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Resumen Trichophyton benhamiae es un dermatofito zoofílico. Puede causar tinea corporis, tinea faciei y tinea capitis. Se caracteriza por producir lesiones inflamatorias, sobre todo en niños. El objetivo de esta publicación es describir 7 casos clínicos de pacientes pediátricos atendidos entre julio del 2019 y enero del 2020 en nuestra institución. A los pacientes se les solicitó estudio micológico convencional, con posterior confirmación con MALDI-TOF MS y secuencia-ción del ADN ribosomal. Se aisló e identificó T. benhamiae como agente etiológico; el nexo epidemiológico fue el contacto con cobayos. Estas son las primeras descripciones de infecciones causadas por T. benhamiae en Argentina. Al realizar estudios micológicos convencionales, este agente puede confundirse con otros dermatofitos, por lo tanto, se requieren herramientas como MALDI-TOF MS o la secuenciación para llegar a un diagnóstico definitivo. Es importante contar con datos epidemiológicos, como el contacto con mascotas no tradicionales, para una presunción diagnóstica adecuada.

Tinea capitis is still common in developing countries, such as China. Its pathogen spectrum varies across regions and changes over time.This study aimed to clarify the current epidemiological characteristics and pathogen spectrum of tinea capitis in China.A multicentre, prospective descriptive study involving 29 tertiary hospitals in China was conducted. From August 2019 to July 2020, 611 patients with tinea capitis were enrolled. Data concerning demography, risk factors and fungal tests were collected. When necessary, the pathogens were further identified by morphology or molecular sequencing in the central laboratory.Among all enrolled patients, 74·1% of the cases were in patients aged 2-8 years. The children with tinea capitis were mainly boys (56·2%) and were more likely than adults to have a history of animal contact (57·4% vs. 35·3%, P = 0·012) and zoophilic dermatophyte infection (73·5% vs. 47%). The adults were mainly female (83%) and were more likely than children to have anthropophilic agent infection (53% vs. 23·9%). The most common pathogen was zoophilic Microsporum canis (354, 65·2%), followed by anthropophilic Trichophyton violaceum (74, 13·6%). In contrast to the eastern, western and northeastern regions, where zoophilic M. canis predominated, anthropophilic T. violaceum predominated in central China (69%, P 0·001), where the patients had the most tinea at other sites (20%) and dermatophytosis contact (26%) but the least animal contact (39%). Microsporum ferrugineum was the most common anthropophilic agent in the western area, especially in Xinjiang province.Boys aged approximately 5 years were the most commonly affected group. Dermatologists are advised to pay more attention to the different transmission routes and pathogen spectra in different age groups from different regions.

Ya Bin Zhou,* Yuan Yuan Xiao,* Jin Jing Chao, Lin Ma Department of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuan Yuan XiaoDepartment of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of ChinaTel +86 10 59616884Fax +86 10 59718700Email xyy81924@126.comAbstract: Tinea capitis is a common dermatophytosis predominantly occurring in children, which needs oral antifungal drug therapy. Itraconazole pulse therapy has been widely applicated in the treatment of adult onychomycosis. However, only a few studies are available for the treatment of pediatric tinea capitis with itraconazole pulse therapy. The therapy schedules vary with respect to dose and intermission. Here, we report four cases of tinea capitis that were treated with a novel high-dose itraconazole pulse therapy (6– 10 mg/kg/d with 3 weeks off between consecutive pulses). After 2– 3 pulses therapy, all the patients were cured and no adverse reactions were observed. We demonstrate the efficacy and safety of this novel itraconazole pulse therapy schedule. It may be a promising therapy in the treatment of tinea capitis in children.Keywords: tinea capitis, itraconazole pulse therapy, children, Microsporum canis, Nannizzia gypsea

Dermatology for the pediatric skin of color population is the application of dermatology to the genetically diverse and distinctive segment of the pediatric population that includes children of non-White racial and ethnic groups with increased pigmentation including individuals of Asian, LatinX, African, Native American, Pacific Island descent, Indigenous Peoples, among others, with overlap in particular individuals, and mixtures thereof. Treating children of color is a unique skill set within the field of pediatric dermatology, requiring knowledge and sensitivity. The discipline of pediatric skin of color can be challenging. Difficulty in diagnosis of common conditions stems from underlying pigmentation, variations in common hairstyling practices, and differences in demographics of cutaneous disease, whereas some conditions are more common in children of color, other conditions have nuances in clinical appearance and/or therapeutics with regard to skin color. This article is the first in a series of two articles looking at recently published skin-related issues of high concern in children of color. Conditions reviewed in Part 1 include (1) hairstyling hair-related concerns (traction alopecia, central centrifugal cicatricial alopecia, endocrine disruption), (2) autoimmune concerns (cutaneous lupus, vitiligo), and (3) infections (tinea capitis, progressive macular hypomelanosis).

Background Over the years, the focus of infectious diseases in many African countries has been mainly on viral, bacterial and parasitic infections. Serious fungal infections (SFI) with comparable morbidity rate in these countries, remain neglected. Objectives To estimate the burden of SFI in Togo and to stimulate efforts for improved attention. Methods Literature was thoroughly searched for epidemiological data on SFI in Togo. Incidence and/or prevalence of SFI was estimated using socio-demographics, health system's information, risk-groups data and SFI rates obtained from national and international studies. Results About 5.29% of the 7,265,286 Togolese population is estimated to suffer from SFI annually. Among HIV patients, 1,342, 1,650 and 330 may develop cryptococcal meningitis, Pneumocystis pneumonia and disseminated histoplasmosis respectively per year. Oral and oesophageal candidiasis may annually affect 19,800 and 7,535 persons living with HIV respectively. Estimated incidence of invasive aspergillosis (IA) was 283 cases. Prevalence of chronic pulmonary aspergillosis (CPA) was estimated at 191 cases. The annual incidence of allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitization (SAFS) was respectively 4,577 and 6,042 cases. Tinea capitis and recurrent Candida vaginitis presumably affects 232,271 children and 108,979 women respectively. Candidaemia incidence is estimated at 5 cases per 100, 000 inhabitants and fungal keratitis may affect 981 persons annually. Conclusions Serious fungal infections in Togo are probably more significant than expected. These findings underscore the need to increase awareness among healthcare professionals, enhance diagnostic and therapeutic capacities and intensify epidemiological studies for effective management of fungal infections in Togo.

