Ichthyosis associated with widespread tinea corporis: report of three cases

Abstract

Ichthyoses are a common group of keratinization disorders. A non-inflammatory generalized persistent skin desquamation is observed. It is characterized by increased cell turnover, thickening of the stratum corneum and functional changes of sebaceous and sweat glands. All of these favor fungal proliferation. Dermatophytes may infect skin, hair and nails causing ringworm or tinea. They have the ability to obtain nutrients from keratinized material. One of its most prevalent genera is Trichophyton rubrum. Although tineas and ichthyoses are quite common, the association of the two entities is rarely reported in the literature. Three cases of ichthyosis associated with widespread infection by T. rubrum are presented. Resistance to several antifungal treatments was responsible for worsening of ichthyosis signs and symptoms.

An IL-17–dominant immune profile is shared across the major orphan forms of ichthyosis

“…Based on case reports and our experience, Staphylococcus aureus, dermatophyte, and candidal infections occur not infrequently in patients with ichthyosis, although S aureus infections are less common than in those with moderate-to-severe AD. 99,[112][113][114][115][116] Even with an anti-IL-17 drug (secukinumab) for psoriasis, only about 1% of patients have mild-to-moderate mucocutaneous infections, predominantly candidal. 117,118 The reactive role of T H 17/IL-23 skewing to the barrier defects versus a primary pathogenic role in patients with ichthyosis can only be clarified through future studies with targeted antagonists, which include careful monitoring for mucocutaneous infections.…”

Management of congenital ichthyoses: European guidelines of care, part two

“…Some forms of CI seem to be more prone to develop recurrent skins infections, including ARCIs, notably HI, epidermolytic ichthyosis (EI), Netherton syndrome (NS) and keratitis–ichthyosis–deafness (KID) syndrome . Many patients with ARCIs or KID syndrome experience recurrent dermatophytosis (e.g. from Trichophyton rubrum ).…”

Congenital Ichthyosiform Erythroderma Superimposed with Chronic Dermatophytosis: A Report of Three Siblings

“…Several forms exist and are classified based on inheritance, clinical appearance, histopathology, and underlying systemic diseases. Cutaneous fungal colonization persists in these patients secondary to barrier defects, impaired cell‐mediated immunity , delayed scaling, thickened stratum corneum, and abnormal sebaceous and sweat glands .…”

“…The treatment for dermatophytosis in patients with ichthyosis is challenging, often requiring the use of systemic antifungal therapy. Fungistatic agents, such as imidazole and griseofulvin, can be ineffective and require increasingly higher doses and longer treatment courses . Terbinafine may be a super‐ior alternative to treat cutaneous infection with Trichophyton species , especially in individuals with ichthyosis , given its faster onset, fungicidal activity, shorter treatment courses, and ability to concentrate in the stratum corneum and penetrate hair follicles .…”