularly during warmer and more humid periods, prolonged prophylaxis with topical agents should be considered.

Profile of Dermatophytosis among Armed Forces Personnel Attending in Combined Military Hospital, Dhaka

Introduction: Dermatophytes are by far the most significant fungi because of their widespread involvement of population at large and their prevalence all over the world. They are assuming greater significance both in developed and developing countries. Hot and humid climate in the tropical and subtropical countries like Bangladesh makes dermatophytosis a very common superficial fungal skin infection. Objectives: To identify the pattern as well as the aetiological agents of dermatophytosis. Methods: It was a cross sectional study conducted at Dermatology department of CMH, Dhaka. A total 100 patients were recruited through systematic random sampling and examined for cutaneous changes. Skin, nail and hair specimens were taken from the patients and processed by potassium hydroxide preparation (KOH) for direct microscopy and culture. Results: Dermatophytosis was more common in the age group of 21-30 years (28%) and in males (64%). Most of the patients belonged to low socio-economic status (85%). Fungi was demonstrated in 74 cases (74%) either by KOH and/or culture. Dermatophytosis was more common in military persons (39%). Most common clinical type was tinea corporis (45%) followed by tinea cruris (19%). Most common aetiological agent was T. rubrum (62.7%) followed by T. mentagrophyte (25.42%), M. gypseum (5.08%), T. tonsurans (5.08%) and E. floccosum (1.69%). Conclusion: Oral Acyclovir therapy begun within 24 hours of onset of symptoms has been shown to reduce the duration of lesions, pyrexia and overall disease duration. So, Acyclovir should be considered for persons at increased risk of severe Varicella infections. JAFMC Bangladesh. Vol 18, No 2 (December) 2022: 15-18

Tinea pedis: an updated review.

Tinea pedis is one of the most common superficial fungal infections of the skin, with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea pedis. A search was conducted in April 2023 in PubMed Clinical Queries using the key terms 'tinea pedis' OR 'athlete's foot'. The search strategy included all clinical trials, observational studies and reviews published in English within the past 10 years. Tinea pedis is most often caused by Trichophyton rubrum and Trichophyton interdigitale. It is estimated that approximately 3% of the world population have tinea pedis. The prevalence is higher in adolescents and adults than in children. The peak age incidence is between 16 and 45 years of age. Tinea pedis is more common amongst males than females. Transmission amongst family members is the most common route, and transmission can also occur through indirect contact with contaminated belongings of the affected patient. Three main clinical forms of tinea pedis are recognized: interdigital, hyperkeratotic (moccasin-type) and vesiculobullous (inflammatory). The accuracy of clinical diagnosis of tinea pedis is low. A KOH wet-mount examination of skin scrapings of the active border of the lesion is recommended as a point-of-care testing. The diagnosis can be confirmed, if necessary, by fungal culture or culture-independent molecular tools of skin scrapings. Superficial or localized tinea pedis usually responds to topical antifungal therapy. Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis or in immunocompromised patients. Topical antifungal therapy (once to twice daily for 1-6 weeks) is the mainstay of treatment for superficial or localized tinea pedis. Examples of topical antifungal agents include allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate and amorolfine. Oral antifungal agents used for the treatment of tinea pedis include terbinafine, itraconazole and fluconazole. Combined therapy with topical and oral antifungals may increase the cure rate. The prognosis is good with appropriate antifungal treatment. Untreated, the lesions may persist and progress.

Fungal infection in nail psoriasis

Introduction: Onychomycosis is a common superficial fungal infection of nail in both developed and developing countries. It may involve any component of the nail unit, including the nail matrix, the nail bed, or the nail plate. It represents up to 20.0% of all nail disorders. Its prevalence is estimated at 2 to 18 percentage worldwide and up to 48-percentage incidence by age 70. Onychomycosis can be caused by dermatophyte mold, yeasts and non dermatophyte mold. We planned this study to determine the frequency of onychomycosis in psoriatic nails to establish the local perspective as the international studies shows wide variation. Objective: To find the presence of fungal elements in nails of patients affected by psoriasis. Setting: Dermatology (OPD), Baqai Medical University. Duration: 06 months from 15th July 2022 - 15th Dec 2022. Design: Descriptive Cross-sectional study. Results: In this study, out of 96 cases, 32.29% (n=31) of patients were between 18-40 years and 67.71% (n=65) were between 41-70 years of age, mean+SD: 47.32+11.94 years.