A descriptive observational and cross-sectional study was carried out. The clinical characteristics, etiologic agents, treatments and outcome of 33 cases of tinea capitis in the Mycology Unit at Francisco J. Muniz Hospital of Buenos Aires City between January 2015 and December 2019 were analyzed. The median age of the patients was 7 years, 21 of whom were male, 3 were HIV-positive and 22 had pets. The isolated etiologic agents were the following: Microsporum canis in 22 cases, Trichophyton tonsurans in 8, Nannizzia gypsea in 2 and Trichophyton mentagrophytes in one patient. Suppurative tinea capitis (krion Celsi) was detected in 10 cases and the same number of patients presented other skin locations of their dermatophytosis in addition to those in the scalp. Twenty-one cases were orally treated with griseofulvin and 12 with terbinafine. Those patients with suppurative tinea capitis received drops of betamethasone by mouth besides the antifungal drugs. All patients had good clinical and mycological response to the treatments, all lesions disappeared, and mycological studies turned negative by the end of the treatments. We conclude that both drugs were effective for the treatment of tinea capitis; however, lesions in those cases receiving terbinafine involuted more slowly.

Introduction: Superficial dermatophytosis is a common public health problem in India, due to its tropical climate with heat and humidity. Today, the triazoles, mainly Itraconazole and the allylamines, chiefly Terbinafine, are the main ammunitions against dermatophytes. This study is undertaken to compare the safety and efficacy of both the drugs. Materials and Methods: This study was conducted to find the efficacy of Oral Terbinafine and Oral Itraconazole in Tinea Corporis/Tinea Cruris infection. The primary efficacy parameter was change in composite score (pruritus, erythema, pigmentations) from baseline to end of the treatment period. And to compare the safety of Oral Terbinafine and Oral Itraconazole by comparing the following parameters, Liver enzymes - SGOT/SGPT before and after treatment with the study drugs. Drug Dosage: Group 1: Drug –Tab. Terbinafine: Dose 500 mg per day once daily at bedtime for 2 weeks. Group 2: Drug –Tab. Itraconazole: Dose 200 mg per day, once daily at bedtime for 2 weeks. Results: The study participants show significant reduction in itching at the second follow up (after 2 weeks of drug completion) in both groups. Pruritis was reduced in 92% subjects in group 1 and 97.5% subjects in group 2. There was 87% reduction in erythema in group 1 and 93% reduction in group 2. Pigmentations were seen in 2% subjects in both groups indicating relapse of infection. Conclusion: The significant outcome of the study was that oral Itraconazole 200mg/day for 14 days(2 weeks) can be the better antifungal.

Background: The Indian dermatologists are witnessing an epidemic of sorts when it comes to superficial dermatophytosis cases in the last decade. At the receiving end of this epidemic are the patients who are suffering due to impaired quality of life. We tried to assess the impact of tinea on quality of life (QoL) of the patients. Aim: To assess the impact of superficial dermatosis on quality of life using the Dermatology Life Quality Index (DLQI) questionnaire. Settings and Design: Cross-sectional, Observational study. Material and Methods: All patients between the age group of 18 to 70 years presenting with superficial dermatophytosis of more than 3 weeks duration were included after confirming the diagnosis with KOH mount. The patients filled in the DLQI after which scores were calculated and the effect on QoL was assessed. Results: Out of the 170 patients included in the study, majority of them (77, 45.3%) felt that tinea had a very large effect on their QoL and a very few patients (7, 4.1%) felt that tinea had a small effect on their QoL. Out of the 36 (21.2%) patients who felt that their condition had an extremely large effect on their QoL, majority of the patients had tinea corporis et cruris et faciei. Conclusion: Superficial dermatophytosis has a very large effect on the Quality of Life of the patients and it impacts their lives adversely leading to psychological, social and financial problems. Keywords: DLQI, Quality of Life, Superficial dermatophytosis, Tinea.

Background: Dermatophytosis disease was found most common disease worldwide which showed a wide prevalence in tropical country as India and it is a wide importance to know their disease etiology and their clinical presentation. Study objective approaches to determine the clinical variation in Dermatophytosis and the species of fungus isolates which responsible for the infection in this area. Materials and Methods: In our study 1520 specimens were taken from infected skin, hair and nail screened by 10%-20% KOH mount examination and used Sabouraud’s Dextrose Agar (SDA) medium and Sabouraud’s Dextrose Chloramphenicol and Cycloheximide (SCCA) & Dermatophyte Test Medium (DTM) for culture and incubated at 27°C. Further identification done by slide culture method and lactophenol cotton blue mount. Result: Out of 1520 samples taken, 981(64.54%) were found KOH mount positive for fungal elements and 1076 (70.79%) were found culture positive. (21.64%) was found predominantly among other isolated species. Study was found Tinea corporis (50.39%) as common clinically. Conclusion: The study was highlighted with Tinea corporis being the commonest infection type with variable fungal agents and out of other fungal isolates was found a most common isolate in various clinical conditions. Keywords: Dermatophytosis, Trichophyton mentagrophyte, Tinea corporis, Fungal elements, KOH Positive, Lactophenol Cotton Blue, Sabrouraud’s Dextrose Agar.

