Dermatophyte Molds Research Articles

Prevalence of Onychomycosis by Non Dermatophyte Molds in a Tertiary Care Hospital in Kolkata , West Bengal, India

Prevalence of Onychomycosis by Non Dermatophyte Molds in a Tertiary Care Hospital in Kolkata , West Bengal, India

Comprehensive Review of Tinea Capitis in Adults: Epidemiology, Risk Factors, Clinical Presentations, and Management.

Tinea capitis is a fungal infection of the scalp and hair caused by dermatophyte molds, that most often affects children and may also affect adults. Previous estimates suggest that between 3% and 11% of all tinea capitis cases worldwide occur in adults, although updated epidemiological studies are needed to reassess the prevalence of tinea capitis in adult populations specifically. Postmenopausal adult women are most often affected by tinea capitis, with African American or Black women particularly at risk. Adults who experience crowded living conditions, who live in close proximity to animals, who are immunosuppressed, and/or who live in households with affected children are at greatest risk of infection. Tinea capitis can be non-inflammatory or inflammatory in nature, and the subtype affects the extent and severity of clinical symptoms. Fungal culture and potassium hydroxide preparations are the most commonly used diagnostic tools. Trichoscopy, defined as dermoscopic imaging of the scalp and hair, is a useful adjunct to the physical examination. The mainstay of therapy is oral antifungal therapy, and topical therapy alone is not recommended. Since tinea capitis infection is uncommon in adults, there are no widely accepted treatment guidelines. Rather, the same medications used for tinea capitis infection among children are recommended for adults at varying doses, including griseofulvin, and terbinafine, and, less commonly, itraconazole and fluconazole. The prognosis for tinea capitis in adults is typically excellent when prompt and adequate treatment is administered; however, delayed diagnosis or inadequate treatment can result in scarring alopecia. Over the past decade, dermatophyte infections resistant to treatment with topical and oral antifungal agents have emerged. While tinea capitis infections resistant to antifungal therapy have been rarely reported to date, antifungal resistance is rising among superficial fungal infections in general, and antifungal stewardship is necessary to ensure that resistance to treatment does not develop among dermatophytes that cause tinea capitis.

Promising onychomycosis treatment with hypericin-mediated photodynamic therapy: Case reports

BackgroundOnychomycosis (OM) is a common nail plate disorder caused by dermatophyte molds, yeasts, and non-dermatophyte molds, which use keratin in the nail plate as an energy source. OM is characterized by dyschromia, increased nail thickness, subungual hyperkeratosis, and onychodystrophy, and is typically treated with conventional antifungals despite frequent reports of toxicity, fungal resistance, and OM recurrence. Photodynamic therapy (PDT) with hypericin (Hyp) as a photosensitizer (PS) stands out as a promising therapeutic modality. When excited by a specific wavelength of light and in the presence of oxygen, to lead to photochemical and photobiological reactions on the selected targets. MethodsOM diagnosis was made in three suspected cases, and the causative agents were identified by classical and molecular methods, and confirmed by attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR). Susceptibility of planktonic cells of the clinical isolates to conventional antifungals and PDT-Hyp was evaluated, and photoacoustic spectroscopy (PAS) of Hyp permeation in nail fragments ex vivo was analyzed. Furthermore, the patients opted to undergo PDT-Hyp treatment and were subsequently followed up. The protocol was approved by the human ethics committee (CAAE, number 14107419.4.0000.0104). ResultsThe etiological agents of OM in patients ID 01 and ID 02 belonged to the Fusarium solani species complex, being identified as Fusarium keratoplasticum (CMRP 5514) and Fusarium solani (CMRP 5515), respectively. For patient ID 03, the OM agent was identified as Trichophyton rubrum (CMRP 5516). PDT-Hyp demonstrated a fungicidal effect in vitro, with reductions of p3 log10 (p < 0.0051 and p < 0.0001), and the PAS analyses indicated that Hyp could completely permeate through both healthy and OM-affected nails. After four sessions of PDT-Hyp, mycological cure was observed in all three cases, and after seven months, clinical cure was confirmed. ConclusionPDT-Hyp showed satisfactory results in terms of efficacy and safety, and thus can be considered a promising therapy for the clinical treatment of OM.

