Superficial Fungal Infections Research Articles

Monocentric evaluation of the Novaplex dermatophyte multiplex qPCR assay in the diagnosis of dermatophytoses.

Superficial fungal infections caused by dermatophytes are a prevalent global health concern. Rapid and accurate diagnosis of these pathogens through molecular tools would offer a substantial advantage for early detection and effective treatment. The conventional fungal culture presents inherent limitations, including extended result delivery delay and variable sensitivity. This study aimed to evaluate the performance of the multiplex real-time PCR Novaplex dermatophyte assay (Seegene) in comparison to traditional mycological methods including direct examination and culture. A total of 312 nail, skin, and scalp samples collected from patients with suspected superficial fungal infections for mycological diagnosis were retrospectively subjected to the Novaplex dermatophyte assay. Overall, 170 (54.6%) and 186 (59.6%) samples tested positive for dermatophyte culture and dermatophyte PCR, respectively. The concordance between PCR and culture for dermatophyte detection was 87.2%. There were 158 culture-positive/PCR-positive samples, 12 culture-positive/PCR-negative samples, and 28 culture-negative/PCR-positive samples. The sensitivity of PCR against culture varied according to the dermatophyte target, ranging from 90.5% (Trichophyton mentagrophytes/interdigitale/benhamiae), 91.2% (Trichophyton rubrum), to 100% (Microsporum spp. and Trichophyton tonsurans). When considering the final diagnosis using composite criteria, the sensitivity and specificity for the diagnosis of dermatophytosis were 92.9% and 96.6% for PCR, 86.7% and 100% for culture, and 95.4% and 92.2% for direct examination and culture combined, respectively. The Seegene Novaplex dermatophyte assay is an easy-to-use automated one-step extraction-PCR system that offers satisfactory performance for routine diagnosis of dermatophytoses in clinical laboratories, particularly in non-specialized centers. However, it cannot fully replace conventional mycology due to its inability to detect mold infections and to identify dermatophytes at the species level.

Follicular Skin Disorders, Inflammatory Bowel Disease, and the Microbiome: A Systematic Review.

Follicular skin disorders, including hidradenitis suppurativa (HS), frequently coexist with systemic autoinflammatory diseases, such as inflammatory bowel disease (IBD) and its subtypes, Crohn's disease and ulcerative colitis. Previous studies suggest that dysbiosis of the human gut microbiome may serve as a pathogenic link between HS and IBD. However, the role of the microbiome (gut, skin, and blood) in the context of IBD and various follicular disorders remains underexplored. Here, we performed a systematic review to investigate the relationship between follicular skin disorders, IBD, and the microbiome. Of the sixteen included studies, four evaluated the impact of diet on the microbiome in HS patients, highlighting a possible link between gut dysbiosis and yeast-exclusion diets. Ten studies explored bacterial colonization and HS severity with specific gut and skin microbiota, including Enterococcus and Veillonella. Two studies reported on immunological or serological biomarkers in HS patients with autoinflammatory disease, including IBD, and identified common markers including elevated cytokines and T-lymphocytes. Six studies investigated HS and IBD patients concurrently. Our systematic literature review highlights the complex interplay between the human microbiome, IBD, and follicular disorders with a particular focus on HS. The results indicate that dietary modifications hold promise as a therapeutic intervention to mitigate the burden of HS and IBD. Microbiota analyses and the identification of key serological biomarkers are crucial for a deeper understanding of the impact of dysbiosis in these conditions. Future research is needed to more thoroughly delineate the causal versus associative roles of dysbiosis in patients with both follicular disorders and IBD.

