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Dermatophyte infections of the skin and nails are frequent, but current antimycotics have several drawbacks. In search of new treatments, we looked into the vast array of herbal active agents. Derived from plants, they are sustainable, agreeable for patients, and may have less side effects than traditional antimycotics. In this study, we assessed 43 herbal agents for their effectiveness against Trichophyton rubrum (T. rubrum), Trichophyton benhamiae (T. benhamiae), Trichophyton tonsurans (T. tonsurans), and Microsporum canis (M. canis), four major human dermatophyte pathogens. The antifungal effect was tested by incorporating the agents into agar plates and measuring the dermatophyte growth after 7 days. Against T. rubrum, 16 out of 43 herbal agents showed total inhibition of dermatophyte growth. 14 out of 43 herbal agents inhibited the growth of T. benhamiae completely. 18 out of 43 herbal agents were effective against T. tonsurans. Against M. canis, 15 out of 43 herbal agents showed total growth inhibition. Twelve herbal agents inhibited the growth of all tested dermatophytes completely. This study demonstrates the high antimycotic potential of herbal therapeutics and identified promising candidates for the topical treatment of dermatomycoses. Substances are highly agreeable and should be tolerated well. Some might even provide new options for the systemic treatment of fungal diseases. [ABSTRACT FROM AUTHOR]

Introduction: Recalcitrant dermatophytosis is an emerging phenomenon that occurs worldwide, and Trichophyton indotineae is currently the prominent cause. Materials and methods: Skin specimens from patients with tinea infection were obtained by scrubbing and then sectioned into three fragments. Two fragments were subjected to direct microscopic examination and culture, while the third portion was utilized in the PCR method. Results: Isolates were morphologically identified as Trichophyton mentagrophytes/interdigitale complex (n = 60 [83.33%]), Microsporum canis (n = 8 [11.11%]), Trichophyton rubrum (n = 3 [4.16%]), and Epidermophyton floccosum (n = 1 [1.38%]). Among 60 T. mentagrophytes complex isolates, 53 (88.33%) were classified as T. indotineae and seven as T. interdigitale genotype II. The disease duration was longer in the T. indotineae group (P = 0.035). Both Gradient PCR and skin‐sampling methods yield similar results in terms of positive and negative cases (P = 1.0000). The time patients stopped their medication did not impact the positive case numbers (P = 0.803). Gender had no effects on the frequency (P = 0.699). Familial contamination, dermatologic disorder, and other underlying conditions did not differ in the two group infections (P > 0.05). Steroid usage is strongly associated with the emergence of tinea infection (P < 0.04). The duration of antifungal administration had a substantial effect on the emergence of resistant organisms (P = 0.05). Conclusions: Steroid usage, T. indotineae involvement, and prolonged exposure to antifungals were the solid and influential factors in recalcitrant involvement. Regarding quick and suitable diagnosis and treatment, which is essential in preventing recalcitrant cases, we suggest that direct skin sample PCR can meet the demands. [ABSTRACT FROM AUTHOR]

Background: Terbinafine is widely used to treat onychomycosis caused by dermatophyte fungi. Terbinafine resistance in recent years is causing concern. Resistance has so far been associated with single‐nucleotide substitutions in the DNA sequence of the enzyme squalene epoxidase (SQLE) but how this affects SQLE functionality is not understood. Objectives: The aim of this study was to understand newly discovered resistance in two Australian strains of Trichophyton interdigitale. Patients/Methods: Resistance to terbinafine was tested in four newly isolated strains. Three‐dimensional SQLE models were prepared to investigate how the structure of their SQLE affected the binding of terbinafine. Results: This study found the first Australian occurrences of terbinafine resistance in two T. interdigitale strains. Both strains had novel deletion mutations in erg1 and frameshifts during translation. Three‐dimensional models had smaller SQLE proteins and open reading frames as well as fewer C‐terminal α‐helices than susceptible strains. In susceptible strains, the lipophilic tail of terbinafine was predicted to dock stably into a hydrophobic pocket in SQLE lined by over 20 hydrophobic amino acids. In resistant strains, molecular dynamics simulations showed that terbinafine docking was unstable and so terbinafine did not block squalene metabolism and ultimately ergosterol production. The resistant reference strain ATCC MYA‐4438 T. rubrum showed a single erg1 mutation that resulted in frameshift during translation, leading to C‐terminal helix deletion. Conclusions: Modelling their effects on their SQLE proteins will aid in the design of potential new treatments for these novel resistant strains, which pose clinical problems in treating dermatophyte infections with terbinafine. [ABSTRACT FROM AUTHOR]

The failure to successfully treat dermatophyte-related diseases is often due to the formation of biofilms, which makes dermatophytes resistant to antifungals. Here, an attempt has been made to assess inhibition of dermatophyte biofilm production using photodynamic therapy and rhamnolipid biosurfactant. Two methods were used to inhibit biofilm formation by dermophytes Trichophyton mentagrophytes, Trichophyton rubrum and Trichophyton verrucosum, Microsporum canis and Microsporum gypseum. The first method was the use of rhamnolipid with concentrations of 39 to 1000 ppm and the second was the use of photodynamic method with concentrations of 8, 16 and 32 µg/ml of methylene blue. In addition, these two methods were evaluated simultaneously. The biofilm formation was evaluated using spectrophotometry and scanning electron microscopy. Biosurfactant has been shown to have an improved ability to inhibit the formation of biofilm by the strains. Although photodynamic therapy has not been successful, but in combination with biosurfactant, it may have a synergistic effect. By investigating the effect of rhamnolipid on the formation of biofilm, it was found that Microsporum species has a relatively stronger attachment to the surfaces of the wells compared to trichophyton species. The biofilms were evaluated with electron microscope in the simultaneous treatment of rhamnolipid and photodynamics. The results showed that after the treatment, the biofilms became discrete and their structural integrity was reduced. Even in Microsporum species, which were among the most resistant dermatophytes, the changes in the fungal biofilm after treatment were significant. [ABSTRACT FROM AUTHOR]

Antifungal-resistant dermatophyte infections have recently emerged as a global public health concern. A survey of US infectious diseases specialists found that only 65% had heard of this issue and just 39% knew how to obtain testing to determine resistance. Increased clinician awareness and access to testing for antifungal-resistant dermatophytosis are needed.

Background: Dermatophytosis is a common skin infection of cats and many other animals. A reliable diagnosis is crucial because of the zoonotic potential of dermatophytes. The routine mycological diagnostic procedures for dermatophytosis are widely known, but in the case of some isolates, identification based on phenotypic characteristics may be incorrect. Infections caused by Chrysosporium spp. are usually described in reptiles, but in other animals they are uncommon. Case presentation: This study presents a description of a cat with dermatological lesions, that was mistakenly diagnosed with Trichophyton spp. dermatophytosis. Clinical material for mycological examination was collected from alopecic areas on the back of the neck, the ventral abdomen, and the hindlimbs. The initial identification based on phenotypic properties indicated Trichophyton spp. The result of the MALDI-ToF MS allowed the exclusion of the Trichophyton genus. Ultimately, the correct identification as Chrysosporium articulatum was obtained based on the sequencing of ribosomal genes. Conclusions: Interpretation of the results of the mycological examination of samples collected from animals' skin or hair shafts is always challenging. Thus, careful consideration of the primary cause of the clinical lesions observed on the skin is mandatory, and the culture results are worth supporting by molecular methods. [ABSTRACT FROM AUTHOR]

