Pathogenesis, Immunology and Management of Dermatophytosis

Abstract

Dermatophytic infections of the skin and appendages are a common occurrence. The pathogenesis involves complex interplay of agent (dermatophytes), host (inherent host defense and host immune response) and the environment. Infection management has become an important public health issue, due to increased incidence of recurrent, recalcitrant or extensive infections. Recent years have seen a significant rise in incidence of chronic infections which have been difficult to treat. In this review, we review the literature on management of dermatophytoses and bridge the gap in therapeutic recommendations.

Genetic Characterization of Microsporum canis Clinical Isolates in the United States

“…While the immune system is considered competent by 6–12 weeks of age in cats, the cellular processes critical for eliminating dermatophytes (the maturation of phagocytic and antigen-presenting cells) have not been studied [ 48 ]. Mature versions of these phagocytic and antigen-presenting cells are responsible for removing dermatophytes from the host through extra/intracellular lysis of the fungi and cytokine production [ 49 ]. However, immature versions of these cells could have a delayed or less potent response during the beginning stages of infection, preventing kittens from quickly eliminating infection before clinical signs develop.…”

Emerging Trends in the Use of Topical Antifungal-Corticosteroid Combinations

“…Overall, there are two types of skin mycoses: (1) the common superficial type, and (2) the less common deep, invasive and systemic type [ 21 , 22 ]. The majority of superficial fungi that reside on the skin, hair and nails degrade keratin—a structural protein responsible for maintaining the skin’s structural stability and integrity [ 23 ]—and utilise it as a nutrient source for their growth [ 24 , 25 , 26 ]. When a fungal cell invades the skin surface—specifically the cornified top layer of the epidermis rich in keratin—, it produces keratinase enzyme, which degrades the tissue and ultimately causes skin inflammation that is often accompanied by pruritus (itch) [ 24 , 25 , 26 ].…”

“…The majority of superficial fungi that reside on the skin, hair and nails degrade keratin—a structural protein responsible for maintaining the skin’s structural stability and integrity [ 23 ]—and utilise it as a nutrient source for their growth [ 24 , 25 , 26 ]. When a fungal cell invades the skin surface—specifically the cornified top layer of the epidermis rich in keratin—, it produces keratinase enzyme, which degrades the tissue and ultimately causes skin inflammation that is often accompanied by pruritus (itch) [ 24 , 25 , 26 ]. These types of fungi are known as keratinophilic dermatophytes, which include several fungi under the genera Epidermophyton , Microsporum and Trichophyton , and can cause several contagious superficial fungal skin infections (dermatomycoses) of various body regions.…”

Dermatophytosis: Etiological Agents and Associated Risk Factors

“…Dermatophytes are superficial filamentous fungi that invade and feed on keratinized tissues like, skin, hair, and nails, causing an infection [1][2][3].The group of dermatophytes comprises 52 keratin-degrading species divided into nine genera of which Trichophyton (usually affecting skin, hair and nails), Microsporum (usually affecting skin, hair) and Epidermophyton (usually affecting skin) cause infection in human [4,5]. These fungi thrive on skin that is warm and moist, but may also survive directly on the outsides of hair shafts or in their interiors [6].…”

“…A general predominance of dermatophyte infections in males may be due to inhibition of the fungi in women by progesterone [12], but the particular infecting agents also may affect gender distribution [13].The prevalence of dermatophytes is variable in the different regions of the world and within the same country due to factors such as climate, socioeconomically and hygienic conditions of the population, urbanization, immunological system of the host, fungal characteristics and therapeutic actions [14]. Dermatophytic infections is commonly spread in family members, especially in the case of Tinea capitis and Tinea pedis [3]. Several investigators have shown that animals play an important role in the transmission of dermatophytes [6].…”