Tinea Favosa Research Articles

Tinea Favosa: Negligence and Misdiagnosis in Three Cases in Shiraz During 2021 - 2022

Introduction: Tinea favosa, a dermatophytic infection primarily caused by Trichophyton schoenleinii, remains a notable dermatological concern. It is characterized clinically by yellowish cup-shaped crusts on the scalp, and these lesions can result in scarring or non-scarring alopecia. Case Presentation: Three cases of severe tinea favosa transmitted by T. schoenleinii in Afghan immigrants residing in Iran are presented. The prevalence of tinea favosa has declined in Iran, although in some parts of Iran, mostly in the northern cities, the prevalence is still fairly high. Environmental and socioeconomic factors are the most common causes of these differences and elevated prevalence in specific northern cities. Conclusions: The increasing trend of isolation of T. schoenleinii in the immigrant population in Iran should be considered a serious health problem that requires special attention, as it could be a potential source for the re-emergence of this dermatophytic infection in the region. This emerging trend necessitates specialized medical attention and raises broader questions about regional dermatological patterns and their consequences for public health. Tinea favosa epidemiology is subject to change due to shifting migration patterns, evolving socioeconomic conditions, increased international travel, and drug overuse. In light of these findings, we propose the following recommendations: We recommend training and educational programs for healthcare professionals, especially in regions with high immigrant populations, to enhance their ability to accurately diagnose and manage tinea favosa. We also recommend raising awareness about tinea favosa, its symptoms, and the importance of seeking timely medical attention. Targeting both immigrant communities and healthcare providers is crucial.

Comprehensive genome and transcriptome analysis of the dermatophyte Trichophyton schoenleinii reveals the candidate pathogenic genes.

Trichophyton schoenleinii is an anthropophilic dermatophyte that causes tinea favosa. Nowadays, it remains an important pathogen in some regions of the world, mainly epidemic in Africa and West Asia. Despite the medical importance of T.schoenleinii infections, a high-quality reference genome for T.schoenleinii is still unavailable, neither its transcriptomic profile. The aim of the current study was to improve understanding of the underlying pathogenic mechanism of T.schoenleinii, and to define the candidate pathogenic genes of T.schoenleinii. Comprehensive genomic analysis of T.schoenleinii was carried out by Illumina and PacBio sequencing platforms. Transcriptome profiles of T.schoenleinii cultured in vitro in two media containing either keratin or soy protein were determined using RNA sequencing (RNA-seq) technology. Here, we present the first draft genome sequence of T.schoenleinii strain T2s, which consists of 11 scaffolds containing 7474 predicted genes. Transcriptome analysis showed that genes involved in keratin hydrolysis have higher expression in T.schoenleinii grown in keratin medium, including genes encoding proteases, cysteine dioxygenase and acetamidase. Other genes with higher expression include genes encoding the components of the pH-responsive signal transduction pathways and transcription factors, many of which may play a role in pathogenicity. In summary, this study provides new insights into the pathogenic mechanism of T.schoenleinii and highlights candidate genes for further development of novel targets in disease diagnosis and treatment of tinea favosa.

Molecular epidemiology and in vitro antifungal susceptibility of Trichophyton schoenleinii, agent of tinea capitis favosa.

Trichophyton schoenleinii is an anthropophilic dermatophyte usually causing tinea favosa. Only few studies have provided data on molecular epidemiology and antifungal profiles of this fungus due to its limited prevalence after 1950s. Forty-nine strains from Asia (n=27), Africa (n=10), Europe (n=10) and from unknown regions (n=2) were analysed with amplified fragment length polymorphism fingerprinting (AFLP) to reveal intraspecific genetic diversity in this dataset. Amplified fragment length polymorphism fingerprinting genotyping revealed five clusters which did not correspond to geographic origins or clinical characteristics. Additionally, in vitro antifungal susceptibility to seven antifungals was provided for all strains. Terbinafine, ketoconazole, miconazole and itraconazole proved to be the most effective drugs, followed by griseofulvin. No correlation between genotypes and differences in antifungal susceptibility was observed. It is concluded that the AFLP groups are lineages within a single species.