Objective- The microscope investigation of fungi is rapid but these diagnostic procedures show lack of sensitivity and specificity with 15% fallacious results and species or genus level identification is not feasible. Material and Methods- This 18-month prospective study included all dermatophytes that were isolated during that time. Dermatophytes were discovered using standard phenotypic techniques. Therefore, in recent years many molecular methods have been developed which are more specific, precise, rapid and cost effective than conventional phenotypic methods. Samples of skin and nails were analyzed under a microscope using 20% KOH and cultivated on Sabouraud dextrose agar supplemented with DTM Media, cycloheximide, and chloramphenicol. By sequencing the internal transcribed spacer (ITS) r-DNA region, the identity of the fungal isolates was verified. Results- Out Of the 320 samples 270 (84.37%) samples showed growth of fungi (dermatophytes) after culturing on SDA media. Whereas with AP-PCR, 303 (94.68%) samples were positive for dermatophytes. Seven species of dermatophyte namely Trichophyton mentagrophytes, Trichophyton rubrum, Epidermophyton floccosum, Trichophyton tonsurans, Microsporum gypseum, Trichophyton verrucosum and Microsporum canis identified after culturing on SDA media from these 270 samples were confirmed by AP-PCR also. [ABSTRACT FROM AUTHOR]

Dermatophytosis is a cutaneous infection that is able to degrade the keratinized tissues of the animal/human body, like skin, nails, and hair, causing chronic or subacute infection with the contact of some specific fungal strains. Trichophyton mentagrophytes are the most potential fungal pathogen causing dermatophytoses. The present study focuses on computationally based in silico antifungal activity of selected phytocompounds of Leucas aspera (Willd.) Link. against dermatophytic fungus, T. mentagrophytes. Validation and screening of derived phytocompounds is performed using Lipinski rule of five and toxicity test through Protox‐II. Five target genes involved in dermatophytosis, induced by T. mentagrophytes are retrieved from the UniProt Database, and the corresponding proteins such as glucan 1,3‐beta‐glucosidase ARB_02797, Probable class II chitinase ARB_00204, squalene monooxygenase, actin, and ubiquitin are selected for in silico study. Three‐dimensional structures of the target protein were computationally determined and validated through modeling tools and techniques due to the lack of validated protein structures in the database. Then, these proteins are used for in silico molecular docking through the AutoDock Vina tool to find out the promising phytocompounds. This study could be utilized in designing more effective drugs against T. mentagrophytes. Based on this work, a plant‐based natural alternative can be added to the treatment of dermatophytosis rather than synthetic supplements. [ABSTRACT FROM AUTHOR]

Background: Dermatophytosis is a prevalent superficial infection caused by filamentous fungi, primarily affecting the skin and/or its appendages. In recent years, there has been a notable increase in mycotic strains resistant to standard antifungal therapies, including Trichophyton indotineae, a dermatophyte of the Trichophyton mentagrophytes complex. This review aims to provide a comprehensive overview of the treatment options for T. indotineae, elucidating their effectiveness in managing this challenging mycotic infection. Methods: For this review, a search was conducted in the PubMed, Scopus, Web of Science, Embase, and Google Scholar databases, encompassing all published data until March 2024. English-language articles detailing therapy outcomes for patients confirmed to be affected by T. indotineae, identified through molecular analysis, were included. Results: Itraconazole was shown to be a good therapeutic choice, particularly when administered at a dosage of 200 mg/day for 1–12 weeks. Voriconazole was also demonstrated to be effective, while terbinafine exhibited a reduced response rate. Griseofulvin and fluconazole, on the other hand, were found to be ineffective. Although topical treatments were mostly ineffective when used alone, they showed promising results when used in combination with systemic therapy. Mutational status was associated with different profiles of treatment response, suggesting the need for a more tailored approach. Conclusions: When managing T. indotineae infections, it is necessary to optimize therapy to mitigate resistances and relapse. Combining in vitro antifungal susceptibility testing with mutational analysis could be a promising strategy in refining treatment selection. [ABSTRACT FROM AUTHOR]

Onychomycoses are nail infections that require prolonged therapy and have high recurrence rates. Dermatophytes are the main etiological agents of these infections, followed by yeasts and non-dermatophyte filamentous fungi. The limited antifungal arsenal used to treat onychomycosis and the change in the susceptibility profile of these agents contribute to the chronicity and recalcitrant profile of infections. The present study aimed to determine the antifungal activity of extracts obtained from pure and mixed cultures of Candida parapsilosis, Trichophyton mentagrophytes, and Trichophyton rubrum. Additionally, in vivo toxicity tests with Galleria mellonella and time-kill assays were carried out. The susceptibility profiles of dermatophytes were determined using a microdilution technique with minimum inhibitory concentrations (MICs) between 250 and 8000 µg/mL. The time-kill assay, compared to growth control, resulted in the death of dermatophytes within 48 h. No toxicity of the extracts was detected in experiments with Galleria mellonella larvae under the test conditions. The extracts of pure and mixed cultures of Candida parapsilosis and dermatophytes present antifungal activity against T. mentagrophytes and T. rubrum. Isolating and identifying compounds in the extracts may allow the development of new therapeutic approaches to control fungal infections. [ABSTRACT FROM AUTHOR]

This Medical News article discusses terbinafine-resistant tinea, or ringworm, caused by the recently identified fungal species Trichophyton indotineae. [ABSTRACT FROM AUTHOR]

Background: Dermatophytosis is a common and major public health concern worldwide. Despite the increasing availability of antifungal drugs, relapses and untreated cases of dermatophyte infections are reported. Therefore, novel antifungal agents are required. Aminopyrrolnitrin (APRN) shows promise for dermatophytosis treatment because of its antifungal activity. Objectives: This study aimed to assess the antifungal properties of APRN against Trichophyton verrucosum (T. verrucosum), in both laboratory settings and a guinea pig model. Methods: The minimum inhibitory concentrations (MICs) of APRN and enilconazole against T. verrucosum were determined according to the CLSI M38 method. The skins of 16 male guinea pigs were infected with 1.0 × 108 conidia of T. verrucosum and the animals were grouped into sets of four: negative control group (NC) received normal saline; positive control group (PC) received 2 μg/mL of enilconazole; and APRN4 and APRN8 received 4 and 8 μg/mL of APRN, respectively. Clinical, mycological and histological efficacies were measured after 10 days. Results: The MIC90 of APRN and enilconazole against T. verrucosum was 4 and 2 μg/mL, respectively. The clinical scores of PC, APRN4, and APRN8 were significantly lower than those of NC. Clinical and mycological efficacies were higher for APRN8, APRN4 and PC. No fungi were observed in the skin tissues of APRN4 and APRN8, while fungi were observed in 50% of the PC. Conclusion: APRN showed antifungal activity against T. verrucosum in vitro and in vivo and is a potential candidate for the treatment of dermatophytosis. [ABSTRACT FROM AUTHOR]