In today’s busy lifestyle people are suffering from stress and strain, which effects on skin as a pathological condition. Even though spending lakhs together for beauty purpose, due to unhygienic and improper behaviour and not following Sadrutta they are getting skin diseases, due to atmospheric temperature and negligence towards health workers, labors, and women are more prone to get skin diseases like Dadru (Tinea corporis), scabies, eczema, dermatitis etc. Dadru is among them. It is treated with the unique procedure using Jaloukavacharana and some Shamanaoushadis as explained under the classics. As Dadru was explained under the Kshudra kustha in Charaka Samhita. In Shushruta, explained Aseta and Seta Dardu, usually the Seta Dadru is Sukha Sadhya. Mandalakara, Kandu delayed diagnosis and elevations are the classical Lakshanas explained in Dadru. Jaloukavacharana is advised in Vata pitta kapha dushta shonita kushta rogas and it is also known as Tinea corporis. In the present era Jalouka is trending treatment for skin disease, speciality of this Jalouka is less pain, fast relief, less cost, OPD level treatment. Jaloukas which contains Hirudine it increases the blood flow and it reduces itching. If we follow the Sadrutta it will help to prevent from skin diseases and specific Pathya apathya is also very important. You can clearly observe in this article that we followed treatment and Pathy apathy are followed by our classics.

Manjunath Shenoy,1,2 Dhiraj Dhoot,3 Harshal Mahajan,3 Hanmant Barkate3 1Department of Dermatology, Yenepoya Medical College, Deralakatte, Mangalore, India; 2Omega Hospital, Mangalore, Karnataka, India; 3Global Medical Affairs, Glenmark Pharmaceuticals Ltd, Mumbai, Maharashtra, IndiaCorrespondence: Dhiraj DhootGlobal Medical Affairs, Glenmark Pharmaceuticals Ltd, B D Sawant Marg, Andheri (E), Mumbai, Maharashtra, 400099, IndiaTel +91 9619811219Email dhiraj.dhoot@glenmarkpharma.comPurpose: A new oral formulation of itraconazole, called super bioavailable itraconazole (SBITZ), has been launched in India, exhibiting greater bioavailability than conventional itraconazole (CITZ). No clinical studies on its effectiveness and safety in dermatophytosis in comparison with CITZ have been conducted in India. Hence, the aim of this clinical study was to compare the effectiveness and safety of SBITZ capsules and CITZ capsules in dermatophytosis.Patients and Methods: This was an open-label, randomized, double-arm clinical study in which 70 patients (≥ 18 years of age) of either gender and diagnosed with tinea cruris, tinea corporis, and/or tinea faciei were included. The study was divided into two parts, the first part comprising a treatment period of 4 weeks and the second part an observation period for recurrence, comprised of another 4 weeks, thus making an entire study duration of 8 weeks.Results: Of the 70 patients enrolled in this study, 59 (33 patients in the CITZ group and 26 patients in the SBITZ group) were included in the final analysis. In both groups, most patients were diagnosed with tinea cruris et corporis, with five or more lesions. At week 4, 11 patients (33.33%) and 17 patients (65.38%) had achieved complete cure (p< 0.05), whereas 22 patients (66.67%) and 22 patients (84.61%) had achieved mycological cure (p=0.14), in the CITZ and SBITZ groups, respectively. During the observation period, recurrence was seen in 1/11 and 4/17 completely cured patients in the CITZ and SBITZ groups, respectively (p=0.15). A significant difference was noted in resolution of symptoms as well as lesions of dermatophytosis in the SBITZ group (p< 0.05). Both treatments were found to be safe and well tolerated.Conclusion: In the light of real-world evidence on effectiveness and safety, SBITZ should be considered as a potent therapeutic choice to effectively control the current menace of dermatophytosis in India.Keywords: dermatophytosis, super bioavailable itraconazole, conventional itraconazole, India

BACKGROUND Tinea capitis is the most common dermatophyte infection in children. Pathogens differ between populations. During the past few decades pathogen shifts have been reported in many countries around the world. This study aimed to characterize the pathogens involved in tinea capitis in a large tertiary paediatric medical centre in Israel. METHODS The electronic medical records of the dermatology unit were searched for patients diagnosed with tinea capitis from 2010 to 2019, and demographic, clinical and mycological data were retrieved. A stepwise logistic regression was performed to determine the variables most significantly associated with positive cultures. RESULTS The prevalence of Trichophyton tonsurans isolates was found to be significantly increased during 2019. In the logistic regression analysis, alopecia was most significantly associated with a positive culture (OR = 8.72, 95% CI 4.29-17.7, P

Dermatophytes are a group of parasitic fungi that live at the expense of the keratin in the skin, nails and hair. They are generally confined to the stratum corneum of the epidermis and skin appendages, particularly in the tropics, where heat and humidity provide the ideal conditions for the growth of fungi that cause cutaneous infections. The dermatophytes that usually cause only superficial infections of the skin are grouped into three genera: Trichophyton, Microsporum, and Epidermophyton. They can be classified into three groups according to their normal habitats: anthropophilic species, zoophilic species and geophilic species. Dermatophyte infections are subclassified in Latin names according to the sites of skin involved, e.g. Tinea faciei, Tinea manuum, Tinea corporis, Tinea cruris, Tinea pedis, Tinea capitis, Tinea unguium. Trichophyton rubrum is the most common cause worldwide for superficial dermatophytosis. By their metabolic activity they produce inflammatory responses in the form of erythema, scaling, postulation and micro-abscess formation giving rise to itching and discomfort. The high prevalence rate of superficial dermatophytic infection has shown that 20-25% of the world’s population. The diagnosis was confirmed on the basis of clinical presentation, KOH examination of skin and would light examination. The article also discusses the main treatments for superficial dermatophytosis, with a practical approach to the most commonly used topical and systemic drugs, referring also to their dosage and duration of use in different types of the dermatophytic infection. Keywords: Dermatophytosis; Trichophyton rubrum; Tinea; KOH examination.