The turnover intention of internal controllers of Vietnamese commercial banks in the context of COVID-19

Internal control plays an important role in managing the risks of banking system activities. Controllers are always under pressure from control activities due to the bank’s diverse activities. The resignation of internal controllers is relatively common in commercial banks. It is also a matter of concern for the banking and finance industry, which coordinates economic resources for the country, especially when the internal control period occurs again with the pandemic. The study aims to explore the turnover intention of internal controllers in the context of COVID-19 in Vietnamese commercial banks. The study uses the convenience sampling method to collect data from 339 respondents who are working or worked as internal controllers in commercial banks. The study was surveyed in 2023. The study uses quantitative methods for exploratory factor analysis. Ordinary least squares process the data to test the hypotheses. Some factors affect the turnover intention of internal controllers, such as occupational awareness, employment conditions, office environment, and career opportunities, in the context of COVID-19. The result is a useful resource for researchers to comprehensively understand issues related to the turnover intention of internal controllers in the banking industry. The study supports managers of commercial banks in planning the strategic objectives of human resource stabilization for the stable growth of the banking system.

Drug-induced Photosensitivity and Malignant Melanoma in Latino Populations: A Case-Control Study in the All of Us Research Program

Background: Widely prescribed medications, such as anti-inflammatory agents, diuretics, and oral hormonal contraceptives, exhibit photosensitizing properties, heightening susceptibility to ultraviolet light and potentially escalating the risk of skin cancer. This risk is particularly notable for cutaneous malignant melanoma (CMM), a type of skin cancer on the rise among Hispanic/Latino individuals. Objective: This study examines associations between various pharmaceutical agents and the onset of malignant melanoma in self-identified Hispanic/Latino individuals. Methods: Through the All of Us health record database, 80 Hispanic/Latino individuals with diagnosed CMM were selected, forming the case cohort. Each case was age-, race-, and sex-matched to four Hispanic/Latino participants without CMM to compose the control cohort, and the use of numerous potential photosensitizing agents prior to the onset of CMM, if applicable, was documented. Results: Compared to controls, Hispanic/Latino participants with CMM exhibited significantly higher odds of prior use of various pharmacologic agents, including histamine H1-receptor blockers, methotrexate, monoclonal antibodies, small-molecule inhibitors, tetracycline, and tricyclic antidepressants. Topical antifungals were also significantly associated with CMM onset, though the correlation with application sites remains unknown. Conclusion: This study underscores the associations of potential photosensitizing agents with the development of CMM among Hispanic/Latino individuals, a population historically underrepresented in research. Raising awareness is crucial for counseling during prescription to reduce skin cancer incidence. Limitations of this study include unknown agent use duration, time between use and cancer onset, and potential disease influences, necessitating further research to better understand the contribution of these agents to CMM development in Latino populations

Specific Antidermatophytic Activity of Trifluoromethylthiolated Cinnamate Derivatives: A New Approach to the Therapy of Superficial Fungal Infections of the Skin

AbstractDermatomycoses 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.

A qualitative study on apparent and latent contributing factors to driving errors in Iran

Road traffic crashes (RTCs) disproportionately impact low and middle-income countries (LMICs). Current interventions in LMICs primarily target road user behavior, neglecting systemic issues and casting drivers as mere contributors. Given Iran’s unique cultural, financial, and social intricacies, this study aims to explore the latent causes of RTCs, prioritizing drivers’ experiences and encompassing insights from various traffic system components. Applying a qualitative approach, data were collected through 46 semi-structured interviews with 38 participants, including drivers and experts from traffic-related organizations. Content analysis identified ten themes as contributing to driving errors. Direct factors included fatigue influenced by economic and occupational conditions, distraction from internal and external sources, reckless behaviors influenced by traffic culture and environment, and Inadequate driving skills due to training. Macro-scale challenges in road infrastructure, vehicle quality, education, and accident investigations were highlighted. The lack of a centralized traffic safety authority and a predominant focus on penalizing drivers overshadowed systemic issues. The study offers valuable insights into the complex interplay of factors contributing to driving errors in LMICs, advocating for a paradigm shift towards holistic, systemic interventions beyond individual driver behavior and challenging the conventional blame-centric view associated with driving errors.

