Tinea Circinata Research Articles

Human b-2 Defensin in Tinea Versicolor and Tinea Circinata

Abstract Background: Both superficial tinea and pityriasis versicolor are very popular fungal skin infections that affect people all over the world. Recent research suggests that certain antimi-crobial peptides can also play a role in the body's natural defense against fungal infection. Aim of Study: The purpose of the current research would be to investigate the tissue expression of b2-defensin mRNA in lesions of tinea versicolor and lesions of tinea circinata and hence studying its role in fungal infection pathogenesis. Patients and Methods: Twenty patients with tinea versi-color, twenty with tinea circinata, and twenty controls were included in this case control study. For real-time PCR (RT-PCR) gene expression of b2-defensin mRNA, a punch skin biopsy was obtained from the patient's lesional and non-lesional skin, as well as normal skin from a control. Results: b2 defensin was upregulated in lesional areas of tinea versicolor and tinea circinata in comparison to non lesional areas of tinea versicolor, tinea circinata and control. These results reached a statistical significance for mRNA b2 defensin in tinea versicolor and tinea circinata (p-value <0.014). Conclusion: The results back up the theory that antimi-crobial peptides (b2-Defensin) may help the skin fight der-matophytes and M. furfur.

Human Cathelicidin in Tinea Versicolor and Tinea Circinata

Abstract Background: Fungal skin infections such as superficial tinea and pityriasis versicolor are very common and affect people all over the world. Recent research suggests that certain antimicrobial peptides can also play a role in the body's natural defense against fungal infection. Aim of Study: The aim of this research is to look at the tissue expression of Cathelicidin mRNA in tinea versicolor and tinea circinata skin lesions to learn more about its function in fungal infection pathogenesis. Patients and Methods: Twenty patients with tinea versi-color, twenty with tinea circinata, and twenty controls partic-ipated in this case-control study. A punch skin biopsy was obtained from the patient's lesional and non-lesional skin, as well as the control's normal skin, for real time PCR (RT-PCR) gene expression of cathelicidin mRNA. Results: Cathelicidin was upregulated in lesional areas of tinea versicolor and tinea circinata in comparison to non lesional areas of tinea versicolor, tinea circinata and control. These results reached a statistical significance for mRNA cathelicidin in both diseases (p-value <0.001). Conclusion: The results back up the theory that antimi-crobial peptides like Cathelicidin can help defend the skin from dermatophytes and M.furfur.

The profilaggrin N-terminal domain is absent in pityriasis rotunda

Funding sources: this work was in part supported by grants from the Ministries of Health, Labour and Welfare, and Education, Culture, Sports, Science and Technology of Japan. Conflicts of interest: none declared. Madam, Pityriasis rotunda (PR) is a rare keratinizing disorder characterized by round or oval patches that are hyper‐ or hypopigmented, well‐demarcated plaques.1 The main lesional sites are trunk and extremities. This disease entity was initially described in Japan by Toyama in 1906 and was termed tinea circinata.1 This keratinizing disorder has frequently been reported in Japan, South Africa and the West Indies.2, 3 The incidence in caucasian populations appears to be very low. The aetiology of PR is at present unknown. There are several reports that suggest that PR is a form of acquired ichthyosis, a delayed form of congenital ichthyosis, or a skin manifestation of systemic disease.2, 3 Filaggrin is crucial in the formation of the stratum corneum. At the time of terminal differentiation of granular keratinocytes, the 400‐kDa protein profilaggrin is proteolytically cleaved into ∼37‐kDa filaggrin peptides and the profilaggrin N‐terminal domain (PND) containing the S100‐like calcium binding domain.4 Hashimoto et al.5 reported that there was a marked decrease in filaggrin and loricrin expression in PR. Here, we describe a Japanese patient with PR, whose skin lesion showed diminished expression of the PND. We also examined the distribution of filaggrin and loricrin6 in the involved skin of our patient.