The number of Trichophyton quinckeanum infections has increased significantly in recent years. In 2020 in particular, the number of cases increased fivefold compared to 2015. Infections multiplied, especially in the second half of the year, which correlated with the upsurge in field mouse populations. Typical vectors are mice and rats as well as dogs and cats, which hunt the rodents. The animals are usually asymptomatic. In humans, on the other hand, the course is usually more inflammatory corresponding to other zoophilic mycoses. Typical clinical manifestations of the infections are tinea corporis and tinea capitis. Treatment of T. quinckeanum infections is similar to other dermatophyte infections, depending on the severity, location and age of the patient as well as the immune status, previous illnesses and medication. The duration of local therapy should be at least 4 weeks and continued for up to 14 days after the normalization of the skin presentation. Systemic treatment should take place with terbinafine 250 mg once a day orally (in adults). Alternatives are itraconazole, fluconazole and griseofulvin. Only the preparation griseofulvin, which is no longer available in Germany, is approved for children. Alternatively, terbinafine, itraconazole or fluconazole can also be used in children as an "off-label" treatment in an individual healing attempt.

BACKGROUND There has been an alarming increase in the prevalence of chronic, recurrent and steroid modified dermatophytosis of the glabrous skin in the recent years in India. There is paucity of literature on the magnitude of this major public health problem. OBJECTIVE To estimate the prevalence of dermatophytosis and clinico-epidemiological features of chronic and recurrent dermatophytosis (CRD) across India and to evaluate the associated risk factors. METHODS This is a multicentric descriptive cross-sectional study conducted in 13 centres situated across India in two phases during dry and rainy seasons. All consecutive patients presenting with dermatophytosis were screened during the study period of 14 consecutive working days. Patients with CRD of the glabrous skin as per the case definition were included after exclusion of isolated hair and nail infections. Demography, clinical findings and results of potassium hydroxide wet mount were recorded. RESULTS AND CONCLUSION A total of 41,421 patients were screened, out of which 7174 (17.31%) patients had glabrous dermatophytosis. CRD was observed in 1999 (27.86%) patients with 78.08% and 21.95% of chronic and recurrent dermatophytosis, respectively. Family history was present in 50.03% of patients. History of sharing of fomites was present in 50.37% of them. Synthetic tight clothes were worn by 43.47%, while 50.9% gave history of misuse of topical corticosteroid creams. Multiple site involvement was common (69.58%) with tinea cruris (79.99%) and tinea corporis (75.69%) being the most common clinical types. CRD is associated with sharing of fomites, topical corticosteroid misuse and involvement of multiple sites.

Background Traditional medicine is still playing an important role in meeting the basic health care requirement of the peoples in different parts of Ethiopia. There is no published review that clearly indicates documented medicinal plants available in different parts of the country used for treating viral and fungal infections. Currently, viral epidemics with high mortality and morbidity like SARS COV-2 are emerging. Screening of promising drug from plant source is vital to control such viral and fungal infections. In addition, indicating the most commonly used parts of the plant and their route of administration will help for further drug formulation studies. This review aimed to present an indication of the ethnomedicinal plants used for the treatment of fungal and viral infections. Methods The databases (Google Scholar, pub med, hinari, and research gate) were searched for published articles on the ethnobotany of medicinal plants used to treat viral and fungal infection in Ethiopia without restriction in the methodology and year of publication. Viral infections, fungal infections, anti-fungal and anti-viral activity, ethnobotany, Ethiopia, and medicinal plants were the key search terms. Studies that did not have complete ethnobotanical data and did not address viral and fungal infection as a disease treated traditionally by the practitioners were excluded. Results A total of 249 articles were produced by database search. After amendment for exclusion criteria and duplicates, 15 articles were found appropriate for the review. The majority of the studies were qualitative and others were mixed type in nature. All of the medicinal plants traditionally used to treat viral and fungal infections in Ethiopia were not scientifically confirmed. Out of the 95 identified plants, 40.8% were herbs and from the plant parts used and 43.9% and 21.1% were leaves and roots, respectively. The majority, (48.8%), of the plant remedies were given orally. Rabies and Tinea capitis constitute the highest percentage of viral and fungal infections treated by traditional medicinal plants followed by hepatitis and Tinea corporis, respectively. Conclusion Various plants have been used to treat viral and fungal infections. Information obtained from this review serves as a guide to discover novel antiviral and antifungal agents from plants. Therefore, it is advisable for field researchers to properly identify, document, conserve and conduct efficacy and safety studies on such medicinal plants in animal models.

The detection and identification of fungal DNA from clinical samples is one of the fundamental approaches in biomedicine. The incidence, distribution, and control of dermatophytes has progress significantly and the use of phylogenetic species concepts based on rRNA regions have enhanced the taxonomy of dermatophyte species, however, the use of 28S rDNA genes has certain limitations. This gene has been used in dermatophyte taxonomy with limited enumeration, we appraised the sequence disparity within and among groups of the species, the gene ranking in identification, phylogenetic analysis, and taxonomy of 32 strains of eight dermatophyte species. In this study, a set of primers was adopted to amplify the target followed by a partial sequencing of the rDNA. The utilization of a pairwise nucleotide differentiation, an affinity was observed among eight dermatophyte species, with disparity among species ranging from 0 to 197 base pair (bp). Intra-species bp differences were found within strains of Trichophyton eriotrephon, Trichophyton bullosum, Trichophyton simii (Trichophyton genus), Microsporum audouinii, and Trichophyton tonsurans (Microsporum and Trichophyton genus, respectively), however, only some strains of Trichophyton eriotrephon were found to be invariant having three genotypes. Trichophyton tonsurans exhibited most intra-species variability. The characterization and construction of a phylogenetic tree of 28S rDNA gene on dermatophyte species provide a bedrock of an additional finding of connections between species. However, 28S rRNA capture provides a novel method of effective and sensitive detection of dermatophytes lodged in human skin scale. We report for the first time the emergence of T. eriotrephon, T. bullosum, T. simii, T. benhamiae, and Ctenomyces serratus dermatophytes from Tinea capitis in Nigeria.