In Vitro Antifungal Susceptibility Profiles of 12 Antifungal Drugs against 55 Trichophyton schoenleinii Isolates from Tinea Capitis Favosa Patients in Iran, Turkey, and China.

Trichophyton schoenleinii is an anthropophilic dermatophyte mainly causing tinea favosa of the scalp in certain regions of the world, especially Africa and Asia. We investigated the in vitro susceptibilities of 55 T. schoenleinii isolates collected over the last 30 years from Iran, Turkey, and China to 12 antifungals using the CLSI broth microdilution method. Our results revealed that terbinafine and ketoconazole were the most potent antifungal agents among those tested, independently of the geographic regions where strains were isolated.

Generalized Favus: The Story of a Legendary Case of Tinea Favosa

From the moment the Olavide Museum opened its doors in 1882 until its content was packed up around 1965 and lost sight of for a time, it underwent a succession of changes. Some of those changes cannot be fully documented now because the archives of the Provincial Council (Diputación) of Madrid were lost during the Spanish Civil War. The museum was initially housed in Hospital de San Juan de Dios, in the neighborhood of Atocha. Because this hospital treated mainly venereal diseases, much of the information we have about it comes from newspapers or magazines of the period, and their accounts were often sensationalistic. When a large number of the museum's wax figures were rediscovered, along with a great many accompanying documents, in December 2005, the material allowed 3 sculptors—Zofío, Barta, and López Álvarez—to be identified. Case histories corresponding to the figures were also among the papers found. As a result, the truth about certain legends associated with the museum, the sculptors, and the patients could be unraveled. Among the patients whose stories were brought to light was one referred to as the boy with generalized tinea favosa, or crusted ringworm.

Tiña favosa, historia de una leyenda

From the moment the Olavide Museum opened its doors in 1882 until its content was packed up around 1965 and lost sight of for a time, it underwent a succession of changes. Some of those changes cannot be fully documented now because the archives of the Provincial Council (Diputación) of Madrid were lost during the Spanish Civil War. The museum was initially housed in Hospital de San Juan de Dios, in the neighborhood of Atocha. Because this hospital treated mainly venereal diseases, much of the information we have about it comes from newspapers or magazines of the period, and their accounts were often sensationalistic. When a large number of the museum's wax figures were rediscovered, along with a great many accompanying documents, in December 2005, the material allowed 3 sculptors—Zofío, Barta, and López Álvarez—to be identified. Case histories corresponding to the figures were also among the papers found. As a result, the truth about certain legends associated with the museum, the sculptors, and the patients could be unraveled. Among the patients whose stories were brought to light was one referred to as the boy with generalized tinea favosa, or crusted ringworm.

Goya and tinea favosa.

A case of a tinea favosa involving the scalp of a child represented in the painting "Boys climbing a tree" (Muchachos trepando a un árbol), by Francisco Goya y Lucientes, with pictorial representation of favic scutula and consequent alopecia.

Tinea Infection with Scutula-like Lesions Caused by Microsporum Gypseum in a SLE Patient: Case Report and Literature Review

Scutula are characteristic lesions of tinea favosa or favus; the most frequently identified causative organism is Trichophyton schoenleinii. Although scutula-like lesions were described in Microsporum gypseum infection, their presence on glabrous skin in a patient with SLE has not been reported previously. We report a case of tinea infection with scutula-like lesions caused by Microsporum gypseum in a SLE patient, who was treated with topical terbinafine cream, and the lesions resolved completely. In addition, we reviewed the reported cases about this rare clinical manifestation caused by Microsporum gypseum in the medical literature.

Human pathogenic fungus Trichophyton schoenleinii activates the NLRP3 inflammasome

The fungus Trichophyton schoenleinii (T. schoenleinii) is the causative agent of Trichophytosis and Tinea favosa of the scalp in certain regions of Eurasia and Africa. Human innate immune system plays an important role in combating with various pathogens including fungi. The inflammasome is one of the most critical arms of host innate immunity, which is a protein complex controlling maturation of IL-1β. To clarify whether T. schoenleinii is able to activate the inflammasome, we analyzed human monocytic cell line THP-1 for IL-1β production upon infection with T. schoenleinii strain isolated from Tinea favosa patients, and rapid IL-1β secretion from THP-1 cells was observed. Moreover, applying competitive inhibitors and gene specific silencing with shRNA, we found that T. schoenleinii induced IL-1β secretion, ASC pyroptosome formation as well as caspase-1 activation were all dependent on NLRP3. Cathepsin B activity, ROS production and K⁺ efflux were required for the inflammasome activation by T. schoenleinii. Our data thus reveal that the NLRP3 inflammasome plays an important role in host defense against T. schoenleinii, and suggest that manipulating NLRP3 signaling can be a novel approach for control of diseases caused by T. schoenleinii infection.