Tinea capitis is a fungal infection of the scalp and hair caused by dermatophyte molds, that most often affects children and may also affect adults. Previous estimates suggest that between 3% and 11% of all tinea capitis cases worldwide occur in adults, although updated epidemiological studies are needed to reassess the prevalence of tinea capitis in adult populations specifically. Postmenopausal adult women are most often affected by tinea capitis, with African American or Black women particularly at risk. Adults who experience crowded living conditions, who live in close proximity to animals, who are immunosuppressed, and/or who live in households with affected children are at greatest risk of infection. Tinea capitis can be non-inflammatory or inflammatory in nature, and the subtype affects the extent and severity of clinical symptoms. Fungal culture and potassium hydroxide preparations are the most commonly used diagnostic tools. Trichoscopy, defined as dermoscopic imaging of the scalp and hair, is a useful adjunct to the physical examination. The mainstay of therapy is oral antifungal therapy, and topical therapy alone is not recommended. Since tinea capitis infection is uncommon in adults, there are no widely accepted treatment guidelines. Rather, the same medications used for tinea capitis infection among children are recommended for adults at varying doses, including griseofulvin, and terbinafine, and, less commonly, itraconazole and fluconazole. The prognosis for tinea capitis in adults is typically excellent when prompt and adequate treatment is administered; however, delayed diagnosis or inadequate treatment can result in scarring alopecia. Over the past decade, dermatophyte infections resistant to treatment with topical and oral antifungal agents have emerged. While tinea capitis infections resistant to antifungal therapy have been rarely reported to date, antifungal resistance is rising among superficial fungal infections in general, and antifungal stewardship is necessary to ensure that resistance to treatment does not develop among dermatophytes that cause tinea capitis. [ABSTRACT FROM AUTHOR]

Trichophyton rubrum is the major causative organism of dermatophytosis. The methanolic extracts of Pimpinella anisum seed has shown in vitro anti-dermatophytic activity. In the present study, the active compounds present in Pimpinella anisum seed-methanolic extracts was tentatively identified by liquid chromatography/electrospray ionization tandem mass spectrometry. Further molecular docking analysis of these active compounds with Trichophyton rubrum proteins aspartate-beta (β)-semialdehyde dehydrogenase and sialidase was studied. Liquid chromatography/electrospray ionization tandem mass spectrometry analysis revealed the presence of different class of compounds such as polyphenols, flavonoids, tannins, phenolic acids, phenolic acid derivative, fatty acids and lignan. In silico molecular docking analysis of these compounds with Trichophyton rubrum proteins aspartate-β-semialdehyde dehydrogenase revealed the top five compounds with lowest binding energy were phelligridin I (-10.1 kcal/mol), pectolinarin (-9.6 kcal/mol), fortunellin (-9.5 kcal/mol), epigallocatechin gallate (-9.4 kcal/mol) and kaempferol-3-O-glucuronide (-9.2 kcal/mol). In sialidase, the compounds phelligridin I (-10.6 kcal/mol), fortunellin (-9.5 kcal/mol), chicoric acid (-9.2 kcal/mol), epigallocatechin gallate (-9.1 kcal/mol) and kaempferol-3-O-glucuronide (-8.6 kcal/mol) bound with lowest binding energy. All these compounds were found to orient in the active site forming interactions with amino acids involved in catalysis of these proteins. The proteins aspartate-beta-semialdehyde dehydrogenase and sialidase are considered important drug target of Trichophyton rubrum. In silico analysis has shown promising results hence, these compounds identified in the present study might be further studied for its in vitro antidermatophytic activity. Also, the results from the present study clearly indicate that the active compounds present in Pimpinella anisum seed-methanolic extracts through its interaction with proteins present in Trichophyton rubrum might have shown in vitro anti-dermatophytic activity. [ABSTRACT FROM AUTHOR]

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Background: Dermatomycoses count to the most frequent dermatoses in Cambodia. Objectives: The aim of this survey was to investigate the occurrence of dermatophytes in this Southeast Asian country. Methods: From June 2017 to July 2018, skin scrapings were taken from 67 patients with superficial dermatophytosis for mycological diagnostics. Identification of dermatophytes was confirmed by sequencing of the 'internal transcribed spacer'—(ITS) region of the rDNA, and the gene of the Translation Elongation Factor (TEF)‐1α. Results: Patients were suffering from tinea corporis and tinea inguinalis/cruris 42/67 (63%), tinea capitis/faciei 14/67 (21%), tinea corporis/capitis/faciei 6/67 (9%), tinea manuum/pedis 2/67 (3%), tinea pedis 2/67 (3%) and tinea manuum 1/67 (1%). Both, by culture and/or PCR, a dermatophyte was detected in 52 (78%) out of 67 samples. Culture positive were 42 (81%) of 52, PCR positive were 50 (96%). The following dermatophytes were found: Trichophyton (T.) rubrum, 36/52 strains (69%, 29 by culture), T. mentagrophytes/T. interdigitale (TM/TI) 9/52 (17%, six by culture) and Microsporum (M.) canis 5/52 strains (10%, by culture). One strain of Nannizzia (N.) incurvata 1/52 (2%) and N. nana 1/52 (2%) was isolated. Based on sequencing, we demonstrated that two T. mentagrophytes strains out of the nine TM/TI represented the new ITS genotype XXV Cambodia. We found one T. mentagrophytes strain genotype VIII (now, reclassified as T. indotineae). This isolate was terbinafine resistant, and it exhibited the amino acid substitution Phe397Leu in the squalene epoxidase. Three strains of T. interdigitale genotype II* were isolated. Conclusion: This is the first survey on epidemiology of dermatophytes in Cambodia. Currently, T. rubrum represents the most frequent species in Cambodia. One Indian strain genotype VIII T. mentagrophytes was found. A highlight was the first description of the new T. mentagrophytes genotype XXV Cambodia. [ABSTRACT FROM AUTHOR]

Dermatomycosis is an infection with global impacts caused especially by dermatophytes and Candida species. Current antifungal therapies involve drugs that face fungal resistance barriers. This clinical context emphasizes the need to discover new antifungal agents. Herein, the antifungal potential of 10 curcumin analogs was evaluated against four Candida and four dermatophyte species. The most active compound, 3,3'-dimethoxycurcumin, exhibited minimum inhibitory concentration values ranging from 1.9‒62.5 to 15.6‒62.5 µg ml−1 against dermatophytes and Candida species, respectively. According to the checkerboard method, the association between DMC and terbinafine demonstrated a synergistic effect against Trichophyton mentagrophytes and Epidermophyton floccosum. Ergosterol binding test indicated DMC forms a complex with ergosterol of Candida albicans, C. krusei , and C. tropicalis. However, results from the sorbitol protection assay indicated that DMC had no effect on the cell walls of Candida species. The in vivo toxicity, using Galleria mellonella larvae, indicated no toxic effect of DMC. Altogether, curcumin analog DMC was a promising antifungal agent with a promising ability to act against Candida and dermatophyte species. [ABSTRACT FROM AUTHOR]

Dermatophytes and other members of Onygenales are unique in their ability to degrade keratin, affecting hair and nails, and in the case of human hosts, causing skin infections. Subtillisins are essential proteases in keratin assimilation, and subtilisin-like protease 1 (SUB1) and SUB3–7 are specific for dermatophytes. eIF2α kinases are serine-threonine kinases that perform essential functions in response to infection, proteotoxicity, and nutrient scavenging. The relatively conserved nature of EIF2AK4 among fungi makes them potential evolutionary markers, which may contribute to a deeper understanding of dermatophyte taxonomy and evolution. This study aimed to assess the phylogeny of dermatophytes by examining the EIF2AK4 and SUB1 genes compared to the ITS gene marker. The phylogenetic trees generated from the EIF2AK4 and SUB1 genes exhibited a similar topology, which differed from that observed in the ITS tree. Our preliminary findings with a limited dataset suggest that the EIF2AK4 and SUB1 genes provide a reasonably correct reflection of the evolution of Arthrodermataceae. In addition, the study analyzed in vitro keratinolytic responses of 19 dermatophyte species using hairs of a broad range of mammals, including ancestral as well as derived species, as substrates. Trichophyton mentagrophytes and Nannizzia gypsea were the most active in degrading hair, while Trichophyton verrucosum, Trichophyton tonsurans and Epidermophyton floccosum showed low response. Hairs of Hyracoidea and Rodentia were most affected of all mammal hairs, while in contrast, bat hairs were difficult to degrade by nearly all tested dermatophyte species. Zoophilic species showed more activity than anthropophilic dermatophytes, but hair degradation profiles were not diagnostic for particular dermatophyte species. [ABSTRACT FROM AUTHOR]