Evaluation of synthesized biosurfactants as promising corrosion inhibitors and alternative antibacterial and antidermatophytes agents

This study investigated different amino acid-based surfactants (AASs), also known as biosurfactants, including sodium N-dodecyl asparagine (AS), sodium N-dodecyl tryptophan (TS), and sodium N-dodecyl histidine (HS) for their potential anticorrosion, antibacterial, and antidermatophyte properties. The chemical and electrochemical techniques were employed to examine the copper corrosion inhibition efficacy in H2SO4 (1.0 M) solution at 298 K. The results indicated their promising corrosion inhibition efficiencies (% IEs), which varied with the biosurfactant structures and concentrations, and the concentrations of corrosive medium. Higher % IEs values were attributed to the surfactant adsorption on the copper surface and the production of a protective film. The adsorption was in agreement with Langmuir adsorption isotherm. The kinetics and mechanisms of copper corrosion and its inhibition by the examined AASs were illuminated. The surfactants behaved as mixed-kind inhibitors with minor anodic priority. The values of % IEs gained from weight loss technique at a 500 ppm of the tested surfactants were set to be 81, 83 and 88 for AS, HS and TS, respectively. The values of % IEs acquired from all the applied techniques were almost consistent which were increased in the order: TS > HS ≥ AS, establishing the validity of this study. These surfactants also exhibited strong broad-spectrum activities against pathogenic Gram-negative and Gram-positive bacteria and dermatophytes. HS exhibited the highest antimicrobial activity followed by TS, and AS. The sensitivity of pathogenic bacteria varied against tested AASs. Shigella dysenteriae and Trichophyton mantigrophytes were found to be the most sensitive pathogens. HS exhibited the highest antibacterial activity against Shigella dysenteriae, Bacillus cereus, E. coli, K. pneumoniae, and S. aureus through the formation of clear zones of 70, 50, 40, 39, and 35 mm diameters, respectively.AASs also exhibited strong antifungal activity against all the tested dermatophyte molds and fungi. HS caused the inhibition zones of 62, 57, 56, 48, and 36 mm diameters against Trichophyton mantigrophytes, Trichophyton rubrum, Candida albicans, Trichosporon cataneum, and Cryptococcus neoformans, respectively. AASs minimal lethal concentrations ranged between 16 to 128 µg/ml. HS presented the lowest value (16 µg/ml) against tested pathogens followed by TS (64 µg/ml), and AS (128 µg/ml). Therefore, AASs, especially HS, could serve as an effective alternative antimicrobial agent against food-borne pathogenic bacteria and skin infections-associated dermatophyte fungi.

Study of Clinico-mycological profile of onychomycosis at a tertiary care hospital

Abstract Introduction: Onychomycosis (OM) is a common nail disorder caused by dermatophytes, non-dermatophyte moulds and yeasts. The increased prevalence of OM along with the wide range of associated fungi necessitates the accurate laboratory isolation and identification of the causative fungus for optimal management strategies. The aim of the study was to evaluate clinical, epidemiological and mycological characteristics of OM at a tertiary care hospital in Karimnagar. Materials and Methods: The study was conducted at Department of Microbiology for a period of one year. 109 patients clinically diagnosed as OM were subjected to detailed history, clinical examination and investigations. Nail clippings and subungual debris of OM patients were subjected to KOH preparation and culture. Isolates were identified by colony characters, pigment production, microscopic morphology. Results: The maximum number of OM cases belonged to the age group 21-30 years with a male preponderance. Higher incidence was noted in males (71.5%) than females (28.4%). Direct microscopy of the nail clippings in 40% KOH solution was positive in 56.8% and culture was positive in 75.2% cases. The common etiological agent was dermatophytes (45.12% cases) followed by yeasts (34.14% and non dermatophyte molds (20.7% cases). T.rubrum was the commonest among dermatophytes and Candida albicans among the yeasts. Conclusions: Although onychomycosis is not life threatening, it can cause a significant negative impact on the quality of life of infected patients. Early diagnosis and treatment is important to prevent distortion of the nails which can prevent loss of working efficiency of the commonly affected population.

Emerging Fungal Infections: from the Fields to the Clinic, Resistant Aspergillus fumigatus and Dermatophyte Species: a One Health Perspective on an Urgent Public Health Problem.

