BACKGROUND

Superficial mycoses are one of the most common skin conditions encountered in the outpatient clinics, causing significant morbidity amongst patients. Since these are highly prevalent diseases of the skin, the general practitioner should be able to manage uncomplicated cases, with no need for evaluation by a specialist.

The study aimed to determine the knowledge, attitudes, and practices of Filipino medical interns on the management of superficial cutaneous mycoses using a self-administered questionnaire. This may help identify possible gaps in knowledge, as well as obstacles these future clinicians may encounter when managing superficial mycoses. This in turn may assist in the development or improvement of dermatology training among medical students and continuing medical education programs amongst non-dermatologist physicians.

This is a descriptive cross-sectional study among medical interns of the Philippine General Hospital to investigate their knowledge, attitudes, and practices regarding the management of superficial mycoses. Eligible participants were asked to complete an online self-administered survey questionnaire which assessed their capacity to recognize and manage uncomplicated superficial mycoses, and determined their attitudes regarding dermatology training in medical school.

The study included 170 medical interns, with majority having only 1-4 weeks of cumulative duration of dermatology training in medical school. Many of the participants (67.1%) had inadequate overall knowledge scores, but this was not significantly associated with their cumulative duration of dermatology training, as well as with their frequency of encounters with superficial mycosis patients. Most deem dermatology training (92.4%) and learning about the management of superficial mycoses (91.2%) during medical school very important. Majority are interested in attending more courses or training in the subject. Recommendations to improve medical school training on superficial mycoses include more practical approach in dermatology modules, integration of dermatology electives in medical school, and longer duration of dermatology modules/rotations during medical school.

While knowledge scores of medical interns were not significantly associated with the duration of their dermatology training during medical school as well as their encounters with patients with superficial mycoses, it is shown that they have low confidence scores regarding management of superficial mycoses. They deem that learning more about this disease and dermatology in general is vital to their medical education and are desirous of more training in this subject. Recommendations to improve medical school training on superficial mycoses include dermatology modules, rotations or electives in medical school. Additionally, better training during medical school, and formulation of clinical practice guidelines specific to cutaneous mycoses were recommended to improve healthcare delivery for patients with such diseases.

Background: People living with Human Immunodeficiency Virus (PLHIV) are living longer with the advent of highly active antiviral therapy (HAART). Aside from extending the life span, quality of life is vital in PLHIV management. However, there is a paucity of data on the cutaneous manifestations in PLHIV on HAART. The objective of this study is to ascertain the prevalence of cutaneous manifestations, effect on daily lives, and relation to CD4 levels. Methods: This is a prospective cross-sectional study comparing 2 groups of PLHIV patients on HAART and not on HAART therapy done from March 2020 to November 2020. Results: A total of 259 patients were recruited in this study with a mean age of 40 years. There were 216 (83.4%) male and 43 (16.6 %) female. Men having sex with men accounts for 49%. The most common cutaneous disorder was post-inflammatory pigmentation (20.4%). Infective dermatoses were 43 (6.7%), and cutaneous malignancy 3 (0.6%). Mean DLQI in PLHIV on HAART were 2, as compared to PLHIV not on HAART which scored 3. Bidayuh ethnicity accounts for 30% of adverse drug reactions with Bactrim being the most common drug. Conclusion There is a high prevalence of dermatoses in PLHIV. HAART increases the CD4 count of patients thereby reducing the risk of opportunistic infection and related disorders. However, it did not reduce the cutaneous manifestations in PLHIV, as HAART itself may increase the risk of adverse cutaneous drug reactions. DLQI is not the best tool to assess quality of life.
HIV ; Dermatomycoses--pathology

Background: Cutaneous disorders are common clinical manifestations of the Human Immunodeficiency Virus (HIV). In the era of antiretroviral therapy (ART), the spectrum of cutaneous disorders in HIV-infected patients has changed. We assessed the types of dermatoses, including cutaneous infections in HIVpositive patients and the association between the peripheral CD4 cell count and the severity of skin infection. Methods: All HIV-positive patients referred to the Dermatology Department of Hospital Sungai Buloh from January 2021 – December 2021 were enrolled in a prospective cross-sectional study. Patients were subjected to a complete medical and physical examination and appropriate investigation to confirm the diagnosis. Results: A total of 112 (92.6%) male and 9 (7.4%) female patients with a mean age of 38.76 ± SD years participated. The majority of patients were Malay (56.2%), with MSM (54.5%) being the commonest mode of transmission. 65.2% of patients had CD4≥350 cells/ mm3 and 86.7% of patients were on ART. Infections (56.1%) were the most common group of mucocutaneous manifestations, with 45.6% of these due to viral infections. There was no statistically significant correlation between the CD4 count and the severity of skin involvement in bacterial (p=0.302), viral (p=0.145) and fungal (p=0.533) infections. Conclusion Viral infection were the commonest cutaneous manifestations in HIV- positive patients. The frequency and severity of the cutaneous infections were much more common in patients with more advanced immunosuppression.
HIV Infections ; Dermatomycoses