Review on host-pathogen interaction in dermatophyte infections.

Dermatophytosis is a common superficial fungal infection of the skin and its appendages caused by dermatophytes. Recent times have witnessed a dynamic evolution of dermatophytes driven by their ecology, reproduction, pathogenicity and host immune response, influenced by population migration and socioeconomic status. Dermatophytes establish infection following successful adherence of arthroconidia to the surface of keratinized tissues. The proteolytic enzymes released during adherence and invasion not only ascertain their survival but also allow the persistence of infection in the host. While the cutaneous immune surveillance mechanism, after antigen exposure and presentation, leads to activation of T lymphocytes and subsequent clonal expansion generating effector T cells that differentially polarize to a predominant Th17 response, the response fails to eliminate the pathogen despite the presence of high levels of IFN-γ. In chronic dermatophytosis, antigens are a constant source of stimulus promoting a dysregulated Th17 response causing inflammation. The host-derived iTreg response fails to counterbalance the inflammation and instead polarizes to Th17 lineage, aggravating the chronicity of the infection. Increasing antifungal resistance and recalcitrant dermatophytosis has impeded the overall clinical remission. Human genetic research has the potential to generate knowledge to explore new therapeutic targets. The review focuses on understanding specific virulence factors involved in pathogenesis and defining the role of dysregulated host immune response against chronic dermatophytic infections for future management strategies.

An open label, single arm, pilot study to evaluate the safety, tolerability, and efficacy of daily fluconazole 150 mg in subjects suffering from Tinea cruris and Tinea corporis

Background: Dermatophytes are the most common superficial fungal infections worldwide and are treated with prescribed regimens of terbinafine and itraconazole, or with weekly doses of fluconazole. Dermatologists are increasingly encountering treatment failures, and experts suggest that standard treatment regimens are not applicable anymore. We planned an open-label study to evaluate the results of fluconazole 150 mg daily for 8 weeks in patients with tinea cruris and tinea corporis. Methods: Patients were enrolled from the La’Mer Clinic, Mumbai, India. We included adult subjects with uncomplicated dermatophytosis confirmed by microscopic examination of skin scrapings. Pregnancy, poor renal function, and recent exposure to anti-fungal therapy were exclusion criteria. Patients were reviewed on days 14, 28 and 56. The treating doctor scored the severity of erythema, scaling, and pruritus on a four-point scale: absent, mild, moderate, and severe. Of 107 subjects screened, 100 were finally included in the study. Eleven were lost to follow up and one subject withdrew consent. Results: The site of disease was body alone in 29, groin alone in 7, and both body and groin in 64 cases. At 5 weeks, 98%, 100%, and 97% of patients had no scaling, erythema, and pruritus, respectively. Skin scrapings showed 100% mycological cure. In one patient the alanine transaminase level rose from 54.9 to 100.2 U/L, and qualified as a grade 1 adverse event not requiring intervention. No other significant adverse events were noted. Conclusions: Our results suggest that fluconazole 150 mg daily for eight weeks effectively treats dermatophytosis. This regimen is safe and well-tolerated even in patients with co-morbidities. Fluconazole is about eight times less expensive than itraconazole or terbinafine and may be the preferred therapy. Registration: The trial was registered with Clinical Trials Registry, India (Registration number CTRI/2020/06/026110) on 24 June 2020. FDC Company, India, provided financial support for the study.

Tinea versicolor: an updated review.

