The effects of therapeutically relevant concentrations of the human immunodeficiency virus (HIV) proteinase inhibitors saquinavir and indinavir on the in vitro proteinase activity of Candida albicans were investigated with isolates from HIV-infected and uninfected patients with oral candidiasis. After exposure to the HIV proteinase inhibitors, proteinase activity was significantly reduced in a dose-dependent manner. These inhibitory effects, which were similar to that of pepstatin A, and the reduced virulence phenotype in experimental candidiasis after application of saquinavir indicate the usefulness of these HIV proteinase inhibitors as potential anticandidal agents.

Tinea mammae is a dermatophyte infection of the breast. Although rarely reported in this anatomical location, it can mimic other dermatoses. In this paper we describe an 85-year-old man with an erythema at the left breast which had enlarged over the previous 3 weeks. Trichophyton rubrum was isolated. Digital 20-MHz sonography revealed a reduction in echogenicity of the corium and a widened corium. Treatment with fluconazole over 5 weeks led to clearing of the lesion at the glabrous skin. At the end of therapy no difference between the involved and uninvolved skin areas was found sonographically.

Trichophyton rubrum infections occur worldwide. In the last few years Trichophyton rubrum has increasingly often been isolated from other parts of the body besides the soles of the feet, toenails and the groin. Our patient's infection spread from the feet, to the inguinal region, to the thighs, to the hips, to the abdominal wall, to the left forearm and even the axillae. Such skin lesions have recently been called chronic dermatophytosis syndrome. We describe this new entity for the first time in the German literature and discuss it in relation to commonly found Trichophyton rubrum infections.

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