Background Dermatophytosis is a world‐wide distributed common infection. Antifungal drug resistance in dermatophytosis used to be rare, but unfortunately the current Indian epidemic of atypical widespread recalcitrant and terbinafine‐resistant dermatophytosis is spreading and has sporadically been reported in Europe. Objectives To explore the occurrence of clinical and mycological proven antifungal drug resistance in dermatophytes in Europe. Methods A standardized questionnaire was distributed through the EADV Task Force of Mycology network to dermatologists in Europe. Results Representatives from 20 countries completed the questionnaires of which 17 (85 %) had observed clinical and/or mycological confirmed antifungal resistance, two countries published cases of antifungal resistance and one country had no known cases. Conclusions This pilot study confirms that both clinical and mycological antifungal resistance exist in Europe.

Background Superficial fungal infections are common. It is important to confirm the clinical diagnosis by mycological laboratory methods before initiating systemic antifungal treatment, especially as antifungal sensitivity and in vitro susceptibility may differ between different genera and species. For many years, the gold standard for diagnosis of superficial fungal infections has been direct fungal detection in the clinical specimen (microscopy) supplemented by culturing. Lately, newer molecular based methods for fungal identification have been developed. Objective This study was initiated to focus on the current usage of mycological diagnostics for superficial fungal infections by dermatologists. It was designed to investigate whether it was necessary to differentiate between initial diagnostic tests and those used at treatment follow‐up in specific superficial fungal infections. Methods An online questionnaire was distributed among members of the EADV mycology Task Force and other dermatologists with a special interest in mycology and nail disease. Results The survey was distributed to 62 dermatologists of whom 38 (61%) completed the whole survey, 7 (11%) partially completed and 17 (27%) did not respond. Nearly, all respondents (82–100%) said that ideally they would use the result of direct microscopy (or histology) combined with a genus/species directed treatment of onychomycosis, dermatophytosis, Candida‐ and Malassezia‐related infections. The majority of the dermatologists used a combination of clinical assessment and direct microscopy for treatment assessment and the viability of the fungus was considered more important at this visit than when initiating the treatment. Molecular based methods were not available for all responders. Conclusion The available diagnostic methods are heterogeneous and their usage differs between different practices as well as between countries. The survey confirmed that dermatologists find it important to make a mycological diagnosis, particularly prior to starting oral antifungal treatment in order to confirm the diagnose and target the therapy according to genus and species.

No abstract

ECMM 2002 phase with 10% KOH. The clinical specimens were cultured on Mycobiotic-agar Difco media tubes. Results: In 39% of patients the microscopic examination and culture procedures were both positive for fungal infection. Microsporum audouinii was the commonest aetiological agent (40.9%). The other fungi were M. canis (31%), Trichophyton soudanense (16.2%), T violaceum (2.8%), T nientagrophytes var. granulare (2.7%), T toiuurans (3.6%), T schoenleinii (0.3%), T verrucosum (O.l%), T megninii (0.1%) and M. gypseuin (0.3%). Conclusion: The predominance of "imported" dermatophytes (M. audouinii and Trichophyton soudanense) over the resident derniatophyte M. canis was shown in tinea capitis of children under 14 years old. The spread of these infections appear to correlate with the immigration of Africans to Portugal and deserve attention on their sanitary control.

Antagonistic activity of Malassezia yeast towards clinically significant yeast species was studied. Ten Malassezia strains exhibited this activity. M. furfur strain exhibited maximum activity and the least sensitivity to "foreign" metabolites. M. globosa proved to be the most sensitive and the least active. M. furfur metabolites exhibited pronounced activity towards 6 Basidiomycetes strains. This effect was significantly higher in comparison with antagonistic activity towards 13 Ascomycetes species. Studies of a complex of M. furfur antagonistic metabolites showed that it has at least two components: thermolabile proteins with molecular weights of 33 and 35 kDa and a thermostable one, proteinase-resistant. In contrast to metabolites of many other yeast species, this substance is more effective against related Basidiomycetes microorganisms (Cryptococcus albicans), while antagonistic proteins are active mainly towards Ascomycetes, such as Candida albicans. It was found that mycocin-like activity of Malassezia is encoded by chromosomes, but not plasmids.