Wir berichten uber eine Terbinafin-resistente Tinea corporis bei einem Reiseruckkehrer aus Asien. Der erstmals in Indien isolierte Genotyp VIII von Trichophyton mentagrophytes hat in den vergangenen Jahren als Erreger der Tinea corporis und Tinea cruris zugenommen und aufgrund seiner haufigen Resistenz gegenuber Terbinafin an Relevanz gewonnen. Insbesondere nach Reisen nach Asien sollte daher bei therapierefraktarer Tinea die systemische Therapie auf Itraconazol umgestellt werden. Mit Itraconazol in veranderter Darreichung kann eine erhohte Bioverfugbarkeit bei niedrigerer Dosierung erreicht werden.

Background: HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system that can cause immunodeficiency. Immunodeficiency results in increased susceptibility to fungal infections. The other opportunistic infection, condyloma acuminate is prevalent in groups at high risk for HIV acquisition and in HIV-infected individuals. Case: There were ring-shaped reddish patches with scaly and itchy on the right back since 3 weeks ago. Patients often scratch it especially when sweating and hot weather. The itchy reddish patches with scaly were increased in number and size on the right back then spreading over the edge to form ring-like patches. Patient complained ring-shaped reddish patches getting more red, scaly, itchy, and wider . 6 months ago, there was a lump that sometime felt itchy in below part of vulva. Patient in reproductive age and not married yet, but sexually active. Patient had a sexual relation with male who HIV 2 years ago. Patient also suffered HIV and got ARV since 6 month ago. There was no protection (condom) during the sexual intercourse. Dermatologic state in right back with efflorescence is plaque erythema with annular concentric ring forms, scale, and blackish crust. V enereologycal state show vegetation in vulva with size 0,2 - 1,5 x 1 x 0,5 cm with verrucous surface. Acetowhite test is positive result. KOH 10% of skin scrapping show fungal element and fungal culture result is tricophyton rubrum. Patient was diagnosed tinea corporis (TC) and condyloma acuminata (CA) genital griseovulfin 900 mg, cetirizin 10 mg, ketokonazol 2% cream twice a day, tricholoroacetat 90% and showed good improvement. Discussion: Diagnosis tinea corporis and CA genital based on clinical findings and mycological examination. Early diagnosis and proper treatment are important in HIV patients in order to prevent severe infection. After 4 weeks treatment, show improvement on TC however CA lesion no reduced. Keywords: tinea corporis,condyloma acuminate, tinea imbricata, HIV, Reproductive age

Розеофунгин-АС, мазь 2% для наружного применения разработана для лечения микозов кожи разной этиологии, вызванных дерматофитными, дрожжеподобными и плесневыми грибами. Многоцентровое слепое проспективное рандомизированное исследование проводили в Республике Казахстан для сравнения терапевтической эффективности и безопасности препаратов «Розеофунгин-АС, мазь 2%» и «Клотримазол, крем 1%» при лечении tinea pedis и tinea corporis. Препараты применяли 2 раза в день в течение 28 дней. Лабораторные общеклинические и биохимические обследования пациентов проводили на 0, 14 и 28 дни исследования. Микологическое обследование включало микроскопические и культуральные исследования, которые проводились до лечения и на 28-30-й день после окончания лечения. В клиническое исследование III фазы входили 410 пациентов, включая 290 пациентов с tinea pedis и 120 пациентов с tinea corporis. Лечение препаратом «Розеофунгин-АС, мазь 2%» получали 310 пациентов, лечение препаратом «Клотримазол, крем 1%» - 100 пациентов. У больных обеих групп уже на 14 день уменьшалась выраженность субъективных и объективных проявлений. К 28 дню практически все клинические признаки патологического процесса отсутствовали. Совокупная клинико-микологическая эффективность препарата «Розеофунгин-АС, мазь 2%» составила 99,1%, препарата «Клотримазол, крем 1%» - 98,0%. Препарат «Розеофунгин-АС, мазь 2%» проявил высокую эффективность при лечении грибковых инфекций tinea pedis и tinea corporis, вызванных возбудителями трихофитии (Trihophyton rubrum, T. violarum, T. tonsurans), микроспории (Microsporum canis, M. gypseum), кандидоза (Candida albicans, Candida spp.), плесневыми грибами (Penicillium glaucum). В исследовании не были зафиксированы аллергические реакции и индивидуальная непереносимость исследуемого и референтного препаратов. Препарат «Розеофунгин-АС, мазь 2%» является эффективным антимикотическим средством, клинико-микологическая эффективность которого в терапии микозов кожи составляет 99,1%. Препарат имеет высокий уровень переносимости, безопасности и приемлемости RoseofunginAS, ointment 2% for external use was developed for the treatment of skin mycoses of various etiologies caused by dermatophytic and yeastlike fungi and molds. A multicenter, blind, prospective, randomized trial was conducted in the Republic of Kazakhstan to compare the therapeutic effectiveness and safety of RoseofunginAS, ointment 2% and Clotrimazole, cream 1% in the treatment of tinea pedis and tinea corporis. The drugs were administered twice daily for 28 days. Laboratory general clinical and biochemical examinations of patients were performed on days 0, 14, and 28 of the trial. Mycological examination included microscopic and cultural studies, which were carried out before treatment and on days 2830 after the end of treatment. The Phase III clinical trial involved 410 patients, including 290 with tinea pedis and 120 with tinea corporis. Treatment with RoseofunginAS, ointment 2% was administered to 310 patients, 100 patients were treated with Clotrimazole, cream 1%. In patients of both groups, the severity of subjective and objective manifestations decreased already on day 14. By day 28, almost all clinical signs of the pathological process were absent. The cumulative clinical and mycological effectiveness of the drug RoseofunginAS, ointment 2% was 99.1% and that of the drug Clotrimazole, cream 1% reached 98.0%. The drug RoseofunginAS, ointment 2% exhibited high effectiveness in the treatment of fungal infections, including tinea pedis and tinea corporis, with pathogens that cause trichophytosis (Trihophyton rubrum, T. violarum, T. tonsurans), microsporia (Microsporum canis, M. gypseum), candidiasis (Candida albicans, Candida spp.), and molds (Penicillium glaucum). The study did not record allergic reactions and individual intolerance to the study and reference drug. The drug RoseofunginAS, ointment 2% is an effective antimycotic agent, the clinical and mycological effectiveness of which in the treatment of skin mycoses was 99.1%. The drug possesses a high level of tolerance, safety and acceptability.

