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Los dermatofitos son un grupo de hongos responsables de las dermatofitosis o tiñas, pudiendo afectar piel, uñas y pelo. En la actualidad están constituidos por los géneros Epidermophyton, Trichophyton, Microsporum, Arthroderma, Paraphyton, Lophophyton y Nannizzia. El examen microscópico directo y el cultivo en agar siguen siendo el estándar de oro para la identificación, sin embargo, en ocasiones se requiere de la biología molecular para poder corroborar una determinada especie. Dependiendo de la localización, del número de lesiones y de la extensión, el tratamiento de las dermatofitosis puede ser tópico o sistémico. Trichophyton indotineae y T tonsurans pueden expresar resistencia a la terbinafina y azoles, respectivamente.

Dermatophytes are a group of fungi responsible for dermatophytosis or ringworm, which can affect the skin, nails and hair. Currently, they are assembled by the genera Epidermophyton, Trichophyton, Microsporum, Arthroderma, Paraphyton, Lophophyton and Nannizzia. Direct microscopic examination and culture on agar remain the gold standard for identification, however, molecular biology is sometimes required to confirm a certain species. Depending on the location, the number of lesions and the extension, the treatment of dermatophytosis can be topical or systemic. Trichophyton indotineae and T tonsurans can express resistance to terbinafine and azoles, respectively.

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Introdução: A Tinea Capitis (TC) é uma dermatofitose que tem como evolução grave a forma Kerion Celsi (KC). Clinicamente, é caracterizada por manifestações tonsurantes e inflamatórias; diagnosticada por achados clínicos e laboratoriais, como micológico direto com KOH, tricoscopia e cultura fúngica. É utilizado no tratamento de TC antifúngicos sistêmicos por seis a oito semanas. Nesse caso houve associação de infecção secundária por Staphylococcus aureus, caracterizando um quadro atípico, raro. Objetivo: Relatar o caso, pouco descrito na literatura, de criança com Tinea Capitis (TC) com Kerion Celsi (KC) e bacteremia por contaminação secundária local e sistêmica de Staphylococcus aureus. Relato do caso: Paciente feminino, 5 anos, com manchas hiperemiadas, descamativas e pruriginosas de crescimento centrífugo em face, com surgimento de lesões circulares e pelos tonsurados em couro cabeludo que, após uso de antifúngico oral, houve inflamação aguda e saída de secreção. Apesar do tratamento independente domiciliar, com Betametasona e Cetoconazol creme e Cetoconazol 2% xampu, houve involução da lesão de face e ampliação da área de alopecia. Com a procura médica, iniciou tratamento sistêmico com Griseofulvina, seguido de antibioticoterapia oral por quadro bacteriano secundário em couro cabeludo. Houve linfonodomegalia cervical e intensificação do prurido e secreção. Foi internada para análise clínica e laboratorial, com antibioticoterapia endovenosa de amplo espectro: Ceftriaxona e Clindamicina. Colhida cultura da lesão e hemocultura, definiu-se, em ambas, S. aureus. Devido à resistência bacteriana, ocorreu troca para Cefazolina endovenosa. Na alta, a paciente seguiu com apoio dermatológico semanal e Griseofulvina, havendo a troca do antifúngico por Terbinafina. Conclusão: Quadro atípico e raro com progressão para bacteremia. O alerta para o diagnóstico precoce possibilita tratamento oral adequado e menor impacto da doença na qualidade de vida, evitando-se a contaminação secundária bacteriana

Introduction: Tinea Capitis (TC) is a dermatophytosis that has as severe evolution the form Kerion Celsi (KC). Clinically, it is characterized by tonsuring and inflammatory manifestations; diagnosed by clinical and laboratory findings, such as direct mycological with KOH, trichoscopy and fungal culture. It is used in the treatment of systemic antifungal CT for six to eight weeks. In this case there was an association of secondary infection by Staphylococcus aureus, characterizing an atypical, rare condition. Objective: To report the case, little described in the literature, of a child with Tinea Capitis (TC) with Kerion Celsi (KC) and bacteremia due to local and systemic secondary contamination of Staphylococcus aureus. Case report: Female patient, 5 years old, with hyperaemic, scaling and pruritic spots of centrifugal growth on the face, with the appearance of circular lesions and tonsure on the scalp that, after use of oral antifungal, there was acute inflammation and discharge of secretion. Despite the independent home treatment, with Betamethasone and Ketoconazole cream and Ketoconazole 2% shampoo, there was involution of the face injury and enlargement of the area of alopecia. With medical demand, he started systemic treatment with Griseofulvin, followed by oral antibiotic therapy for secondary bacterial condition in the scalp. There was cervical lymph node enlargement and intensification of pruritus and secretion. She was hospitalized for clinical and laboratory analysis, with broad spectrum intravenous antibiotic therapy: Ceftriaxone and Clindamycin. Culture of the lesion and blood culture, was defined in both S. aureus. Due to bacterial resistance, there was exchange for intravenous Cefazolin. At discharge, the patient followed with weekly dermatological support and Griseofulvin, with the exchange of antifungal by Terbinafine. Conclusion: Atypical and rare condition with progression to bacteremia. Early diagnosis provides adequate oral treatment and less impact of the disease on quality of life, avoiding secondary bacterial contamination