Ichthyosiform Irritant Contact Dermatitis Caused by Antiseptics for Personal Hygiene

Background: Antiseptics are commonly used for personal hygiene in Taiwan. We have previously reported a series of ichthyosiform irritant contact dermatitis induced by cetrimide-containing antiseptics. Objectives: To report a new series of antiseptics-induced ichthyosiform irritant contact dermatitis and bring attention to the potential irritation effects of antiseptics. Methods: We reviewed the clinicopathologic features of cases of cetrimide dermatitis, Savlon dermatitis or ichthyosiform irritant contact dermatitis diagnosed in our department (October 1993-August 2008). Cases with characteristic ichthyosiform, scarlet to dusky red or chemical burn-like skin lesions, primarily affecting the flexures and/or genital areas, and relevant exposure histories were included. Results: There were 35 patients (14 men and 21 women), aged from 3 to 79 years (mean 45 years) Most patients were seen in summer with a recognizable underlying pruritic dermatosis, and had used commercial products containing cetrimide. The exposure time was from 4 days to 2 months (mean 3.4 weeks). The great majority (80%) had moderate or severe skin lesions characterized by scarlet to dusky red or brownish lesions with a collodion membrane-like surface, and showed a preferential involvement of the flexural and genital areas, especially the groin and axilla where the lesions often manifested centrifugal rings. In no case was antiseptics-related dermatitis suspected by the clinicians or the patients. Skin biopsy was performed in 5 patients; all revealed changes consistent with cetrimide ichthyosiform irritant contact dermatitis. Conclusions: Our study showed that self-application of cetrimide-containing antiseptics is still an important cause of irritant contact dermatitis in southern Taiwan. This dermatitis should be differentiated from ichthyosis, tinea circinata, erythema annulare centrifugum, and nutritional deficiency diseases. Recognition of the clinical characteristics can prompt clinicians to inquire about exposure to antiseptics and facilitate correct diagnosis.

Plaque of Tinea Circinata: Infection From a Cow

Plaque of Tinea Circinata: Infection From a Cow

Efficacy of topical griseofulvin in treatment of tinea corporis

Tinea infections are among the most common dermatological conditions throughout the world. Griseofulvin is a classical oral fungistatic antibiotic, active against Epidermophyton floccosum, Trichophyton and Microsporum species, the causative fungi of tinea corporis. To evaluate the efficacy of topical griseofulvin in the treatment of tinea circinata using three different vehicles for drug delivery. Sixteen patients with tinea circinata were instructed to apply either griseofulvin gel form in group A or a similar placebo gel for control group; a niosomal gel formulation of griseofulvin for group B or; a liposomal gel formulation of griseofulvin for group C. Patients were evaluated both clinically and mycologically after 3 weeks. Marked improvement was seen for groups A, B and C both clinically and mycologically while no improvement was observed in the placebo group. Mild and transient irritation was reported in four patients. Our results show that topical griseofulvin preparations may be effective and safe in treating tinea circinata and that further large-scale studies may establish the high efficacy of the niosomal gel formulation.

