Dermatophytosis in patients with human immunodeficiency virus infection: Clinical aspects and etiologic agents

Costa, J. R. da; Neves, Rejane Pereira; Delgado, Marília; Lima-Neto, Reginaldo Gonçalves de; Morais, Viviane Martha Santos de; Coêlho, Maria Rosângela Cunha Duarte

doi:10.1016/j.actatropica.2015.07.012

Cited by 29 publications

(21 citation statements)

References 21 publications

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“…This finding agrees with literature data and confirms the results from a recent Brazilian survey where onicomycosis and Tinea pedis were the most common clinical pictures in 84 HIV-infected patients evaluated [27]. In contrast, another study from the same country described a high frequency (70%) of Tinea corporis in 20 HIV-infected patients [28].…”

Section: Discussionsupporting

confidence: 92%

Dermatophytes Species Isolated of HIV-Infected Patients Identified by ITS-RFLP and ITS Region Sequencing from Triangulo Mineiro, Minas Gerais State of Brazil

Bragine-Ferreira¹,

eacute²,

uacute³

et al. 2019

AiM

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Dermatomycoses are a group of diseases worldwide distributed and affect skin, hair and nails. Several fungal species can be envolved and keratinophilic fungi belonging to the genera Trichophyton, Microsporum and Epidermophyton are very common. These infections are globally distributed and their incidence has progressively increased. Despite their high incidence, few studies have been carried out in HIV-infected patients, regarding frequency, clinical presentations, and species identification. This study aimed to evaluate some epidemiological and clinical aspects of dermatophytosis in HIV-infected patients and to attempt phenotypical and molecular characteristics of their agents. Of 398 patients included, 306 were HIV-infected. Clinical data and samples of skin, hair and nail lesions were simultaneously obtained. The dermatophytes yielded in culture were phenotypically identified and evaluated by ITS-RFLP and ITS (Internal Transcribed Space) sequencing. Dermatophytes frequency in HIV-infected patients with cutaneous lesions was 11.76% similar to the 15.22% observed in non-HIV individuals. Trichophyton rubrum was the most common isolated species in both groups. Throught ITS-RFLP, 29/32 (90.63%) of dermatophytes isolates were identified at the species level. From the 10 isolates randomly selected for ITS sequencing, seven confirmed the ITS-RFLP results while three Trichophyton sp. were not identified as dermatophytes. The identification of these species in HIV-infected patients is highly desirable in order to improve the knowledge of their fre-How to cite this paper: Bragine-Ferreira, T., de Lima-Júnior, L.

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Section: Discussionsupporting

confidence: 92%

Dermatophytes Species Isolated of HIV-Infected Patients Identified by ITS-RFLP and ITS Region Sequencing from Triangulo Mineiro, Minas Gerais State of Brazil

Bragine-Ferreira¹,

eacute²,

uacute³

et al. 2019

AiM

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“…TCR-mediated immunity is achieved by adaptive immune cells but also by innate cells as gd T cells. It is well known that CD4 þ T cells are a crucial component of the immune defense against dermatophytes (Heinen et al, 2017), and the importance of adaptive immunity is also emphasized by the high incidence of severe or long-lasting dermatophyte infections reported in patients with AIDS (Costa et al, 2015;Gupta et al, 2000). However, a recent report showed that adaptive immunity is dispensable for dermatophyte clearance in a mouse model of deep dermatophytosis, a rare condition induced by the anthropophilic pathogen Trichophyton rubrum (Dahl and Grando, 1994;Nenoff et al, 2014b).…”

Section: Discussionmentioning

confidence: 99%

Th1 and Th17 Immune Responses Act Complementarily to Optimally Control Superficial Dermatophytosis