Tinea capitis favosa misdiagnosed as tinea amiantacea

IntroductionFavus of the scalp or tinea capitis favosa is a chronic dermatophyte infection of the scalp. In almost cases, favus is caused by Trichophyton schoenleinii, anthropophilic dermatophyte. It is characterized by the presence of scutula and severe alopecia. Besides the classic clinical type of tinea capitis favosa, there are many variant of clinical form which may persist undiagnosed for many years. In this work, we report an atypical form of favus to Trichophyton schoenleinii which was misdiagnosed as tinea amiantacea. Case-reportAn 11-year old girl came to the outpatient department of dermatology (day 0) with history of tinea amiantacea treated unsuccessfully with keratolytic shampoo (day – 730). She presented a diffuse scaling of the scalp with thick scaly patches and without scutula or alopecia. A diagnosis of tinea favosa by T. schoenleinii was made by mycological examination. She was treated with griseofulvin and ketoconazole in the form of foaming gel for twelve weeks. Despite treatment, clinical evolution was marked by appearance of permanent alopecia patches. The follow-up mycological examination was negative. ConclusionBecause of ultimate evolution of favus into alopecia, we emphasize the importance of mycological examination in case of diffuse scaling.

Case report: onychomycosis due to Trichophyton schoenleinii

Trichophyton schoenleinii is an antropophilic dermatophyte transmitted by contact between humans. This genus is an aetiological agent of mycosis of the scalp – tinea favosa. Infections with T. schoenleinii were the most frequent dermatomycoses in Poland before the Second World War. Improvements in living conditions and hygiene after the Second World War have led to considerable decrease of infection with this fungus. We describe a patient who had a toenails involvement due to T. schoenleinii.

Épidémiologie des teignes du cuir chevelu chez les consultants externes à l’hôpital d’enfants de Rabat (Maroc)

The aims of this report on results of a retrospective study were to identify the incidence of this pathology among outpatients at the Children's Hospital in Rabat, Morocco, the species involved, their respective prevalence, and the influence of the age and sex of the patient. Between 1993 and 2007, a mycological examination was performed on 2962 patients in the dermatology service of Ibn Sina University Health Center in Rabat. Mean patient age was 35 (ages ranged from three months to 70 years). Direct microscopic examination was made of all the patients' hair, followed by culture on Sabouraud medium leading to the identification of scalp ringworm in 1299 patients. The age group most affected was children under ten years of age (50% of the cases), mostly boys (M: F sex-ratio 1:14). The majority of cases of ringworm in our study were caused by Trichophyton mentagrophytes with 992 cases (76.4%), followed by Microsporum canis with 174 cases (13.4%). Inflammatory ringworm was identified in 32 patients (2.5%) and 30 cases of honeycomb ringworm (tinea favosa) (2.3%). Trichophyton violaceum was more frequent among girls and M.canis was more frequent among boys. Analysis of the incidence of the different species over the years revealed a clear decrease in case of tinea favosa, a decreasing trend for T.violaceum and a significant recrudescence of M.canis. T.violaceum continues to be the most common species of scalp ringworm in Morocco, despite a significant increase in M.canis. Tinea favosa has been practically eradicated.