On An Epidemic Skin Disease Somewhat Resembling Eczema and Pityriasis Rubra

Under this title, the author describes a peculiar form of skin disease which apparently appeared in an epidemic form in the Lambeth Infirmary. The cases which occurred were 163 in number—89 males, 74 females—and they were observed between July 1st and October 31st, 1891 and represented 19.2 percent of all the patients who came under treatment during that length of time. His definition of the disease is: A contagious malady, in which the main lesion is a dermatitis, sometimes attended by the formation of vesicles, and always resulting in a desquamation of the cuticle; usually accompanied by a certain amount of constitutional disturbance and running a more or less definite course of seven or eight weeks. The eruption presented three stages: A papulo-erythematous stage, which lasted from three to eight days. The eruption began as an erythematous papular rash, the skin being considerably thickened and indurated and in parts oedematous. The margin of the patch faded out and terminated sometimes with and sometimes without an abrupt raised edge, a few papules being scattered beyond. Instead of the papular rash, the first symptom was in some cases a raised blotch of congestion, having an abrupt margin and a circular outline, or in others, there were one or more flat papules which enlarged and resembled tinea circinata. Stage of exudation and desquamation—three to eight weeks. Confluence of the rash taking place, the appearances for days and weeks would be a crimson thickened and indurated surface, continually desquamating in scales and flakes of all sizes mixed with dried up exudation. According to the presence or absence of the latter, there were two varieties of the disease—a moist type, which ran a more rapid course and in which the papules became vesicles and a copious exudation, such as is seen in eczema, took place; the second variety, a dry one, was more prolonged, the skin remaining dry throughout, no exudation occurring and the appearances being those of a pityriasis rubra. Stage of subsidence. By degrees the inflammation subsided, the skin remaining thick, indurated, polished in appearance, brown in color, sometimes raw or smooth, shiny and parchmentlike, with cracks and fissures here and there. In some cases, eversion of the eyelids was noted and in some of the older people, a purpuric condition. . . George T. Elliot. J Cutan Genito-Urin Dis. May 1892;10:207-209.

Studies on the parasitic forms of Trichophyton rubrum isolated from patients with granuloma trichophyticum using the "agar-implantation method".

ABSTRACTWe studied the conversion of T. rubrum from hyphae to spherical cells using the agar‐implantation method. Thirteen cultures of T. rubrum were isolated from tinea superficialis and granuloma trichophyticum and they were implanted into the peritoneal cavities of ddY male mice. The cultures were divided into three groups according to their parasitic forms. The first group consisting of two cultures were isolated from tinea unguium and tinea pedis (hyperkeratotic type); they were destroyed in the peritoneal cavities of mice by the sixth week. The eight cultures in the second group were isolated from tinea cruris, tinea circinata and tinea pedis (vesicular type); they converted to spherical cells and survived for 16 weeks. The three cultures of the third group were isolated from granuloma trichophyticum; they survived and grew as hyphal forms in the peritoneal cavities of mice for over 26 weeks without spherical cell conversion. In conclusion, the parasitic forms of the three cultures isolated from granuloma trichophyticum differed from the cultures isolated from tinea superficialis.

Un cas insolite d’herpès circiné

A 61-year-old patient presented with an eczematous patch on the left wrist, suspect of a contact dermatitis to his watch. This lesion did not respond to the usual topical treatment. On the contrary, new lesions appeared on both forearms. A fungous culture was positive and confirmed the diagnosis of tinea circinata. Appropriate treatment allowed a complete cure within 1 month.

An epidemiological, clinical, and mycological study of human ringworm due to Trichophyton verrucosum in Japan.

ABSTRACTEpidemiological, clinical, and mycological studies based on a total of fifty‐eight cases of human ringworm caused by Trichophyton verrucosum were made. They consisted of thirty‐nine epidemically occurring cases in the Tono area of Iwate prefecture in 1962 and nineteen cases occurring sporadically in Miyagi and Yamagata prefectures from 1970 through 1973. The results are summarized as follows: 1) The majority of the patients were farm workers or their family members, who had opportunity for direct contact with infected cattle. 2) The infection was most frequent during the winter months. 3) Familial occurrence was noted in twenty‐six members of eleven families. 4) The most commonly affected sites were the exposed areas of the body, particularly the forearm of an adult and the face of a child. 5) The clinical features of the lesions were classified into the following six types: agminate folliculitis, tinea circinata, kerion celsi, sycosis trichophytica, granuloma trichophyticum Majocchi, and a hyperkeratotic form of tinea manum which may be previously unreported. 6) In general, lesions showed a marked inflammation with intense erythema, edema, and pustule formation, and without central clearing. 7) The causative organism easily invades the hair follicle, so that a deep‐seated lesion may not be uncommon. 8) On comparative studies, the brain heart infusion agar (Difco) containing dextrose, peptone, thiamine HCl and antibiotics was found to be adequate for the isolation and the identification of Trichophyton verrucosum. 9) The fungus grew more easily at 37 °C than at room temperature (25 °C), and growth was inhibited by the addition of actidione. 10) The lesions of the agminate folliculitis type and of the hairy parts should be treated orally with griseofulvin because of a possible aggravation due to topical medication.Outside of the Tohoku district of Japan a total of thirty‐eight cases have been observed in Hokkaido from 1967 to 1972 and four cases were seen in southwestern Japan in two recent years.

