Giant Cell Granuloma in Trichophyton rubrum Infection/Riesenzellgranulom bei Trichophyton rubrum Infektion

Summary: A case of giant cell granuloma caused by Trichophyton rubrum is reported. Clinically the fungus had elicited skin coloured flat topped papules and plaques. Fungal filaments were absent in these areas histologically though skin scales revealed mycelia in KOH mount and grew T. rubrum. The histological findings suggest that histiocytes and plasma cells were mainly involved in the defence against T. rubrum infection in this case.
Dermatophytoses are common in India. Tinea corporis is the second common mycosis in Madras, the first being tinea cruris, and the frequent sites affected are the waist and other areas of the trunk, both in children and adults. The usual type of skin lesions are rings and circinate patches with well defined border. In the present communication we have deseribed an atypical clinical and histological presentation by T. rubrum.
Zusammenfassung: Bericht über einen Fall eines Riesenzellgranuloms bei oberflächlicher Trichophyton-rubrum-Infektion.
Klinisch hatte der Pilz hautfarbene flache Papeln und Plaques hervorgerufen. Während histologisch Pilzelemente nicht nachgewiesen werden konnten, fanden sich im Nativpräparat Mycelien und in der Kultur Trichophyton-rubrum-Kolonien. Der histologische Befund deutet an, daß bei diesem Fall in erster Linie Histiozyten und Plasmazellen die Abwehr gegen die Trichophyton-rubrum-Infektion übernommen hatten.     

Treatment of disseminated onychomycosis due to Trichophyton rubrum with itraconazole under control of plasma levels

Successful treatment of a disseminated Trichophyton rubrum infection of the nails is reported. Under therapy with 50 mg/100 mg itraconazole daily total remission was achieved after 5 months (finger nails) and 6 months (toe nails) respectively. Plasma levels of itraconazole were determined twice a month to control the regularity of the treatment using HPLC.     

Epidemiology of the Dermatophytoses in the Florence Area: 1982–84. II. Trichophyton rubrum Infections: Epidemiologie der Dermatophytosen in Florenz und Umgebung:1982–84. II. Trichophyton rubrum-Infektionen

Summary: 41.6% of the dermatophytoses observed in the Dept. of Dermatology at Florence between 1982 and 1984 were caused by Trichophyton rubrum. The most frequent dermatophytoses were tinea pedis, tinea cruris and tinea corporis, all of which particularly affected males. The data are compared to those of a previous study (1979–1981) showing that the incidence of tinea pedis and tinea cruris has increased since then. Certain unusual clinical cases are described.
Zusammenfassung: 41,6% der Dermatophytosen, die in den Jahren 1982 bis 1984 beobachtet wurden, wurden von Trichophyton rubrum verursacht. Die häufigsten Dermatophytosen waren Tinea pedis, Tinea cruris und Tinea corporis, vorwiegend beim männlichen Geschlecht Die Angaben werden mit jenen unserer vorherigen Untersuchungen (1979–1981) verglichen. Eine zunehmende Häufigkeit der Tinea pedis und der Tinea cruris wird beobachtet Es wird über einige besondere klinische Bilder berichtet.     

Degradation of Human Hair by some Dematophytes and other Keratinophilic Fungi: Der Abbau von menschlichem Haar durch einige Dermatophyten und andere keratinophile Pilze

Summary: The ability to degrade human hair by chrgsosponum crassitunicatum, Chrysosporium tropicam, Malbranchea aumntiaca, Wchophyton rubnun and lkichophyton temstre was determined by anatysing pmtem and sulphydryl group in culture fluid. The data showed that among the test organisms Trichophyton terrestre is a strong keratinolytic fungus, while Malbranchea aarantiaca was fonnd to be the poorest m this respect.
Zusammenfassung: Durch Bestimmung von Protein- und Sulfhydryl-Gmppen im Nährmedium wurde bei folgenden Wzen die Fäeit aun Abbau menschlichen Haares beslimmt: Chrysosponum cmdnnkatum, chrysosponm tropicam, Malbranchea aurantiaca, Trichophyton rubrum und Trihophyton ternstre. Es zeigte sich, das lkichophyton ternstre und Malbranchea aurantiaca die dwlchsten kemtinoiyfischen Eigenschaften besaß.     