Purpose of ReviewFor this review, we use a One Health approach to examine two globally emerging public health threats related to antifungal drug resistance: triazole-resistant Aspergillus fumigatus infections, which can cause a life-threatening illness in immunocompromised hosts, and antifungal-resistant dermatophytosis, which is an aggressive skin infection caused by dermatophyte molds. We describe the state of current scientific knowledge and outline necessary public health actions to address each issue.Recent FindingsRecent evidence has identified the agricultural use of triazole fungicides as an important driver of triazole-resistant A. fumigatus infections. Antifungal-resistant dermatophyte infections are likely driven by the inappropriate use of antifungal drugs and antibacterial and corticosteroid creams.SummaryThis review highlights the need for a One Health approach to address emerging antifungal resistant infections, emphasizing judicious antifungal use to preserve available treatments; strengthened laboratory capacity to identify antifungal resistance; and improved human, animal, and environmental surveillance to detect emerging resistance, monitor trends, and evaluate the effectiveness of efforts to decrease spread.

SPECTRUM OF SUPERFICIAL MYCOSIS IN A TERTIARY CARE HOSPITAL–A MATTER OF CONCERN

BACKGROUND : Supercial mycosis has been recognized as a common fungal condition worldwide, including India. It refers to fungal infection of skin and its appendages. AIM &amp; OBJECTIVES : 1) To determine the frequency of fungal agents isolated from clinically suspected cases of supercial mycoses, in a tertiary health care hospital. 2) To access the risk factors associated with it. 3) To analyse the demographic prole associated with supercial mycosis. MATERIAL &amp; METHODS: The prospective study was carried out, over a period of 12 months (January 2021 to December 2021), samples such as skin scarping, hair plugs and nail clipping obtained from patients were submitted to Department of Microbiology for the fungal etiology. Samples were subjected to direct microscopy by KOH mount and fungal culture as per standard convectional technique. RESULTS: A total of 63 clinically suspected cases of supercial mycosis were enrolled in the study. Among the isolates recovered the most common were Dermatophytes(41.26%) followed by Candida(14.28%), Aspergillus(6.3%), Mucor(3.1%) and remaining 23.80% were sterile. Among the Dermatophytes, T.rubrum 42.30% was the predominant pathogen followed by T.mentagrophytes 34.61%. The most common age group affected was 21-40 years of age with male predominance of male to female ratio of 1.5:1. Out of total of 48 samples of supercial mycosis 26 were positive by direct microscopy and 48 samples were positive both by microscopy and culture. Most of the positive cases were recovered from immunocompromised individuals suffering from diabetes (37.5%) followed by prolonged antibiotic therapy (25.02%), long steroid therapy (12.5%) and chemotherapeutic agents (10.41%). The cases were mainly seen in the months between April to July which correlates the infection with the humid season. CONCLUSION: The study pinpointed dermatophytes as the most common clinical pattern of supercial mycosis with a male predominance. Dermatophytic infection is one of the emerging fungal disease along with non dermatophytic molds, especially in immunocompromised individuals prompt treatment and management can herald the onset of ensuing complications, thereby limiting the morbidity and thus improving the quality of life.

Assessment of Psoriatic Patients for Onychomycosis

Introduction: Psoriasis is a chronic, common, immune-mediated inflammatory disease that affects the skin, joints and nails. Nail involvement is very common in the course of psoriasis; Psoriasis can involve any element of the nail apparatus-nail bed or matrix, or both. Resulting a disturbance in the nail morphology (pitting, leukonychia, onycholysis, subungual hyperkeratosis, oil spot) and nail dystrophy, the psoriatic nails lose their natural preventing barrier and therefore are more predisposed to fungal infections. Onychomycosis is fungal infection of nails caused by yeasts, dermatophyte and nondermatophytemoulds. Psoriatic patients with nail changes more liable to invasion by fungal elements than psoriatic patients without nail changes. Objective: To assess the frequency of onychomycosis in psoriatic patients nails due to the presence of predisposing nail changes to fungal elements infection. Materials and Methods: The nail specimens were prepared by scrubbing and clippings from the 30 psoriatic patients with nail changes and another 30 without nail changes. The nail specimens were taken from each patient undergoes 2 laboratory examinations: direct Result: Totally, we studied 60 psoriatic patients (30 men and 30 women). The mean age was 24.5±13.7years. The most common clinical form of psoriasis was psoriasis vulgaris (85%) and (15%) Arthropathic psoriasis. The percentage of positive mycology in psoriatic patients with nail changes 21(70%) is higher than; the group of psoriatic patients without nails changes 10(33.3%). The fungal agents, which isolated in this study, were Yeast like fungi (candida spp.) and Non Dermatophyte Moulds (NDM). Conclusion: This study revealed statistically significant relation between nail psoriasis and mycological results were the P-value= 0.037.