Fungous Infections in Children

The discovery of effective antifungal agents (griseofulvin, amphotericin B, tolnaftate) has greatly simplified treatment of the superficial mycoses commonly seen in children. This presentation is limited to information which may be of use to the practicing physician. The importance of identification of the causative organism is emphasized. The infections considered include tinea capitis, tinea circinata, tinea pedis and candidiasis.

Epidemic due to Microsporum canis.

Although tinea capitis and tinea circinata caused by Microsporum canis are fairly common diseases, they most often cause sporadic infections. 1,2 In the summer of 1957, a sudden small epidemic involving at least 12 persons occurred in a small town, and all cases could be traced to one kitten. The entire family, both parents and three children, who owned the kitten were infected, as well as eight other persons in the immediate neighborhood. One child who lived several blocks away was a frequent visitor at the home where the kitten lived and also became infected. Of the 12, Two were adults; 2 were adolescents, and 8 were children from 2 to 8 years of age. All 12 developed typical lesions of tinea circinata with oval erthyematosquamous patches with involuting centers and active borders. Only two children developed tinea capitis, and these cases were of the noninflammatory type.

Tinea pedis as a source of infection in the family.

A housewife was first seen in our dermatology clinic on March 3, 1956, because of a rash on the left which had been present for nine months. Originally small, this lesion had gradually enlarged but had not spread to other regions of the body surface. At the time of onset, July, 1955, the weather was warm, and the patient was in the first trimester of her second pregnancy. After she had been delivered of a healthy boy by Cesarean section in January, the eruption persisted and showed further slow growth. She attempted to treat the eruption with alcohol and with petrolatum (Vaseline) without any success. The lesion was moderately pruritic. The patient denied having had any earlier skin diseases. On examination, a clinically rather typical tinea circinata with an active scaling border was seen on the left buttock (Figure). Direct examination

MANHATTAN DERMATOLOGICAL SOCIETY

<b>Tinea Capitis et Corporis Contracted from a Monkey.</b>Presented byDr. Orlando Canizares. S. H., a girl aged 4 years, developed an eruption on the chest about two weeks after her parents had acquired a pet monkey. The patient often played with the monkey in close contact, especially around the neck. A few days after onset the eruption spread to the neck and back, and a patch of alopecia appeared on the scalp. Other lesions later developed on her arms. The eruption has been present now for about five weeks. The father, mother, brother, and both grandmothers of the patient also present lesions of tinea circinata. Eight of her cousins also contracted ringworm of the body, and two of them also present ringworm of the scalp. All had been in contact with the monkey. There is a patch of alopecia on the scalp about the size of a silver dollar

Allergic confirmation that some cases of erythema annulare centrifugum are dermatophytids.

IN A PREVIOUS article it was stated that some cases of erythema annulare centrifugum are dermatophytids.1This was based on the fact that several cases of this disease were found to fulfill the minimal basic criteria for the diagnosis of a dermatophytid. In addition, in two of these cases, erythema annulare centrifugum was reproduced and abolished by the experimental production and eradication of tinea pedis. In 1930, Epstein and Grunmandel2presented a definitive work on the local immunoallergic changes occurring in tinea circinata. In both experimental and spontaneous human tinea circinata, they produced a cruciform superinfection through the center of the annular lesions and demonstrated by this method that local immunity occurred not only in the center of the resolving infection, but also in a zone around the fungous focus. These changes were demonstrable only during a specific phase of the disease. It is likely that this corresponds

Unusual site of infection with Microsporum audouini.