ABSTRACT Superficial infections of the skin, hair, and nails by fungal dermatophytes are the most prevalent of human mycoses, and many infections are refractory to treatment. As current treatment options are limited, recent research has explored drug synergy with azoles for dermatophytoses. Bisphosphonates, which are approved to treat osteoporosis, can synergistically enhance the activity of azoles in diverse yeast pathogens but their activity has not been explored in dermatophytes or other molds. Market bisphosphonates risedronate, alendronate, and zoledronate (ZOL) were evaluated for antifungal efficacy and synergy with three azole antifungals: fluconazole (FLC), itraconazole (ITR), and ketoconazole (KET). ZOL was the most active bisphosphonate tested, displaying moderate activity against nine dermatophyte species (MIC range 64–256 µg/mL), and was synergistic with KET in eight of these species. ZOL was also able to synergistically improve the anti-biofilm activity of KET and combining KET and ZOL prevented the development of antifungal resistance. Rescue assays in Trichophyton rubrum revealed that the inhibitory effects of ZOL alone and in combination with KET were due to the inhibition of squalene synthesis. Fluorescence microscopy using membrane- and ROS-sensitive probes demonstrated that ZOL and KET:ZOL compromised membrane structure and induced oxidative stress. Antifungal activity and synergy between bisphosphonates and azoles were also observed in other clinically relevant molds, including species of Aspergillus and Mucor. These findings indicate that repurposing bisphosphonates as antifungals is a promising strategy for revitalising certain azoles as topical antifungals, and that this combination could be fast-tracked for investigation in clinical trials.IMPORTANCEFungal infections of the skin, hair, and nails, generally grouped together as “tineas” are the most prevalent infectious diseases globally. These infections, caused by fungal species known as dermatophytes, are generally superficial, but can in some cases become aggressive. They are also notoriously difficult to resolve, with few effective treatments and rising levels of drug resistance. Here, we report a potential new treatment that combines azole antifungals with bisphosphonates. Bisphosphonates are approved for the treatment of low bone density diseases, and in fungi they inhibit the biosynthesis of the cell membrane, which is also the target of azoles. Combinations were synergistic across the dermatophyte species and prevented the development of resistance. We extended the study to molds that cause invasive disease, finding synergy in some problematic species. We suggest bisphosphonates could be repurposed as synergents for tinea treatment, and that this combination could be fast-tracked for use in clinical therapy.

A case study published in the Clinical & Experimental Dermatology journal highlights the emergence of terbinafine-resistant Trichophyton indotineae, a novel dermatophyte species, causing extensive dermatophytosis in a traveler returning to London, UK. The patient, a 26-year-old White man, presented with widespread, pruritic plaques on various body sites after traveling to Central and South America. Despite multiple treatments, including terbinafine, the infection persisted until it was successfully treated with itraconazole. The study emphasizes the need for clinicians to consider T. indotineae in cases of tinea corporis with widespread plaques and highlights the importance of mycological investigation and accurate diagnostic testing for effective management of this emerging drug-resistant dermatophytosis. [Extracted from the article]

Background: Superficial mycoses are fungal infections limited to the outermost layers of the skin and its appendages. The chief causative agents of these mycoses are dermatophytes and yeasts. The diagnosis of dermatophytosis can be made by direct mycological examination with potassium hydroxide (10%–30%) of biological material obtained from patients with suspected mycosis, providing results more rapid than fungal cultures, which may take days or weeks. This information, together with clinical history and laboratory diagnosis, ensures that the appropriate treatment is initiated promptly. However, false negative results are obtained in 5%–15%, by conventional methods of diagnosis of dermatophytosis. Objectives: To study the metabolic profiles of the commonly occurring dermatophytes by NMR spectroscopy. Patients/Materials: We have used 1D and 2D Nuclear Magnetic Resonance (NMR) experiments along with Human Metabolome Database (HMDB) and Chenomx database search for identification of primary metabolites in the methanol extract of two fungal species: Trichophyton mentagrophyte (T. mentagrophyte) and Trichophyton rubrum (T. rubrum). Both standard strains and representative number of clinical isolates of these two species were investigated. Further, metabolic profiles obtained were analysed using multivariate analysis. Results: We have identified 23 metabolites in the T. mentagrophyte and another 23 metabolites in T. rubrum. Many important metabolites like trehalose, proline, mannitol, acetate, GABA and several other amino acids were detected, which provide the necessary components for fungal growth and metabolism. Altered metabolites were defined between Trichophyton mentagrophyte and T. rubrum strains. Conclusion: We have detected many metabolites in the two fungal species T. mentagrophyte and T. rubrum by using NMR spectroscopy. NMR spectroscopy provides a holistic snapshot of the metabolome of an organism. Key metabolic differences were identified between the two fungal strains. We need to perform more studies on metabolite profiling of the samples from these species for their rapid diagnosis and prompt treatment. [ABSTRACT FROM AUTHOR]

Background: Terbinafine, an allylamine antifungal, is crucial for treating dermatophytosis by inhibiting squalene epoxidase (SQLE) in the ergosterol biosynthetic pathway. However, resistance is emerging, particularly in India and Southeast Asia, but reports of resistance spread worldwide. Despite this, comprehensive studies on terbinafine resistance in Trichophyton are still limited. Objectives: This research aimed to determine the prevalence of terbinafine resistance in the Czech Republic, with a focus on Trichophyton rubrum and Trichophyton mentagrophytes, and investigate the underlying molecular mechanisms. Patients/Methods: A total of 514 clinical strains of T. rubrum and 240 T. mentagrophytes collected from four Czech clinical institutions were screened for terbinafine resistance. Molecular investigations included DNA sequencing, specifically the ITS rDNA region and SQLE gene, as well as antifungal susceptibility testing following EUCAST guidelines. Results: While no resistance was observed in T. rubrum, 2.5% of T. mentagrophytes strains exhibited resistance, marked by the F397L mutation in SQLE. Notably, resistance surged from 1.2% in 2019 to 9.3% in 2020 but reverted to 0% in 2021. All resistant strains were identified as T. mentagrophytes var. indotineae. Resistant strains exhibited high MICs for terbinafine (≥4 mg L−1) but low MICs to the other seven antifungals tested except for fluconazole. Conclusions: This study highlights the emergence of terbinafine‐resistant T. mentagrophytes strains in the Czech Republic, with the F397L mutation being pivotal. Due to the relatively low resistance level, the current guidelines for dermatomycosis treatment in the Czech Republic remain effective, but ongoing surveillance is essential for timely adaptations if resistance patterns change. [ABSTRACT FROM AUTHOR]