Biologics, as IL17 inhibitors, are frequently prescribed for moderate to severe plaque psoriasis. Although mucocutaneous candida infections are a well-known side effect of IL-17 inhibitors, there is no data about dermatophyte infection under this therapy. Generalized tinea corporis can mimic the clinical picture of psoriasis, especially if concomitant treatment with topical corticosteroids is used. Therefore, physician should be aware of this differential diagnosis if they suspect a loss of efficacy of IL-17-inhibitors with a flare-up of psoriasis.

Topical preparations of allylamines and imidazoles are the commonly used medications for the treatment of tinea corporis, having extended efficacy and good safety profile. In our study, we have compared topical terbinafine, an allylamine and topical miconazole, which is an imidazole to assess their efficacy and safety in tinea corporis infection. Hundred patients with tinea corporis infection were equally randomized to receive either terbinafine (1%) or miconazole (2%) for 4 weeks. The reduction in clinical symptoms (pruritus, erythema, vesicle, and desquamation), attaining mycological cure, reduction in composite score, as well as physician global assessment were evaluated from baseline to the end of intervention, and at follow up visit, and compared between the groups. Incidence of adverse drug reactions was also noted for safety analysis. Baseline demographic characteristics of terbinafine and miconazole groups were similar. The study demonstrated statistical significance reduction in clinical symptom scores, attaining Mycological cure, composite score and Physician Global Assessment from baseline to 4th week and follow up week between both groups with a p value

Background Indonesia is a tropical country, warm and humid, with numerous environmental fungi. Data on fungal disease burden helps policy makers and clinicians. Objectives We have estimated the incidence and prevalence of serious fungal diseases. Methods We found all published and unpublished data and estimated the incidence and prevalence of fungal diseases based on populations at risk. HIV data were derived from UNAIDS (2017), pulmonary tuberculosis (PTB) data from 2013-2019, data on chronic pulmonary aspergillosis (CPA) was used to estimate CPA prevalence and likely deaths, COPD data from Hammond (2020), lung cancer incidence was from Globocan 2018, and fungal rhinosinusitis was estimated using community data from India. Results Overall ~7.7 million Indonesians (2.89%) have a serious fungal infection each year. The annual incidence of cryptococcosis in AIDS was 7,540. Pneumocystis pneumonia incidence was estimated at 15,400 in HIV and an equal number in non-HIV patients. An estimated 1% and 0.2% of new AIDS patients have disseminated histoplasmosis or Talaromyces marneffei infection. The incidence of candidemia is 26,710. The annual incidence of invasive aspergillosis was estimated at 49,500 and the prevalence of CPA is at 378,700 cases. Allergic bronchopulmonary aspergillosis prevalence in adults is estimated at 336,200, severe asthma with fungal sensitization at 443,800, and fungal rhino sinusitis at 294,000. Recurrent vulvovaginal candidiasis is estimated at 5 million/ year (15 - 50 years old). The incidence of fungal keratitis around 40,050. Tinea capitis prevalence in schoolchildren about 729,000. Conclusions Indonesia has a high burden of fungal infections.

Tinea capitis (TC) is an infection of the scalp and hair caused by a dermatophyte fungus. Typically caused by the zoophilic and geophilic species of Microsporum and Trichophyton, it remains the commonest cutaneous fungal infection in children. A 9-year-old Nepalese boy was evaluated in outpatients for multiple boggy scalp lesions for two months. Suspecting a bacterial etiology, the lesions were excised and sent for cultures. While bacterial cultures failed to grow, endothrix spores were readily detected in potassium hydroxide preparation and histopathology. Trichophyton tonsurans was identified by the phenotype method and later confirmed by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF). Systemic antifungal therapy for 6 weeks along with local wound dressings resulted in complete recovery. At 2-year follow-up, focal alopecia was seen; however, no recurrence was noted.

