The diagnosis and management of tinea

Moriarty, B.; Hay, Roderick J.; Morris‐Jones, Rachael

doi:10.1136/bmj.e4380

Cited by 123 publications

(101 citation statements)

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“…Tinea refers to superficial infection of skin, hair and nails due to one of three fungal genera, Microsporum, Epidermophyton and Trichophyton, collectively known as dermatophytes (Clayton & Midgley, 1989;Hay, 1995;Moriarty et al, 2012). These associated infections are among the most common diseases worldwide and cause serious chronic morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…The disease is often atypical and aggressive in patients with untreated human immunodeficiency virus infection. Patients with psoriasis not only have an increased risk of onychomycosis but also require laboratory confirmation as the two conditions may be clinically similar (Moriarty et al, 2012). Trichophyton rubrum is the main pathogen implicated (Brillowska-Dabrowska et al, 2007;Tsoumani et al, 2011), followed by Trichophyton interdigitale, formerly Trichophyton mentagrophytes var.…”

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confidence: 99%

“…interdigitale (Cafarchia et al, 2013;Clayton & Midgley, 1989; Gräser et al, 1999;Nenoff et al, 2007). Less commonly associated species are Epidermophyton floccosum and Trichophyton verrucosum (Moriarty et al, 2012). In addition to dermatophytes, Candida and non-dermatophyte moulds may be recovered from clinically affected nails; however, their clinical significance is controversial (Brillowska-Dabrowska et al, 2007).…”

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confidence: 99%

“…These associated infections are among the most common diseases worldwide and cause serious chronic morbidity. Tinea unguium, a dermatophyte infection of nails, also known as onychomycosis, has a prevalence of at least 12.4 % in the general population of Europe (Moriarty et al, 2012), whereas in older individuals it is as high as 50 % (Salgo et al, 2003). The disease is often atypical and aggressive in patients with untreated human immunodeficiency virus infection.…”

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Evaluation of a commercial PCR test for the diagnosis of dermatophyte nail infections

Spiliopoulou

Bartzavali

Jelastopulu

et al. 2015

Journal of Medical Microbiology

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Tinea unguium, known as onychomycosis, is a dermatophyte infection of nails with worldwide distribution. Conventional methods for detecting fungi in nail specimens are either non-specific (microscopy) or insensitive (culture). PCR has been used to improve sensitivity in detecting the causative fungi in nail specimens from patients with suspected onychomycosis. Results of a commercial multiplex PCR for the detection of dermatophytes, especially Trichophyton rubrum (the main dermatophyte implicated), as compared to conventional methods are presented. A total of 418 nail scrapings obtained from dermatological outpatients were handled in the Laboratory of Microbiology between May 2010 and May 2013. Among them, multiplex PCR detected 126 (30.1 %) dermatophyte-positive samples, whereas culture revealed 44 (10.5 %). Direct microscopy revealed 63 (15.1 %) positive specimens. T. rubrum was identified in 116 out of 126 (92 %) positive PCR samples and 40 out of 44 (91 %) dermatophyte-positive cultures. Implementation of PCR increased species-specific detection of dermatophytes by 21.1 %, leading to a threefold increase as compared to culture alone. Multiplex PCR offers a time-saving diagnostic tool for tinea unguium and augments laboratory assistance to clinical evaluation for proper treatment. INTRODUCTIONTinea refers to superficial infection of skin, hair and nails due to one of three fungal genera, Microsporum, Epidermophyton and Trichophyton, collectively known as dermatophytes (Clayton & Midgley, 1989;Hay, 1995;Moriarty et al., 2012). These associated infections are among the most common diseases worldwide and cause serious chronic morbidity. Tinea unguium, a dermatophyte infection of nails, also known as onychomycosis, has a prevalence of at least 12.4 % in the general population of Europe (Moriarty et al., 2012), whereas in older individuals it is as high as 50 % (Salgo et al., 2003). The disease is often atypical and aggressive in patients with untreated human immunodeficiency virus infection. Patients with psoriasis not only have an increased risk of onychomycosis but also require laboratory confirmation as the two conditions may be clinically similar (Moriarty et al., 2012). Trichophyton rubrum is the main pathogen implicated (Brillowska-Dabrowska et al., 2007;Tsoumani et al., 2011), followed by Trichophyton interdigitale, formerly Trichophyton mentagrophytes var. interdigitale (Cafarchia et al., 2013;Clayton & Midgley, 1989; Gräser et al., 1999;Nenoff et al., 2007). Less commonly associated species are Epidermophyton floccosum and Trichophyton verrucosum (Moriarty et al., 2012). In addition to dermatophytes, Candida and non-dermatophyte moulds may be recovered from clinically affected nails; however, their clinical significance is controversial (Brillowska-Dabrowska et al., 2007). Conventional diagnosis is based on detection of fungal elements by direct microscopy of clinical specimens, followed by culture and morphological identification of the fungus. The whole procedure is time-consuming, requiring 10 to 15 ...

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of a commercial PCR test for the diagnosis of dermatophyte nail infections

Spiliopoulou

Bartzavali

Jelastopulu

et al. 2015

Journal of Medical Microbiology

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show abstract

“…Tinea incognito usually occurs after inappropriate treatment with topical steroids. Wood's lamp examination, mycological culture, direct microscopy and molecular tehniques like polymerase chain reaction are the methods to reach a definitive diagnosis [1]. Dermatophyte infections can be managed with antifungal and keratolytic agents [2].…”

Section: Introductionmentioning

confidence: 99%