Objective To estimate the performance of confocal laser scanning microscopy (CLSM) in the diagnosis of superficial cutaneous fungal infections. Methods This study recruited 59 patients with clinically suspected superficial cutaneous fungal infections.Three typical lesions were selected in each patient for CLSM and microscopic examination.Results CLSM revealed hyphae in stratum corneum in 56％ (14/25) of tinea manus or pedis and 79.17％ (19/24) of tinea cruris lesions,7 out of 8 tinea manus or pedis and 94.12％( 16/17 ) of tinea cruris early lesions (＜ 3 weeks ),and 41％ (7/17) of tinea manus or pedis and 3 out of 7 tinea croris old lesions (＞ 3 weeks).All the CLSM-positive specimens were positive for microscopic examination,and among the CLSM-negative specimens,fungal elements were observed by microscopic examination in 8 out of 11 tinea manus or pedis specimens,4 out of 5 tinea cruris specimens,1 tinea manus or pedis and 1 tinea cruris specimen of early lesions,and 7 out of 10 tinea manus or pedis and 3 out of 4 tinea cruris specimens of old lesions.No hypha was found by CLSM in any of the 10 tinea versicolor specimens,while microscopic examination revealed fungal elements in 8 of them.Neither CLSM nor microscopy revealed fungal elements in lesions from 5 patients with tinea manus or pedis and 5 patients with tinea cruris after treatment with topical bifonazole cream for 2 weeks.Conclusions CLSM shows a good consistency with light microscopy in the examination of early lesions of tinea marnus and pedis as well as tinea croris,and may serve as a valuable tool for clinical diagnosis.

Objective To investigate the distribution and epidemiology of fungal pathogens in zoonotic dermatophytoses.Methods Seventy-four patients with dermatophytoses and 72 pets from 64 families,who were all culture positive for dermatophytes,were included in this study and classified into 64 family-based groups.Fungal culture and direct microscopic examination were carried out for species identification of fungal isolates,internal transcribed spacer (ITS) sequence analysis and random amplified polymorphic DNA (RAPD) analysis were performed for molecular identification and homology analysis.Results Dermatophyte species were consistent among the patients and pets from the same families for all the 64 family-based groups.A total of 146 fungal strains were isolated,including 93 Microsporum canis (M.canis) strains and 53 Trichophyton interdigitale (T.interdigitale) strains.M.canis was isolated from 42 (65.7％) family-based groups including 34 groups keeping cats and 8 groups keeping dogs,while T.interdigitale from 22 (34.3％) groups,including 14 groups keeping rabbits,6 groups keeping cats and 2 groups keeping dogs.There were 54 (75.0％) pets with obvious clinical symptoms (erythema,desquamation,depilation,etc),and 18 (25.0％) asymptomatic pets which were all cats.Among the 18 asymptomatic cats,14 carried M.canis,and 4 T.interdigitale.ITS sequencing and RAPD analysis revealed a high homology between the fungal pathogens in the same family-based groups.Conclusions M.canis and T.interdigitale are common species of dermatophytes in zoonotic dermatophytoses,and both of them have host specificity.Zoonotic dermatophytes can be transmitted between human and domestic animals,and attention should be paid to asymptomatic animals (carriers).

Objective To analysis changes in species distribution of pathogenic dermatophytes from patients with tinea capitis in the Hangzhou Third Hospital between 2015 and 2017.Methods Demographic and mycological data were collected from 321 patients with confirmed tinea capitis in the Hangzhou Third Hospital between 2015 and 2017,and analyzed retrospectively.Results Of the 321 patients with tinea capitis,180 were males,and 141 were females.Their age of onset ranged from 1 month to 70 years.There were 154 (47.9％) preschool children and 13 (4.0％) adults.A total of 321 fungal strains were isolated,including 159 (49.5％) strains of Microsporum canis,110 (34.3％) strains of Trichophyton mentagrophytes,38 (11.8％) strains of Trichophyton violaceum,8 (2.5％) strains of Trichophyton tonsurans,4 (1.2％) strains of Microsporum gypseum,and 2 (0.6％) strains of Trichophyton rubrum.There was no significant difference in the distribution of fungal species (x2 =9.09,P ＞ 0.05) or the proportion of anthropophilic and non-anthropophilic dermatophytes among different age groups (x2 =1.85,P ＞ 0.05).The proportion of non-anthropophilic dermatophytes significantly differed among 2015,2016 and 2017 (x2 =23.82,P ＜ 0.01).From 2015 to 2017,the proportions of Microsporum canis were 32.5％,47.6％ and 59.6％ respectively,and the proportions of Trichophyton mentagrophytes were 53.0％,35.4％ and 23.7％ respectively.Conclusions During 2015-2017,the main population with tinea capitis in Hangzhou Third Hospital was preschool children.Moreover,the main pathogenic dermatophyte was Microsporum canis,whose proportion gradually increased year by year,followed by Trichophyton mentagrophytes,whose proportion gradually decreased year by year.

Objective To analyze the clinocopathological characteristics of infectious granulomas.Methods The clinical features,histopathological manifestations of 39 patients with infectious granulomas were analyzed retrospectively.Results Among 39 cases of infectious granulomas,there were 15 males and 24 females,and 17 cases of fungal granuloma and 22 cases of tuberculous granuloma.There was no statistically significant difference in gender and age between fungal granulomas and tuberculous granulomas.The mean course of tuberculous granuloma aud tuberculous granuloma was (0.88 ± 0.67) years and (5.54 ± 3.49) years,respectively (t =4.51,P =0.00);there was no significant difference in mean age of onset in fungal granuloma patients and tuberculous granuloma patients [(54.6 ± 19.6) vs.(47.6 ± 18.1) years,P ＞0.05)].There were 4 and 18 cases of fungal and tuberculous granulomatosis at the face,and 13 and 3 cases at the extremities (all P =0.00);the lesions occurred in the trunk in one case of tuberculous granuloma.The clinical manifestations of fungal and tuberculous granulomas as plaques/nodules were in 14 cases aud 22 cases (P =0.08);as ulcers and pus exudates were in 10 and 2 cases,respectively (P =0.00).The histopathological features showed epidermal hyperplasia in 12 and 4 cases,infiltrative patterns in 4 and 21 cases,infiltration of neutrophils in 14 and 3 cases,infiltration of plasma cells in 15 and 5 cases,infiltration of eosinophils in 10 and 0 cases,necrosis in 1 and 10 cases in fungal granulomas and tuberculous granulomas,respectively (P =0.00,0.00,0.00,0.00,0.00,0.01).Conclusion Fungal granuloma and tuberculous granuloma are different in the lesion sites,clinical manifestations and histopathological features.