Genetic Ichthyosis and Trichophyton rubrum Infection in Infants: Genetische Ichthyosen und Trichophyton-rubrum-Infektionen bei kleinen Kindern

Summary: Extensive and chronic tinea glabrosa in one infant and a chronic tinea manuum and tinea unguium in another due to Trichophyton rubrum infection have been described. X-Linked ichthyosis vulgaris in the former and ichthyosis vulgaris (dominant) in the latter case were the associated conditions. The slow epidermal turnover and slow nail growth are the probable predisposing factors in these infants. It is emphasised that genetic ichthyotic disorders are more prone for T. rubrum infection. Zusammenfassung: Beschreibung einer ausgedehnten chronischen Tinea corporis bei einem Säugling sowie einer Tinea manuum mit Onychomykose bei einem weiteren Kind. Bei dem ersten Kind lag eine X-chromosomal gebundene Ichthyosis und bei dem zweiten eine Ichthyosis vulgaris vor. Der langsame epidermale turnover und das langsame Nagelwachstum werden hier als prädisponierende Faktoren angesehen. Es wird daraufhingewiesen, daß Patienten mit genetisch bedingten Ichthyosen anfällier für T. rubrum-Infektion sind.     

Cultural evidence for a bullous type of tinea pedis

Maceration, hyperkeratosis and vesicles are well known as typical clinical correlates of dermatophyte infection of the feet. It seems, however, still to be controversial whether bullae also belong to the clinical spectrum. In a 48-year-old female Trichophyton rubrum could be cultured from the fluid obtained by aspiration of an interdigital bulla. In another case Trichophyton mentagrophytes could be isolated from the interdigital space but not from a bulla found on the sole, microscopic investigation, however, being positive. This emphasizes the hypothesis that blisters found on the foot can be due to dermatophytes.     

Fixed Drug Eruption to Griseofulvin

Summary: A case of dermatophytosis treated with oral griseofulvin developed fixed drug eruption to the drug. The present report is the second of its kind observed in world literature.
Zusammenfassung: Bei einem Patienten, der wegen einer Dermatophytose Griseofulvin oral erhielt, entwickelte sich ein fixes Arzneimittelexanthem. Dieses ist der zweite berichtete Fall in der Weltliteratur.     

Sialic acids are absent from the dermatophytes Trichophyton mentagrophytes and Trichophyton rubrum

Experiments were performed to determine whether sialic acids are expressed in two dermatophytes: Trichophyton rubrum and T. mentagrophytes, similarly to other fungal pathogens. Chemical extraction of mycelia and microconidia followed by high-performance thin-layer chromatography and colorimetric assays were all negative for sialic acid. Incubation of dermatophytes in the presence of Limax flavus agglutinin, specific for sialic acid, was negative in a fluorescence staining test. We have also used other lectins that bind to sialic acid and/or other sugar residues, and these ligands coupled to fluorescein strongly stained these fungi. Such fluorescence staining was not abolished or reduced when fungi were pretreated with sialidase. Different strains of influenza virus which recognize sialic acid residues were also used, but no agglutination of the dermatophytes was observed. Based on these methods, which successfully revealed the presence of sialic acids in other fungal pathogens, we show that these monosaccharides do not occur in both dermatophyte species. Thus, sialic acids do not seem to play a role in the pathogenicity of these fungi.     

A case of tinea corporis purpurica

We present a case of tinea corporis purpurica localized to the legs of a 47-year-old woman. Trichophyton rubrum was the aetiological agent. So far, only a single report has been made on tinea corporis purpurica. Although the exact mechanism of purpura formation is unknown, we postulate the virulence of the fungal strain and host immune response to play a role.     

Contact dermatitis due to ciclopiroxolamine

We report a case of contact dermatitis because of ciclopiroxolamine milk in a 43-year-old woman with tinea pedis and onychomycosis caused by Trichophyton rubrum. Ciclopiroxolamine is regarded as a weak sensitiser because of the few allergic reactions described in relation to its widespread use.     