Introducción: La Tinea Capitis (TC) es una dermatofitosis cuya evolución severa es la forma Kerion Celsi (KC). Clínicamente se caracteriza por manifestaciones amigdalizantes e inflamatorias; se diagnostica por hallazgos clínicos y de laboratorio, como micología directa con KOH, tricoscopia y cultivo fúngico. Se utiliza en el tratamiento de la TC antifúngica sistémica durante seis a ocho semanas. En este caso se asoció infección secundaria por Staphylococcus aureus, caracterizando una condición atípica y rara. Objetivo: Reportar el caso, poco descrito en la literatura, de un niño con Tinea Capitis (TC) con Kerion Celsi (KC) y bacteriemia por contaminación secundaria local y sistémica de Staphylococcus aureus. Caso clínico: Paciente femenino, de 5 años de edad, con placas hiperémicas, descamativas y pruriginosas de crecimiento centrífugo en la cara, con aparición de lesiones circulares y pelo tonsurado en el cuero cabelludo que, luego de utilizar un antifúngico oral, presentó inflamación aguda y salida de secreciones. A pesar del tratamiento independiente domiciliario, con crema de Betametasona y Ketoconazol y shampoo de Ketoconazol al 2%, se presentó involución de la lesión facial y agrandamiento del área de alopecia. Con la búsqueda médica se inició tratamiento sistémico con Griseofulvina, seguido de antibioticoterapia oral por una afección bacteriana secundaria en el cuero cabelludo. Había agrandamiento de los ganglios linfáticos cervicales y aumento del prurito y la secreción. Ingresa para análisis clínicos y de laboratorio, con antibioticoterapia endovenosa de amplio espectro: Ceftriaxona y Clindamicina. Tras la recogida de cultivo de la lesión y hemocultivo, se definió S. aureus en ambos. Debido a la resistencia bacteriana, hubo un cambio a cefazolina intravenosa. Al alta, la paciente continuó con soporte dermatológico semanal y Griseofulvina, reemplazándose el antifúngico por Terbinafina. Conclusión: Condición atípica y rara con progresión a bacteriemia. La alerta para el diagnóstico precoz permite un adecuado tratamiento oral y menor impacto de la enfermedad en la calidad de vida, evitando contaminaciones bacterianas secundarias

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Resumen Querión Celso es una micosis ocasionada por hongos dermatofitos que daña el cuero cabelludo principalmente a niños y en raras ocasiones a adultos. La forma de infección para los humanos proviene de los animales y del suelo y se relaciona con mala higiene personal, hacinamiento en las viviendas, condiciones de subdesarrollo y pobreza. Se presenta un caso de un niño de 9 años con una úlcera de 7 cm de diámetro en el cuero cabelludo y en forma de placa circular que presentaba material purulento, pelo quebradizo y un área alopécica. Al inicio, se abordó de manera terapéutica como una infección bacteriana; posteriormente, se solicitó estudio micológico que evidenció una coinfección por el microorganismo Microsporum gypseum. Se le confirmó el diagnóstico de tiña capitis con afección inflamatoria y se le prescribió griseofulvina, lo que resultó en una curación completa.

Abstract Kerion Celsi is a mycosis caused by dermatophyte fungi that mostly affects children and rarely adults, causing damage to the scalp. The form of infection for humans comes from animals and the soil. The infection is related to poor personal hygiene, overcrowded homes, underdeveloped conditions, and poverty. A case of a 9-year-old boy with a 7cm diameter ulcer on the scalp and in the form of a circular plaque that presented purulent material, brittle hair and an alopecic area is presented. Initially it was therapeutically addressed as a bacterial infection, a mycological study was requested, which showed coinfection by the microorganism Microsporum gypseum, the diagnosis of tinea capitis with inflammatory condition was confirmed, and Griseofulvin was prescribed, resulting in complete cure.

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Trichophyton violaceum es un dermatofito antropofílico endémico en África, Europa, Centroamérica y China. El incremento de los fenómenos de movilidad humana ha contribuido a su aparición en áreas no endémicas. Su principal manifestación clínica es la tinea capitis, seguida por la tinea corporis. En la población pediátrica afecta con mayor frecuencia el cuero cabelludo; y en adultos, la piel glabra. Presentamos el primer caso en Chile de tinea causada por T violaceum. Correspondió a una mujer chilena de 21 años que presentó placas faciales de un mes de evolución después de un viaje a Tanzania, África, sin respuesta a tratamientos médicos previos. Se sospechó una dermatofitosis alóctona y mediante cultivos especiales, se identificó una colonia de crecimiento lento, coloración violeta-negruzca, superficie cerosa y rugosa, con vellosidades aterciopeladas; compatible con T violaceum. Se confirmó mediante secuenciación de ADN ribosomal amplificando la región ITS. Se trató con terbinafina oral con respuesta clínica completa.

Trichophyton violaceum is an anthropophilic dermatophyte endemic in Africa, Europe, Central America and China. The increase in human mobility has recently contributed to the appearance in non-endemic areas. The main clinical manifestation is tinea capitis followed by tinea corporis. We present the first case in Chile of tinea caused by T violaceum. The case was a 21 year-old Chilean woman who presented asymptomatic facial plaques one month after arriving from Tanzania, Africa, with no clinical response to previous medical treatments. An allochthonous dermatophytosis was suspected and with special cultures, a slow-growing colony was identified with a violet-blackish color, waxy and rough surface, and velvety villi; all characteristics of T violaceum. The diagnosis was confirmed by ribosomal DNA sequencing amplifying the ITS region. She was treated with oral terbinafine obtaining a complete clinical response.

