Zur Veränderung des Dermatophytenspektrums bei dermatologisch relevanten Erkrankungen

Abstract

Zusammenfassung Innerhalb der letzten 70 Jahre hat sich die Zusammensetzung des Artenspektrums aus Hautläsionen isolierter Dermatophyten erheblich verändert. Vor dem 2. Weltkrieg dominierten in Deutschland Microsporum audouinii und Epidermophyton floccosum, seit den 50er Jahren übernahm Trichophyton rubrum die Spitzenposition und erreicht heute 80–90 % aller Dermatophytenisolate. Diese Entwicklung ist für Mittel‐ und Nordeuropa typisch und steht mit der erheblichen Zunahme der Tinea pedis in ursächlichem Zusammenhang. In Südeuropa und in arabischen Ländern stehen zoophile Dermatophyten (M. canis und T. verrucosum) an erster Stelle. Auf die Infektionswege für die Verbreitung der Tinea pedis wird anhand experimenteller Daten hingewiesen. Die Vermutung einer genetisch fixierten Disposition für T.‐rubrum‐Infektionen steht im Widerspruch zu den hier aufgezeigten epidemiologischen Zusammenhängen.

Fulminant Papulopustular Tinea Corporis Caused by Trichophyton mentagrophytes

“…T. mentagrophytes is one of the most common dermatophytes causing cutaneous human fungal disease worldwide (2). T. mentagrophytes is a zoophilic dermatophyte, usually found on rodents, dogs and cats (3).…”

Pseudomycetoma for Microsporum canis

“…The reason for this change in pathogen is not clear. 33 Urban cases are acquired through epidemics in schools or between members of a family; in addition, poor hygiene and malnourishment are contributing factors. 34 Simple contact of the fungi with the skin and adnexa can produce the disease, although a genetic or immunologic predisposition has been suggested.…”

“…47 The most frequent causal agents are T tonsurans and M canis, with worldwide distribution. 33,46,48 Clinically the dermatophyte appears as a pseudoalopecic plate with a scale on its surface from which hairs approximately 5 mm long grow. The dermatophyte's inflammatory forms as granulomas or pseudomycetomas had been reported mainly in immunocompromised patients, related to the physiopathology of the infection.…”

Tinea of glabrous skin

“…Infection can occur anywhere where barefoot persons come into contact with infectious scales on the floor from the feet of others. The detection of dermatophytes on the floor of industrial or public showers or baths has been reported by many authors [11, 39, 40]. T. rubrum and T. interdigitale can survive for many months in a dry environment away from a host.…”

“…Today the prevalence of onychomycosis alone in Germany is 12.4 %[1]. Certain occupations face a particularly high risk of infection, with the highest rate of fungal infection of the feet being found in miners with 72.9 % of those examined [14, 39]. Exogenous factors are clearly responsible for the spread of tinea pedis and thus of T. rubrum .…”