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BackgroundCurrent literature lacks a recent global analysis of scabies. This study aims to analyze the burden and epidemiological characteristics of scabies using data from the Global Burden of Disease (GBD) 2021 study.Methodology/principal findingsThe analysis assessed disability-adjusted life years (DALYs), prevalence, and incidence of scabies from 1990 to 2021, stratified by geographic location, socio demographic index (SDI), gender, and age. In 2021, scabies caused 5.3 million DALYs, 206.6 million prevalence, and 622.5 million incidence, primarily affecting children and young people. The burden was heaviest in middle SDI regions and lowest in high SDI regions. Oceania, Tropical Latin America, and East Asia ranked as the top three regions in global scabies burden. Nationally, Fiji, Guam, Tonga, Tuvalu, and Northern Mariana Islands had the highest age-standardised DALY rates. From 1990 to 2021, global age-standardized rates (ASRs) of DALYs, prevalence, and incidence for scabies declined, while the absolute numbers increased. These ASRs showed an upward trend in high and high-middle SDI regions, with significant increases in Central Latin America and high-income North America. Larger burden increases were observed in Sri Lanka, the United States of America, and Mexico compared to other countries and territories. In terms of age, these ASRs increased from 40, particularly for women and the elderly.Conclusions/significanceThe global scabies burden was higher in tropical regions, particularly among children and young people, in 2021. Between 1990 and 2021, the burden increased in higher SDI regions, Central Latin America, and high-income North America, warranting focused attention. Additionally, the rising burden among adults over 40, particularly women and the elderly, highlighted the need for targeted interventions.

A woman presented with purulent infiltrating plaques on her hands and arms after a 7-year history of nephrotic syndrome. She was ultimately diagnosed with subcutaneous phaeohyphomycosis, which is caused by Alternaria section Alternaria. The lesions completely resolved after 2 months of antifungal treatment. Interestingly, spores (round-shaped cells) and hyphae were observed in the biopsy and pus specimens, respectively. This case report highlights that distinguishing subcutaneous phaeohyphomycosis from chromoblastomycosis may be difficult if the diagnosis is solely based on pathological findings. It also emphasizes that the parasitic forms of the dematiaceous fungi in immunosuppressed hosts may vary with the site and environment.

Key Clinical Message Scabies is a highly infectious parasitic skin disease, The most common lesions are solid and 2–3 mm in diameter (papules). Very few cases will develop into nodular scabies, and microscopy is frequently negative in patients with clinically diagnosed nodular scabies. The accuracy of microscopy depends on the expertise of the operator, particularly in finding burrows and extracting the relevant material.

BackgroundCutaneous disseminated sporotrichosis (CDS), also called hematogenous sporotrichosis, is a rare condition that usually affects immunocompromised patients. The current work presents the case of a woman with diabetes mellitus associated with CDS.Case presentationA 59-year-old woman with diabetes mellitus presented with a two-year history of ulcerated rashes on the left ankle and both sides of the jaw. Physical examination revealed three annular areas of erythematous and raised plaque with an ulcer over the left ankle and both sides of the jaw. Based on laboratory findings, elevated blood glucose concentration and decreased white cell count were observed. Sporothrix globosa was identified in the mycological culture of biopsied tissue from the three lesions and this was confirmed by DNA sequencing. The skin lesions healed after two-month itraconazole therapy.ConclusionsDiabetes is a risk factor for disseminated sporotrichosis, which may be induced by hematogeneous spread, repeated inoculation, or autoinoculation. This study raises awareness among clinicians, with regard to the notion that people with possibly altered immune function are potentially vulnerable to severe clinical forms of sporotrichosis.

Chromoblastomycosis (CBM) is a chronic fungal infection of the cutaneous and subcutaneous tissues caused by brown pigmented fungi. Fonsecaea monophora is one of the most common pathogens of CBM in China. Most formal cases have been reported from Southern China, however, the infection is not uncommon in Eastern China where very few case series are available. To describe the clinical aspects of CBM, we report a series of 11 cases between 2018 and 2021 at a single medical center in Eastern China. The patients were predominately male (n = 9) and the disease duration ranged from 3 months to 20 years. Plaque type lesions were the most common clinical manifestations. There were 7 cases of mild forms and 3 cases of severe forms. Among the 3 severe cases, one case gave up treatment due to economic poverty; one case did not respond to a 1-year systemic treatmen; one case was cured by combination therapy of 10 months. Other cases were cured by treatment with antifungal agents. All cases of direct mycological examination were positive. All isolates were identified by morphology and sequencing of the the ITS regions of ribosomal DNA, Ten were F. monophora and 1 was Cladophialophora carrionii. All cases had been evaluated at other clinics, where 8 cases were misdiagnosed as other diseases. As a neglected tropical disease (NTD), CBM is still a major challenge in the field of dermatology, especially in its severe clinical forms. As an effective and simple diagnostic method of CBM, direct microscopic examination should be further promoted in rural hospitals.

Abstract Background Dermatophytes are keratinophilic fungi, that usually infect the hair, stratum corneum, and nails. However, dermatophytes occasionally invade the dermis, subcutaneous tissues, and internal organs, resulting in a condition called deep dermatophytosis. We report a case of an unusual presentation of Trichophyton rubrum infection causing multiple fungal abscesses in the lower extremities of an immunocompromised patient. Case presentation A 66-year-old male who had been receiving immunosuppressive drugs for 7 years developed numerous subcutaneous nodules in the lower extremities. The yellow purulent fluid obtained from the cyst was positive for T. rubrum. Topical bifonazole cream was effective for tinea pedis, but oral Sporanox 400 mg/day was discontinued after 2 months because the patient died from pneumonia after hospitalization for a lumbar fracture. Conclusions Although deep dermatophytosis is very rare, dermatomycosis should be considered in any examination of patients who are receiving immunosuppressive drugs. Fungi can enter the bloodstream and disseminate to distant major organs, including the lymph nodes, liver, brain, and bone, which often causes systemic infections that can be fatal.