Hand, Foot and Nail Disease — a Common Manifestation of Chronic Dermatophytosis./Hand-Fuß-Nagel-Befall — eine häufige Erscheinungsform der chronischen Dermatophytose

Summary:  A retrospective study of 83 patients with dermatophytosis verified by culture and a duration of disease exceeding one year was performed. Among these chronic patients males dominated (70%) and Trichophyton rubrum was isolated in 87% of cases. Tinea pedis is no Ionger the most common exponent of chronicity. Multiple localization of lesions increased with the disease duration and in 67% of chronic cases the infection started in the interdigital area, proceeded to the glabrous skin of the foot and to the toe-nails, finally affecting palms and fingernails. Predisposing factors were found in 19% of the cases and atopy was registered in a few only. It appears that with the increasing incidence of T. rubrum infections a specific syndrome is developing in chronic patients characterized by affection of hand, food and nail with no obvious linking to atopy.
Zusammenfassung:  Es wurde eine retrospektive Verlaufsanalyse an 83 Patienten mit kulturell gesicherter Dermatophytose von mehr als 1jähriger Dauer durchgeführt. Unter diesen chronisch kranken Patienten überwogen Männer (70%), und in 87% aller Fälle war Trichophyton rubrum isoliert worden. Bei chronischer Dermatophytose ist die Tinea pedis nicht mehr die häufigste Erscheinungsform. Multiple Lokalisationen werden mit längerer Erkrankungsdauer häufiger, und bei 67% chronischer Dermatophytosen beginnt die Infektion im Interdigitalraum, dehnt sich auf die glatte Haut der Füße und auf die Zehennägel aus und befällt schließlich Palmarregion und Fingernägel. Prädisponierende Faktoren lagen bei 19% der Patienten vor, Atopie wurde nur in wenigen Fällen gefunden. Offenbar entwickelt sich mit dem gehäuften Auftreten von T. rubrum - Infektionen ein spezifisches Syndrom an chronisch-kranken Patienten, das durch den Hand-Fuß-Nagel-Befall charakterisiert ist und keine Beziehung zur Atopie erkennen läßt.     

Podopompholyx due to pemphigus vulgaris and Trichophyton rubrum infection. Report of an unusual case

Summary. We report the case of a 48-year old man who after a disease-free interval of 7 years developed a relapse of pemphigus vulgaris (PV) presenting as pompholyx of the left foot. The patient was first thought to suffer from a dyshidrosic form of tinea pedis due to Trichophyton rubrum. Although the concomitant occurrence of a dermatomycosis and PV has been described previously, our case illustrates an unusual and misleading presentation of PV, which may delay the correct diagnosis.
Zusammenfassung. Wir berichten über einen 48-jährigen Patienten, der nach einem 7-jährigen krankheitsfreien Intervall ein Pemphigus vulgaris (PV)-Rezidiv unter dem klinischen Bild eines Podopompholyx entwickelte. Der Nachweis eines Trichophyton rubrum führte zunächst zur Diagnose einer Fußmykose. Obwohl bereits ein gemeinsames Auftreten von PV und Dermatomykosen beschrieben wurde, weist unser Fall auf einen sehr atypischen klinischen Aspekt eines PV hin, der die Diagnosestellung verzögern kann.     

Erythema mwltiforme in Dermatophytosis

Summary: Erythema multiforme (EMF) due to dermatophytosis caused by Tricho-phyton rubrum has been described in a 64 year old male with grandmal. Specific treatment with oral griseofulvin cleared the condition in 3 weeks time. This case is reported for the rarity of EMF being produced by an anthropophilic dermatophyte, Trichophyton rubrum.
Zusammenfassung: Ein Erythema exsudativum multiforme bei einem 64 jährigen Patienten wird beschrieben, das durch eine Dermatophytose mit Trichophyton rubrum als Erreger hervorgerufen wurde. Eine spezifische Behandlung mit Griseofulvin brachte die Erscheinungen innerhalb von drei Wochen zur Abheilung. Dieser Fall wird berichtet, weil die Verursachung eines Erythema exsudativum multiforme durch den anthropo-philen Dermatophyten Trichophyton rubrum eine Rarität darstellt.     