A low-cost and versatile paramagnetic bead DNA extraction method for Mycobacterium ulcerans environmental surveillance.

Buruli ulcer (BU) is a neglected tropical skin disease, with an incidence that has dramatically increased in temperate southeastern Australia over the last decade. In southeastern Australia, BU is a zoonosis with native possums the major wildlife reservoir of the causative pathogen, Mycobacterium ulcerans. Infected possums shed M. ulcerans in their excreta, and excreta surveys using PCR to screen for the presence of pathogen DNA are a powerful means to predict future areas of Buruli ulcer risk for humans. However, excreta surveys across large geographic areas require testing of many thousands of samples. The cost of commercial DNA extraction reagents used for preparing samples for PCR testing can thus become prohibitive to effective surveillance. Here, we describe a simple, low-cost method for extracting DNA from possum excreta using paramagnetic beads. The method is versatile and adaptable to a variety of other sample types including swabs collected from possum tissues and pure cultures of mycobacteria.

Inborn errors of immunity and invasive fungal infections: presentation and management.

We review the clinical presentations of invasive fungal infections in a selection of inborn errors of immunity. In addition, we review the particularities of their management, including antifungal therapy, prophylaxis, and immunomodulatory treatments. Patients with chronic granulomatous disease and with signal transducer and activator of transcription 3 (STAT3) deficiency are particularly prone to aspergillosis. Mold-active antifungal prophylaxis should be prescribed to all patients with chronic granulomatous disease, and in patients with STAT3 deficiency and underlying parenchymal lung disease. Invasive fungal infections are rare in patients with STAT1 gain-of-function mutations, while the clinical phenotype of caspase-associated recruitment domain-containing protein 9 deficiency encompasses a wide range of superficial and invasive fungal infections. Most patients with inborn errors of immunity and invasive fungal infections require prolonged durations of antifungals. Hematopoietic stem cell transplantation should be considered early for patients with chronic granulomatous disease, but results have been more mixed for other inborn errors of immunity with active invasive fungal infections. Inborn errors of immunity can confer increased susceptibility to a variety of invasive fungal infections, which can present with specific clinical and radiological features. Management of fungal infections in these patients is often challenging, and relies on a combination of antimicrobial prophylaxis, antifungal treatments, and immunomodulation.

52625 Optimal Duration for Specimen Transportation Using Specimen Storing Envelopes in Superficial Fungal Infections

52625 Optimal Duration for Specimen Transportation Using Specimen Storing Envelopes in Superficial Fungal Infections

Bienestar laboral y condiciones ocupacionales en docentes de carreras de Ciencias de la Salud durante la crisis sanitaria por COVID-19

BackgroundStudent well-being during the COVID-19 pandemic, and its relationship to personal and academic factors, has been extensively studied. However, there are few studies regarding this phenomenon in teachers. ObjectiveTo evaluate the relationship between occupational conditions and teachers’ wellbeing at work, in terms of their engagement and burnout, in health career teachers during the COVID-19 health crisis in Chile. MethodsQuantitative study, with an observational and cross-sectional design and relational scope, with a non-probabilistic sampling strategy and by convenience, a sample of 234 health science teachers was obtained, who answered the UWES-17 Work Engagement Scale, the Maslach Burnout Inventory HSS version, a Scale of resources available for teaching and a sociodemographic questionnaire and working conditions, after reading and accepting an informed consent. ResultsTeachers reported high work engagement in its dimensions of vigor, absorption and dedication, moderate emotional exhaustion and less depersonalization and lack of personal fulfillment. Burnout and engagement showed inverse correlations with each other in almost all their factors (p<0.05), except in the case of absorption. In addition, both variables showed a relationship with gender, age of the teachers and access to quiet places to work (p<0.05). ConclusionsThe sociodemographic characteristics of teachers showed to be more associated with their reported well-being than their academic conditions. In terms of available resources, quiet spaces for work were more important than access to technology.