Heinen

Cambier

Antoine

et al. 2019

Journal of Investigative Dermatology

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Dermatophytoses are among the most common fungal infections worldwide but little is known about the immune response in them. By comparing Trichophyton benhamiae acute superficial dermatophytosis in WT and Rag2 mice, we showed that TCR-mediated immunity is critical for fungal clearance and clinical recovery. In WT mice, CD4+ T-cells isolated from the skin-draining lymph nodes exhibit both Th1 and Th17 differentiation during infection, with regard to produced cytokines or mRNA levels of transcription factors. Using IL-17A- and IFN-γ-deficient mice, we showed that IL-17A and IFN-γ are individually dispensable, but together contribute to the optimal resolution of dermatophytosis. Furthermore, we generated and infected IL-17A and IFN-γ double-deficient mice and showed that both fungal clearance and clinical recovery were much lower in these mice than in single-deficient mice, suggestive of the complementary roles of the two cytokines in dermatophytosis resolution. Thus, our data suggest that TCR-mediated immunity is critical for the optimal control of superficial dermatophytosis and that adaptive immunity is polarized to both Th1 and Th17 responses, with the Th17 antifungal response acting on dermatophyte clearance and the Th1 one being involved in both fungal clearance and Th17-inflammation down-modulation.

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“… 6 – 12 T. rubrum is by far the most common cause of dermatophytosis worldwide and is the most common cause of tinea corporis in North America. 13 – 15 Tinea corporis secondary to tinea capitis is often caused by T. tonsurans . 16 On the other hand, tinea corporis resulting from close contact with dogs or cats is often caused by M .…”

Section: Etiologymentioning

confidence: 99%

Tinea corporis: an updated review

Leung¹,

Lam²,

Leong³

et al. 2020

DIC

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Background Tinea corporis is a common fungal infection that mimics many other annular lesions. Physicians must familiarize themselves with this condition and its treatment. Objective This article aimed to provide a narrative updated review on the evaluation, diagnosis, and treatment of tinea corporis. Methods A PubMed search was performed with Clinical Queries using the key term ‘tinea corporis.’ The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies, and reviews. The search was restricted to the English language. The information retrieved from the mentioned search was used in the compilation of the present article. Results Tinea corporis typically presents as a well-demarcated, sharply circumscribed, oval or circular, mildly erythematous, scaly patch or plaque with a raised leading edge. Mild pruritus is common. The diagnosis is often clinical but can be difficult with prior use of medications, such as calcineurin inhibitors or corticosteroids. Dermoscopy is a useful and non-invasive diagnostic tool. If necessary, the diagnosis can be confirmed by microscopic examination of potassium hydroxide wet-mount preparations of skin scrapings from the active border of the lesion. Fungal culture is the gold standard to diagnose dermatophytosis especially if the diagnosis is in doubt and results of other tests are inconclusive or the infection is widespread, severe, or resistant to treatment. The standard treatment of tinea corporis is with topical antifungals. Systemic antifungal treatment is indicated if the lesion is multiple, extensive, deep, recurrent, chronic, or unresponsive to topical antifungal treatment, or if the patient is immunodeficient. Conclusion The diagnosis of tinea corporis is usually clinical and should pose no problem to the physician provided the lesion is typical. However, many clinical variants of tinea corporis exist, rendering the diagnosis difficult especially with prior use of medications, such as calcineurin inhibitors or corticosteroids. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made and appropriate treatment initiated.

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Dermatophytosis in patients with human immunodeficiency virus infection: Clinical aspects and etiologic agents

Cited by 29 publications

References 21 publications

Dermatophytes Species Isolated of HIV-Infected Patients Identified by ITS-RFLP and ITS Region Sequencing from Triangulo Mineiro, Minas Gerais State of Brazil

Dermatophytes Species Isolated of HIV-Infected Patients Identified by ITS-RFLP and ITS Region Sequencing from Triangulo Mineiro, Minas Gerais State of Brazil

Th1 and Th17 Immune Responses Act Complementarily to Optimally Control Superficial Dermatophytosis

Tinea corporis: an updated review

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