Summary Cutaneous serratia marcescens (S. marcescens) infection is very rare and most cases had history of skin trauma or cutaneous procedure done before. It presents in various forms like non-healing ulcers, abscess formation, nodules with an intermittent course or as granulomatous lesions, thus mimicking non-infective lesions. Antibiotic choice is challenging due to multiple antibiotic resistant strains. We are reporting a case of cutaneous S. marcescens in a 70-year old lady with diabetes mellitus presented with non-healing ulcers over the dorsum of left hand for 6 months.
Serratia marcescens ; Dermatomycoses

Aims: Andrographis paniculata (AP), a medicinal herb was selected to investigate the antifungal activity on selected dermatophyte fungi. The phytochemical screening was also carried out to evaluate its chemical constituents. Methodology and results: The potato dextrose agar (PDA) incorporated with aqueous, ethanol and methanol AP extracts at concentrations 0.99% (v/v), 1.96% (v/v) and 7.41% (v/v) were used for selected fungi culturing; Trichophyton mentagrophytes, T. rubrum, T. interdigitale, Microsporum fulvum, M. nanum, M. gypseum, M. canis, Fusarium solani and Aspergillus fumigatus. Phytochemical screening showed the presence of flavonoids, saponins and tannins in the ethanol extract and flavonoids alone in both aqueous and methanol extracts. Studies on antifungal effects indicated that the ethanol extract significantly increased the mycelial inhibition percentage of all tested fungi, especially at a concentration of 7.41% (v/v). All ethanol AP extract concentrations inhibited M. gypseum and M. canis (p<0.05) with at least 36.00% mycelial inhibition. In aqueous AP extract, it significantly increased the mycelial inhibition of T. mentagrophytes, T. interdigitale and M. gypseum (p<0.05), while the methanol AP extract significantly inhibited all fungi at a concentration of 7.41% (v/v) except for T. rubrum, M. gypseum and F. solani (p<0.05). No spore sedimentation was recorded for the fungal spores of T. rubrum, M. nanum, T. mentagrophytes, M. gypseum and T. interdigitale at 7.41% (v/v) ethanol AP. Conclusion, significance and impact of study It is concluded that the ethanol AP extract contained phytochemical constituents and showed the highest antifungal activity. In addition, this extract has a great potential to treat dermatophytes effectively.
Antifungal Agents ; Phytochemicals ; Andrographis paniculata ; Dermatomycoses

Tinea versicolor (TV) is a common fungal skin disease caused by the Malassezia species. This disease usually presents as hypopigmented- or hyperpigmented coalescing scaly macules, papules, patches or plaques on the trunk and upper arms. Herein, we report a rare clinical manifestation of TV in a 29-year-old man presenting with marked follicular, erythematous, and hyperkeratotic papules on the trunk with erythematous scaly macules and patches on the upper extremities with intermittently spared skin. We initially suspected pityriasis rubra pilaris, however, skin biopsy results and mycological examination revealed TV. Polymerase chain reaction-based sequence analysis revealed Malassezia globosa. The patient was successfully treated with oral itraconazole and topical terbinafine.
Adult ; Arm ; Biopsy ; Dermatomycoses ; Humans ; Itraconazole ; Malassezia* ; Pityriasis Rubra Pilaris* ; Pityriasis* ; Sequence Analysis ; Skin ; Tinea Versicolor* ; Tinea* ; Upper Extremity

While mycological examinations, potassium hydroxide preparation, and fungus culture remain the gold standard for the diagnosis of superficial dermatomycoses, mycological procedures have limitations because they are rather complex, time-consuming, and require skilled personnel and additional mycological tools. Dermoscopy is a simple, non-invasive diagnostic technique that allows better visualization of morphologic structures of the skin than the naked eye. It is easily performed with a hand-held dermoscope and allows immediate diagnosis. It has been primarily used to evaluate pigmented skin lesions, but recent advances indicate that it can also be a useful and convenient tool for diagnosing superficial dermatomycoses. The determination of specific dermoscopic patterns of fungal infection, especially in selected cases involving terminal hairs or nails, could lead to a straightforward diagnosis and facilitate their differentiation from non-fungal skin diseases. In addition, dermoscopy permits better inspection of subtle clinical features caused by fungi that are less evident to the naked eye; thus, in most cases, it can enhance clinician's diagnostic accuracy and confidence level, and allow determination of the best site for adequate mycological sampling as well as therapeutic monitoring. However, it should be a part of the evaluation in combination with other mycological tests because it does not substitute confirmatory examination for superficial dermatomycoses.
Dermatomycoses* ; Dermoscopy* ; Diagnosis ; Fungi ; Hair ; Onychomycosis ; Potassium ; Skin ; Skin Diseases ; Tinea Capitis