COMPARATIVE STUDY OF EFFICACY OF ORAL TERBINAFINE ALONE AND ORAL TERBINAFINE WITH TOPICAL 8% CICLOPIROX OLAMINE IN ONYCHOMYCOSIS

Onychomycosis is a common fungal infection of nail plate caused by dermatophytes, non dermatophyte molds &amp; yeasts. Tinea unguium on the other hand refers specifically to infection caused by dermatophytes. Onychomycosis represents 50% of all nail disorders and 30% of all mycotic infections of skin.1 It is distributed worldwide with prevalence of 3% to 9%. It is generally considered as a disease of middle aged and elderly affecting a large and significant number of people. There has been a recent increase in the incidence as well as a spectrum of causative pathogens associated with onychomycosis. 50 patients of onychomycosis who attended our outpatient department were randomly selected. These 50 patients were equally divided into two groups A and B. Patients in group A (25) were given only oral terbinafine 250mg/once daily for 12 weeks. Patients in group B (25) were given oral terbinafine 250mg/once daily for 12 weeks along with 8% Ciclopirox Olamine nail lacquer which is applied topically once daily at night. In our present study combination therapy give high mycological cure rates than oral terbinafine monotherapy. Combination therapy (oral terbinafine 250mg daily dose with 8% ciclopirox olamine nail lacquer) showed 70 % clinical cure rate and 60 % mycological cure.

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

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

Current trends of antifungal susceptibility pattern of dermatomycosis in a tertiary care hospital by Etest and VITEK-2 methodologies

Dermatomycosis affect the superficial layers of the skin, nails and hair and are often caused by dermatophytic molds, candida & non dermatophytic molds. However, over the last decade, an increasing number of non– dermatophyte filamentous fungi & non albicans Candida have been recognized as agents of skin and nail infections in humans, producing lesions clinically similar to those caused by dermatophytes. Although tissue invasion by them is a rare possibility, they are important as a public health problem particularly in the immunocompromised. There are limited studies on the efficacy of antifungal agents against dermatophytes. This study was conducted to test the efficacy of 3 systemic antifungal agents viz. Voriconazole, Itraconazole & Fluconazole using the E-test method and 2 systemic antifungals viz. Itraconazole and Voriconazole by VITEK-2. Three different species of dermatophytes which were isolated from the clinically suspected cases were Trichophyton mentagrophytes, T.rubrum and M.gypseum. According to the obtained results, Itraconazole and Voriconazole showed the lowest MIC range while Fluconazole had the highest MIC range for most fungi tested. Determining the resistance pattern is especially necessary to assist clinicians in treating superficial fungal infections more effectively. This will minimize side effects and prevent development of antifungal resistance & treatment failures. Keywords: Dermatomycosis, Antifungal resistance, Etest, VITEK-2, Voriconazole, Itraconazole, Fluconazole.

Rise of superficial mycoses: A clinicoepidemiological study among the patients attending tertiary health care centre in north India

