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Microsporum Tinea


Presentation

  • An otherwise healthy 69-year-old woman presented two large patches of slightly erythematous scaling alopecia localized on the vertex and on the left parietal region of the scalp. The only subjective sign was itching.[ncbi.nlm.nih.gov]
  • Khosravi AR, Mansouri P, Naraghi Z, Shokri H, Ziglari T (2008) Unusual presentation of tinea cruris due to Trichophyton mentagrophytes var. mentagrophytes. J Dermatol 35: 541-5.[clinical-pediatrics-dermatology.imedpub.com]
  • Epidemiology, clinical presentation and diagnosis of onychomycosis. Br J Dermatol. 2003 ;149: 1 - 4. Google Scholar Crossref Medline ISI 4. Romano, C, Massai, L. Proximal subungual hyperkeratosis of the big toe due to Microsporum gypseum.[journals.sagepub.com]
  • An 18-year-old man presented with asymptomatic white maculopapules on the scrotum [Figure 1]. He unintentionally discovered the lesions on the scrotum during a bath 6 days previously but neglected them because of no cutaneous symptoms.[e-ijd.org]
Asymptomatic
  • Three family members and five class-mates were found to be asymptomatic carriers of M. audouinii and were consequently treated to avoid further transmission or reinfection of the treated patients.[ncbi.nlm.nih.gov]
  • Upon clinical examination, family members of the patients were asymptomatic. However, samples from the father, mother and sister of patient 1 all yielded M. audouinii in culture, i.e., they were asymptomatic carriers.[academic.oup.com]
Chronic Infection
  • The annular, scaly patches may coalesce to form large areas of chronic infection when Trichophyton rubrum is the etiologic agent.[atmph.org]
  • References: [1] [2] [3] [4] [5] Tinea Tinea pedis ( athlete's foot ) Tinea corporis ( ringworm ) Tinea capitis Favus Definition Chronic infection caused by Trichophyton schoenleinii Severe form of tinea capitis Epidemiology : more common in Africa, the[amboss.com]
  • Long-term treatment with medications such as itraconazole or ketoconazole may be used for chronic infections.[courses.lumenlearning.com]
Recurrent Infection
  • Persons who have extensive or recurrent infections may require systemic antifungal therapy. 6[cdc.gov]
  • Identification of a specific zoophilic species as the infection source can be helpful in preventing recurrent infection.[aafp.org]
Sepsis
  • Amphotericin is generally given IV for systemic fungal or candidal sepsis or disseminated infection. Questions 1. The most common cause of Tinea capitis in the United States is:. .. .. a. M. canis. .. .. b. T. tonsurans. .. .. c.[hawaii.edu]
Pathologist
  • He has a diploma in tropical medicine and hygiene from the University of Sydney and is a Fellow of both the Royal Australasian College of Physicians and the Royal College of Pathologists of Australasia.[books.google.com]
Pharyngitis
  • Safety Adverse events such as fever, pharyngitis and influenza-like symptoms occurred in 18%–42% of patients in the terbinafine groups and 17% in the griseofulvin group.[mja.com.au]
Suggestibility
  • This appraisal suggests that irrespective of an identical ribosomal ITS region distinct M. audouinii strains can display a spectrum of morphological and physiological features that is broader than currently outlined in mycological textbooks.[ncbi.nlm.nih.gov]
  • The logistic regression analysis of terbinafine therapies suggested a tendency to a higher cure rate at higher daily doses, and a lower cure rate with longer duration of treatment.[mja.com.au]
  • She reported that her hair had gradually grown back again and we suggested that she discontinue the treatment. Three months after discontinuation of the treatment she visited the department again.[ijdvl.com]
  • Histopathological examination revealed numerous hyphae and spores in the stratum corneum after Periodic acid-Schiff (PAS) staining, which was suggestive of a superficial fungal infection [Figure 2].[e-ijd.org]
  • However, in children with Microsporum infections, new evidence suggests that the effect of griseofulvin is better than terbinafine.[cochrane.org]
Neglect
  • He unintentionally discovered the lesions on the scrotum during a bath 6 days previously but neglected them because of no cutaneous symptoms. However, a few days later, the size and number of the lesions had gradually increased.[e-ijd.org]
  • In addition, the risk factors include socioeconomic conditions such as overcrowding, poverty, and neglect of personal hygiene. [2] Although dermatophytes have a worldwide distribution, some species are found in specific areas.[atmph.org]
  • In our case, the fungal skin disease was neglected and not initially well treated.[latunisiemedicale.com]
Trichotillomania
  • Possibilities include: Alopecia areata Trichotillomania Seborrheic dermatitis Atopic dermatitis Contact dermatitis Psoriasis Systemic Lupis Erythematosus Pityriasis amiantacea Bacterial folliculitis Kerion It is also important to distinguish dermatophytosis[pedclerk.bsd.uchicago.edu]
  • The differential diagnosis of tinea capitis includes alopecia areata, trichotillomania, traction alopecia, and seborrheic dermatitis. View/Print Figure Figure 1. Tinea capitis. Note the hair loss and marked crusting. Copyright Logical Images, Inc .[aafp.org]
  • The differential diagnosis of tinea capitis includes seborrheic dermatitis, psoriasis, alopecia areata, trichotillomania and some dystrophic hair disorders. With the presence of a kerion, a bacterial infection must be considered.[hawaii.edu]