Background: Trichophyton rubrum and Trichophyton mentagrophytes variant interdigitalis are the most frequent etiologic agents of onychomycosis. Diagnosis of certainty requires mycological examination, which often results unfeasible. Objectives: The aim of our study is to describe pathogen specific dermoscopic features, allowing a differential diagnosis without the need for cultural examination, in order to prescribe the most appropriate treatment anyway. Patients and methods: We conducted an observational retrospective study on 54 patients with a culture proven diagnosis of distal subungual onychomycosis of the toenail, caused by Trichophyton rubrum or Trichophyton mentagrophytes variant interdigitalis. Using a videodermatoscope we collected data on nail colour (white, yellow, orange, brown, dark) and on dermoscopic patterns (aurora, spikes, jagged, ruin, linear edge, dots, striae). Results: Fifty-four patients, with a total of 72 nails, were eligible for this study. Analysing the association between discoloration of the nail plate and type of infection (T. rubrum or T. interdigitalis), no correlation turned out to be statistically significant. Instead, significant associations between spikes and T. rubrum infection and striae and infection from T. interdigitalis were identified. Finally, a 100% specificity was identified for white colour and ruin pattern for T. rubrum infection, and brown colour, jagged border and aurora pattern for T. interdigitalis. Conclusions: Trying to find relationships between specific pathogens and dermoscopic patterns, we found out an association between spikes and striae and T. rubrum and T. interdigitalis respectively. Further larger studies are however necessary to evaluate our preliminary findings. [ABSTRACT FROM AUTHOR]

Background: The number of terbinafine-resistant Trichophyton indotineae is increasing in recent years while the treatment is still a matter to discuss. Objectives: To explore the best therapeutic approach, we present real-world treatment of T. indotineae infection by analysing publicly available data. Methods: We have reviewed all published articles, mainly including case reports and case series, on the drug-resistant T. mentagrophytes complex by using the key search terms to search the databases. Results: We enrolled 25 articles from 14 countries, including 203 times of treatment information for 113 patients. The cure rate of itraconazole 200 mg per day at the fourth, eighth and the twelfth week were 27.27%, 48.48% and 54.55%, respectively, which was significantly higher than terbinafine 250 mg per day (8.77%, 24.56% and 28.07%) and even 500 mg/d terbinafine. Griseofulvin 500-1000 mg for 2-6 months may be effective while fluconazole had no record of successful treatment. Voriconazole and ravuconazole had potential therapeutic efficacy. Topical therapy alone showed limited therapeutic efficacy, but the combination with oral antifungals can be alternative. Conclusion: Oral itraconazole 200 mg per day for 4-8 weeks was the most effective treatment out of these commonly used antifungal drugs, and can be prior selection. [ABSTRACT FROM AUTHOR]

Introduction: Wrestling, considered the national sport of Iran, has gained immense popularity among Iranians. Wrestlers frequently encounter skin conditions, with dermatophyte fungal infections, particularly tinea gladiatorum (TG), being a common issue. TG, caused by the Trichophyton genus, has emerged as a major health concern for wrestlers and other contact sport athletes worldwide. This study aimed to assess the genotypic diversity and antifungal susceptibility of Trichophyton tonsurans isolates responsible for TG in Iranian wrestlers from Mazandaran province, northern Iran. Materials and Methods: A total of 60 clinical T. tonsurans isolates collected from various cities in Mazandaran, were included in the study. The isolates were identified through PCR-restriction fragment length polymorphism and sequencing methods. Genomic DNA was extracted from these isolates, and the non-transcribed spacer (NTS) region of ribosomal RNA (rRNA) was targeted for genotyping using newly designed primers. Haplotype analysis was performed to explore genetic diversity, and antifungal susceptibility to terbinafine (TRB) and itraconazole (ITC) was assessed. Results: The results revealed five distinct NTS types: NTS-I, NTS-II, NTS-III, NTS-IV and NTS-V, with NTS-IV being the most prevalent. The distribution of NTS types varied across different cities, suggesting potential transmission patterns among wrestlers. Antifungal susceptibility testing showed that all isolates were susceptible to TRB, while one isolate demonstrated resistance to ITC. Genotypic diversity was not correlated with antifungal susceptibility, emphasising the importance of monitoring susceptibility to ensure effective treatment. Haplotype analysis highlighted significant genetic diversity among the T. tonsurans isolates. This diversity may be attributed to factors such as human-to-human transmission, geographic location and lifestyle changes. The study's findings underscore the need for comprehensive genotypic analysis to understand the epidemiology and evolution of T. tonsurans infections in athletes. Conclusion: In conclusion, this study provides valuable insights into the genotypic diversity and antifungal susceptibility of T. tonsurans isolates causing TG in Iranian wrestlers. The presence of multiple NTS types and varying susceptibility patterns highlights the complexity of T. tonsurans infections in this population. Further research is warranted to track the transmission routes and genetic evolution of T. tonsurans strains among wrestlers and develop effective control measures. [ABSTRACT FROM AUTHOR]

Kerion Celsi is an inflammatory, deep fungal infection of the scalp. It is rare in neonates but gets more common in children about 3 years and older. It represents with swelling, boggy lesions, pain, alopecia and purulent secretions. Secondary bacterial infection is not unusual after maceration. Extracutaneous manifestations include regional lymphadenopathy, fever and very rare fungemia. Id-reactions can occur. Diagnosis is based on clinical suspicion, clinical examination and medical history. Diagnosis should be confirmed by microscopy, fungal culture and molecular procedures. The most common isolated fungal species are anthropophilic Trichophyton (T.) tonsurans and zoophilic Microsporum (M.) canis, while geophilic species and moulds rarely cause Kerion Celsi. Treatment is medical with systemic and topical antifungals supplemented by systemic antibiotics when necessary, while surgery needs to be avoided. Early and sufficient treatment prevents scarring alopecia. The most important differential diagnosis is bacterial skin and soft tissue infections. [ABSTRACT FROM AUTHOR]

Trichophyton rubrum is the leading causative agent of dermatophytosis worldwide. Keratinocytes are the first line of defense that drives an immune response against fungal invasion. Host-specific pattern recognition receptors (PRRs) recognize pathogen-associated molecular patterns (PAMPs) to trigger immunological pathways. Fungal cell wall components are the primary sources of fungal PAMPs, and some pathogens increase cell wall rearrangement to evade the immune system. Glycolysis and enhanced lactate levels are critical for improving host immune responses to fungal infections. Using reverse transcription–quantitative polymerase chain reaction (RT-qPCR), we evaluated the transcriptional responses of human genes involved in fungal recognition and glycolytic metabolism and fungal cell-wall-related genes in a co-culture model of human keratinocytes with T. rubrum. We observed the upregulation of several Toll-like receptors (TLRs), NOD-like receptors (NLRs), and glycolytic genes. Complementarily, we measured intra- and extracellular glucose levels and the increase in lactate production in the co-culture supernatant. We noted a distinct transcriptional regulation pattern of fungal cell-wall-related genes from fungal growth on keratin as the primary carbon source compared to co-culture with human keratinocytes. Our results showed new insights into the transcriptional adaptation of keratinocytes, particularly in regulating genes involved in sensing and metabolic processes, during the interaction with T. rubrum. [ABSTRACT FROM AUTHOR]