Pharmacies Counselling of Patients in the Era of Antifungal Resistance.

Tinea pedis is one of the most prevalent superficial fungal infections. Initial antifungal treatment is often acquired over-the-counter (OTC) without previous consultation with a physician. Lately, increasing antifungal terbinafine resistance has been documented in Denmark and globally and it is therefore of interest to assess how Danish pharmacies advise customers with tinea pedis. One hundred Danish pharmacies were randomly selected and an employee interviewed from each. A structured question guide was followed, with the possibility to add further comments. Interviews of 94 pharmacies were conducted. Six pharmacies never replied. Terbinafine as standard dose or cutaneous solution terbinafine one time application (Lamisil Once (R)) were recommended by 99% of the pharmacy employees as first-line treatment. The customer was advised to seek medical attention when tinea pedis was recurring (93%), or when treatment duration was > 2 weeks (77%). The majority (88%) of the pharmacy employees had no knowledge about antifungal resistance. Only few pharmacy employees were aware of the current problem of antifungal resistance and the majority advised costumers to initiate treatment using OTC topical terbinafine. The problem of emerging antifungal resistance requires attention in order to provide customers with tinea pedis effective treatment and prevent further societal spread of resistance to antifungals.

A dynamic yard space reservation algorithm based on reward-penalty mechanism

Increasing throughput at container terminals leads to higher yard occupancy rates, reduced yard service capacity, and inefficient use of space. These issues result in longer waiting times for trucks, underutilized yard slots, and longer distances between berth positions and the yard, particularly under high occupancy conditions. Traditional methods for allocating yard space fail to adequately consider dynamic container arrival patterns, conflict between container operations, and efficient use of yard resources. This paper introduces an innovative approach to improve yard efficiency by dividing yard container retrieval into time intervals and dynamically reserving yard slots within each interval. This method aims to minimize operational conflicts, reduce distances between blocks and berths, and avoid excessive reservations. We propose a dynamic reservation algorithm based on a reward-penalty mechanism to handle the problem's complexity and real-time demands. Furthermore, a time-series reward-penalty mechanism, which considers past reservation feedback and future reservation potential, ensures the concentration and continuity of container groups in the yard. Our evaluation metrics and multiple experimental scenarios demonstrate that this method significantly enhances yard efficiency and overall port productivity compared to static and other dynamic algorithms.

La eficacia de los aceites ozonizados en el tratamiento de pacientes con micosis superficiales.

Abstract. Superficial mycoses are one of the main reasons for consulta-tion in the dermatological area. In recent years, the therapeutic effectiveness of ozonated oils in fungal infections has been verified in different countries due to its broad germicidal and antifungal spectrum. The objective is to evaluate the efficacy of the use of ozonated sunflower oil in the treatment of superficial mycoses in patients of the Mycology consultation at the Dermatology Service of the Hospital Vargas de Caracas, Instituto Autonómo de Biomedicina “Dr. Ja-cinto Convit”. A cross-sectional descriptive, experimental study was conducted, where 36 patients diagnosed with superficial mycosis and ten healthy subjects were evaluated. Of the group of 36 patients, 26 were treated with ozonated sun-flower oil (AGO) and ten patients with non-ozonized sunflower oil (AGNO). Ten healthy individuals represented the AGO sensitivity control. The most frequent superficial mycosis evaluated in the AGO group was tinea corporis (31%), fol-lowed by denture stomatitis (23%) and for the AGNO group, tinea pedis (50%). Regarding the etiological agent, an improvement with the AGO treatment of 86% for Candida albicans and 60% for the Trichophyton rubrum complex was evidenced at week eight of treatment. It is concluded that the antifungal effect of AGO is more significant for the genus Candida spp than for dermatophytes, evidencing a total improvement of the lesions with six weeks of treatment.

Dermatophytosis in Companion Animals in Portugal: A Comprehensive Epidemiological Retrospective Study of 12 Years (2012-2023).