Workup

  • See Workup for more detail. Management Topical therapy is recommended for a localized infection because dermatophytes rarely invade living tissues.[emedicine.medscape.com]
Microsporum
  • A mycological culture was positive for Microsporum gypseum. Tinea capitis is uncommon in adults; furthermore, isolation of Microsporum gypseum from this type of lesion is rare.[ncbi.nlm.nih.gov]
  • Keywords: Immunodeficiency, Microsporum gypseum, scrotum How to cite this article: Tan H, Lan XM, Zhou CJ, Yang XC. Pseudomembranous-like tinea of the scrotum infected by Microsporum gypseum in a young man.[e-ijd.org]
  • . , ImbabiS.E. and MahgoubE.S. (1974): Microsporum canis infection in calves. -Sabouraudia, 13: 154–156. Google Scholar 2.[link.springer.com]
  • Yu C, Zhou J, Liu J. (2010) Tinea incognito due to Microsporum gypseum. J Biomed Res 24: 81-3.[clinical-pediatrics-dermatology.imedpub.com]
Trichophyton Tonsurans
  • Although there is great local variation in the epidemiology of TC worldwide, Trichophyton tonsurans is currently the most common cause of TC with Microsporum canis second.[edizioniscriptamanent.it]
  • MacKenzieD.W.R. (1961): The extra-humane occurrence of Trichophyton tonsurans var. sulfureum in a residential school. - Sabouraudia 1: 58–64. Google Scholar 23. MaleO ., ThurnerJ. and JukschW.[link.springer.com]
  • We report two cases in children 5 and 7 years old, in which Microsporum gypseum and Trichophyton tonsurans were isolated.[odermatol.com]
  • In immunosuppressed patients, there are reports of lesions in the form of concentric rings caused by dermatophytes other than Trichophyton concentricum too, mostly by Trichophyton tonsurans, known as Tinea indesiciva or Tinea pseudoimbricata.[e-ijd.org]
  • The most common species involved are T. rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, and Microsporum canis. [3] Tinea corporis is by, and large the most common infection caused by dermatophytes in India as reported by most workers and[atmph.org]

Treatment

  • With an intermittent regimen the duration of treatment with active drug can be much shorter compared to continuous therapy. We found that itraconazole pulse therapy for M. canis tinea capitis was a safe and effective treatment in an infant.[ncbi.nlm.nih.gov]
  • Itraconazole versus griseofulvin in the treatment of tinea capitis: a double-blind randomized study in children. Int J Dermatol 1994; 33: 743-7. Elewski B. Treatment of tinea capitis beyond griseofulvin. J Am Acad Dermatol 1999; 40: S27-30.[jpad.com.pk]
  • Despite this treatment, further analyses conducted during and after therapy remained positive. In January 2009, treatment with oral griseofulvin was started (20 mg/kg once daily).[academic.oup.com]