The increase in incidence of superficial fungal infections combined with the emergence of antifungal resistance represents both a global health challenge and a considerable economic burden. Recently, dermatophytes, the main culprit causing superficial fungal infections, have started to exhibit antifungal resistance. This can be observed in some of the most common species such as Trichophyton rubrum and Trichophyton mentagrophytes. Importantly, the new subspecies, known as Trichophyton indotineae, has been reported to show high resistance to terbinafine, a first-line treatment for dermatophyte infections. Compounding these issues is the realization that diagnosing the causative infectious agents requires using molecular analysis that goes beyond the conventional macroscopic and microscopic methods. These findings emphasize the importance of conducting antifungal susceptibility testing to select the appropriate antifungal necessary for successful treatment. Implementing these changes may improve clinical practices that combat resistant dermatophyte infections. [ABSTRACT FROM AUTHOR]

Rose bengal (RB) solutions coupled with a green laser have proven to be efficient in clearing resilient nail infections caused by Trichophyton rubrum in a human pilot study and in extensive in vitro experiments. Nonetheless, the RB solution can become diluted or dispersed over the tissue and prevented from penetrating the nail plate to reach the subungual area where fungal infection proliferates. Nanoparticles carrying RB can mitigate the problem of dilution and are reported to effectively penetrate through the nail. For this reason, we have synthesized RB‐encapsulated chitosan nanoparticles with a peak distribution size of ~200 nm and high reactive oxygen species (ROS) production. The RB‐encapsulated chitosan nanoparticles aPDT were shown to kill more than 99% of T. rubrum, T. mentagrophytes, and T. interdigitale spores, which are the common clinically relevant pathogens in onychomycosis. These nanoparticles are not cytotoxic against human fibroblasts, which promotes their safe application in clinical translation. [ABSTRACT FROM AUTHOR]

Background: Thuja orientalis generally recognized as Chinese arborvitae, placed under the family Cupressaceae is a commonly available medicinal plant in India. Objectives: In present research work Thuja leaves essential oil stored in three temperatures for two-years storage periods was evaluated against fungi causing ring worm infection in man. Materials and Methods: Thuja oil was hydro-distilled and stored for 24 months in airtight amber glass bottles at three distinct temperatures. MIC was determined through semi solid agar diffusion method containing BHIA medium. Anti-dermtophytic activity of stored oil was examined in triplets after every fourth month of storage up to 2 years. Results: Oil stored in refrigerator was found to be more stable up to two year of storage time. No activity changes were observed in this condition against all test fungi. While variable temperature condition of room temperature was found less suitable for the storage of oil. MIC against Candida albicans was increased 40% after 2 years (>3.5 μL/mL) and 66% against Microsporum fulvum. Oil stored at 30ºC temperature condition was found more stable upto IV testing. Slightly changes were observed during Vth testing against C. albicans, M. fulvum and M. canis. Conclusion: Present study concluded that essential oil of Thuja put away in chilliness condition can reserved their quality and properties of antifungal behaviour for long time. Accordingly, putting away of volatile oil ointment items in coolness (beneath 8ºC) condition is best guidelines for long term use of therapeutic items. [ABSTRACT FROM AUTHOR]

Trichophyton rubrum is the primary causative agent of dermatophytosis worldwide. This fungus colonizes keratinized tissues and uses keratin as a nutritional source during infection. In T. rubrum–host interactions, sensing a hostile environment triggers the adaptation of its metabolic machinery to ensure its survival. The glyoxylate cycle has emerged as an alternative metabolic pathway when glucose availability is limited; this enables the conversion of simple carbon compounds into glucose via gluconeogenesis. In this study, we investigated the impact of stuA deletion on the response of glyoxylate cycle enzymes during fungal growth under varying culture conditions in conjunction with post-transcriptional regulation through alternative splicing of the genes encoding these enzymes. We revealed that the ΔstuA mutant downregulated the malate synthase and isocitrate lyase genes in a keratin-containing medium or when co-cultured with human keratinocytes. Alternative splicing of an isocitrate lyase gene yielded a new isoform. Enzymatic activity assays showed specific instances where isocitrate lyase and malate synthase activities were affected in the mutant strain compared to the wild type strain. Taken together, our results indicate a relevant balance in transcriptional regulation that has distinct effects on the enzymatic activities of malate synthase and isocitrate lyase. [ABSTRACT FROM AUTHOR]

A Filipino woman in her forties had facial erythema that was being self-treated with over-the-counter (OTC) drugs purchased outside of Japan. The drugs included clobetasol propionate, antibiotic, and antifungal components. Her facial erythema symptoms were worse during summertime. KOH direct examination of annular erythema was positive for fungal hyphae and negative for Demodex folliculorum. Fungal culture revealed Trichophyton indotineae based on internal transcribed spacer sequence analysis. Minimal inhibitory concentration for terbinafine was 0.06 µg/mL. We made a diagnosis of tinea faciei with steroid rosacea. We treated the patient with oral itraconazole. Physicians should be aware of increasing T. indotineae infections and increasing self-medication using topical OTC steroids combined with antifungals and antibiotics not only in India but also among foreign people living in other countries such as Japan. [ABSTRACT FROM AUTHOR]

Trichophytosis (ringworm) is included in the category of dermatomycoses or superficial mycoses, being a fungal infection, produced by a microscopic fungus of the genus Trichophyton. Since in recent decades an increase in the incidence of trichophytosis has been observed in humans and susceptible animals, either with asymptomatic or symptomatic evolution, a more detailed knowledge of the important sources of transmission of this disease from animals to humans is still required, for the adoption of more effective parasitological surveillance measures for this dermatophytosis. In this sense, it is necessary to know some aspects related to the morphology, the epidemiological implications and the correct establishment of the diagnosis, but also the choice of effective therapeutic protocols to prevent, treat and combat this dermatomycosis in animals and humans. In this regard, a growing interest has been given in recent years to pets that represent a permanent risk of human contamination, but the evolution of this disease in farm animals cannot be neglected. [ABSTRACT FROM AUTHOR]

This study used to be conducted in the Graduate Studies Laboratory at the College of Science, Kirkuk University in Iraq from 11/7/2021 to 25/5/2022 with the aim of investigating the fungi causing motive pores and skin ailments, i.e., dermatomycosis in the human physique (tinea corporis) and the incidence of Trichophyton mentagrophytes. A total of 120 samples were collected from sufferers referred to the Dermatology Consultant at Azadi Teaching Hospital and some non-public clinics in Kirkuk, age groups ranging from 1 to 60 years and both genders. All samples were examined and recognized using traditional methods and using culture media for the fungi. The direct microscopic examination of the fungi showed positive results, with an infection rate of 66.66%, while the laboratory culture showed positive results, with 49.16%. The results of the phenotypic examinations of the isolated dermatophytes showed that they belong to the two genera, Trichophyton and Microsporum. The results showed that Trichophyton was the most diagnosed specimen compared to Microsporum. The least patient specimen was diagnosed, and 5 species of Trichophyton were isolated, T. mentagrophytes exhibited the highest prevalence (9.2%), while the lowest belonged to T. interdigitale (2.5%). In the case of Microsporum, two species were isolated, so that, the infection rate of males (33.33%) was higher than that of females (15.83%). The result showed the highest infection rate of T. mentagrophytes in the age group 21-30 years, while the lowest among the group 50-61. After final identification of T. mentagrophytes by PCR, the consequences of the PCR assay were sent to the Genebank website to verify the kind of fungus through comparing it with the fungi registered at this site. [ABSTRACT FROM AUTHOR]

