Fungal Skin Diseases Research Articles

A systematic analysis of the global burden of skin disease: lesions learned

BackgroundSkin diseases are some of the most common human illnesses across geographies and time. Despite this, there are surprisingly few large epidemiological studies that provide accurate data on cutaneous disease incidence and prevalence or estimates of the global burden of skin disease. The overall aim of this study was to estimate the global burden of disease attributable to 15 categories of skin disease from 1980 to 2010 for 187 countries, by age and sex, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2010. MethodsFor each of the following diseases we performed systematic literature reviews and analysed the resulting data using a negative binomial Bayesian meta-regression tool: eczema, psoriasis, acne vulgaris, pruritus, alopecia areata, decubitus ulcer, urticaria, scabies, fungal skin diseases, impetigo, abscess and other bacterial skin diseases, cellulitis, viral warts, molluscum contagiosum, and non-melanoma skin cancer. Once estimates of disease prevalence were generated, we determined appropriate disability attributable to that disease and applied GBD 2010 disability weights to determine non-fatal burden. FindingsThree skin conditions are in the top ten most prevalent diseases worldwide, and eight fall into the top 50. When considered collectively, skin conditions range from being the second to the 11th leading causes of years lived with disability at the country level for 2010 and from the third to the 28th leading causes of disability-adjusted life-years. InterpretationUsing more data than have ever been used previously, novel methods, and a more parsimonious choice of disease categories, we found that skin conditions are widespread, and the burden due to these diseases is enormous. Such a burden is particularly large for a field that receives relatively little attention in global health. These results suggest an urgent need for the inclusion of skin disease prevention and treatment in future global health efforts. FundingBill & Melinda Gates Foundation.

Evaluation of the incidences of dermatophillic infection in Rajastahan: Case studies from Rajasthan, India

Dermatophytosis accounts for the majority of fungal skin diseases. Sixty (60) case studies (45 males and 16 females) of dermatophyte infection were carried out. Out of the 60 cases, 13% cases were healthy and 87% cases were found infected with one or more fungi. In 95% of cases, the fungal species recovered were from the infected symptomatic area like inflammatory lesions redness, dry patches itching, flaky rings, and 6.7% of cases from pain. The pattern of distribution of site of infection was recorded maximum at internal parts (54%) followed by hand (15%), neck (12%) and leg (6%). The incidence of Aspergillus niger (19%), Cladosporium sp. (14%),Aspergillus flavus (13%), Trichophyton sp. (13%) and Microsporum sp. (5%) was high andFusarium sp., Curvularia sp., Penicillium sp., Trichothecium roseum, Epidermetaphyton sp., Drechslera sp. and Alternaria sp. was low. Key words: Evaluation, incidence, dermatophillic infection, clinical isolates.

Topographic diversity of fungal and bacterial communities in human skin

Traditional culture-based methods have incompletely defined the etiology of common recalcitrant human fungal skin diseases including athlete’s foot and toenail infections. Skin protects humans from invasion by pathogenic microorganisms, while providing a home for diverse commensal microbiota1. Bacterial genomic sequence data have generated novel hypotheses about species and community structures underlying human disorders2,3,4. However, microbial diversity is not limited to bacteria; microorganisms such as fungi also play major roles in microbial community stability, human health and disease5. Genomic methodologies to identify fungal species and communities have been limited compared with tools available for bacteria6. Fungal evolution can be reconstructed with phylogenetic markers, including ribosomal RNA gene regions and other highly conserved genes7. Here, we sequenced and analyzed fungal communities of 14 skin sites in 10 healthy adults. Eleven core body and arm sites were dominated by Malassezia fungi, with species-level classifications revealing greater topographical resolution between sites. By contrast, three foot sites, plantar heel, toenail, and toeweb, exhibited tremendous fungal diversity. Concurrent analysis of bacterial and fungal communities demonstrated that skin physiologic attributes and topography differentially shape these two microbial communities. These results provide a framework for future investigation of interactions between pathogenic and commensal fungal and bacterial communities in maintaining human health and contributing to disease pathogenesis.