Prognosis

  • ., shared combs and hats Pathogenesis dermatophytes live only in keritinized tissues (hair, skin, and nails) symptoms result from host's innate immune response Prognosis excellent since most cases resolve with treatment Presentation Symptoms itchiness[medbullets.com]
  • Prognosis Excellent with good compliance and subsequent precautions to avoid repeat infection. Prevention Good skin hygiene. Good nail hygiene. Avoiding prolonged wetting or dampness of the skin and feet.[patient.info]
  • It is seen most commonly in children aged between 5 and 10 years. [6] Mean age of onset is in patients aged 6.9-8.1 years. [7] Prognosis Tinea capitis carries a positive prognosis, with the vast majority of those treated obtaining resolution of the infection[emedicine.medscape.com]

Etiology

  • The etiological agents vary from time to time and by geographical area, although they normally are zoophilic dermatophytes and in the last years also anthropophilic species.[ncbi.nlm.nih.gov]
  • The annular, scaly patches may coalesce to form large areas of chronic infection when Trichophyton rubrum is the etiologic agent.[atmph.org]
  • Tinea capitis: still no change in the etiological spectrum of disease in our scenario. J Pak Assoc Dermatol 2002; 12: 119-21. Koumantaki E, Georgalla S, Rallis E, Papadavid E.[jpad.com.pk]

Epidemiology

  • KEYWORDS: Conidia; dermatophytes; epidemiology; hair perforation; keratin; morphology[ncbi.nlm.nih.gov]
  • Epidemiology of onychomycosis in Crete, Greece: a 12-year study. Mycoses. 2016 ;59(12): 798 - 802. Google Scholar Crossref ISI 2. Baswan, S, Kasting, GB, Li, SK.[journals.sagepub.com]
  • PhilpotC.M. (1977): Some aspects of the epidemiology of tinea. - Mycopathologia 62: 3–13. Google Scholar 26.[link.springer.com]
  • Although there is great local variation in the epidemiology of TC worldwide, Trichophyton tonsurans is currently the most common cause of TC with Microsporum canis second.[edizioniscriptamanent.it]
  • Regular conventional and molecular epidemiological surveillance and testing for antifungal susceptibility to the newer oral antifungal agents is an essential component in the management of tinea capitis. abstract No: Full conference title:[aspergillus.org.uk]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology [ 3 ] Infection is limited to the dead layers of skin but encouraged by a damp and warm local environment.[patient.info]
  • Pathophysiology Dermatophytes, which are keratinophilic fungi, are the causative agents. These are molds that live in the cornified layers of the skin and are capable of invading the outermost layer of skin, hair, and nails.[dermatologyadvisor.com]
  • Pathophysiology Tinea capitis is caused by fungi of species of genera Trichophyton and Microsporum. Tinea capitis is the most common pediatric dermatophyte infection worldwide.[emedicine.medscape.com]

Prevention

  • Close collaboration with veterinary and educational programs within infant communities are required for adequate prevention. 2011 Wiley Periodicals, Inc.[ncbi.nlm.nih.gov]
  • In such cases, concomitant use of ketoconazole shampoo 2-3 times a week is also recommended to prevent fomite transmission. References 1. Devliotou-Panagiotidou D, Koussidou-Eremondi T, Chaidemenos GC, Theodoridou M, Minas A.[ijdvl.com]
  • Cryptococcal meningitis, cryptococcosis transmitted into other areas (e.g. lungs, skin) Prevention against recurring cryptococcal meningitis in AIDS and HIV patients.[hasco-lek.pl]
  • Because candidiasis can become invasive, patients suffering from HIV/AIDS, cancer, or other conditions that compromise the immune system may benefit from preventive treatment.[courses.lumenlearning.com]
  • Treatment of tinea pedis - helps prevent onychomycosis. [ 8 ] Wearing clean, loose-fitting underwear.[patient.info]

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