In a tropical country like India, the warm and humid climate plays an important role in the increased incidence of superficial fungal infections. This is a study to identify the causative fungi of dermatophytosis and their in vitro antifungal susceptibility pattern among patients reporting to multiple tertiary care hospitals. Skin scrapping, nail clipping, and hair follicles were processed for microscopy, culture, and antifungal susceptibility testing as per standard guidelines. Antifungal susceptibility was performed as per published by Clinical Laboratory Standards Institute for yeasts (M27–A3) and filamentous fungi (M38–A2). The study sample had a predominantly male population with the commonest age group being 21–30 years (39.57%) followed by 31–40 years (31.46%). Tinea corporis (57.30%) was the most common clinical presentation followed by tinea cruris (20.85%) and onychomycosis (14.73%). Microscopy positivity was 43.19%, while culture positivity was 23.97%. Dermatophytes accounted for the majority of isolates. All fungal isolates had high minimum inhibitory concentration (MIC) to fluconazole, suggesting that dermatophytes are possibly resistant to this drug. Trichophyton mentagrophytes is confirmed as the dominant pathogen of dermatophytosis in all three tertiary care hospitals. [ABSTRACT FROM AUTHOR]

Background: The annual increase in the number of camels entails a parallel increase in the incidence of trichophytosis, which poses a great threat to the health and life of both this species of animals and other organisms that contact and surround them. Aim: The aim of the study was to develop and establish the quality of vaccines inactivated by ultrasonic exposure for the prevention and treatment of trichophytosis in camels, and to compare them with chemically deactivated vaccines. Methods: The peculiarity of the technology of production of these vaccines was the use of an innovative method of inactivation of fungal strains by ultrasonic waves, which allowed to achieve high positive results in theory, and was subsequently confirmed in practice by immunizing sick and healthy animals. The first tests of the obtained vaccines were conducted in laboratory conditions on experimental rabbits. Results: The results of prophylactic and therapeutic vaccinations were one hundred percent positive, which made it possible to conduct further tests directly on camels of industrial farms, the expected result of which was also positively confirmed at the end of the research. Conclusion: As a result of this experiment, the effectiveness, stability, and safety of the manufactured vaccines were established, which made it possible to approve the regulatory and technical documentation and patent them as an innovative and effective development for the prevention and treatment of camel trichophytosis, which will reduce the growth of infection and further overcome the mass spread of the disease both among camels and among the surrounding organisms to which it is transmitted. [ABSTRACT FROM AUTHOR]

Pet hedgehogs, which are increasingly favoured companions, have garnered attention due to their potential as carriers of zoonotic diseases. These small insectivorous mammals, native to Europe, Asia, and Africa, are commonly kept as pets. The encroachment of humans into hedgehog habitats has brought these animals closer to people, raising concerns about disease transmission. This article reviews the current knowledge regarding zoonotic disease associated with pet hedgehogs, with a particular focus on mycotic infections caused by Trichophyton erinacei. Data from various regions and hedgehog species are synthesised to assess the significance of pet hedgehogs as potential reservoirs and transmitters of zoonotic pathogens. Our study highlights the importance of understanding the health risks associated with pet hedgehogs and underscores the need for continued research to mitigate zoonotic disease transmission from these potentially disease-carrying companions. [ABSTRACT FROM AUTHOR]

The essential oils of aromatic and medicinal plants are an important resource used to control several health conditions; however, information about their composition and antimicrobial activity is scarce. This study used a gas chromatography-mass spectrometry (GC-MS) to analyze the composition of the essential oil (EO) of Tagetes lunulata Ort., a Mexican endemic plant, known as wild cempaxúchitl. The major components of the EO include: verbenone (47.17%), α-pinene (10.93%), 1,1,1-Trifluoro-2-hexanone (9.63%), β-caryophyllene (6.10%), germacrene-D (4.99%), L-verbenone (4.89%), and E-tagetone (4.44%). The disk agar diffusion method was used to evaluate the antimicrobial activity of T. lunulata against Trichophyton rubrum (athlete's foot). A significant antimicrobial activity was observed with a ≥60% EO concentration. The dilution method was used to determine the minimum inhibitory concentration (MIC): 200 µg ml-1. The T. lunulata EO recorded a strong antimicrobial activity against T. rubrum; therefore, it is a natural alternative for the control of natural antifungals. [ABSTRACT FROM AUTHOR]

From 2014-2019, 8 juvenile black bears (Ursus americanus) from different geographic regions were presented to the California Department of Fish and Wildlife because of emaciation, alopecia, and exfoliative dermatitis that resulted in death or euthanasia. Autopsy and histopathology revealed that all 8 bears had generalized hyperkeratotic dermatitis, folliculitis, and furunculosis. Skin structures were heavily colonized by fungal hyphae and arthrospores; fungal cultures of skin from 7 bears yielded Trichophyton equinum, a zoophilic dermatophyte reported only rarely in non-equid species. Additional skin conditions included mites (5), ticks (2), and coagulase-negative Staphylococcus sp. infections (2). No other causes of morbidity or mortality were identified. Molecular comparisons performed at the University of Texas Fungal Reference Laboratory determined that all isolates produced identical banding patterns, potentially representing a clonal population. Dermatophytosis is commonly localized and limited to the stratum corneum of the epidermis and hair follicles. Generalized disease with dermal involvement is rare in immunocompetent individuals; illness, malnutrition, age, or immunosuppression may increase susceptibility. Underlying causes for the severe disease impact in these bears were not evident after physical or postmortem examination. The mechanism by which bears from different geographic locations had severe, T. equinum-associated dermatophytosis from a potentially clonal dermatophyte could not be explained and warrants further investigation.

A recent article in the British Journal of Dermatology reports on the emergence of a cluster of multidrug-resistant Trichophyton indotineae, a fungus that causes recalcitrant dermatophytosis, in China. While previous cases of this infection have been reported in other countries, this is the first domestic case in China without a history of foreign travel, suggesting local transmission. The article presents 14 new cases of T. indotineae infection, describing the clinical features and resistance of the pathogenic isolates. The strains were found to be highly resistant to multiple antifungals, including terbinafine, itraconazole, fluconazole, posaconazole, and griseofulvin. The authors recommend considering T. indotineae infection in challenging-to-treat dermatophytosis cases and emphasize the need for ongoing public health surveillance to monitor the potential epidemic. [Extracted from the article]

Key Clinical Message: While the initial lesions of tinea capitis are often overlooked due to their small size and numerous hairs emerging from the follicle, it is crucial not to dismiss the partial presence of comma or harpin hairs and black spots. [ABSTRACT FROM AUTHOR]

We describe a case of tinea genitalis in an immunocompetent woman in Pennsylvania, USA. Infection was caused by Trichophyton indotineae potentially acquired through sexual contact. The fungus was resistant to terbinafine (first-line antifungal) but improved with itraconazole. Clinicians should be aware of T. indotineae as a potential cause of antifungal-resistant genital lesions. [ABSTRACT FROM AUTHOR]

This article discusses a case of multidrug-resistant Trichophyton rubrum, a fungus that commonly causes skin infections. The patient, a 67-year-old woman, had large-scale plaques on her abdomen, groins, legs, and gluteal area that had not responded to various topical and systemic antifungal treatments. Resistance testing revealed that the fungus was resistant to terbinafine and itraconazole, and had a high minimum inhibitory concentration (MIC) for fluconazole. The patient was eventually treated with voriconazole, which led to complete remission. The article emphasizes the importance of resistance testing in cases of treatment failure or relapse to choose effective treatment and prevent the spread of resistance. [Extracted from the article]