EVALUATION OF THE IMMUNE RESPONSE TO <i>T. VERRUCOSUM</i> VACCINES

Dermatophytosis is considered as one of the most important fungal skin disease affecting both humans a nd animals otherwise its importance as zoonotic diseas e. Treatment of ringworm in cattle is expensive and time consuming especially on herd level. Vaccination can be a giant step forward to prevent the occurrence of mycozoonosis between the affected animals with ringworm and susceptible man. Fifty skins scraping samples were collected from animals (cattle, sheep and calves) suffering from skin lesions suspected t o be ringworm. Then these collected samples were subjected to mycological examination and identification. T. verrucosum is the main causative agent of collected skin scra pings. Two types of vaccines were prepared from this strain (Culture filtrate and formalin ina ctivated vaccines). Rabbit model was used for chall enge testing of the vaccines. The rabbits were separated into four groups as follow: Each group contained 3 rabbits each one was injected subcutaneously with 1 ml of culture filtrate with adjuvant twice for seve n days intervals. Group No. 2 rabbits each one was injecte d intramuscularly with 1 mL formalin-inactivated wi th adjuvant. The 3rd group is control positive and 4th one is control negative. Vaccination programme is done via injection twice with one week interval and the challenge by scarification of the skin with 0.2 mL of 5×10 7 fungal elements/mL. For 3 days. Humeral immune response was assessed by measuring anti-T. verrucosum antibodies using ELISA technique (direct method). By using statistical analysis of ANOVA, the mean optical density of anti- T. verrucosum specific IgG level in rabbits artificially immuniz ed with culture filtrate with adjuvant vaccine significantly increa se from (1.97) post first vaccination to reach (2.4 3) post second vaccination and still high after challenge w ith the virulent T. verrucosum strain (2.32) when compared with control positive (1.57). The results revealed that both type of vaccines induce good hum eral immune response in vaccinated animals. Culture filt rate vaccine used as a treatment in infected farm animals by two doses within 2 weeks and noted that healing occurred.

The occurrence of Trichophytosis among people and cattle on a farm in Vojvodina, Serbia

Dermatophytoses are frequent contagious fungal skin diseases that affect the skin of people and animals. Zoophile dermatophytes pose a significant problem for both human and veterinary medicine, and they are especially present among bovines. In this paper we showed a simultaneous occurrence of trichophytosis among professionally exposed people and bovines on a farm in Vojvodina, Serbia. The tested samples (skin scrapings and hair) originating from people and animals, were positive for Trichophyton verrucosum dermatophyte which was determined by applying a direct microscopic examination of the smears, as well as the isolation and identification of the agents.

Germ Tube Mediated Invasion of Batrachochytrium dendrobatidis in Amphibian Skin Is Host Dependent

Batrachochytrium dendrobatidis (Bd) is the causative agent of chytridiomycosis, a fungal skin disease in amphibians and driver of worldwide amphibian declines.We focussed on the early stages of infection by Bd in 3 amphibian species with a differential susceptibility to chytridiomycosis. Skin explants of Alytes muletensis, Litoria caerulea and Xenopus leavis were exposed to Bd in an Ussing chamber for 3 to 5 days. Early interactions of Bd with amphibian skin were observed using light microscopy and transmission electron microscopy. To validate the observations in vitro, comparison was made with skin from experimentally infected frogs. Additional in vitro experiments were performed to elucidate the process of intracellular colonization in L. caerulea.Early interactions of Bd with amphibian skin are: attachment of zoospores to host skin, zoospore germination, germ tube development, penetration into skin cells, invasive growth in the host skin, resulting in the loss of host cell cytoplasm. Inoculation of A. muletensis and L. caerulea skin was followed within 24 h by endobiotic development, with sporangia located intracellularly in the skin. Evidence is provided of how intracellular colonization is established and how colonization by Bd proceeds to deeper skin layers. Older thalli develop rhizoid-like structures that spread to deeper skin layers, form a swelling inside the host cell to finally give rise to a new thallus.In X. laevis, interaction of Bd with skin was limited to an epibiotic state, with sporangia developing upon the skin. Only the superficial epidermis was affected. Epidermal cells seemed to be used as a nutrient source without development of intracellular thalli. The in vitro data agreed with the results obtained after experimental infection of the studied frog species. These data suggest that the colonization strategy of B. dendrobatidis is host dependent, with the extent of colonization most likely determined by inherent characteristics of the host epidermis.