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Las dermatofitosis corresponden a un grupo de enfermedades micóticas comunes en piel y fanéreas, donde Trichophyton rubrum es el agente causante más frecuente a nivel mundial y presente en nuestros 2 casos de pacientes masculinos con estas micosis, una en uñas y la otra en piel. Sin embargo, el enfoque de esta publicación se basa principalmente en la presencia de 2 interesantes contaminantes (uno en cada caso clínico) presentes solo en los cultivos de las primeras siembras como saprófitos y por ende como propágulos de dispersión, asociados al ambiente y sin intervención clínica demostrada en ambas micosis. La descripción morfofisiológica de estos 2 contaminantes Metarhizium purpureo-genum(similis) y Monascus ruber fue más bien una curiosidad esencial que el micólogo clínico adquiere en su contínua formación y ante la posibilidad de infecciones mixtas, pudiendo conjugar sus hallazgos junto al análisis taxonómico y los factores geográficos y edáficos asociados a su distribución. (AU)

Dermatophytoses belongs to a group of common mycotic diseases in skin and pharynals, where Trichophyton rubrum is the most frequent causative agent worldwide and present in our 2 cases of male patients with these mycoses, one in nails and the other in skin. However, the focus of this publication is mainly about the presence of 2 interesting contaminants (one in each clinical case) present only in the crops of the first sowings as saprophytes and therefore as dispersal propagules, associated with the environment and without clinical intervention demonstrated in both mycoses. The morphophysiological description of these 2 contaminants, Metarhizium purpureogenum (similis) and Monascus ruber was rather an essential curiosity that the clinical mycologist acquires in his continuous training and in the face of the possibility of mixed infections, being able to combine his findings together with the taxonomic analysis and the geographic and edaphic factors associated with its distribution. (AU)

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A descriptive observational and cross-sectional study was carried out. The clinical characteristics, etiologic agents, treatments and outcome of 33 cases of tinea capitis in the Mycology Unit at Francisco J. Muñiz Hospital of Buenos Aires City between January 2015 and December 2019 were analyzed. The median age of the patients was 7 years, 21 of whom were male, 3 were HIV-positive and 22 had pets. The isolated etiologic agents were the following: Microsporum canis in 22 cases, Trichophyton tonsurans in 8, Nannizzia gypsea in 2 and Trichophyton mentagrophytes in one patient. Suppurative tinea capitis (krion Celsi) was detected in 10 cases and the same number of patients presented other skin locations of their dermatophytosis in addition to those in the scalp. Twenty-one cases were orally treated with griseofulvin and 12 with terbinafine. Those patients with suppurative tinea capitis received drops of betamethasone by mouth besides the antifungal drugs. All patients had good clinical and mycological response to the treatments, all lesions disappeared, and mycological studies turned negative by the end of the treatments. We conclude that both drugs were effective for the treatment of tinea capitis; however, lesions in those cases receiving terbinafine involuted more slowly.

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La tiña capitis (TC) es una infección por dermatofitos con una alta prevalencia en la población pediátrica. Su epidemiología ha cambiado en las últimas décadas debido a la creciente migración poblacional alrededor del mundo. Se han identificado factores de riesgo ambientales y propios del huésped, relacionados al desarrollo de esta infección. Las manifestaciones clínicas son variables y dependen del agente causal. La dermatoscopia y la luz de Wood son herramientas útiles para la aproximación diagnóstica, sin embargo, la confirmación de la infección se basa en las pruebas micológicas. El aislamiento del agente causal permite orientar el tratamiento antifúngico adecuado, siendo estos eficaces y seguros en población pediátrica. El tratamiento se centra en la terapia antimicótica sistémica en combinación con medidas locales. El objetivo del manuscrito es hacer una revisión actualizada sobre el enfoque clínico y terapéutico de la TC en población pediátrica.

Tinea capitis (TC) is a dermatophyte infection with a high prevalence in the pediatric population. Its epidemiology has changed in recent decades due to increasing population migration worldwide. Environmental and host-specific risk factors have been identified which are with the development of this infection. The clinical manifestations are variable and depend on the causal agent. Dermatosco- py and Wood's lamp are useful tools for the diagnostic approach; however, the confirmation of in fection is based on mycological tests. The identification of the causal agent allows guiding the appro priate antifungal treatment, which is specific and safe in the pediatric population. Treatment focuses on systemic antifungal therapy combined with local measures. The objective of this paper is to carry out an updated review of the clinical and therapeutic approach to TC in the pediatric population.

