Research

9 pages, 2279 KiB

Open AccessArticle

The Dermatophyte Trichophyton rubrum Induces Neutrophil Extracellular Traps Release by Human Neutrophils

by Ana Paula Carvalho Reis, Giovanna Azevedo Celestrino, Mariana Villas Bôas Igoa, Thais Martins Jesus, Tábata Takahashi França, Daniel Valério Silva Moreira, Paula Ordonhez Rigato, Paula Keiko Sato, Antonio Condino-Neto, Irene L. Noronha, Luciane Alarcão Dias-Melicio, Pritesh Jaychand Lalwani, Gil Benard and Maria Gloria Teixeira Sousa

J. Fungi 2022, 8(2), 147; https://0-doi-org.brum.beds.ac.uk/10.3390/jof8020147 - 31 Jan 2022

Cited by 4 | Viewed by 2902

Abstract

Neutrophils are the first leukocytes recruited to the site of infection and are thought to be responsible for fungal elimination from the skin such as dermatophytes. Neutrophils are able to secrete reactive oxygen species (ROS) and neutrophil extracellular traps (NETs) that can kill [...] Read more.

Neutrophils are the first leukocytes recruited to the site of infection and are thought to be responsible for fungal elimination from the skin such as dermatophytes. Neutrophils are able to secrete reactive oxygen species (ROS) and neutrophil extracellular traps (NETs) that can kill different fungi, including Aspergillus, spp., Candida albicans, and Phialophora verrucosa. However, NET production in response to Trichophyton rubrum, the main etiologic agent of dermatophytosis, has yet to be studied. We demonstrated that human neutrophils produce NETs against different morphotypes of T. rubrum in a dose-dependent manner and NET formation is dependent on ROS production. In addition, ROS production by human neutrophils in response to T. rubrum is dependent on NADPH oxidase, but not on fungal viability. NETs mediated killing of T. rubrum. Collectively, these results demonstrate that T. rubrum was able to trigger the production of NETs, suggesting that these extracellular structures may represent an important innate immune effector mechanism controlling physiological response to T. rubrum infection. Full article

(This article belongs to the Special Issue Fungal Infections in Dermatology)

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Review

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21 pages, 2688 KiB

Open AccessReview

The Role of the Cutaneous Mycobiome in Atopic Dermatitis

by Milena Szczepańska, Leszek Blicharz, Joanna Nowaczyk, Karolina Makowska, Mohamad Goldust, Anna Waśkiel-Burnat, Joanna Czuwara, Zbigniew Samochocki and Lidia Rudnicka

J. Fungi 2022, 8(11), 1153; https://0-doi-org.brum.beds.ac.uk/10.3390/jof8111153 - 31 Oct 2022

Cited by 9 | Viewed by 2574

Abstract

Atopic dermatitis is a chronic inflammatory skin disorder characterized by eczematous lesions, itch, and a significant deterioration in the quality of life. Recently, microbiome dysbiosis has been implicated in the pathogenesis of atopic dermatitis. Changes in the fungal microbiome (also termed mycobiome) appear [...] Read more.

Atopic dermatitis is a chronic inflammatory skin disorder characterized by eczematous lesions, itch, and a significant deterioration in the quality of life. Recently, microbiome dysbiosis has been implicated in the pathogenesis of atopic dermatitis. Changes in the fungal microbiome (also termed mycobiome) appear to be an important factor influencing the clinical picture of this entity. This review summarizes the available insights into the role of the cutaneous mycobiome in atopic dermatitis and the new research possibilities in this field. The prevalence and characteristics of key fungal species, the most important pathogenesis pathways, as well as classic and emerging therapies of fungal dysbiosis and infections complicating atopic dermatitis, are presented. Full article

(This article belongs to the Special Issue Fungal Infections in Dermatology)

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14 pages, 1828 KiB

Open AccessFeature PaperReview

Emerging Trends in the Use of Topical Antifungal-Corticosteroid Combinations

by Dalibor Mijaljica, Fabrizio Spada and Ian P. Harrison

J. Fungi 2022, 8(8), 812; https://0-doi-org.brum.beds.ac.uk/10.3390/jof8080812 - 01 Aug 2022

Cited by 2 | Viewed by 6877

Abstract

A broad range of topical antifungal formulations containing miconazole or terbinafine as actives are commonly used as efficacious choices for combating fungal skin infections. Their many benefits, owing to their specific mechanism of action, include their ability to target the site of infection, [...] Read more.