PA01.80. The review of herbal anti-allergy and anti-histaminic drugs

Purpose: The symptoms of an allergic reaction communicate sensitization to certain antigens in the environment. Initiation of antigen reaction stimulates mast cells to release histamine into the blood which interacts with the cells to produce most of the symptoms of the allergy. Drugs that block only the action of histamine are known as antihistaminic while the drugs preventing mast cells from releasing histamine are considered as anti allergic agents. Ayurveda considers Mandagni (Jadharagni in hypofunctional state) as the root cause of the all diseases which produces Ama (Antigen/Visha). Drugs possessing Deepan, Pachan, and Vishaghna properties may prevent histamine release and allergic reactions. Udardaprashamana, Kandughna, Swasahara group of drugs may prevent acute histaminic reaction. Keeping this concept in view a critical review was made about the herbs mentioned in the classical Ganas and aushadhyogas of compilatory works of medieval India in addition to reported activities during 20th century research works. The study aims to identify herbs with Antihistaminic and Antiallergy activity and to discuss safety and efficacy of herbal anti histaminics over the drugs of modern medicine which may produce certain adverse effects like nausea, drowsiness, nasal burning etc. Method: Analysis of drugs mentioned in the management of pratishyaya, shwas, kasa, and skin conditions like Seetpitta, Udarda, Vicharchika etc. was made. Review of research data mentioned in various journals and monographs was also analysed. Result: Vishaghna and Udardaprashamana dashemani may have profound activity in controlling allergic reactions. Kandughna Dashemani may be useful to control fungal and allergic skin diseases. Pippali, Tulsi, Kantakari may be useful in the management of allergic disease of respiratory tract. Azadirachta indica (Nimba), Albezzia lebbeck (Shirish), Glycerrhyza glabra (Yashtimadhu) etc. have provided ample scientific evidence for antihistaminic activity. Conclusion: Recent researches confirmed Anti histaminic and Anti allergic activity of Adhatoda vasica (vaasaa), Aloe vera (kumari), Azadirachta indica (nimba), Curcurma zedoaria (karchura), Nigella sativa (upakunchikaa), Inula racemosa (pushkarmoola), Tinospora cordifolia (guduchi), Benincasa hispida (krushmanda) etc. which are safer to use.

Lacaziosis and lacaziosis-like prevalence among wild, common bottlenose dolphins Tursiops truncatus from the west coast of Florida, USA

Lacaziosis (lobomycosis; Lacazia loboi) is a fungal skin disease that naturally occurs only in humans and dolphins. The first reported case of lacaziosis in a bottlenose dolphin Tursiops truncatus occurred in 1970 in Sarasota Bay, Florida, USA, and subsequent photo-ID monitoring of the Sarasota Bay dolphin population has revealed persistence of the disease. The objectives of this study were to estimate lacaziosis prevalence (P) in 2 bottlenose dolphin populations on the west coast of Florida (Sarasota Bay and Charlotte Harbor) and compare disease occurrence to other published estimates of lacaziosis in dolphin populations across the globe. Historic photographic records of dolphins captured and released for health assessment purposes (Sarasota Bay) and photo-ID studies (Charlotte Harbor) were screened for evidence of lesions consistent with lacaziosis. Health assessment data revealed a prevalence of lacaziosis in the Sarasota Bay bottlenose dolphin population between 2 and 3%, and analyses of photo-ID data provided a lacaziosis-like prevalence estimate of 2% for Charlotte Harbor dolphins. With the exception of lacaziosis prevalence estimates for dolphins inhabiting the Indian River Lagoon (P = 0.068; P = 0.12), no statistically significant differences were seen among Sarasota Bay, Charlotte Harbor, and other published estimates. Although lacaziosis is a rare disease among these dolphin populations, studies that assess disease burden among different populations can assist with the surveillance of this zoonotic pathogen.

