Trichomycosis (trichobacteriosis): Clinical and microbiological experience with 56 cases

Abstract

Background:Trichomycosis is asymptomatic bacterial infection of the axillary hairs caused by Corynebacterium sp.Objective:to bring a series of cases of trichomycosis, its clinical and microbiological experience.Materials and Methods:This report consists in a linear and observational retrospective study of 15 years of cases of trichomycosis confirmed clinically and microbiologically.Results:Fifty six confirmed cases of trichomycosis were included in this report. The majority were men 53/56 (94.6%), mean age was 32.5 years. The most commonly affected area was the axilla (92%), trichomycosis flava was the principal variant 55/56 (98.2%) and signs and symptoms associated were hyperhidrosis (87.5%), hairs’ texture change (57.1%) and odor (35.7%). Bacterial concretions were observed in all cases, and the predominant causative agent in 89.3% of all cases was Corynebacterium sp. Thirty patients were included in therapeutic portion of the study, and 28 (93.3%) of them experienced a clinical and microbiological cure.Conclusion:Trichomycosis is asymptomatic, superficial infection, which primarily affects axillary hairs.

Trichomycosis axillaris

“…Those reported include the pubic, inter-gluteal and eyebrow regions [2,5]. Differential diagnosis includes erythrasma, tinea, white and black piedra, pediculosis, and Trichosporonaselie [2,7]. Microscopic examination with 10% KOH shows pods or concretions, which are actually masses of bacteria surrounding the hair shaft.…”

“…While the axillae are involved in roughly 97% of cases, it is possible for other areas of the body to also be affected. Those reported include the pubic, inter-gluteal and eyebrow regions [2,5]. Differential diagnosis includes erythrasma, tinea, white and black piedra, pediculosis, and Trichosporonaselie [2,7].…”

“…In fact, when a patient has all three of these diseases, it is given a special name, "the Corynebacterium triad" [3]. An adult male with axillary hyperhidrosis and bromhydrosis, stained clothes, and roughened texture of axillary hairs, are the typical historical findings that aid physiciansin the diagnosis of trichomycosis axillaris [2,4,7]. This disease can produce three types of hair discoloration: yellow, which is most common (98% of cases), red, and black [3].…”

“…Microscopic examination with 10% KOH shows pods or concretions, which are actually masses of bacteria surrounding the hair shaft. When direct pressure is applied to these structures,microscopic visualization of 5-1μmcoccoids and diptheroids adherent to hair shafts eliminates a fungal etiology, while the absence of coral red fluorescence under woods lamp rules out erythrasma [1][2][3]. Woods lamp is also useful in determining which parts of the body are affected, as infected hair shafts fluoresce under low-intensity UV light due to the presence of bacterial concretions [2].…”

“…This bacterium is present in nature as both bacillus and diphtheroid, and mostly causes disease in humid, tropical climates [1][2][3]. The mechanism of infection involves physical contact between the bacteria and the hair shaft.…”