A broad range of topical antifungal formulations containing miconazole or terbinafine as actives are commonly used as efficacious choices for combating fungal skin infections. Their many benefits, owing to their specific mechanism of action, include their ability to target the site of infection, enhance treatment efficacy and reduce the risk of systemic side effects. Their proven efficacy, and positioning in the treatment of fungal skin infections, is enhanced by high patient compliance, especially when appropriate vehicles such as creams, ointments and gels are used. However, inflammation as a result of fungal infection can often impede treatment, especially when combined with pruritus (itch), an unpleasant sensation that elicits an urge to scratch. The scratching that occurs in response to pruritus frequently accelerates skin damage, ultimately aggravating and spreading the fungal infection. To help overcome this issue, a topical antifungal-corticosteroid combination consisting of miconazole or terbinafine and corticosteroids of varying potencies should be used. Due to their inherent benefits, these topical antifungal-corticosteroid combinations can concomitantly and competently attenuate inflammation, relieve pruritus and treat fungal infection. Full article

(This article belongs to the Special Issue Fungal Infections in Dermatology)

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13 pages, 2656 KiB

Open AccessReview

Mycetoma: Development of Diagnosis and Treatment

by Xingpei Hao, Marcus Cognetti, Rhonda Burch-Smith, Emerald O’Sullivan Mejia and Gene Mirkin

J. Fungi 2022, 8(7), 743; https://0-doi-org.brum.beds.ac.uk/10.3390/jof8070743 - 19 Jul 2022

Cited by 9 | Viewed by 5121

Abstract

Mycetoma describes a heterogeneous group of cutaneous and subcutaneous infections caused by either fungi (eumycetomas) or bacteria (actinomycetomas). It is characterized by a triad of clinical symptoms: painless subcutaneous tumor-like swelling, multiple sinuses and fistulas, and discharged grains in pus. This predominantly affects [...] Read more.

Mycetoma describes a heterogeneous group of cutaneous and subcutaneous infections caused by either fungi (eumycetomas) or bacteria (actinomycetomas). It is characterized by a triad of clinical symptoms: painless subcutaneous tumor-like swelling, multiple sinuses and fistulas, and discharged grains in pus. This predominantly affects the feet in more than 70% of patients. It is endemic in the “mycetoma belt” regions, including Africa, South America, and South Asia. Autochthonous mycetoma is rare in the United States of America (USA). We recently reported a Latin American immigrant with eumycetoma in the State of Maryland, USA. With millions of immigrants from endemic regions, the true number of mycetomas in the USA is most likely higher than currently recognized. With the aim to raise the awareness of clinicians about mycetoma, especially dermatologists and podiatrists, we update the development of the epidemiology, etiology, clinical presentations, pathogenesis, diagnosis, differential diagnosis, and treatment of mycetoma. Full article

(This article belongs to the Special Issue Fungal Infections in Dermatology)

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9 pages, 1531 KiB

Open AccessReview

Transmission of Onychomycosis and Dermatophytosis between Household Members: A Scoping Review

by Aria Jazdarehee, Leilynaz Malekafzali, Jason Lee, Richard Lewis and Ilya Mukovozov

J. Fungi 2022, 8(1), 60; https://0-doi-org.brum.beds.ac.uk/10.3390/jof8010060 - 06 Jan 2022

Cited by 11 | Viewed by 2969

Abstract

Onychomycosis is a common fungal infection of the nail, caused by dermatophytes, non-dermatophytes, and yeasts. Predisposing factors include older age, trauma, diabetes, immunosuppression, and previous history of nail psoriasis or tinea pedis. Though many biological risk factors have been well characterized, the role [...] Read more.

Onychomycosis is a common fungal infection of the nail, caused by dermatophytes, non-dermatophytes, and yeasts. Predisposing factors include older age, trauma, diabetes, immunosuppression, and previous history of nail psoriasis or tinea pedis. Though many biological risk factors have been well characterized, the role of the environment has been less clear. Studies have found evidence of transmission in 44% to 47% of households with at least one affected individual, but the underlying mechanisms and risk factors for transmission of onychomycosis between household members are incompletely understood. A scoping literature review was performed to characterize and summarize environmental risk factors involved in the transmission of onychomycosis within households. A total of 90 papers met the inclusion criteria, and extracted data was analyzed in an iterative manner. Shared household surfaces may harbor dermatophytes and provide sources for infection. Shared household equipment, including footwear, bedding, and nail tools, may transmit dermatophytes. The persistence of dermatophytes on household cleaning supplies, linen, and pets may serve as lasting sources of infection. Based on these findings, we provide recommendations that aim to interrupt household transmission of onychomycosis. Further investigation of the specific mechanisms behind household spread is needed to break the cycle of transmission, reducing the physical and social impacts of onychomycosis. Full article

(This article belongs to the Special Issue Fungal Infections in Dermatology)

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15 pages, 304 KiB

Open AccessReview

Pathogenesis, Immunology and Management of Dermatophytosis

by Shishira R. Jartarkar, Anant Patil, Yaser Goldust, Clay J. Cockerell, Robert A. Schwartz, Stephan Grabbe and Mohamad Goldust

J. Fungi 2022, 8(1), 39; https://0-doi-org.brum.beds.ac.uk/10.3390/jof8010039 - 31 Dec 2021

Cited by 18 | Viewed by 6333

Abstract

Dermatophytic infections of the skin and appendages are a common occurrence. The pathogenesis involves complex interplay of agent (dermatophytes), host (inherent host defense and host immune response) and the environment. Infection management has become an important public health issue, due to increased incidence [...] Read more.