It is not surprising to find tinea circinata in one or several adult members of the families of children suffering from tinea capitis caused by the genus Microsporum. The following case is reported because of the unusual site of an infection with Microsporum audouini in an adolescent, presumably contracted from her young brother, who had tinea capitis. REPORT OF CASE D. M., a 17-year-old girl, was first seen by us on March 17, 1953. She presented circinate to imbricate lesions on the mons veneris. There were satellite lesions on the lower abdomen with a tendency to spread toward the right inguinal region (Figure). The disease was of three months' duration and had been unsuccessfully treated with various ointments. Examination under filtered ultraviolet light revealed bright-green fluorescence of the pubic hair. The scalp, axillae, and the rest of the body were free of infection. Microscopically, hairs from the pubic region showed

Superficial fungus infections in infants.

IT IS WELL known that superficial infections caused by the Candida species (intertrigo, glossitis, perleche, etc.) are relatively common in infants. Also, tinea favosa (a rare fungus infection of the scalp) tends to involve more than one member of the family, including infants. With the exception of these two forms of dermatomycosis, the modern textbooks of dermatology and pediatrics do not mention tinea infections occurring in infancy. However, Duhring,1in his textbook on diseases ofthe skin, published in 1888, stated that infants are very susceptible to ringworm infections. He cited a case which had been reported by Lynch2in 1876; in this instance a lesion, noted six hours after birth, was identified as tinea circinata when the child reached 3 weeks of age. During the past year we have observed 10 infants who had superficial fungus infections. In each instance the disease had its onset before

The use of bloodagar for the primary isolation of dermatophytes.

The introduction of blood agar as additional medium for primary culturing of fungi from “tinea circinata” lesions has proven successful in increasing the yield of positive results. Early distinctive features ofT. gypseum andT. rubrum in hanging drop cultures are described.

EVALUATION OF FUNGOUS DISEASE OF THE EXTERNAL AUDITORY CANAL

ALTHOUGH medical mycology preceded bacteriology by many years, there remains considerable misunderstanding concerning fungi and their relationship to man. This is particularly true about fungous disease of the external auditory canal. In the past decade considerable effort has been devoted to clarifying many of the aspects of this disease, but much work remains to be done. HISTORICAL REVIEW Mycetes have been studied for nearly three hundred years. In 1677 Hooke, with the aid of a magnifying lens, first discovered that the yellow spots on roses were living organisms. Micheli classified aspergilli as a genus of molds in 1729. In 1839 Langenbeck discovered that thrush was caused by a fungus. In the same year Schoenlein described the fungus causing favus. During the next thirty years the study of mycology flourished with the work on tinea circinata by Gruby in 1842, tinea versicolor by Eichstedt in 1846 and tinea pedis by Fox

TRICHOPHYTOSIS, INCLUDING ONYCHOMYCOSIS UNIVERSALIS, SIMULATING TINEA IMBRICATA

Realizing the greater luxuriance of all forms of plant life in the tropics, it is not difficult to understand an analogy between the tinea imbricata of those regions and widespread dermatophytosis (of tropical origin) in the north. As early as 1855 Barensprung1insisted that tinea circinata was etiologically identical with eczema marginatum, and in 1878 Tillbury Fox2stated that some and more medical men. practising in tropical parts, . . . entirely concur in the view that eczema marginatum and the oriental phase of ringworm known as Indian, Chinese, etc., that is, tinea imbricata, are one and the same disease. That Barensprung and Fox did not have the advantage of the later clarifying mycologic work of Castellani and Sabouraud on the epidermophytons and of Castellani on the endodermophytons is beside the mark: it does not detract from the significance of the view of the forty and more medical