Dermatophytosis, commonly referred to as ringworm, is a common superficial fungal infection in companion animals and humans. Between 2012 and 2023, plucked hair and scraped scale samples from domestic dogs and cats with clinical suspicion of dermatophytosis were collected from 355 veterinary medical centres across mainland Portugal. A total of 4716 animal samples were inoculated onto DERM agar, incubated at 25 °C for up to 4 weeks, and periodically examined macro- and micro-scopically to observe and evaluate fungal growth. Of these, 271 samples were removed due to contaminant fungi. Of the 568 positive cultures, the highest number were from the North (48.1%; 95% CI: 44.0-52.2%) and Centre (32.4%; 95% CI: 28.7-36.4%) regions. Microsporum canis was the most frequently isolated species (63.9%), followed by Trichophyton spp. (20.3%) and Nannizia gypsea (formerly Microsporum gypseum) (8.1%). Felines exhibited a higher frequency (17.4%) compared with dogs (9.1%) (p < 0.001). In dogs, the Yorkshire Terrier, West Highland White Terrier, Miniature Pinscher, Dalmatian and Miniature Schnauzer demonstrated a significant predisposition to dermatophytosis (p < 0.05). In cats, the Persian and Scottish Fold breeds were significantly predisposed (p < 0.05). No significant differences were found between sexes (p > 0.05). These findings underscore dermatophytosis as an increasing public health concern due to its zoonotic and contagious nature, providing comprehensive insights into the epidemiology of dermatophytosis in Portugal.

Upgrade of the LHCb RICH detectors and characterization of the new opto-electronics chain

The LHCb detector has been upgraded to manage a five-fold increase in the instantaneous luminosity delivered to the experiment during LHC Run 3 and to readout data at the full bunch crossing rate of 40 MHz. The enhanced LHCb RICH detectors now feature Multianode Photomultiplier Tubes (MaPMTs), covering a total area of approximately 4 square meters, and brand-new frontend electronics to comply with the trigger-less readout architecture. The opto-electronics chain is capable of detecting single photons at repetition rates of up to 100 MHz/cm2 while maintaining an exceptionally low noise. The RICH upgrade is comprehensively outlined, including details about the characterization and studies on the photon detection system. The stability and uniformity achieved by optimizing the parameters of the opto-electronics chain enable the RICH system to function successfully and to provide excellent charged hadron identification in high occupancy conditions.

A surge in the incidence of invasive Group A Streptococcus hand infections: a single Hand Unit experience.

We highlight an increase in the number of invasive Group A streptococcal soft tissue infections and present the impact of those on the hand surgery service, based on a single Hand Unit experience at the Pulvertaft Hand Centre.

Acid Dosing Increases Recoverable Phosphorus during Different Occupancy Conditions in Full-Scale Urine Diversion System

Acid Dosing Increases Recoverable Phosphorus during Different Occupancy Conditions in Full-Scale Urine Diversion System

Skin mycosis distribution, and burden of visits over a decade in Colombia: ecological study

ObjectivesTo describe the sociodemographic distribution of dermatomycosis and the visits burden over a 10-year period of care. MethodsAn ecological study was conducted using data on visits and people treated in the Colombian Health System during 2010-2019 using the International Classification of Diseases, Tenth Revision codes (ICD-10). Departments and geopolitical regions were the units of analysis, and visit burden was reported as frequency, intensity (visits per person), and rate of dermatomycosis visits (per 10,000 visits; 95% confidence interval). ResultsA total of 4,570,593 visits were analyzed. The most used ICD-10 codes were B369 (superficial mycosis, unspecified), B360 (pityriasis versicolor), B354 (Tinea corporis), B359 (dermatophytosis), and B351 (Tinea unguium) (56.5%), with visits primarily involving the adult population (27-59 years; 32.2%), women (43.4%), and urban populations (57.3%). Amazonas department had the highest rate of visits (2.36 per 10,000), while Nariño had the highest intensity of visits (1.94 visits per person). Caribbean region had the highest rate of visits (17.0 per 10,000 visits; 17.0-17.0), followed by the Amazon region (16.3 per 10,000 visits; 16.2-16.4). ConclusionsThe annual visits burden of dermatomycosis in Colombia is high and concentrated in susceptible geographic areas, possibly due to socio-environmental factors. This health problem is overshadowed by chronic diseases and trauma but is often recurrent, and chronic, and induces out-of-pocket costs for treatment.