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BACKGROUND: Dermatophytoses in children are common pathologies worldwide caused mainly by Trichophyton rubrum. However, due to the globalization and the atypical pets that people nowadays own, some zoonotic species are also involved in these lesions. CASE REPORT: We present two cases of tinea faciei caused by the zoonotic mould Trichophyton erinacei in two children that owned a guinea pig and a hedgehog, respectively. Mycological diagnosis was performed inoculating skin scales on Sabouraud-glucose agar plates supplemented with chloramphenicol, with and without gentamicin, and on Sabouraud-glucose agar tubes, with and without cycloheximide. Microscopical examination in both cases and ITS region sequencing to confirm the identification (performed in one of them) were compatible with T. erinacei. Multiple treatments like corticosteroids and antibiotics were prescribed prior to the accurate diagnosis. Finally, both patients received topical and oral terbinafine, respectively, the lesions being resolved entirely. CONCLUSIONS: Zoonotic fungi must be considered in the diagnosis of skin lesions. An accurate medical record, with a guided anamnesis about possible risk factors and an ongoing and open dialogue between health professionals, are essential to improve both the management of these exotic and zoophilic dermatophytoses.

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RESUMEN La tiña de la cabeza (tineacapitis) es una dermatofitosis del cuero cabelludo frecuente en niños. Es la más común de todas las micosis cutáneas en este grupo de edad a nivel mundial, y es muy rara en adultos. Se ha considerado unproblema de salud pública importante durante décadas.Algunos de los factores asociados son higiene personal deficiente, hacinamiento y bajo nivel socioeconómico.El agente etiológico frecuentemente aislado fue elMicrosporumcanis con un 82,09 %, seguido por Trichophytontonsurans con 17,91%. Enconclusión,la tineacapitis ocupa un lugar preponderante que merece ser estudiado,siendo necesarios la detección y tratamiento precoz para evitar complicaciones.Se presenta un caso de tineacapitis, en el que se evidencia clínicamente infección micótica por Microsporumcanis.

SUMMARY Ringworm of the head (tinea capitis) is a frequent dermatophytosis of the scalp in children. In fact, it is the most common of all cutaneous mycosis in this age group worldwide, being very rare in adults. It has been considered an important public health problem for decades, of the factors associated are: poor personal hygiene, overcrowding and low socioeconomic level. The most frequently isolated etiologic agent was Microsporumcanis with 82.09% followed by Trichophyton tonsurans with 17.91% In conclusion tinea capitis occupies a preponderant place that deserves to be studied, being necessary the detection and early treatments to avoid complications.A case of tinea capitis is presented, where there is clinically evidence of fungal infection by Microsporumcanis.

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OBJECTIVE: The aim of this study was to evaluate the epidemiological profile of dermatophytoses from 2008 to 2017 in the area of "Barcelonès Nord", located in north-eastern Spain. METHODS: From 2008 to 2017, 13,419 specimens obtained from patients with suspected superficial mycosis were subjected to direct microscopy and culture. Clinical and sociodemographic data were recorded. Proportions were compared using Chi-square and Fisher's exact tests. A logistic regression model was used for multivariate analysis. RESULTS: Trichophyton rubrum was the most frequently isolated fungus (76.1%), followed by Trichophyton mentagrophytes/Trichophyton interdigitale (11.9%) and Microsporum canis (2.9%). Among the population over 15 years of age, tinea unguium pedum (40.4%) and tinea corporis (29.1%) were the predominant dermatophyte infections. Tinea capitis was mostly prevalent (53.6%) among patients up to 15 years of age, followed by tinea corporis (21.4%). We observed an increase in non-endemic anthropophilic dermatophytes (Trichophyton soudanense, Microsporum audouinii and Trichophyton violaceum) in the last few years. These species were associated with the population up to 15 years of age (p<0.001), having tinea capitis (p=0.0017) and being of African/Hindustani origin (p<0.001). CONCLUSIONS: We confirmed the spread of T. rubrum as the predominant dermatophyte in our area and reported an increase in non-endemic anthropophilic dermatophytes in the last few years, especially in the African and Hindustani population up to 15 years of age.

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O objetivo desta pesquisa foi verificar a prevalência de dermatófitos em tegumento de bovinos e ovinos hígidos e a sua capacidade de transmissão e desenvolvimento da doença. Para isso, foram coletadas amostras de pelo e descamações de 90 bovinos e 90 ovinos hígidos. Essas amostras foram semeadas em meio DTM e ágar Sabouraud Dextrose enriquecido com extrato de levedura, tiamina, antibióticos (estreptomicina e cloranfenicol) e suplementado de cicloheximida, sendo essas incubadas a 35 oC por 10 dias. As culturas positivas foram avaliadas macro e microscopicamente e, os fungos foram identificados por métodos bioquímicos. Verificou-se que as espécies isoladas com maior frequência, nos bovinos, foram T. mentagrophytes e M. gypseum. Nos ovinos, foi constatada maior ocorrência do agente T. verrucosum, seguido por T. mentagrophytes e M. gypseum. Houve também isolamento de M. canis, porém, em um número reduzido de amostras. Assim, concluiu-se que o tegumento de bovinos e de ovinos hígidos apresentou incidência elevada de dermatófitos de diferentes espécies, em amostras coletadas durante o período chuvoso do ano. Por isso, em animais jovens ou naqueles submetidos a elevados níveis de estresse e, consequente queda da resposta imunológica, o risco de desenvolvimento da dermatofitose e da transmissão dos dermatófitos neste período são eminentes.(AU)