Epizootiological and clinical characteristics of bovine dermatophytosis caused by Trichophyton verrucosum

Dermatophytoses present frequent contagious fungal skin diseases in humans and animals. Zoophyllic types of dermatophytes are almost always present in animals. The dominant dermatophyte specie in cattle and other ruminants is Trichophyton verrucosum of the Family Arthrodermataceae. In the course of this investigation, a total of 566 animals of the Holstein- Friesian breed were examined epizootiologically and clinically. Methods of epizootiological, clinical and laboratory examinations were applied. The material used for laboratory investigations that included direct microscopic examinations including the isolation and identification of the cause, were hair samples and skin scars of cattle suspected of having the infection. Using the described methods, we established and described cattle infection with T. verrucosum in a farm in the district Juznobacki okrug, in the Republic of Serbia. A prevalence of cattle skin infection with T. verrucosum of 29.5% was established. In addition to the exhibited charateristic eflorescences that correspond to the clinical picture of dermatophytoses, we also registered the occurrence of hemorrhages, suppurations and necroses. Further epizootiological investigations are necesssary in order to eliminate the source of infection.

Nodular granulomatous fungal skin diseases of cats in the United Kingdom: a retrospective review

IDEXX Laboratories database of cases submitted from the UK between March 2005 and February 2008 (36 months) was investigated for feline nodular granulomatous skin disease associated with fungal infection. Cytological and/or histological slides were reviewed and the diagnosis was based on the microscopic pattern of the inflammatory response and morphology of the causative organism. Aetiological diagnoses were hyalohyphomycosis (64 of 77 cases), phaeohyphomycosis (five of 77 cases) and dermatophytic pseudomycetoma (eight of 77 cases). All cases of hyalohyphomycosis were suspected to be alternariosis based on common features including anatomical distribution of lesions (48 of 64 cases involved the nostril and bridge of nose, face and ears), pattern of histological changes, morphology of the causative organism and results of fungal culture (Alternaria three of 16 and 'saprophyte' nine of 16 cases). Cases of phaeohyphomycosis were demographically and histologically similar to those of alternariosis, except the causative organisms were deeply pigmented brown and had a variety of morphologies that were different from Alternaria. Dermatophytic pseudomycetomas had a characteristic histological pattern including the presence of fungal microcolonies or grains within the tissue. These occurred most often on the trunk (five of eight cases) and four of eight cases were in Persian cats. These findings indicate that alternariosis is by far the most common nodular fungal skin disease of cats in the UK.

Lacaziosis in Bottlenose Dolphins (Tursiops truncatus) in the Indian River Lagoon, Florida, USA

The objective of this study was to document the presence of the fungal granulomatous skin disease lacaziosis in stranded Indian River Lagoon (IRL) bottlenose dolphins (Tursiops truncatus). From 1 January 2007 through 31 December 2007, stranded dolphins from the northern part of the IRL were thoroughly examined, and appropriate tissue samples were collected. The intralesional fungal agent (Lacazia loboi) was identified histologically in three bottlenose dolphins. Histologically, lacaziosis has been previously documented in IRL dolphins inhabiting the southern portion of the lagoon. Our findings suggest that the disease occurs throughout the lagoon. Enhanced monitoring of the prevalence of lacaziosis in dolphins throughout the IRL is needed to assess changes in population health.

Ophthalmology: An approach to fungal skin disease in reptiles and amphibia

Ophthalmology: An approach to fungal skin disease in reptiles and amphibia

Equine Bacterial and Fungal Diseases: A Diagnostic and Therapeutic Update

Bacterial and fungal skin diseases are important in the horse. Bacterial skin diseases (pyoderma) are most often caused by Staphylococcus species, Corynebacterium pseudotuberculosis or Dermatophilus congolensis . The most common clinical signs associated with bacterial skin infections are crusts, papules, abscesses, and draining tracts; the latter two lesions are more commonly associated with C. pseudotuberculosis . Ideally, antibiotic treatment should be based on bacterial culture and sensitivity. Fungal infections are most commonly caused by dermatophytes (“ringworm”) or Sporothrix schenkii , although the role of Malassezia in equine skin disease is beginning to be investigated. The clinical signs of fungal infections are variable and may include alopecia, crusts, papules, pruritus, nodules, ulcers, and draining tracts. The latter three lesions are more commonly associated with S. schenkii infection. Treatment is dependent on the organism cultured and may include both topical and/or systemic treatment.