Trends in occupational respiratory conditions with short latency in the UK.

Occupational short-latency respiratory disease (SLRD; predominantly asthma, rhinitis, hypersensitivity pneumonitis, and occupational infections) prevalence is difficult to determine but certain occupations may be associated with increased susceptibility. This study aimed to examine which occupations and industries are currently at high risk for SLRD and determine their respective suspected causal agents. SLRD cases reported to the SWORD scheme between 1999 and 2019 were analysed to determine directly standardized rate ratios (SRR) by occupation against the average rate for all other occupations combined. 'Bakers and flour confectioners' and 'vehicle spray painters' showed significantly raised SRR for SLRD in general, mostly due to occupational rhinitis (234.4; 95% CI 200.5-274.0) and asthma (63.5; 95% CI 51.5-78.3), respectively. Laboratory technicians also showed significantly raised SRR for occupational rhinitis (18.7; 95% CI 15.1-23.1), primarily caused by laboratory animals and insects. Metal machining setters and setter-operators showed increased SRR for occupational hypersensitivity pneumonitis (42.0; 95% CI 29.3-60.3), largely due to cutting/soluble oils. The occupation mostly affected by infectious disease was welding trades (12.9; 95% CI 5.7-29.3), mainly attributable to microbial pathogenicity. This study identified the occupational groups at increased risk of developing an SLRD based on data recorded over a recent two-decade period in the UK. Occupational asthma and rhinitis were identified as the prevailing conditions and hypersensitivity pneumonitis as a potentially rising respiratory problem in the metalworking industry.

Beyond the Surface: Decoding Pityriasis Versicolor Through Clinical, Dermoscopic and Microbiological Exploration

Abstract Background: Pityriasis versicolor (PV) is an asymptomatic, superficial fungal infection caused by the Malassezia species and causes discolouration of the skin leading to altered pigmentation. It is usually a clinical diagnosis, but in doubtful cases wherein potassium hydroxide (KOH) mount is unavailable, alternative modalities like dermoscopy aid in the management. Aims and Objectives: To evaluate the clinical and dermoscopic patterns in PV and correlate with the associated risk factors and study the fungal culture. Materials and Methods: A cross-sectional observational study was conducted for 12 months. A total of 115 patients clinically diagnosed with PV showing positivity on KOH mount were recruited. Dermoscopy was done, following which the scales were scraped and cultured in the laboratory on Saborauds dextrose agar and modified Dixon media, and the results were analysed after 3 weeks. Results: Among the 115 participants, on clinical evaluation, 79 patients had achromic and 36 patients had chromic lesions. The dermoscopic features were categorized into domains such as scaling, pigmentation and other features. Fine scaling was the most common feature observed in 88.7% of the patients. Pigmentary changes were noted in all the patients with non-uniform pigmentation being the most common. We have also observed and described newer dermoscopic findings such as barbed wire fence appearance of ridges and furrows, fluffy cotton ball appearance of hypopigmented perifollicular lesions and sprinkled pepper appearance of pigmented dispersion. Out of the 115 KOH mount positive cases, 51 (44.3%) showed growth on fungal culture with Malassezia furfur being the most common species to be isolated in 18 patients. Conclusions: Dermoscopy is a new, popular non-invasive diagnostic modality, which shows specific features like fine scaling, pigment alteration, ridges and furrows with perifollicular involvement, and can be used to diagnose doubtful cases of PV as an adjunct or substitute to a KOH mount.