Tinea versicolor is a common superficial fungal infection of the skin with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea versicolor. A search was conducted in July 2022 in PubMed Clinical Queries using the key terms "tinea versicolor" OR "pityriasis versicolor". The search strategy included all clinical trials, observational studies and reviews published within the past 10 years. Tinea versicolor is caused by Malassezia species, notably M. globosa, M. furfur and M. sympodialis. The condition is characterized by scaly hypopigmented or hyperpigmented macules/patches, primarily located on the upper trunk, neck and upper arms. The diagnosis is usually based on characteristic clinical features. If necessary, a potassium hydroxide preparation test can be performed to reveal numerous short, stubby hyphae intermixed with clusters of spores. Most patients with tinea versicolor respond to topical antifungal therapy, which has a better safety profile (fewer adverse events, fewer drug interactions) and lower cost compared to systemic treatment and is therefore the treatment of choice. Oral antifungal therapy is typically reserved for patients with extensive disease, frequent recurrences or disease that is refractory to topical therapy. Advantages of oral antifungal therapy include increased patient compliance, shorter duration of treatment, increased convenience, less time involved with therapy and reduced recurrence rates. On the other hand, oral antifungal therapy is associated with higher cost, greater adverse events and potential drug-drug interactions and is therefore not the first-line treatment for tinea versicolor. Long-term intermittent prophylactic therapy should be considered for patients with frequent recurrence of the disease. Selection of antifungal agents depends on several factors, including efficacy, safety, local availability, ease of administration, likelihood of compliance and potential drug interactions of the antifungal agent.

P041 Preliminary evaluation of gradient concentration strips for detection of terbinafine resistance in Trichophyton spp.

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PMObjectivesDermatophytosis is the most common superficial fungal infection. Trichophyton rubrum and T. mentagrophytes are the most frequently isolated species, but their incidence varies according to geographical regions. Terbinafine is the main molecule used to treat this type of infection. In recent years, a high incidence of chronic infections, reinfections, and treatment failures due to a newly described specie, T. indotineae, have been reported in India and recently described in Europe. It is currently a public health problem for the management of these infections in this country.Until now, the monitoring of dermatophyte susceptibility to antifungals was rarely performed due to the lack of standardized in vitro tests. Since then, an in vitro technique has been standardized by the European Committee for Antimicrobial Susceptibility Testing (EUCAST) to test terbinafine and other antifungals. Recently, a gradient concentration strip method has been marketed.The aim of this study was to compare terbinafine susceptibility testing by the gradient concentration strip (GCS) method and the EUCAST standardized method.MethodsA panel of 47 molecularly identified isolates of T. interdigitale, T. mentagrophytes, and T. indotineae was used. The panel included 39 terbinafine- susceptible isolates and 8 terbinafine resistant isolates for which the squalene epoxidase gene was sequenced.Minimum inhibitory concentration (MIC) of terbinafine was determined using EUCAST microdilution broth method for dermatophytes. Inoculum was supplemented with cycloheximide and chloramphenicol. Final drug concentrations ranged from 0.008 to 8 μg/ml and microtiter plates were incubated at 25°C for 5 days. The MIC was determined spectrophotometrically with a 90% growth inhibition endpoint.MIC of terbinafine was also determined using GCS (Terbinafine Ezy MIC™ Strip, HiMedia, India) on RPMI agar. The plates were incubated for 5 days at 25°C. After incubation, MIC was read by using a complete inhibition endpoint. Isolates were considered wild-type when MIC was ≤ 0.125 μg/ml.ResultsEUCAST MIC values ranged from 0.008 to 0.0625 μg/mL and from 0.25 to 16 μg/ml for susceptible and resistant isolates, respectively.GCS MIC values ranged from 0.002 to 0.03 μg/ml and 0.125 to >32 for susceptible and resistant isolates, respectively.The categorical agreement (percentage of strains found in the same category) by the two techniques was 98%.ConclusionThese preliminary results show that GCS can detect resistance to terbinafine and could be used as a screening method. These results must be confirmed on a larger panel of isolates.

Fluconazole for common tinea infection: An updated review of evidence and treatment guidance

Dermatophytosis is the most common superficial fungal infection of the skin, hair, and nails. Tinea corporis, tinea cruris and tinea pedis are highly prevalent and frequently recur in India. Dermatologists and general physicians in India have been observing an increase in the prevalence of superficial fungal infections and find it clinically challenging to treat recalcitrant dermatophytosis due to new isolates, antifungal resistance, patient non-compliance, changing pathophysiology and symptoms. This review discusses the pharmacology, clinical efficacy, and safety of different dosage regimens of weekly oral fluconazole.

Assessment of the Clinical Diagnosis of Onychomycosis by Dermoscopy.