Trichophyton rubrum is responsible for the majority of dermatophytosis. Current systemic and topical antifungals against dermatophytosis are often tedious and sometimes unsatisfactory. Antimicrobial photodynamic therapy (aPDT) is a non-invasive alternative suitable for the treatment of superficial fungal infections. This work investigated the photodynamic inactivation efficacy and effects of aloe-emodin (AE), a natural photosensitizer (PS) against T. rubrum microconidia in vitro, and evaluated the treatment effects of AE-mediated aPDT for T. rubrum-caused tinea corporis in vivo and tinea unguium ex vivo. The photodynamic antimicrobial efficacy of AE on T. rubrum microconidia was evaluated by MTT assay. The inhibition effect of AE-mediated aPDT on growth of T. rubrum was studied. Intracellular location of AE, damage induced by AE-mediated aPDT on cellular structure and surface of microconidia and generation of intracellular ROS were investigated by microscopy and flow cytometry. The therapeutic effects of AE-mediated aPDT against dermatophytosis were assessed in T. rubrum-caused tinea corporis guinea pig model and tinea unguium ex vivo model. AE-mediated aPDT effectively inactivated T. rubrum microconidia in a light energy dose-dependent manner and exhibited strong inhibitory effect on growth of T. rubrum. Microscope images indicated that AE is mainly targeted to the organelles and caused damage to the cytoplasm of microconidia after irradiation through generation of abundant intracellular ROS. AE-mediated aPDT demonstrated effective therapeutic effects for T. rubrum-caused tinea corporis on guinea pig model and tinea unguium in ex vivo model. The results obtained suggest that AE is a potential PS for the photodynamic treatment of dermatophytosis caused by T. rubrum, but its permeability in skin and nails needs to be improved.

Dermatophytes, the most common causative agents, are assuming high significance in developing countries like India. These organisms metabolise keratin and cause a range of pathologic clinical presentations, including tinea pedis, tinea corporis, tinea cruris, etc. Although usually painless and superficial, these fungi can behave in an invasive manner, causing deeper and disseminated infection and should not be neglected. The lesions may become widespread and may have significant negative social, psychological, and occupational health effects, and can compromise the quality of life significantly. The recent prevalence of dermatophytosis in India ranges from 36.6-78.4%. Currently, dermatologists across India are inundated with cases of dermatophytosis presenting with unusual large lesions, ring within ring lesions, multiple site lesions (tinea cruris et corporis), and corticosteroid modified lesions, making diagnosis a difficult bet. 1 First line of therapy has always been a topical agent; while in resistance of the topical agents next preferred treatment are the oral therapies of antifungal agents (Ketoconazole, Terbinafine, Fluconazole and Itraconazole). However complementary and alternative therapy has also shown the significant results in control of growth of these dermatophytes. Homoeopathy has always been a safe and cost effective treatment in cases of dermatophyte infections.2 The present case report of a 31 years old Muslim female, Sepia officinalis 1M and Sulphur (30C and 200C) have shown marked improvement in the reduction of the lesion. Key words: Tinea corporis, homoeopathy, totality of symptoms, repertorisation.

Background-Superficial Mycosis, which is the most common fungal infection affecting human beings, includes Dermatophytosis and Dermatomycoses, which are the infections of superficial keratinized layer of skin, nail & hair by Dermatophytes and non Dermatophytic moulds or yeasts respectively. This clinical entity is very common in hot, humid tropical climate of India with prevalence ranging from 30-60% but its precise case magnitude and epidemiology in North eastern India cannot be stated as there are only few studies conducted. So, this study is undertaken to 1) Find the prevalence of Superficial Mycosis in a tertiary health care centre of Southern Assam. 2) Study the clinical profile of the cases 3) Isolate and identify the causative agents of Superficial mycosis. Materials & Method- The study has been conducted on 250 samples from clinically suspected and untreated cases of superficial mycosis from Aug 2017 to Dec 2018. 2 separate sets of samples from edge of skin lesion/nail /hair were collected, of which 1 sample was subjected to direct microscopy with (10-40) % KOH and the other part was subjected to 2 sets of fungal culture in SDA tubes at 25°C and 37°C & followed for 3 weeks. In Culture positive cases, fungal identification was based on colony morphology, pigment production & LPCB mount. For confirmation of isolates, Slide Culture and biochemical tests were done. Result-Out of total 250 samples,115 samples (46%) showed presence of fungal elements in KOH examination, of which 73 were culture positive and of the KOH negative samples 10 samples were culture positive, thus making the prevalence 33.2% (83/250). Clinically, Tinea corporis was the most common form of both superficial mycosis & Dermatophytosis and Pityriasis Versicolor has been found the most common Dermatomycosis. Males(21-50yrs) were affected by superficial mycosis more than Females(16-30yr). Trichophyton mentagrophyte was the mostly isolated agent causing superficial mycosis. Keywords: Superficial mycoses, prevalence, Assam, Slide Culture, Urease.

Background Tinea capitis is a common fungal infection in Israel, most commonly caused by the dermatophyte Trichophyton tonsurans. Objectives To investigate the effectiveness of oral antifungal monotherapy in producing clinical or complete cure. We also evaluated the impact of topical therapy (bifonazole 1% shampoo and/or betamethasone valerate 0.1% solution), prior to oral treatment, on patients' likelihood of clinical or complete cure. Methods A retrospective chart review was conducted. Patients with mycologically confirmed tinea capitis were treated with one of four regimens: (1) terbinafine (greater than 40 kg: 250 mg/day, 20 to 40 kg: 125 mg/day, less than 20 kg: 62.5 mg/day), (2) itraconazole 5 mg/kg daily, (3) fluconazole 6 mg/kg daily, or (4) griseofulvin 20 mg/kg daily. We used generalized linear models (GLM) to determine whether there was a significant association between the odds of cure and choice of treatment. Results The causative species was Trichophyton tonsurans in all but 6 cases that grew T violaceum. For pediatric patients, the odds of having complete or clinical cure within 6 weeks was greater if they used terbinafine compared to itraconazole, fluconazole, or griseofulvin (odds ratio [OR] = 9.06, P = .047). The likelihood of complete or clinical cure within 8 weeks of oral therapy was lower if topical steroids were previously used compared to if topical antifungals were used prior to systemic treatment (OR = 0.29, P = .046). Conclusions Our findings substantiate prior literature demonstrating that terbinafine is non-inferior to griseofulvin, itraconazole, and fluconazole in the therapy of pediatric tinea capitis caused by T tonsurans.