The purpose of this study was to determine the prevalence of dermatophytes in healthy cattle and sheep teguments, and their ability to transmit and develop diseases. Samples of fur and flaking from 90 healthy cattle and 90 healthy sheep were collected. These samples were plated on DTM medium and Sabouraud Dextrose agar supplemented with yeast extract, thiamine, antibiotics (streptomycin and chloramphenicol) enhanced with cycloheximide. They were then incubated at 35 °C for 10 days. Positive cultures were macroscopically and microscopically evaluated, and fungi were identified by biochemical methods. It was found that the most frequent species isolated in cattle were T. mentagrophytes and M. gypseum. In sheep, a higher occurrence of the agent T. verrucosum could be observed, followed by T. mentagrophytes and M. gypseum. There was also the isolation of M. canis, but in a small number of samples. Thus, it could be concluded that the tegument of healthy cattle and sheep showed high incidence of dermatophytes from different species in samples collected during the rainy season of the year. Therefore, in young animals, in those subjected to high levels of stress and consequent drop in immune response, there is eminent risk of developing dermatophytosis and transmission of dermatophytes in this period.(AU)

El objetivo de esta investigación ha sido verificar la prevalencia de dermatofitos en tegumento de bovinos y ovinos hígidos y su capacidad de transmisión y desarrollo de la enfermedad. Para ello, se recolectó muestras de pelo y descamaciones de 90 bovinos y 90 ovinos hígidos. Esas muestras fueron sembradas en medio DTM y agar Sabouraud Dextrosis enriquecida con extracto de levadura, tiamina, antibióticos (estreptomicina y cloranfenicol) y suplementado de cicloheximida, siendo esas incubadas a 35ºC durante 10 días. Los cultivos positivos fueron evaluados macro y microscópicamente y los hongos fueron identificados por métodos bioquímicos. Se verificó que las especies aisladas con mayor frecuencia, en los bovinos, fueron T. mentagrophytes y M. gypseum. En los ovinos, se constató mayor ocurrencia del agente T. verrucosum, seguido por T. mentagrophytes y M. gypseum. También hubo aislamiento de M. canis, sin embargo, en un número reducido de muestras. Así, se concluyó que el tegumento de bovinos y de ovinos hígidos presentó una elevada incidencia de dermatofitos de diferentes especies, en muestras recogidas durante el período lluvioso del año. Por lo tanto, en animales jóvenes o en aquellos sometidos a altos niveles de estrés y, consecuente caída de la respuesta inmunológica, el riesgo de desarrollo de la dermatofitosis y de la transmisión de los dermatofitos en este período son eminentes.(AU)

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CASE REPORT: The case is presented of a 3-year-old girl with an erythematous oedematous plaque associated with blepharitis, and chalazion in the right upper eyelid. She received empirical treatment with topical corticosteroids, as well as an antifungal and antibiotic, without observing any improvement. The culture of the eyelid scrape showed Microsporum canis. Therefore, she was prescribed oral terbinafine and topical miconazole-betamethasone, achieving a clinical and microbiological recovery. DISCUSSION: Eyelid infection due to dermatophytes is uncommon, but it should be considered among the diagnostic suspicions of palpebral skin lesions. The microbiological study is a key factor for its diagnosis and appropriate treatment.

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BACKGROUND: No reliable data are available in the province of Buenos Aires regarding the frequency of dermatophytoses and other fungal diseases. The distribution of the clinical forms and the species involved are also unknown. AIMS: To present the data collected by the laboratories participating in the Mycology Network of the province of Buenos Aires (MNPBA) from a retrospective epidemiological survey on dermatophytoses. METHODS: A descriptive and exploratory analysis was performed on the cases of dermatophytoses gathered between 2002 and 2007 by the Mycology Network of the province of Buenos Aires. RESULTS: Of the 3966 dermatophytosis cases reported by 41 laboratories in 31 municipalities, more than a half occurred in three highly populated urban municipalities. The male:female ratio was 1:1.5. The most frequent clinical form was tinea unguium, diagnosed in 904 cases (51.83%), followed by tinea capitis (19.32%), tinea corporis (15.19%), tinea pedis (6.77%), tinea cruris (3.73%), and tinea manuum (2.18%). The species involved was identified in 1368 (33.49%) cases. Trichophyton rubrum was the most common species, with a frequency of 42.03%. An association was found between urban municipalities and T. rubrum or the Trichophyton mentagrophytes complex. CONCLUSIONS: Results from the MNPBA survey provide valuable information that should enable further interventions to be designed in order to prevent and control the disease.

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Resumen Introducción: Las dermatofitosis son infecciones comunes en humanos, provocadas por hongos de los géneros Trichophyton, Microsporum y Epidermophyton. Objetivo: Determinar la frecuencia de E. floccosum en dermatofitos aislados en un laboratorio de la Región de Valparaíso durante las últimas tres décadas. Conocer las localizaciones más frecuentes, los grupos etarios y sexo de los pacientes afectados por este agente. Materiales y Método: Se revisaron los informes de cultivos superficiales con desarrollo de E. floccosum, Microsporum spp y Trichophyton spp de las tres últimas décadas del laboratorio de Micología de la Universidad de Valparaíso. Se registró en una planilla Excel el resultado del cultivo, edad, sexo y ubicación de la lesión de los pacientes. Resultados: El total de dermatofitosis con agente identificado fue de 6.780. En 26 casos hubo desarrollo de E. floccosum, de éstos, 73% (19/26) fueron en hombres y con una edad promedio de 37 años. La frecuencia disminuyó progresivamente desde la década de los ochenta hasta la del 2000. El grupo etario más afectados fue el de 36-60 años. Las localizaciones más frecuentemente afectadas fueron la planta y uñas de los pies. Conclusiones: Existe una disminución progresiva de la frecuencia de aislamiento de E. floccosum en el período estudiado. El sexo masculino y el grupo etario de 36-60 años fueron los más afectados. Las localizaciones más frecuentes fueron la planta y uñas de los pies.