Cutaneous Manifestation of HIV/AIDS in Sudanese patients

The importance of skin manifestations of HIV/ AIDS cannot be overestimated. In a significant number of AIDS patients, skin provides the first clinical signs of the infection and the contribution of dermatology in the early diagnosis of the disease is quite substantial. The onset of immunosuppression after years of infection with HIV may be heralded by the development of various viral, fungal, bacterial and other skin diseases. Depressed immunity impacts subtle or overt differences on the clinical picture of dermatological conditions suggesting to the aware dermatologist the possibility of underlying HIV infection, hence an opportunity of early diagnosis. The literature is replete with reports about the cutaneous manifestations of AIDS and its impact on the clinical picture of coexisting skin diseases [1-4]. The present study is the first of its kind in the Sudan. Sud J Dermatol Vol.2(2) 2004: 47-53

Rapid identification and differentiation of fungal DNA in dermatological specimens by LightCycler PCR

The aim was to develop a LightCycler PCR method for the rapid detection and differentiation of fungal DNA in dermatological specimens such as skin scales and skin swabs. LightCycler PCR assays were established for seven primer sets specific for fungal DNA. For each primer set LightCycler melting points were defined by amplification of DNA from 21 fungi and sensitivity was determined by amplification of serial dilutions of fungal DNA. A protocol was established that allows detection and differentiation of mould and yeast DNA with one highly sensitive PCR reaction by assessment of LightCycler melting points. Two subsequent LightCycler PCR reactions and one RFLP reaction allowed the differentiation of dermatophytes and non-dermatophyte moulds and the subclassification of yeasts. Analysis of clinical samples from 38 patients with fungal skin diseases provided conclusive new diagnostic information in 9/38 cases (23.7 %) by this PCR protocol that was not equally provided by direct microscopy and mycological culture. Thus the LightCycler PCR protocol established here represents a rapid diagnostic tool that aids in the diagnosis of fungal skin disease in a substantial number of patients.

P‐68 The role of cytological and histopathological examination in small animal dermatology

Two clinical laboratory diagnostic methods, cytology and histology, were introduced in practice, and the conditions, circumstances and advantages of their application were defined. Samples were obtained by skin biopsy (n = 35) and cytological sampling techniques (n = 33) from 41 dogs and four cats with skin disease. Cases were grouped into three categories: allergic dermatitis, fungal and parasitic skin diseases, and other skin diseases (including endocrinopathies, autoimmune, neoplastic, congenital, hereditary and infrequent skin disease). In each category, histological findings were evaluated for their information and their role in achieving the clinical diagnosis. We grouped the results of the histological examination into three groups: (1) essential to make the diagnosis and gave the final diagnosis; (2) not essential, but was a confirmation, and gave only the causal category; and (3) only a histological diagnosis without causal category. Results proved that histological diagnoses alone helped significantly in reducing the numbers of differential diagnoses in fungal and parasitic, and other skin diseases. The histological diagnoses were significantly more important in determining the final diagnosis in cases of other skin diseases compared to the allergic dermatitis (P < 0.001) and infectious (fungal and parasitic) (P < 0.01) skin problems. Cytological examination provided significantly less information (P < 0.01) compared to the histological results in the group of other skin diseases, but there was no significant difference between the informative values of both methods comparing all cases. Significance, usefulness and necessity of histopathological and cytological methods applied in the clinical practice were justified in this study. Funding: IAMS Company.

Antibacterial and antifungal activities of some extracts and fractions of Mitracarpus scaber Zucc. (Rubiaceae)