Background: Tinea capitis is an infection caused by dermatophyte fungi of scalp hair follicles and the neighboring skin. Antifungal drugs as terbinafine that are used to treat dermatophytosis direct the ergosterol synthesis pathway. Aim of the work: The current study aimed to identify species and in vitro antifungal susceptibility profile of terbinafine on dermatophytes clinical isolates accompanied by sequencing of the highest minimal inhibitory concentration (MIC) isolates. Patients and methods: The present study is a descriptive cross-sectional study was conducted at Al-Azhar Hospital outpatient clinic, in the period from the 1st of July 2019 to the 15th of July 2020. Samples from 50 patients diagnosed clinically as tinea capitis were taken for microscopic examination by KOH and lactophenol cotton blue and culture on Sabouraud's dextrose agar followed by in vitro susceptibility testing to terbinafine then sequencing of the highest MIC isolates. Results: The isolated dermatophyte species were 16 (32%) isolates of M. canis and 23(46%) isolates of T.violaceum. The MIC varied from 0.003-.092 μg/ml for M.canis and from 0.005-0.116 μg/ml for T.violaceum. It was found in M. canis strain has two base variations with type strain from GenBank whereas T.violaceum strain has ten base variations in the two representative isolates with the highest MIC. Conclusion: T. violaceum was detected as the most common fun‌gal species followed by M. canis. The MIC results to terbinafine showed sensitivity to the antifungal agents. By comparing the M. canis and T. violaceum isolates with type strain on GenBank, some base-pair substitutions were found.

Die Tinea capitis ist weltweit bei Kindern bis zum 12. Lebensjahr verbreitet. Die schwerste Form ist das Kerion Celsi mit schmerzhaften Abszessen und Lymphadenopathie. Wir berichten uber einen 11-jahrigen Jungen mit Kerion Celsi, der zunachst unter der haufigen Fehldiagnose einer bakteriellen Infektion antibiotisch therapiert wurde. Nach mykologischer Diagnostik konnte eine Infektion mit Microsporum canis gesichert werden. Es wurde die orale Therapie mit Griseofulvin eingeleitet, die zur kompletten mykologischen Abheilung nach 8 Wochen Behandlung fuhrte. Eine narbige Alopezie konnte nicht mehr verhindert werden. Bei purulenten Infektionen der Kopfhaut ist bei Kindern immer eine fruhzeitige mykologische Diagnostik erforderlich.

Fungal infections are a growing cause of concern in both hospital and non-hospital settings all over the world. Fungal infections are often characterized by the location of the infection. These may be referred to as superficial, subcutaneous, or systemic, which is also referred to as deep-seated. Dermatomycosis are superficial fungal infections of the skin & or its appendages.This study was undertaken to determine: 1) The predominant dermatophytes and non dermatophytes causing dermatomycosis. 2) The clinicomycological profile of dermatomycosis.641 samples from clinically suspected cases of dermatomycosis including the skin, hair, and nail samples were collected. All the relevant clinical, demographic, and epidemiological details were noted. Samples were then subjected to direct microscopy and fungal culture.Of the total 641 cases, 337 (52.6%) were males and 304 (47.4) were females (Table 1). The most commonly affected age group was 20–39 years (51%). Out of total, 340 (53%) were nail samples, 283 (44.1%) were skin samples, and 18 (2.9%) were hair samples. Onychomycosis was the commonest clinical presentation (48.8%) followed by Scaly skin lesions (13.1%). Moreover, Tinea corporis was seen in 10.3%, Tinea cruris in 5.3% cases. KOH wet mount was performed on all 641 samples with 230 (35.9%) showing positive results. Whereas, 312 (48.7%) were positive by culture. the most common Fungi isolated in our study were Dermatophytes n=154 (49.4%), followed by Non-dermatophyte molds (NDMs) n=93 (29.8%) and Yeasts n=65 (20.8%).A combination of direct microscopy and culture was found to be superior than direct microscopy and culture alone. The recovery of NDMs and yeasts from routine dermatological samples in addition to the usual suspects, dermatophytes, also increases the awareness and suspicion among clinicians and mycologists to look beyond dermatophytes as the lone cause of superficial skin infections. Additionally, given the geographical location of Kashmir valley and its temperate climate with extremely cold winters (November to March) and a relatively milder summer with moderate humidity levels, when compared to the rest of northern Indian states doesn’t make it a suitable environment for fungal infections, more so the superficial mycosis. That said, people at risk are always vulnerable to develop fungal infections.

Background: Dermatophytosis has been a common contagious disease and remain an important public health problem among people worldwide and particularly in developing countries. This study was done in order to know prevalence of keratinophilic fungi in the soil samples of Ajmer region and its clinical correlation. Materials and Methods: Five samples (5gm each) of garden soil were collected from each of the randomly selected 10 sites of Ajmer region in sterile polythene bags & pH of soil was recorded. All samples were processed in the laboratory using hair bait technique and incubated at 28 + 2?C for 3-4 weeks. Fungi grown were subcultured onto Sabourauds Dextrose Agar (SDA) with chloramphenicol & SDA with cycloheximide and identified using standard mycological procedures. Results: Out of 50 soil samples cultured 28 (56%) samples were positive for keratinophilic fungi. 64.28% were dermatophytes and 12.8% were non-dermatophytic fungi. The predominant isolate among dermatophytes was Trichophyton spp. (64.28%) where as Aspergillus spp. (12.8%) was the commonest non-dermatophyte. Conclusion: In our hospital, dermatophytic infection including Tinea corporis is one of the most common clinical presentations of skin infection. Trichophyton spp. is commonest causative agent of Tinea corporis. Interestingly Trichophyton spp. was the most commonly isolated dermatophyte in our study suggesting soil as a source of dermatophytic infections. Keywords: Dermatophytosis, Dermatophytic, Keratinophilic fungi.