Background: Dermatophytoses are frequent infections in human, which are produced by fungus genera Trichophyton, Microsporum and Epidermophyton. Aim: To determine frequency of E. floccosum in isolated dermatophyte in a laboratory from Valparaíso during the last three decades, in addition to knowing the most frequent localization, age and gender of patients affected by this agent. Method: All superficial culture reports, issued by the Universidad de Valparaíso's mycology laboratory in the last three decades, with E. floccosum, Microsporum spp and Trichophyton spp development, has been reviewed. Patients age, gender, location of the injury and culture report has been registered in an excel spreadsheet. Results: The total number of reports with dermatophyte development in the culture was 6,780. Only 26 cases show E. floccosum development, 73% of this (19/26) were present on men with and average age of 37 years. Frequency did progressively fall since eighty's until 2000 decade. The age group most affected by this etiological agent was 30-36 years. The most frequently localization in both man and woman were foot plant and nails. Conclusions: Frequency of isolation did decrease progressively in dermatophytose by E. floccosum for the study period. Masculine gender and 36-60 age group were the most affected. The most frequently localization were foot plant and nails.

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En el marco del 80 aniversario del Instituto de Medicina Tropical Pedro Kourí, se exponen en apretada síntesis, las actividades más relevantes en el campo del diagnóstico, la investigación y la docencia desarrolladas hasta el momento por el Laboratorio de Micología de la referida institución. A 38 años de su creación, este sigue siendo uno de los pocos lugares en Cuba que se desempeña en este campo y que se reconoce por los logros científico-técnicos alcanzados. Sin lugar a duda, estos responden básicamente al cuadro de salud nacional, sin descuidar el entorno regional y mundial. Todos los resultados que se exponen, se encuentran sustentados por más de 100 publicaciones y otras obras científicas, lo que avala la calidad y rigor del trabajo desplegado. Sirva este artículo para homenajear al fundador del Instituto de Medicina Tropical Pedro Kourí y a todos los científicos que en el transcurso de estos años contribuyeron a engrandecer su nombre(AU)

In the framework of the 80th anniversary of Pedro Kouri Tropical Medicine Institute, a succinct presentation is provided of the most relevant activities in the fields of diagnosis, research and teaching so far performed by the Mycology Laboratory at the Institute. Thirty-eight years after its founding, the Laboratory continues to be one of the few places in Cuba devoted to this field and recognized for its scientific and technical achievements, which no doubt essentially respond to the national health status, without neglecting the regional and global environment. All the results presented are endorsed by over 100 publications and scientific works, which is evidence of the quality and rigor of the work done. May this paper be a tribute to the founder of Pedro Kouri Tropical Medicine Institute and all the scientists who have brought prestige to its name throughout these years(AU)

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BACKGROUND: Dermatophytoses are skin superficial mycoses in which clinical manifestations are directly related to the virulence of the infecting microorganism or the host immunity. CASE REPORT: We describe a severe case of dermatophytosis associated with exfoliative erythroderma, substantial palmoplantar keratoderma, onychodystrophy affecting all nails, diffuse non-scarring alopecia and tissue fungal invasion by Trichophyton tonsurans, which led us to the diagnosis of AIDS. Direct examination and culture for fungi from skin scraping from two different sites were performed. Biopsy and histopathological exam were also performed on three different sites. Direct examination of the lesions' scraping revealed septate hyaline hyphae and arthroconidia, identified as Trichophyton tonsurans by culture in glucose Sabouraud agar and Mycosel agar. A scalp biopsy revealed follicular fungal invasion and Majocchi's granuloma. Due to the severity of the presentation we requested an anti-HIV serology, which was positive. The patient was treated with itraconazole, 200mg/day, for 120 days, which promoted a complete regression of the lesions. CONCLUSIONS: Severe and atypical forms of dermatophytosis could lead to a diagnosis of AIDS.

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Introducción: las dermatofitosis por Microsporum spp. son infecciones frecuentes y han experimentado cambios en los distintos continentes, durante los últimos años. Objetivo: conocer las especies del género Microsporum que causan dermatofitosis, además de analizar las diferencias según sexo, edad y localización de estas infecciones, en pacientes de la región de Valparaíso. Materiales y Método: se revisaron los informes emitidos por el Laboratorio de Micología de la Facultad de Medicina de la Universidad de Valparaíso, durante el período 2002-2016. Se seleccionaron los informes de pacientes con examen microscópico directo con hifas, artroconidios y/o microconidios, además de cultivo con desarrollo de alguna especie del género Microsporum. En una planilla Excel se registraron las variables de edad, sexo, ubicación de la lesión, resultado del examen microscópico directo e identificación de la especie. Resultado: se incluyeron 285 pacientes, el 61,4% fueron mujeres, con un promedio de edad de 16 años. El grupo de los menores de 8 años fue el que presentó más infecciones, seguido por el de 16-35 años. Las localizaciones más frecuentes fueron cuero cabelludo y uñas. La tiña capitis se diagnosticó principalmente hasta los 35 años, luego de lo que predominó la onicomicosis de pies. El agente que se aisló con mayor frecuencia fue M. canis, seguido por M. gypseum. Conclusiones: las mujeres y los menores de 8 años presentaron la mayoría de las dermatofitosis por Microsporum spp. La tiña capitis fue la localización más frecuente, especialmente en niños y la onicomicosis fue la segunda en frecuencia, principalmente en adultos. M. canis fue el agente más frecuente, seguido por M. gypseum.