Introduction: Superficial mycoses refer to the disease of skin, hair and nail caused by fungi, are a serious problem due to deficient sanitation and education. This group includes dermatophytoses, non dermatophytic molds and Candida spp. Microscopic detection of fungal elements using wet mount preparation of 10% and 40% potassium hydroxide (KOH) is a rapid and precise tool for laboratory diagnosis. Objectives: This retrospective study was conducted to evaluate the sensitivity of wet preparation direct microscopy using potassium hydroxide for early detection of fungal elements from various clinical specimens and thereby helping the clinicians in initiating the appropriate antifungal treatments. Materials and Methods: All clinical specimen like skin and nail scrapping from patients suspected of superficial mycoses were subjected to KOH examination for screening and detection and positive samples were cultured on SDA (Sabouraud’s Dextrose Agar) medium for identification. Results: A total of 5734 samples of clinically suspected patients of superficial mycoses attended the tertiary care teaching hospital between September 2013 and August 2017 were included. 3165 patients (55%) were found to be positive by KOH examination. In the present study the most common clinical type was tinea cruris (74.3%) followed by tinea corporis (22.6%) in the patients attending tertiary health care centre. Conclusion: Clinical finding and wet mount with KOH can be believed upon as the single most important rapid and sensitive tool for early diagnosis of superficial mycoses. Since there is a high incidence of superficial mycoses in rural people coming to the tertiary heath care facilities therefore preventive and early screening measures are need of hours. Keywords: Potassium hydroxide preparation, Superficial mycoses, Tinea spp.

Pestalotioid fungi: A rare agent of onychomycosis among agriculture workers.

Background and Purpose: Pestalotioid fungi are ubiquitous environmental molds that have received considerable attention in recent times not only because of their role as a plant pathogen but also owing to their high frequency of retrieval from human diseases. Regarding this, the present study was conducted to investigate onychomycosis caused by pestalotioid fungi, commonly considered important phytopathogens causing grey blight disease in Camellia sinensis.Materials and Methods: A total of 122 agriculture workers were enrolled from Assam, India. Direct microscopic examination was carried out using 40% KOH to determine the presence of any fungal element. Further processing of the specimens for the isolation of fungi was performed using the standard protocol. In addition, the keratinolytic potential of the isolates was evaluated by means of the in vitro hair perforation test.Results: Out of 103 culture-positive samples, non-dermatophyte and dermatophyte molds constituted 82.52% (n=85) and 6.79% (n=7) of the samples, followed by yeasts (n=1, 0.9%) and sterile hyphae (n=10, 9.7%). With regard to the isolated non-dermatophyte molds (82.69%), 4 cases belonged to pestalotioid fungi, such as Neopestalotiopsis piceana (n=1), Pestalotiopsis species (n=1), and Pseudopestalotiopsis theae (n=2). The keratinolytic activity of Pestalotiopsis species showed perforation by disrupting the hair cortex; furthermore, macroconidia were found to be present inside the human hair.Conclusion: A high rate of NDM isolation may be attributed to constant exposure to adverse environmental and occupational hazards. This study highlighted the importance of “pestalotioid fungi” as the rare etiologic agent of onychomycosis. Another remarkable finding was the keratinolytic potential of Pestalotiopsis species, which is unique in this study.

A study on non-dermatophyte moulds as pathogens of onychomycosis

Introduction: Onychomycosis, a fungal infection of nails is ordinarily caused by dermatophytes non dermatophytes and yeasts. The isolation of non-dermatophyte moulds in onychomycosis specimens are being reported increasingly in different geographic regions. Therefore aim of this study was to determine the role and pattern of non- dermatophyte moulds as causative agents of onychomycosis. Materials and Methods: The study was carried out from September 2017 to September 2018 and 70 samples were included in the study. KOH examination and culture have been carried out in all the samples. Moulds were identified based on colony morphology, microscopic examination with Lacto phenol cotton blue stain (LPCB) and slide culture & Yeasts were identified by Gram staining germ tube test‚ urease test and using Chrome agar. Results: Out of 70 samples 42(61%) showed growth in culture, among this most common isolate belongs to non- dermatophyte fungi. Fusarium species (45%) was the most common among the non dermatophyte isolates followed by candida species. Curvulera, Acremonium sps‚ Fonsacea and Trichosporon species were the other non-dermatophyte moulds isolated. Conclusion: Non-dermatophyte moulds should be considered as important pathogens with a high index of suspicion in evaluating the patients with culture negative for dermatophytes or those subjects ending up in treatment failure. Keywords: Non- dermatophyte moulds, Dermatophytes, Onychomycosis, Yeast, Fusarium.