Skin (review)

Reviewed by: Skin Eva Åhrén Skin. Curated by Javier Moscoso. Wellcome Collection, 183 Euston Road, London, June 10-September 26, 2010. Skin is a stylish and evocative exhibition that deals with the surface of our bodies, our largest organ, its structure and finish, in sickness and in health, for better or for worse, until death takes it apart. The suggestive exhibition architecture, designed by Jesus Moreno & Asociados, consists of large sheets of felt on visible wood structures, hanging like sutured skin on dry bones. Skin is represented here in diverse media from different ages and places: sixteenth-century anatomical engravings; latex skin garments by contemporary artist Olivier Goulet; an ancient terra-cotta votive torso with guts spilling out through a slit; early-twentieth-century popular medical film; uncannily life-like nineteenth-century waxworks; contemporary photography-based, digitally produced art. There is also real human skin: seven pieces of tattooed skin from Henry Wellcome's collection of over three hundred pieces bought in France in the 1920s; the dry skin of a curled-up [End Page 677] Peruvian mummy; and a curious little skin-covered anatomical model with a facial expression of horror, showing white teeth in its open mouth, with writhing limbs and a gaping open rib cage. Among all these captivating objects there was one that particularly moved me: a life-size wax model of a boy, five or six years of age, curled up on a shiny white silk cushion, naked and exposed, with glass eyes staring sadly from under half-closed eyelids, his skin covered with horrendous skin lesions. For someone like me, who has struggled with a chronic skin disorder all my life, the portrait of the suffering little boy cut right through my intellectual engagement with this smart show. But, skin being the sensitive interface between our inner selves and the outer world, there are many more objects here that have a strong, disturbing presence. The catalog is a small but nicely designed leaflet (with surprises hidden in its folds) in which there is not much room for detailed information on the many items in the exhibition. The web site (http://www.wellcomecollection.org/whats-on/exhibitions/skin.aspx) is richer and contains film clips, audio, essays, and image galleries under the exhibition's thematic headings, Objects, Marks, Impressions, and Afterlives, plus objects from the Wellcome Library's collection. Why only some of the images are supplemented by full captions eludes me. The web caption for the wax model described above, for example, is "'Generalized Tinea Favosa' by Enrique Zofio, 1881. Tinea favosa is a fungal infection of the scalp and body," whereas its caption in the gallery is fuller and places it in a historical context of model making and dermatology. Thus, anachronistically, the text of the web exhibition objectifies the boy as an example of a disease just as the modeler did in his day, whereas the model itself gives the nameless boy, long since dead, a haunting presence through the indexicality of wax casting. (And the caption neglects to mention that the model is a moulage.) Curator Javier Moscoso has used some of the conceptual strategies we have come to expect of art and anatomy shows: thematic juxtapositions of old and new artworks with scientific illustrations and artifacts and a concluding section of contemporary "cutting-edge" science, technology, and art with some interactive features. Predictable as this may sound, the show's concentration on one organ and careful choice of cultural representations, together with the relatively small space and congenial design, make this an unusually well focused and stimulating exhibition. Although some themes and subjects could have been explored in more depth, particularly sex and race, Skin is wonderful, visually rich, and analytically astute. [End Page 678] Eva Åhrén University of Uppsala, Sweden Copyright © 2010 The Johns Hopkins University Press

Clinical and mycological characteristics of tinea favosa

Clinical and mycological characteristics of tinea favosa

Tinha favosa: relato de ocorrência familiar em Itapecerica da Serra (município da Grande São Paulo)

Os autores relatam 4 casos de tinha favosa por Trichophyton schoenleinii de ocorrência familiar, identificados na cidade de Itapecerica da Serra, município da Grande São Paulo. Todos os casos foram tratados com griseofulvina por via oral na dose de 1.0 mg/kg/dia por no mínimo 3 meses, tendo ocorrido cura clínica e laboratorial em 2 pacientes, e os dois restantes necessitaram de terapêutica mais prolongada.