Introduction: the dermatophytosis caused by Microsporum spp. are frequent infections that have been undergone through changes in the different continents during the last years. Objective: to know the species of the Microsporum genus that cause dermatophytosis, besides to analyze the differences according to sex, age and location of these infections in patients from the region of Valparaíso. Materials and Method: the reports issued by the Mycology Laboratory of the University of Valparaíso during the period 2002-2016 were reviewed. Patients who had lesions compatible with dermatophytosis, direct microscopic examination with hyphae, arthroconidia and/or microconidia, and culture with development of some species of the genus Microsporum were selected. In an excel file, the variables of age, sex, location of the lesion, direct microscopic examination and identification of the species were recorded. Results: 285 patients were included in this study, 61.4% of them were women, with a mean age of 16 years. The group of children under 8 years old present greater quantity of infections, followed by the group of 16 to 35 years old. The most frequent locations were scalp and nails. The tinea capitis was diagnosed mainly until 35 years old, after which the foot onychomycosis become predominate. The agent that was most frequently isolated was M. canis, followed by M. gypseum. Conclusions: women and children under the age of 8 years presented the most infections. Tinea capitis was the most common site especially in children, and onychomycosis was the second most frequent, mainly in adults. M. canis was the most frequent agent followed by M. gypseum.

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Resumen ANTECEDENTES: las dermatofitosis son micosis superficiales causadas por un grupo de hongos parásitos de la queratina, denominados dermatofitos. Comprenden tres géneros: Trichophyton, Microsporum y Epidermophyton. Son cosmopolitas, predominan en climas cálidos y húmedos, y representan 70 a 80% de todas las micosis. OBJETIVO: identificar la frecuencia de consulta por tiña del cuerpo en una zona urbana tropical. MATERIAL Y MÉTODO: estudio descriptivo, abierto y transversal, en el que durante tres meses en 2015 se registraron todos los pacientes con diagnóstico clínico de tiña del cuerpo que asistieron a la consulta de dermatología de un hospital de segundo nivel de Playa del Carmen, Quintana Roo, México. Se registraron los datos demográficos, tiempo de evolución, topografía y factores predisponentes asociados. Se realizó examen directo en escama con hidróxido de potasio (KOH), cultivo micológico en medio de Sabouraud y examen directo del cultivo con azul de lactofenol para identificar al agente causal. RESULTADOS: de 546 consultas de dermatología general se detectaron 17 pacientes (3%) y se corroboró el diagnóstico con KOH en 14 pacientes (82%, nueve mujeres [64%]), entre éstos hubo crecimiento en el cultivo en 9 muestras (64%). Se aisló Microsporum canis en 4 (44%), Trichophyton rubrum en 4 (44%) y T. mentagrophytes en uno (11%). Los límites de edad fueron 3 y 57 años (4 niños, 28.5%). El tiempo de evolución promedio fue de 15 semanas. La localización más frecuente fueron las extremidades. Los factores predisponentes más comunes fueron el contacto con mascotas infectadas y la administración de corticoesteroides. CONCLUSIONES: la tiña del cuerpo representa 3% de la consulta de dermatología en un hospital de una zona urbana tropical. Fue más frecuente en mujeres, predominó en las extremidades y en 28.5% afectó a población pediátrica. T. rubrum y M. canis fueron los agentes causales más frecuentes.

Abstract BACKGROUND: Dermatophytosis are superficial mycosis caused by dermatophytes, a group of fungi that parasite keratin, and is composed of three genera: Trichophyton, Microsporum and Epidermophyton. They predominate on hot and humid climates, and are responsible of 70-80% of all mycosis. OBJETIVE: To identify the frequency of consultation for tinea corporis. MATERIAL AND METHOD: A descriptive, open and cross-sectional study in which, during three months in 2015, all patients with clinical diagnosis of tinea corporis that attended to the dermatology department in a second level hospital at Playa del Carmen, QR, Mexico, were registered including demographic data, such as progression time, topography and associated predisposing factors; a KOH mount was performed, as well as mycological culture in Sabouraud dextrose agar and microscopic examination of the colony with lactophenol blue to identify the causal agent. RESULTS: Out of 546 visits to the dermatology service, the diagnosis was confirmed in 17 patients (2.5%) and diagnosis was confirmed with a positive KOH mount in 14 patients (82%, nine women [64%]), and in 9 samples there was culture growth (64%). Microsporum canis and Trichophyton rubrum were isolated in 4 cases (44%) each, and Trichophyton mentagrophytes in one case (11%). Age range was 3-57 years, with four children registered (28.5%). The progression time of the disease was 15 weeks in average. The most frequent topography was the extremities. The most common predisposing factors were contact with infected pets and the administration of corticosteroids. CONCLUSIONS: Tinea corporis represents 3% of the dermatology consultation in a second level hospital in urban tropical zone. It is more frequent in female patients, affecting more frequently extremities; 28.5% were children. The isolated causal agents were M. canis and T. rubrum.

