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      Microsporum gypseum Infection Among Two Related Families With a Zoonotic Aspect: A Prospective Case Series

      research-article
      1 , , 2 , 2 , 3
      ,
      Cureus
      Cureus
      aseer region, itraconazole, dermatophytes, zoonosis, tinea, dermatophytosis

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          Abstract

          Background and purpose

          The Microsporum gypseum complex is a globally distributed group of geophilic dermatophytes that primarily affect animals but can also rarely cause dermatomycoses in humans. With some regional and occupational variations, tinea corporis is the most prevalent presentation of the infection. The aim of this study was to report on the diagnosis and treatment of dermatophytosis cases among related families, and their pets, from southern Saudi Arabia. Up-to-date information on dermatophytes and dermatophytosis is needed.

          Methods

          This is a prospective case series undertaken at the Dermatology Outpatient Clinic of King Khalid University, Saudi Arabia. Six patients with suspected dermatophytosis were received at our hospital in 2022 and have been followed for recovery with or without scars. Characteristics of fungal pathogens were examined phenotypically on the basis of microscopic and growth characteristics, and laboratory data were used to initiate treatment with oral fluconazole, topical terbinafine cream, or oral itraconazole.

          Results

          Clinical features and culture results confirmed tinea capitis and tinea corporis caused by M. gypseum, which was also present in a pet cat. Tinea capitis cases (n = 4) did not respond to fluconazole and terbinafine treatment, but treatment with itraconazole resulted in a full recovery. Tinea corporis cases (n = 2) were treated with terbinafine, which resulted in a full recovery within four weeks, with no signs of scarring.

          Conclusions

          M. gypseum presents with serious persistent lesions and is extremely contagious. Treatment is durable but challenging, and breaking the transmission chain is more difficult.

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          Most cited references22

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          Tinea Capitis: Current Status

          R Hay (2016)
          Tinea capitis remains a common childhood infection in many parts of the world. Yet knowledge of the underlying pathogenetic mechanisms and the development of effective immunity have shown striking advances, and new methods of diagnosis ranging from dermoscopy to molecular laboratory tests have been developed even though they have not been assimilated into routine practice in many centres. Treatment is effective although it needs to be given for at least 1 month. What is missing, however, is a systematic approach to control through case ascertainment and therapy.
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            In vitro activity of fluconazole, itraconazole, voriconazole and terbinafine against fungi causing onychomycosis.

            Onychomycosis is one of the commonest dermatological diseases worldwide. The antifungal activity of current medications varies, and treatment failure occurs in 25-40% of treated patients.
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              Is Open Access

              Management of tinea corporis, tinea cruris, and tinea pedis: A comprehensive review

              The prevalence of superficial mycotic infection worldwide is 20–25% of which dermatophytes are the most common agents. Recent developments in understanding the pathophysiology of dermatophytosis have confirmed the central role of cell-mediated immunity in countering these infections. Hence, a lack of delayed hypersensitivity reaction in presence of a positive immediate hypersensitivity (IH) response to trichophytin antigen points toward the chronicity of disease. Diagnosis, though essentially clinical should be confirmed by laboratory-based investigations. Several new techniques such as polymerase chain reaction (PCR) and mass spectroscopy can help to identify the different dermatophyte strains. Management involves the use of topical antifungals in limited disease, and oral therapy is usually reserved for more extensive cases. The last few years have seen a significant rise in the incidence of chronic dermatophyte infections of skin which have proven difficult to treat. However, due to the lack of updated national or international guidelines on the management of tinea corporis, cruris, and pedis, treatment with systemic antifungals is often empirical. The present review aims to revisit this important topic and will detail the recent advances in the pathophysiology and management of tinea corporis, tinea cruris, and tinea pedia while highlighting the lack of clarity of certain management issues.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                31 December 2023
                December 2023
                : 15
                : 12
                : e51402
                Affiliations
                [1 ] Dermatology Division, Department of Internal Medicine, College of Medicine, King Khalid University, Abha, SAU
                [2 ] Department of Clinical Microbiology and Parasitology, King Khalid University, Abha, SAU
                [3 ] Department of Clinical Microbiology and Parasitology, College of Medicine, King Khalid University, Abha, SAU
                Author notes
                Faisal Hassan Tobeigei ftobeigei@ 123456kku.edu.sa
                Article
                10.7759/cureus.51402
                10826859
                38292972
                b578cdb9-fb49-4445-a0ae-58fbeb6ac426
                Copyright © 2023, Tobeigei et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 31 December 2023
                Categories
                Dermatology
                Infectious Disease

                aseer region,itraconazole,dermatophytes,zoonosis,tinea,dermatophytosis

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