Trichophyton schoenleinii . [Descriptions of Fungi and Bacteria

Abstract A description is provided for Trichophyton schoenleinii . Information is included on the disease caused by the organism, its transmission, geographical distribution, and hosts. HOSTS: Primarily a pathogen of man (causing mycoses). Also recorded infecting camel (RMVM 14, 2079), cat, cattle, dog, guineapig, hedgehog, horse, mouse, rabbit and birds (RMVM 5, 1141). The identity of the fungus in at least some of these animal infections is doubtful. DISEASE. Favus (tinea favosa), characterized by the development of low-grade folliculitis in which the infected hair follicles become filled with hyphae, arthrospores and debris to form yellowish, cup-shaped, elevated, waxy plaques (scutulae). Infected hairs show on endothrix invasion, containing hyphae and air bubbles where hyphae have degenerated, and usually exhibit a dull greenish fluorescence under Wood's light. Favus is a chronic infection, usually limited to the scalp, and leads to scarring, atrophy and permanent alopecia if untreated. Atypical scalp infections, with scaling or crusting without scutula formation, are also seen. Infections of the body (tinea corporis), producing vesicles, papules and papulosquamous lesions, often with scutula formation, and of the nails (tinea unguium, onychomycosis) also occur. Infections of the brain, bones, eyes, gastrointestinal tract, lymph nodes and muscles have also been reported (Sabouraud, 1910: 528-529; RMVM 3, 1136; 4, 1084, 1377; 6, 3207). GEOGRAPHICAL DISTRIBUTION: Worldwide. Occurs most commonly in N. Africa, the Middle East and S. and E. Europe, and many cases reported elsewhere have been in immigrants from these areas (RMVM 10, 602; 13, 1558).

A critical survey of 1000 cases of dermatophytosis in the Tel Aviv area during 1970-1975.

Clinical and mycological data on 1000 cases of dermatophytosis seen from 1970 to 1975 are reported. Tinea pedis was present in 44%, T. rubrum being the main causative agent; nail involvement was present in 41% of these cases. Tineainguinalis was present in 13%, 38% of them females, withT. rubrum isolated in 87% and the swimming-pool incriminated as the main source of contamination. There were various manifestations of tinea corporis in 128 patients, withT. rubrum responsible in 91%. Among the 21 cases of tinea capitis, there was one adult female with a kerion-type due toT. violaceum, 4 cases due toM. gypseum and 2 toM. canis. Tinea favosa was seen in 6 patients, all of them females and one with a spreading fungus on the soles and palms. Amonh the 10 cases with tinea barbae,T. rubrum was found in 4,T. tonsurans in 3,T. mentagrophytes in 2 andM. gypseum in one. There were widespread lesions ofT. rubrum located on large areas of the body and including the legs, arms, groins and nails, in 11 patients with other disorders, including diabetes, Cushing's syndrome and lymphoma.

Dermatofitosis en Costa Rica. I. Observaciones sobre 76 casos

Clinical, epidemiological and mycological observations were made on 76 overt cases of dermatophytosis which were examined in 1957, 1 958 and early 1959. All clinical forms were observed ( except tinea favosa and tinea imbricata) in the following order of frequency : tinea corporis, tinea capitis, tinea unguium, tinea cruris, tinea pedis, tinea manus and tinea axillaris. Around 30 per cent of the patients showed two or more combined forms, but it was not pos­sible to detect any infection which was caused by two or more dermatophytes. The isolated fungi were, according to their frequency, T. rubrum, M.canis, M. gypseum, T. tonsurans, T. mentagrophytes, T. verrucosum and E. floc­cosum. The majority of the lesions in exposed areas of the body were due to dermatophytes of the zoophilic and geophilic groups, while those lesions in unexposed areas were generally caused by anthropophilic fungi. Morphologically, the cultures matched well established patterns. The physiologic study indicated that T. rubrum produces red pigment in corn meal­ dextrose agar easily, not so T. mentagropbytes. T. tonsurans showed partial or total requirement for inositol. No strain was stimulated either by nicotinic acid or histidine. T. mel1tagropbytes as well as M. canis and E. floccosum were cap­ able of producing in vitro perforations in the human hair. T. rubrum did not perforate the hair.

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 ENLARGING CONCEPTION OF DERMATOPHYTOSIS

At present, the word eczema is used to designate almost any dermatitis whose cause has not been discovered. Thus, in the past, the word tinea was used for any disease of the scalp, for the ancients had no means of establishing the etiology of any of these diseases, except perhaps pediculosis. Nevertheless, one form of tinea differed so greatly from all the others, and had such cleancut peculiarities, that it became known as tinea vera. It was known also as tinea lupinosa, and later, in England, as porrigo lupinosa. This is the disease now known as favus. The tinea favosa of all authors before 1800 was not favus at all but impetigo. The transfer of the adjective, favosa, from impetigo to the disease now known as favus was due to Alibert, whose mistake has become fixed in modern usage. Although the disease was recognized as a distinct entity, its etiology