Objective: To evaluate in vitro the potential antibacterial and antifungal activities of two crude extracts (n-hexane and 80% MeOH) from Mitracarpus scaber (Zucc) (Rubiaceae) leaves and that of fractions from of the partion of the 80% MeOH extract aiming to locate active fractions. Materials and methods: The n-hexane and 80% MeOH extracts of M. scaber leaves were separately obtained by maceration followed by exhaustive percolation with corresponding solvent. They were dried in vaccuo and their antibacterial and antifungal activities evaluated in vitro by the dilution method against 21 clinical isolates including 13 bacteria, 3 dermatophytes and 2 yeasts. Results: The two extracts exhibited a pronounced antibacterial activity against Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus faecalis (minimal inhibitory concentration and minimal bactericidal concentration 500 µg/ml). Both activities found in the 80% MeOH extract were located in the diethylether fraction from its partition with minimal inhibitory concentration of 7.8 to 62.5 µg/ml and minimal bactericidal concentration of 15.7 to 62.5 µg/ ml for the antibacterial activity and, minimal inhibitory concentration of 7.8 to 31.25 µg/ml and minimal fungicidal concentration of 15.7 to 62.5 µg/ml for the antifungal activity against all cited microorganisms above. It was however ineffective against Proteus mirabilis and Pseudomonas aeruginosa (minimal inhibitory concentration and minimal bactericidal concentration > 500 µg/ml). Conclusion: Mitracarpus scaber leaf extracts possess a wide antibacterial and antifungal spectra of activity that can justify and support its traditional use as a remedy for the treatment of fungal and bacterial skin diseases.

Structural and Antimicrobial Studies of Some Divalent Transition Metal Complexes with Some New Symmetrical Bis (7-Formylanil Substituted-Sulfoxine) Schiff Base Ligands

Symmetrical bis (7-formyanil substituted-8-hydroxyquinoline-5-sulfonic acid), Schiff bases, react with Co(II), Ni(II) and Cu(II) ions to give MnL (n=1, 2) complexes as established by conductometric titration in 1 : 1 DMF: H2O. The complexes were identified by elemental analyses, molecular weight determination, thermal analysis, infrared, magnetic moments, electronic absorption, and electron spin resonance spectra. The suggested general geometry for these complexes may have a tetrahedral crystal structure and the general formula is [M2L(OH24], where M(II) = Co, Ni and Cu and L = 7―X―H2 L(―X―= dimethyl, p-phenyl, o-phenyl), while for the, trimethyl, ligand and the tetrahedral crystal structure has the general formula [M2L(OH2)2].Antimicrobial activity of these ligands and their transition metal complexes has been investigated on some common fungi and bacteria. A considerable increase in the biocide acticity of these ligands has been observed on coordination with transition metal ions, therefore, these complexes can be used in the chemotherapy of candidiaces and other fungal skin diseases.

Structural and Microbial Studies of some Transition Metal Complexes of 7-Substituted-8-Hydroxyquinoline-5-Sulphonic Acid Ligands

The reaction of 7-substituted derivatives of the ligand 5-sulpho-8-hydroxyquinoline (7-X-HL), (X=H, NH 2 , NO 2 and I), with some biologically important transition metal ion such as {Cr(III), Fe(III), Mn(II), Fe(II), Co(II), Ni(II), and Cu(II)} was investigated. The formation of ML n (n=1, 2) complexes of the ligand Na[7-I-HL] has been established by conductometric titrations in 10% (v/v) ethanol-water. The complexes of the ligands with all of the above transition metal ions which have been synthesized were characterized by elemental analyses, molecular weight determinations, X-ray diffraction (XRD), magnetic moments (µ eff ), and thermal analyses (DTA and TG). The data suggest the composition of these complexes, which have an octahedral coordination. The general formula is Na 2 [ML 2 (H 2 O) 2 ]·4H 2 O where M(II)=Mn, Fe, Co, Ni and Cu. The thermal analyses of the complexes show that for Na 3 [ML 3 ]·6H 2 O where M(III)=Cr and Fe all water molecules are lattice water. The antibacterial activity of these ligands and their divalent transition metal complexes has been determined on gram-positive ( Sarcina lutea ) and gram-negative ( Escherichia coli ) bacteria at 37°C, and antifungal activity has been determined on common fungi viz . ( Aspergillus niger , and Candida albicans ) at 30°C. A considerable increase in the biocidal activity of these ligands on being coordinated with transition metal ions has been reported. These compounds can be recommended to use for the chemotherapy of candidiaces and other fungal skin diseases.

Epidemiology of fungal skin and nail disease: roundtable discussion held at Dermatology 2000, Vienna, 17 May 1993.

Epidemiology of fungal skin and nail disease: roundtable discussion held at Dermatology 2000, Vienna, 17 May 1993.