Onychomycosis Caused by Malassezia pachydermatis in a Dog

Background: Malassezia species are commensal skin organisms of warm-blooded vertebrates that can act as opportunistic pathogens. Malassezia pachydermatis is of importance in both veterinary and human medicine. Recognised initially as causes of infection of the skin, they are now known to be superficial commensals as well as potential causes of infections in domestic animals and more serious human conditions such as fungemia. They have also been implicated in the pathogenesis of allergic and other inflammatory diseases. Onychomycosis is defined as fungal infection of the claw (nail disease) caused by dermatophytes (Microsporum and Trichophyton genus), non-dermatophyte molds (hyaline and dematiaceous) and/or yeasts. The objective of this work was to report a case of canine onychomycosis by Malassezia pachydermatis based on reference standard diagnostics of this pathology.Case: A 9-year-old male West Highland White Terrier presented history of claw abnormality: brown staining and partly brittle. The dog has no apparent history of trauma on the affected claw and no skin disease was reported. Direct examination of claw was performed using the tape strip technique revealed Malassezia organisms. Nail fragments were cultured onto Sabouraud Dextrose Agar with Chloramphenicol and Cycloheximide. After 10 days of incubation (32ºC) nail fragments allowed the isolation of pure colonies of Malassezia pachydermatis. The histopathological evaluation was performed by Sector of Veterinary Clinical Pathology, Faculdade de Veterinária (FAVET/UFRGS) and fungal infection due to Malassezia pachydermatis was confirmed by histopathologic examination (Hematoxylin and eosin and Grocott’s methenamine silver stain) of the nail, that revealed abundant yeasts (blastoconidia).Discussion: Fungal infection of the skin, hair and nails are common and are primary caused by the dermatophyte molds. Non-dermatophyte molds isolated from nails constitute a long list, but only a few species cause onychomycoses. These include Scopulariopsis brevicaulis, Fusarium sp., Acremonium spp., Aspergillus spp., Penicillium spp. Yeasts like Malassezia and Candida spp. are saprophytes and usually represent incidental contaminants associated with a non-sterile specimen at mycological culture, however in some cases they may parasite the nails and become an etiological agent of the disease. M. pachydermatis, normally present on the skin and in the ear canal of dogs and cats, can act as opportunistic pathogenic microbe and frequently causes dermatitis and otitis in mammals. In the case of onychomycosis, there is little evidence that Malassezia yeasts are implicated in nail plate invasion, although this may be a rare occurrence. All species of the genus are obligatory lipid-dependent forms, with the exception of M. pachydermatis, as well as absence of keratinolytic ability. Malassezia organisms were commonly retrieved from the subungual claw fold region of normal healthy dogs (should be considered resident microflora of the normal canine claw fold). Some authors suggests that high numbers of yeast can be detected on cytological evaluation of the skin surface of the canine claw fold from allergic dogs in both the absence and presence of concurrent signs of pruritus and paronychia.

Antifungal Activity of Petroleum Ether and Ethanol Extracts of Moringa Oleifera Seeds

The activity of petroleum ether and ethanol extracts of Moringa olifera seeds have antifungal activity on different fungi including dermatophyte, non-dermatophyte molds and yeasts, which isolated from human skin and nail fungal infections. From 70 samples collected from skin and nail infection; 20 dermatophyte isolates, 21 non dermatophyte moulds and 25 yeast were isolated. While macromorphological and micromorphological as well as cultivation on differential media identified all isolated molds (derematophyte and non dermatophye molds), cultivation on corn meal media and chromogenic Candida agar could identified isolated yeasts. EME is having more antifungal activity than PME on all tested fungi.

Antifungal susceptibility pattern of dermatomycosis in a tertiary care hospital of North India

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Dermatomycoses affect the outer layers of the skin, nails and hair without tissue invasion and are often caused by dermatophytic molds, candida &amp;amp; non dermatophytic molds. Although not dangerous, they are important as a public health problem particularly in the immunocompromised. There are limited studies on the efficacy of antifungal agents against dermatophytes in North India.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study was conducted to test the efficacy of 5 systemic antifungal agents viz. voriconazole, itraconazole, terbinafine, fluconazole &amp;amp; griseofulvin using Microbroth dilution technique.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Three different species of dermatophytes which were isolated from the clinically suspected cases were &lt;em&gt;Trichophyton mentagrophytes&lt;/em&gt;, &lt;em&gt;T. rubrum&lt;/em&gt; and &lt;em&gt;M. gypseum&lt;/em&gt;. According to the obtained results, Itraconazole and Voriconazole showed the lowest MIC range while Fluconazole and Griseofulvin had the highest MIC range for most fungi tested.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Despite several treatment options being available for cutaneous fungal infections, due to an inappropriate response, there is an increasing need for determining an antifungal susceptibility profile for specific fungal strains. This will enable the clinician to select an appropriate antifungal agent with minimal side effects to avoid antifungal resistance and treatment failure.&lt;/p&gt;