Dermatomycosis refers to any fungal infection of the skin and may be caused by dermatophytes, yeast, or other fungi, including those that do not usually cause cutaneous disease. Clinical diagnosis of a dermatomycosis can be confirmed by microscopic detection of fungal elements, by identification of the species through culture, or by histologic evidence of the presence of fungal material in the tissue. In superficial mycoses, direct smear with KOH and fungal culture are the most valuable and useful diagnostic methods. For this reason, skin biopsy is not often employed in the workup of dermatophytosis or other superficial mycoses. But it is useful in diagnosis of deep fungal infections and some lesions in which KOH examination of scale is negative. This review article aims to provide insights on the histopathology and various special stains in diagnosing dermatomycosis.
Arthrodermataceae ; Biopsy ; Coloring Agents ; Dermatomycoses ; Diagnosis ; Fungi ; Mycoses ; Skin ; Tinea ; Yeasts

BACKGROUND: The need for dermatological consultations for hospitalized patients has gradually increased and there are a number of dermatoses caused by underlying psychological conditions. However, the data regarding the analyses of these consultations for psychiatric inpatients are limited. OBJECTIVE: To analyze the demographics and the type of dermatoses among inpatients with primary psychiatric diseases. METHODS: We retrospectively reviewed 581 consultation reports for inpatients referred by the Department of Psychiatry between January 1, 2009 and December 31, 2014. RESULTS: The proportion of the consulted patients from the Department of Psychiatry was 25.9% (331 consulted inpatients/1279 psychiatric inpatients). The most common age group was the 40~49 year-old group (19.3%) and the male to female ratio was 1:1.14. There were no remarkable findings regarding the annual or seasonal distribution. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the most common underlying psychiatric disorders were mood disorders (41.0%), followed by schizophrenia and other psychotic disorders (25.0%), and substance-related disorders (12.1%). The most frequent skin disorders were eczematous dermatoses (34.6%) and infectious dermatoses (32.2%); dermatomycosis (20.8%) was especially common. The most common reasons for consultation were new-onset dermatologic problems (68.5%), followed by persistence or aggravation of pre-existing dermatologic disorders (28.7%). CONCLUSION: This study reports the dermatologic characteristics of psychiatric inpatients. We conclude that dermatologists and psychiatrists need to be concerned about the education and continuous management of various skin diseases in psychiatric patients.
Demography ; Dermatomycoses ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Female ; Humans ; Inpatients* ; Male ; Mood Disorders ; Psychiatry ; Psychotic Disorders ; Referral and Consultation* ; Retrospective Studies ; Schizophrenia ; Seasons ; Skin ; Skin Diseases ; Substance-Related Disorders

BACKGROUND: The prevalence and clinical characteristics of dermatomycosis are not static but change under the influence of various forces such as geographic factor, social environment and development in prophylaxis and treatment. OBJECTIVE: To investigate the present status of dermatomycosis and changes on the prevalence, sex, age distribution and causative organisms. METHODS: We performed clinical and mycological studies on 7,785 cases of dermatomycosis among outpatients of Dermatologic clinic of Chonnam University Hospital for 10 years, from January 2001 to December 2010. RESULTS: The incidence of dermatomycosis was 12.5% of outpatients and show the highest incidence over 7th decades (24.2%). The incidence of tinea pedis (24.1%) was the highest, followed by onychomycosis (18.1%). Coexisting fungal infections were found 693 (9.2%) and the cases of tinea pedis with onychomycosis were the most common. The positive rate of KOH examination was 49.7% and the positive rate of culture on Sabouraud's dextrose agar media was 36.5%. Trichophyton rubrum was the most common causative organism of dermatomycosis (51.1%), followed by Candida species (33.2%). CONCLUSIONS: Consideration of the changes between current and past epidemiologic, clinical and mycological features in the cutaneous fungal infections are important to investigational efforts, diagnosis, and treatment.
Agar ; Age Distribution ; Candida ; Dermatomycoses ; Geography ; Glucose ; Humans ; Incidence ; Onychomycosis ; Outpatients ; Prevalence ; Social Environment ; Tinea Pedis ; Trichophyton