Background: The annual increase in the number of camels entails a parallel increase in the incidence of trichophytosis, which poses a great threat to the health and life of both this species of animals and other organisms that contact and surround them. Aim: The aim of the study was to develop and establish the quality of vaccines inactivated by ultrasonic exposure for the prevention and treatment of trichophytosis in camels, and to compare them with chemically deactivated vaccines. Methods: The peculiarity of the technology of production of these vaccines was the use of an innovative method of inactivation of fungal strains by ultrasonic waves, which allowed to achieve high positive results in theory, and was subsequently confirmed in practice by immunizing sick and healthy animals. The first tests of the obtained vaccines were conducted in laboratory conditions on experimental rabbits. Results: The results of prophylactic and therapeutic vaccinations were one hundred percent positive, which made it possible to conduct further tests directly on camels of industrial farms, the expected result of which was also positively confirmed at the end of the research. Conclusion: As a result of this experiment, the effectiveness, stability and safety of the manufactured vaccines were established, which made it possible to approve the regulatory and technical documentation and patent them as an innovative and effective development for the prevention and treatment of camel trichophytosis, which will reduce the growth of infection and further overcome the mass spread of the disease both among camels and among the surrounding organisms to which it is transmitted. [Open Vet J 2023; 13(7.000): 864-872]

Background: Dermatophytes are the most common causative pathogens of mycoses worldwide and usually cause superficial infections. However, they can enter deep into the dermis lead to invasive dermatophytosis such as deeper dermal dermatophytosis on rare occasions. Erythroderma is a severe dermatological manifestation of various diseases resulting in generalized skin redness, but erythroderma due to fungi infections is barely reported. In this article, we reported the first case of erythroderma combined with deeper dermal dermatophytosis due to Trichophyton rubrum (T. rubrum) in a patient with myasthenia gravis. Case presentation: A 48-year-old man was hospitalized because of erythema with scaling and nodules covering his body for a month. The patient had a history of myasthenia gravis controlled by regularly taking prednisolone for > 10 years and accompanied by onychomycosis and tinea pedis lasting > 8 years. Based on histopathological examinations, fungal cultures, and DNA sequencing results, the patient was finally diagnosed with dermatophyte-induced erythroderma combined with deeper dermal dermatophytosis caused by T. rubrum. After 2 weeks of antifungal treatment, the patient had recovered well. Conclusions: This case report shows that immunosuppressed patients with long histories of superficial mycoses tend to have a higher risk of developing invasive dermatophytic infections or disseminated fungal infections. Dermatologists should be alert to this condition and promptly treat the superficial dermatophytosis. [ABSTRACT FROM AUTHOR]

Background: Trichophyton benhamiae, an anthropophilic dermatophyte, can cause dermatophytosis in humans and animals with rising zoonotic infections through pets, primarily in Europe. Dermatophytosis from T. benhamiae is often misdiagnosed due to its inflammatory symptoms. We report a case of tinea corporis from T. benhamiae var. luteum in a Japanese woman, contracted from pet Czech degus. Case: The 40-year-old patient developed neck papules resembling acne. Initial treatment with topical antibiotics and steroids exacerbated the rash. Fungal elements were not detected by direct potassium hydroxide examination. Skin biopsy confirmed fungal elements in the stratum corneum and hair follicles, and tinea corporis was diagnosed. Oral terbinafine 125 mg was initiated without topical agents. Erythematous papules appeared on her limbs, determined as a trichophytid reaction. After two months, her skin improved significantly. Fungal culture identified T. benhamiae var. luteum colonies with a yellowish hue. Mating tests classified the strain as Americano-European race (−) with MAT1-1 genotype. This was diagnosed as tinea corporis from T. benhamiae var. luteum, likely transmitted from pet Czech degus. Conclusions: The incidence rate of pet-transmitted cutaneous fungal infections may increase in Japan with the trend to keep exotic pets. Dermatologists must recognize dermatophytosis clinical features from anthropophilic dermatophytes to prevent misdiagnosis and understand evolving nomenclature and pathogenesis. [ABSTRACT FROM AUTHOR]

Tinea capitis is a common dermatophyte infection of the scalp in children. It is an uncommon infection in adults and usually affects postmenopausal women and immunocompromised patients. We report an immunocompetent elderly female with inflammatory tinea capitis caused by Trichophyton violaceum and review the literature for the past 5 years to describe the disease, its epidemiologic characteristics, dermatophyte species involved and treatment options used. The total number of cases was 11, including 8 women and 3 men, with an average age of 48.36. The most commonly isolated dermatophyte was Trichophyton tonsurans, and most cases were treated successfully with oral terbinafine with no side effects. In our case, the diagnosis was established by direct examination, culture and histological examination. Remedy with itraconazole and prednisolone was very successful. Early diagnosis of tinea capitis in adults is necessary to provide early treatment and minimize sequelae of the disease. [ABSTRACT FROM AUTHOR]

This research aims to analyze and optimize the antifungal property of a composite material made of polyurethane (PUR) and silver nanoparticles (AgNPs) against the fungus Trichophyton rubrum to find the optimal parameters that allow the highest inhibition of the fungal growth to be used in healthcare aimed at the population vulnerable to fungal infections, such as people suffering from diabetes mellitus, thus creating an opportunity for the generation of antifungal products for healthcare applications. This study analyzes the effect of three variables on the antifungal properties of the composite material: nanoparticle size, concentration, and the application of an ultrasonic treatment as a method to aid the dispersion of the AgNPs into PUR matrix. The proposed methodology includes tests in accordance with a standar to evaluate the growth inhibition of the fungi on a culture medium. A categorical logistic regression model was adjusted from 23 factorial design with five replicates, which was optimized by the use of multi-objective genetic algorithms. The experimental factors showed a significant effect on the growth inhibition of the fungus, and the optimal levels were determined. [ABSTRACT FROM AUTHOR]

Introduction: Reactive sulphur species (RSS) have been recently discovered to be a part of a major endogenous antioxidant system. Nonetheless, the RSS was implicated as an underlying mechanism in reducing the efficacy of several antibiotics, such as penicillin and carbapenem. The emergence of drug resistance has been a global concern. In fact, several incidences on the azole resistant Trichophyton sp. isolates in the clinical setting, such as clotrimazole, have also been reported. Clotrimazole is a broad-spectrum antifungal commonly used in dermatophytosis management caused by the Trichophyton, Epidermophyton, and Microsporum genera. This study investigated the role of RSS, as a potential element underlying the resistance against clotrimazole. Methods: The Trichophyton rubrum growth in sulphide-rich environment was initially established by exposing towards several concentrations of sodium hydrosulphide (NaHS). Then, to investigate the potential interaction between the RSS and clotrimazole, the T. rubrum were treated with 1000 µM of clotrimazole, with or without co-treatment several concentrations of NaHS. Broth microdilution method was performed to observe the growth of the fungus. Results: As expected, clotrimazole exhibited cytotoxic effect towards T. rubrum at high concentration. Interestingly, the growth of T. rubrum was significantly recovered (p<0.01) in samples co-treated with clotrimazole (1000 µM) and NaHS in a dose-dependent manner. Co-treatment with the highest concentration of NaHS (1000 µM), the T. rubrum growth was recorded approximately 90%, despite being exposed to 1000 µM of clotrimazole. Conclusion: In conclusion, RSS potentially interferes with the efficacy of clotrimazole. The exact mechanism underlying such activity warrants further investigation. [ABSTRACT FROM AUTHOR]