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Introducción: los dermatofitos son las principales causas de micosis superficial. Su epidemiología es poco conocida en Paraguay. Objetivos: describir las especies prevalentes, tipos de tiñas y características según sexo y edad de pacientes que acudieron al Laboratorio Central de Salud Pública, Asunción- Paraguay,en el período 2000-2016. Materiales y Métodos: se estudiaron pacientes de todas las edades con diagnóstico de micosis superficiales. Las muestras procesadas fueron uñas, pelos y escamas epidérmicas Se realizaron exámenes directos con KOH y cultivos. La identificación fue por macro y microscopía de las colonias. Resultados: de 6.652 pacientes con sospecha de micosis superficiales, 803 (12%) fueron positivas para dermatofitos. Los aislamientos fueron Microsporumcanis (33,9%), Trichophytonrubrum (23,8%), Trichophytonmentagrophytes (22%), Trichophytontonsurans (12,6%), Microsporumgypseum (6,2%), Trichophytonverrucosum (1,4%), un aislamiento para Microsporummanuumy Epidermophytonfloccosum respectivamente. Los tipos de tiñas fueron: capitis (54,3%), corporis (27,1%) yunguium (9,8%), pedís (3,8%), cruris (3%) y manuum (2%). Conclusión: el hongo prevalente fue Microsporumcanis (33,9%) y la tiña más frecuente fue capitis.

Introduction: dermatophytes are the main causes of superficial mycosis. Its epidemiology is less known in Paraguay. Objectives: to describe the prevalent species, types of tinea and features according to sex and age of patients who attended the Central Laboratory of Public Health, Asunción-Paraguay, in the period 2000-2016. Materials and Methods: patients of all ages with a diagnosis of superficial mycosis were studied. The samples processed were nails, hairs and epidermal scales. Direct tests were carried out with KOH and cultures. The identification was by macro scopy and microscopy of the colonies. Results: of 6,652 patients with suspected superficial mycoses, 803 (12%) were positive for dermatophytes. The isolates were Microsporum canis (33.9%), Trichophyton rubrum (23.8%), Trichophyton mentagrophytes (22%), Trichophyton tonsurans (12.6%), Microsporum gypseum (6.2%), Trichophyton verrucosum (1,4%), isolation for Microsporum manuum and Epidermophyton floccosum respectively. The types of tinea were: capitis (54.3%), corporis (27.1%) and unguium (9.8%), pedis (3.8%), cruris (3%) and manuum (2%). Conclusion: The prevalent fungus was Microsporum canis (33.9%) and the most frequent tinea was capitis.

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Este trabajo tuvo como objetivo determinar la presencia de micosis superficiales (MS) en la etnia Yanomami de Mawaca, estado Amazonas. De 176 personas examinadas, 64 mostraron lesiones sospechosas de MS, obteniendo 65 muestras: 10 de pitiriasis versicolor (PV) y 55 de dermatofitosis. El estudio micológico consistió en realizar exámenes directos, cultivos en agares micológicos, perforación del pelo in vitro, pruebas de ureasa y agar púrpura de bromocresol-glucosa-sólidos lácteos (Agar BCP-MS-G). De las 10 muestras sospechosas de PV, 3 fueron positivas, dos de niños menores de 10 años y una de un adulto, todos con lesiones en cara. En 36 raspados obtenidos se observaron hifas hialinas septadas. Se aislaron 52 colonias sospechosas de dermatofitos y de éstos, uno fue compatible con el Complejo Microsporum gypseum, de una lesión en la rodilla de un adulto. Las 51 restantes pertenecieron al Complejo Trichophyton rubrum, de los cuales, nueve perforaron el pelo in vitro, 24 hidrolizaron la urea y ninguno alcalinizó el medio Agar BCP-MS-G; la forma clínica fue tinea corporis y las lesiones se localizaron principalmente en espalda y oreja en adultos y niños, respectivamente. Estos resultados revelan la existencia de MS en la población Yanomami, sirviendo de base para futuros estudios epidemiológicos.

The purpose of this study was to determine the presence of superficial mycoses (SM) in the Yanomami ethnicity at Mawaca, Amazon State. Of 176 persons examined, 64 showed suspicious SM lesions, from which we obtained 65 samples: 10 pytiriasis versicolor (PV) and 55 dermatophytosis. The mycological study consisted in carrying out direct examination, culture in mycological agar, in vitro hair perforation, and urease and bromocresol purple-milk solids glucose agar (BCP-MS-G Agar) tests. Of the 10 PV suspicious lesions, 3 were positive, two in children under 10 years old and one in an adult, all with face lesions. In 36 scrapings we saw septate hyaline hyphae. Fifty-two dermatophyte suspicious colonies were isolated and of these, one was compatible with the Microsporum gypseum Complex, from a lesion on the knee of an adult. The other 51 belonged to the Trichophyton rubrum Complex, of which nine were in vitro hair perforations, 24 hydrolized urea, and none alkalinized the BCP-MS-G agar medium; the clinical form was tinea corporis and the lesions were mainly localized at the back and ears in children and adults respectively. These results reveal the existence of SM in the Yanomami population, serving as basis for future epidemiological studies.