Non dermatophytic molds causing onychomycosis: a rising trend in North India

Background: Onychomycosis is rarely life threatening but can affect patient’s quality of life by its associated morbidity and cosmetic disfigurement that makes it an important public health problem. So the current study was undertaken to look for causes of onychomycosis including the non-dermatophytic molds that are normally considered as contaminants. Methods: A total of 100 nail samples from clinically suspected cases of onychomycosis, were processed by direct microscopy of the KOH mount followed by two sets of culture on Sabourauds’ Dextrose Agar and incubated at 25ºC and 37ºC and were examined once a week for a period of 4-6 weeks, to look for the fungal causative agent. Results: Infection was more common among males and amongst age group 21-30 years (31%). The finger nails (57%) were more commonly involved than toe nails (43%). Onychomycosis was mostly caused by molds (55%), followed by dermatophytes (15.8%) and yeasts (9.3%). Aspergillus niger and A. flavus (13% each) were the most common molds, T. verrucossum (4.6%) was the most common dermatophyte, while Candida albicans (6.5%) was the most common yeast isolated. Conclusions: There is a rising trend of non dermatophytic molds causing onychomycoses, Thus microbiologists should look for all the possible causes of superficial fungal infection.

Clinico-Mycological Pattern of Hair and Skin Infection in New Delhi

Introduction: Fungus parasitizing structures rich in keratin, like hair, skin and nails, lead to a dermal inflammatory response with intense itching and cosmetic disfigurement. Hence, diagnosis, treatment and regional epidemiological characteristics of the fungus by in vitro culture are required. Aim and objective: To see the Clinico-mycological pattern of skin and hair infections in dermatology outpatient’s in New Delhi. Materials and methods: This study was conducted (April 2013-December2013) in Mycology laboratory of a tertiary care hospital, New Delhi on 100 consecutive outpatients with clinical suspicion of superficial fungal infection of hair and skin. Plucked hair and scrapings, biopsy, and scales of skin were collected. Potassium Hydroxide (KOH) mounts and culture on Sabourauds Dextrose Agar (SDA) was done and incubated at 25°C and 37°C for 4-6 weeks. Identification was done by colony morphology, microscopic of Lactophenol cotton blue (LPCB) mounts and slide culture as per standard mycological procedures. Results: The infection was more common in males (66%) with a male: female ratio of 1.9:1 and predominantly seen in <10 years of age (30%). Tinea corporis (32%) was the commonest presentation, followed by T. capitis (26%), T. mannum (20%), T. pedis (20%) and T. faciei (2%). Direct microscopy by KOH mount was positive in 37%, 46% by culture and 27% by both microscopy and culture. Dermatophytes were grown in 27(24.5%), while 17 (16.5%) had growth of non dermatophyte moulds (NDM) with only 6 (5.8%) of yeasts. Trichophyton rubrum (7.8%) was the commonest dermatophyte. T. verrucossum (5.8%), T. schoenleinii (5.8%), T. mentagrophyte (3.9%) and T. violaceum (1.9%) were also isolated. Aspergillus flavus (2.9%) was the most common NDM. Other NDMs isolated were, A. terreus, A. fumigatus, A. niger, Penicillium spp., Syncephalastrum spp., Paecillomyces spp., Mucor spp. Rhizopus spp. and Epicoccum spp. Conclusion: There is a rising trend of Non dermatophytic Moulds causing infection replacing the most common Dermatophytes.

Onychocryptosis together with onychomycosis due to non dermatophyte molds treated by brace and citric acid

Onychocryptosis together with onychomycosis due to non dermatophyte molds treated by brace and citric acid