Molecular typing of Trichophyton rubrum clinical isolates from Poland

The aim of this study was to investigate the intraspecific diversity of Trichophyton rubrum clinical isolates. Thirty clinical isolates of T. rubrum were selected for molecular typing by PCR amplification of two tandemly repetitive elements (TRS-1 and TRS-2) of the rDNA and randomly amplified polymorphic DNA (RAPD) analysis with primers designated 1 and 6. The assignment to the species T. rubrum was achieved by nested PCR of ITS1. Five PCR types were produced from the TRS-1 and three from the TRS-2 locus. Thirteen and 23 individual profiles were obtained by RAPD, with primer 1 and 6 respectively. At the phylogenetic level, 26 (87%) isolates were allocated into four clusters, with each cluster comprising isolates of over 80% similarity. The reproducibility of TRS typing was 100%, whereas that of RAPD was 40% and 30%, when using primer 1 and 6 respectively. Neither correlation between the morphological characteristics and the TRS-1-TRS-2 or RAPD genotype nor between TRS-1-TRS-2 and RAPD genotyping was observed. Although both the TRS amplification and RAPD analysis possess the ability to discriminate between T. rubrum strains, the TRS typing method is particularly valuable as its results are much more reproducible, more easily interpreted and recorded than those generated by RAPD.     

Trichophyton rubrum Infection in the Napkin Area — A Case Report/Trichophyton-rubrum-Infektion in der Windelregion — Ein Fallbericht

Summary: Report on a 14 month old, otherwise healthy infant with Trichophyton rubrum infection in the napkin area and on the feet. It resolved after one month of topical treatment. Follow-up in 4 months did not show relapse or reinfection.
Zusammenfassung: Bericht über ein 14 Monate altes, sonst gesundes Kind mit einer Trichophyton-rubrum-Infektion in der Windelregion und an den Füßen. Die Mykose heilte nach einer einmonatiger Lokalbehandlung ab. Ein Wiederauftreten oder eine neue Infektion wurden nicht beobachtet.     

First isolation of Trichophyton raubitschekii (syn. T. rubrum) in Europe

Trichophyton raubitschekii is a rare dermatophyte which belongs to the Trichophyton rubrum species complex. Since 1981, only a few cases of dermatophytosis due to this anthropophilic causative agent were published. In this paper the authors report the first cases of Tinea corporis caused by Trichophyton raubitschekii (syn. T. rubrum) in Europe. The patients, one immigrant from Ghana and three from Cameroon, had typical lesions of tinea corporis. Four strains were isolated and characterized by conventional and molecular methods. On morphological and physiological grounds the isolates were identified as T. raubitschekii by the following phenotypical features: (1) velvety colony texture; (2) brown pigment; (3) abundant macroconidia and (4) positive urease activity. Molecular diagnostics were performed by single strand conformation polymorphism (SSCP) and sequence analysis of the ATPase9 intron of the mitochondrial (mt) DNA and the internal transcribed spacer (ITS) region of the rDNA, respectively. The ITS sequences and SSCP patterns of the ATPase9 intron were found to be identical among the four strains and also when compared to reference strains of T. rubrum. As shown in the present paper, T. raubitschekii is genetically identical to T. rubrum but differs in some phenotypical characteristics. Since misidentification with other dark-coloured dermatophyte variants is possible, medical mycologists should bear in mind the special morphological characteristics of T. raubitschekii (syn. T. rubrum) for future identifications.     

Nine male cases of tinea genitalis

Nine cases of tinea genitalis observed in Siena and Terni (Italy) between 1988 and 2003 are reported because of their infrequency. The patients were males ranging in age from 23 to 45 years. The lesions, situated on the penis, glans and scrotum, were preceded by dermatophytosis in other sites (groin five cases; feet two cases; toenails two cases; hands in one; beard in another). Mycological examination consisting of direct microscopy and culture led to isolation of Trichophyton rubrum in five cases, Epidermophyton floccosum in two and T. mentagrophytes var. interdigitalis in the others. Clinical diagnosis is not always easy. In three cases the lesions had been misdiagnosed as eczema.