BackgroundAs a common clinical superficial fungal infection, the diagnosis of onychomycosis relies on clinical features, traditional KOH direct microscopy and fungal culture. In recent years, dermoscopy has been widely used in the diagnosis and treatment of infectious diseases and has provided new options for the diagnosis of onychomycosis.ObjectiveTo evaluate the value of dermoscopy in the clinical diagnosis of onychomycosis and to explore the relationship between each clinical subtype and the dermoscopic pattern.MethodsA retrospective study of 114 cases of clinically suspected onychomycosis was conducted to compare the differences between dermoscopy and fungal pathogenic examination (microscopy and culture) in the diagnostic sensitivity of onychomycosis and to analyze the relationship between nine common dermoscopic modalities and clinical subtypes of onychomycosis.ResultsAmong the 114 proposed patients, 87 nails with positive fluorescent staining microscopy and/or positive fungal cultures were diagnosed as onychomycosis. The sensitivity and specificity of dermatoscopy, using the mycological findings as a reference, were 86.21 and 33.33%, respectively. The incidence of common dermatoscopic patterns in the 87 nails with confirmed onychomycosis was as follows: white flocculation in 76 cases (87.35%), longitudinal nail pattern in 72 cases (82.76%), jagged changes in the distal nail plate in 69 cases (79.31%) and yellow staining in 46 cases (52.87%), these four patterns were more commonly seen in the distal lateral subungual onychomycosis and total dystrophic onychomycosis, but there was no statistical difference in the positive dermatoscopic pattern between these two types (P > 0.05).ConclusionDermoscopy can be an important aid in the diagnosis of onychomycosis, especially when fungal microscopy or culture is not appropriate, but this method is still not a substitute for fungal microscopy and culture.

In Vitro Antifungal Activity of Plain Socks and Zinc Oxide Nanoparticle–Coated Socks

Fungal foot infection is a common superficial fungal infection and is recognized as an important public health problem. Related to the wearing of occlusive footwear, foot infection is usually caused by dermatophytes and nondermatophyte molds. Previous in vitro studies have demonstrated that zinc oxide nanoparticles (ZnO-NPs) have antimicrobial activity against fungi. This study, therefore, evaluated the ability of socks coated with ZnO-NPs to inhibit fungal growth in an in vitro model mimicking real-life situations. Scale from patients with fungal foot infections was equally divided into three groups: control, plain socks, and ZnO-NP socks. The specimens in the control group were routinely fungal cultured, whereas in the plain sock and ZnO-NP sock groups, scale was incubated with plain socks and ZnO-NP socks, respectively, for 24 hours. After incubation, each piece of sock was cultured. The fungal culture results of the three groups were progressively evaluated for 4 weeks. From 31 specimens, the positive fungal culture results of the control, plain sock, and ZnO-NP sock groups were 100%, 64.5%, and 54.8%, respectively. Specimens incubated with plain socks (P = .001) or with ZnO-NP socks (P < .001) had a significant reduction in the number of positive fungal cultures compared with the control. Plain socks and ZnO-NP socks significantly inhibited fungal growth relative to the control. The wearing of either plain socks or ZnO-NP socks can prevent fungal foot infection because these socks act as a barrier to the insoles of shoes.

Dermoscopic features of uncomplicated tinea versus steroid-modified tinea: An observational study in Indian patients

Background: Tinea is one of the most common superficial fungal skin infections. Steroid-modified tinea infections may present with atypical morphology. This study aims to observe the difference between dermoscopic features of uncomplicated dermatophytosis and steroid-modified dermatophytosis. Methods: This observational study was conducted in 60 patients with tinea cruris, tinea corporis and tinea faciei in the outpatient dermatology department of a tertiary care center. Patients were divided into group A and group B. Group A included 30 patients with no history of steroid use in the past three months. Group B included 30 patients with a history of steroid usage in the past three months. Dermoscopy was performed in both groups using a USB 2.0 dermoscope (Dino-Lite Premier AM3113T &reg; , Magnification &ndash; 20x to 50x and 200x) to study the characteristic features in tinea infections. Chi-square test and Fisher&rsquo;s exact test were applied as applicable. Results: Out of 60 cases of dermatophytosis, 20 cases were of tinea corporis, 28 cases of tinea cruris, and 12 cases of tinea faciei. Dermoscopic features of hair follicular involvement (perifollicular scale, follicular micropustules, the involvement of vellus hair, yellow hair, morse code hair, and transparent hair) were significantly more common in group B than in group A (P = 0.004, P = 0.039, P = 0.0001, P = 0.01, P = 0.03, P = 0.002, respectively for each feature). Conclusions: All dermatophytosis patients with a history of steroid use showed characteristic signs on dermoscopic examination irrespective of their morphologic appearance. Thus, dermoscopy can be used as a rapid diagnostic method for steroid-modified cases of tinea. &nbsp; Keywords : dermoscopy, morse code hair, steroid-modified tinea , yellow hair