Dermatophytic infections of the skin and appendages are a common occurrence. The pathogenesis involves complex interplay of agent (dermatophytes), host (inherent host defense and host immune response) and the environment. Infection management has become an important public health issue, due to increased incidence of recurrent, recalcitrant or extensive infections. Recent years have seen a significant rise in incidence of chronic infections which have been difficult to treat. In this review, we review the literature on management of dermatophytoses and bridge the gap in therapeutic recommendations. Full article

(This article belongs to the Special Issue Fungal Infections in Dermatology)

Other

Jump to: Research, Review

12 pages, 617 KiB

Open AccessSystematic Review

Applications of Reflectance Confocal Microscopy in the Diagnosis of Fungal Infections: A Systematic Review

by Samavia Khan, Banu Farabi, Cristian Navarrete-Dechent, Babar Rao and Bijan Safai

J. Fungi 2023, 9(1), 39; https://0-doi-org.brum.beds.ac.uk/10.3390/jof9010039 - 26 Dec 2022

Cited by 5 | Viewed by 1483

Abstract

Cutaneous and adnexal fungal infections are typically diagnosed with potassium hydroxide (KOH) skin scrapings, fungal cultures, and Periodic acid-Schiff (PAS) biopsy staining. All three current methods of fungal diagnosis require sample processing and turnover time which leads to a delay in diagnosis. Reflectance [...] Read more.

Cutaneous and adnexal fungal infections are typically diagnosed with potassium hydroxide (KOH) skin scrapings, fungal cultures, and Periodic acid-Schiff (PAS) biopsy staining. All three current methods of fungal diagnosis require sample processing and turnover time which leads to a delay in diagnosis. Reflectance confocal microscopy (RCM) is a non-invasive, in vivo skin imaging technology that provides real-time dermatologic diagnoses. We present an updated systematic review of the applications of RCM in diagnosing fungal infections in an effort to explore the utility of RCM as an adjunct clinical tool in detecting cutaneous and adnexal fungi We systematically searched the MEDLINE (via PubMed) for studies published from January 2000 to October 2022 that described the utility of RCM in the setting of fungal infections. Of the 25 studies that met the inclusion criteria, 202 patients were included. The following information on the application of RCM in the setting of fungal infections was extracted from each study, if reported: study type, year published, number of patients included, diagnosis/diagnostic methods, and RCM description. Concordant within all included studies, fungal infections presented on RCM as bright, linear, branching, filamentous structures at the level of stratum corneum. A limitation of this review is that 11 of 25 studies were case reports (n = 1). Larger scale studies should be conducted to explore the utility of RCM in diagnosing fungal infections and to enrich the RCM descriptions of specific fungal conditions. Full article

(This article belongs to the Special Issue Fungal Infections in Dermatology)

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7 pages, 2274 KiB

Open AccessCase Report

Tinea Incognito—A Great Physician Pitfall

by Julia Nowowiejska, Anna Baran and Iwona Flisiak

J. Fungi 2022, 8(3), 312; https://0-doi-org.brum.beds.ac.uk/10.3390/jof8030312 - 18 Mar 2022

Cited by 6 | Viewed by 5966

Abstract

Tinea incognito is a dermatophyte infection exacerbated after inadequate administration of topical or systemic glucocorticoids. A 57-year-old man presented to the Department of Dermatology due to skin lesions persisting for one month. He reported having recently worked under hot conditions, in tight clothing, [...] Read more.

Tinea incognito is a dermatophyte infection exacerbated after inadequate administration of topical or systemic glucocorticoids. A 57-year-old man presented to the Department of Dermatology due to skin lesions persisting for one month. He reported having recently worked under hot conditions, in tight clothing, which caused sweating. Later, he noticed erythematous–exfoliative lesions in his groins and on the buttocks. He presented to the general practitioner who diagnosed him with eczema and prescribed clobetasole ointment. Since the skin lesions became more severe, he presented to the Department of Dermatology. On the physical examination, extensive erythematous–infiltrative lesions were observed in the area of medial, lateral, and posterior surface of both thighs and buttocks. Pustules were also present. Suspicion of tinea incognito was raised, and direct mycological examination and culture confirmed the presence of dermatophytes. The patient was prescribed topical terbinafine and oral itraconazole. Tinea incognito may be challenging to diagnose because the clinical presentation is relatively nonspecific and definitive culture or histopathological diagnosis such as by microscopic sample examination to identify fungal elements is not universally available. Every doctor has to keep in mind the fact that tinea may be a great mimicker of other dermatoses and to not prescribe medications without microscopic confirmation of tinea, and refer patients for dermatological consultation in case of doubt. Full article

(This article belongs to the Special Issue Fungal Infections in Dermatology)

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