Elsevier

Clinics in Dermatology

Volume 28, Issue 2, March–April 2010, Pages 146-150
Clinics in Dermatology

The changing face of Microsporum spp infections
Edited by Mihael Skerlev, MD, Phd, Paola Miklić, MD
The changing face of Microsporum spp infections

https://doi.org/10.1016/j.clindermatol.2009.12.007Get rights and content

Abstract

Significant changes in epidemiology, etiology, and the clinical pattern of mycotic infections caused by Microsporum spp have been observed in recent years. Fungal infections caused by M canis, followed by M gypseum and M hominis, involving skin and its appendages, represent one of the most common diseases worldwide and a recalcitrant problem in dermatology that demands appropriate diagnostic and treatment strategies. The most striking clinical phenomena of superficial and kerion and other forms of tinea, such as tinea capitis, fungal infections of the glabrous skin (tinea pedis, manus, cruris et corporis), and even onychomycosis due to Microsporum spp are described, with emphasis on the changes that have occurred in the last decade. The data on significant differences in the prevalence and clinical pattern of the fungal skin infections caused by Microsporum spp today compared with the data at the beginning of the epidemic breakout might still be rather controversial, depending also on the patients' lifestyle and geography. In general, physicians should be aware of the clinical spectrum of mycotic infections due to Microsporum spp to avoid mistakes in identifying the fungal etiology and to provide patients with the proper therapy.

Introduction

Superficial fungal infections are of great importance in dermatologic practice. The clinical appearance of lesions consistent with fungal infections may simulate other dermatologic entities, making the diagnosis difficult.1 Fungal infections caused by Microsporum spp involving both the skin and the appendages represent one of the most common diseases and a challenging problem in dermatology.2 Significant changes in epidemiology, etiology, and the clinical pattern of mycotic infections due to Microsporum spp have recently been observed. The most striking clinical phenomena are described, taking into consideration the significant differences and specificities. Some changes have been observed in the epidemiology of Microsporum spp infections; however, the most significant have been detected in the clinical pattern.

Section snippets

Changes in epidemiology

Microsporum spp, especially M canis, are one of the most commonly reported causative agents of dermatomycoses worldwide, especially in Europe, including the Mediterranean and Central Europe, and major parts of Asia, Africa, and South America.3 In North America and the United Kingdom, however, tinea capitis is predominantly caused by Trichophyton tonsurans.4 Cats and dogs are the main reservoir of M canis as well as some other mammalian species, including rabbits.3 Human-to-human infection has

Tinea capitis

A significant increase in the incidence and a change in the clinical pattern of tinea capitis has been observed in recent decades.14 For example, the frequency of M canis infection in Croatia (Mediterranean and Central Europe) ranged from 1 case in the year 1978 verified by culture to 328 positive cultures in 2008 based on our own data from the Reference Laboratory for Dermatological Mycology and Parasitology of the Ministry of Health and Social Welfare of the Republic of Croatia of the

Treatment considerations

In most cases of glabrous skin involvement such as with tinea pedis or manus, topical antimycotic treatment should be sufficient, providing that the predisposing factors such as diabetes, immunodeficiency, antibiotic treatment, separation of the intertriginous regions, and proper clothing have been successfully managed. Tinea capitis, however, represents a clear indication for systemic antimycotic therapy. Tinea capitis caused by M canis has been recognized as difficult to treat. Lower cure

Conclusions

Significant changes in epidemiology, etiology, and the clinical pattern of Microsporum spp infections that require appropriate diagnostic and treatment strategy have been observed. The data on significant changes in the prevalence and clinical pattern of fungal skin infections due to Microsporum spp are rather controversial, depending on patient lifestyle and geography. There must be greater awareness of these changes to establish the proper diagnosis and treatment to achieve the cure of the

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