A study of antifungal susceptibility pattern of dermatophytes at tertiary care center

Dermatophytes are fungi that can cause infections of the skin, hair &amp; nails due to their ability to invade keratin. Dermatophytosis is the most common superficial fungal infection worldwide; it is common in tropics and subtropical regions. It may present in epidemic proportions in areas of high humidity: The present study aimed to identify various species causing dermatophytosis &amp; to determine the invitro susceptibility pattern against commonly used systemic antifungal agents in our tertiary care center.A total of 149 samples were collected of infected skin, hair and nails in a period of 1 year from January 2020 to December 2020. Samples were collected under aseptic condition by skin scrapping, nail and hair clipping by using scalpel or forceps. Identification of the causative pathogen was done by performing slide culture, lacto-phenol cotton blue mount, hair perforation tests and urease tests. We adopted a newly developed agar based disk diffusion assay to test susceptibility of clinically isolated dermatophytes for antifungal susceptibility testing.Microbiological investigations revealed the presence of dermatophytic fungi in 71.8% of the samples. Trichophyton rubrum was the predominant pathogen isolated. The study showed Itraconazole to be most effective antifungal drugs against dermatophytes followed by terbinafine and fluconazole.Further intensive epidemiological and invitro antifungal susceptibility studies of dermatophytes are required which will have more public health significance.

Comparing the Therapy of Otomycosis Using Clotrimazole with Iodine Tincture: A Clinical Trial.

Introduction:Otomycosis, as a common superficial fungal infection, is the term to infection of external auditory canal. Despite numerous studies on diverse antifungal agents, there is no common consent on effective agent for treatment of otomycosis. Therefore, the purpose of this study is compared therapy of otomycosis using two therapeutic agents; clotrimazole and iodine tincture.Materials and Methods:This research is a clinical trial study included 160 patients who were presented otomycosis. All patients were randomly assigned into two therapeutic groups of clotrimazole and Iodine Tincture (80 cases in each group). The results of response to thrapy were evaluated on 4, 10, and 20 days. Statistical analyses were performed using Independent-Samples t-test, Chi-Square, and Fishers҆ Exact tests in SPSS software v.18, in 0.05 significant level.Results:Fungal species were isolated including Aspergillus (72.5%) and Candida albicans (22.5%). After 4thday of treatment, 7.5% of the tincture group and 11.2% of the clotrimazole group revealed a good response to treatment (P=0.30). A good response to treatment was observed in35.0 and 41.2% of the patients on 10th day of treatment (P=0.44); and in 67.5 and 62.5% of the patients on 20th day of treatment (P= 0.20). There was no significant relationship between the two therapeutic arms.Conclusion:In this study, both clotrimazole and tincture showed the identical therapeutic efficacy on otomycosis. Our findings suggested that tincture can be used as a supplementary antifungal option for treatment of otomycosis.

Epidemiology of dermatophytoses in paediatric population in Southwestern Poland, 2011-2016.

IntroductionDermatophytoses are the most common superficial fungal infections in paediatric population. Its pathogen pattern has changed over years.AimTo analyse the spectrum of dermatophytoses in children living in Southwestern Poland, in the years 2011–2016.Material and methodsA total of 1705 patients were diagnosed with fungal skin infection in the Mycological Laboratory, Dermatology Department of the Wroclaw Medical University. Of them, 163 were under 18 years of age.ResultsIn 105 cases, dermatophytoses were detected. The collected specimens were examined using direct microscopy examination, staining, culture on specific media and PCR technique. The most common dermatophytes were Trichophyton rubrum and Trichophyton tonsurans (31.4% each), followed in the descending order by Trichophyton mentagrophytes (21.9%), Microsporum canis (13.3%) and Epidermophyton floccosum (1.9%). The most commonly affected body sites were glabrous skin of the trunk and extremities (41.7%), followed by face (22.2%), scalp (15.7%) and toe nails (14.8%).ConclusionsThis study revealed the most common types of dermatophytoses and their pathogens in children in Southwestern Poland. In comparison to earlier data obtained from this region, new epidemiological trends have been revealed. We observed the shift towards anthropophilic dermatophyte infections and an increasing number of onychomycosis in children. Because of climatic variations, migration, and changing lifestyle practices, further studies on dermatophytoses are necessary to improve our knowledge on the epidemiology of fungal infections.

Treatment Pattern of dermatophytosis at the outpatient clinic of a tertiary healthcare hospital of Chhattisgarh, Central India

Background: in the recent past dermatophytosis are being highly prevalent, main culprit behind is inappropriate use of antifungal agents and self-medications which is leading to exponential rise in global burden superficial fungal infections, and antifungal drug resistance. Clinician’s management pattern data collection on time to time to have a check on the resistance/sensitivity pattern of the commonly prescribed antifungals in clinical grounds is important. Aims and objectives: The present study was to describe the pattern of antifungal drug prescription and self-medication for common superficial fungal infections of skin in dermatology OPD in tertiary care hospital of Chhattisgarh. Materials and Methods: Current study was a cross sectional unicentric study conducted at Dermatology OPD of Pt J.N.M. Medical College Raipur, the data collection for this observational study was undertaken for a period of six months. All patients attending the dermatology OPD with tinea infections were included in the study. This study was designed to record parameters include information related to demographic, disease profile, medications prescribed, number of drugs, dosage & duration were reported. Self medication pattern was also being observed during this study. Results: A total of 17286 patients attended dermatology OPD and 42% patients were suffering from tinea. The most common fungal infection was Tinea cruris 55.07%, the commonest treatment pattern was Combination of oral T amongst which clotrimazole (67.04%)were the commonest. Commonly prescribed individual antifungal was oral Fluconazole 73.11%. The self-medication prevalence for dermatophytosis was 62.26%. Self-medication drugs were mainly topical (creams) FDC of antifungal and steroids. Around 76% of the self-medication information

SnapshotDx Quiz: December 2020

SnapshotDx Quiz: December 2020

Conceptual Study on Effect of Edagajadi Yoga and Gandhapashanadi Lepa in the Management of Sidhma Kushtha W.S.R. to Pityriasis Versicolor

Tinea versicolor is a common superficial fungal infection of the skin, prevalent in the hot and humid environment of India. It is caused by the&#x0D; Malassezia species which is a dimorphic, lipophilic fungus most frequently affecting the seborrheic areas of the body like face, neck, upper back and chest. Normally 10- 15% of the general practitioner’s encounter skin disorders in their day to day practice with overall prevalence rate of 30% or more probably occurring in tropical zones. Kustha a type of skin disorder mentioned in Ayurveda is a Tridoshaja Vyadhi, where Twaka, Rakta, Mamsa and Ambu are the main Dushyas. According to Charaka, Sidhma is a Kapha Vata Pradhan Vyadhi and According to Sushruta, Sidhma is Kapha Pradhan vyadhi. Management of sidhma includes Shodhana, Shamana and Bahirparimarjana Chikitsa among them Shamana in the form of kwatha &amp; Bahirparimarjana Chikitsa as Lepa has shown appreciable result in many previous researches. So, need of time is to go for cost effective, safe and efficient treatment of Sidhma. Although, there are many drugs available in modern medical science for the treatment of Pityriasis versicolor which is found to be effective but is unsatisfactory for long term prophylaxis, so there is need of the hour to look into the safe, efficient &amp; satisfactory remedy which not only treat the above ailments, but also ensure reduction in the episodes of relapse of the disease. Keeping all the above points in mind Edagajadi yoga &amp; Gandhapashanadi lepa has been selected to know its efficacy in treating Sidhma kushtha (Pityriasis versicolor). Edagajadi yoga &amp; Gandhapashanadi lepa consists of 10 drugs with different properties which includes Edagaja, Vidanga, Haridra, Daruharidra, Amlatasa, Kushta, Pippali, Gandhak, yavkshar, sarshapa taila.&#x0D; Keywords: Sidhma, Pityriasis versicolor, Edagajadi yoga, Gandhapashanadi lepa