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Deep facial mycosis due to Trichophyton verrucosum-molecular genetic identification of the dermatophyte in paraffin-embedded tissue-case report and review of the literature.
Mycoses. 2018 Mar; 61(3):152-158.M

Abstract

Deep trichophytosis is relatively uncommon. The infection of the bearded area is also known as sycosis barbae or tinea barbae and can be caused by various fungal species, most often zoophilic fungi. We report on an 80-year-old male patient with severe sycosis barbae who had no animal contact and was treated with systemic antibiosis without improvement. Microbial and mycological investigations using swabs from oozing lesions revealed Staphylococcus haemolyticus and Candida parapsilosis. Histology demonstrated fungal elements in hair follicles. Paraffin-embedded material was subjected to further mycological analysis. For molecular diagnostics DNA was prepared from paraffin sections for real-time polymerase chain reaction (RT-PCR). For sequencing, DNA was isolated from paraffin-embedded skin tissue and the ITS region of the rDNA was selected. Sequencing of the ITS2 region of rRNA revealed a 100% accordance with Trichophyton (T.) verrucosum. Treatment with oral terbinafine achieved a complete remission. Sycosis barbae is an important differential diagnosis for infections of the bearded area. Nucleic acid amplification techniques (NAAT) are more and more used for direct examination of dermatophytes in clinical samples, eg T. verrucosum. NAAT are also used as culture confirmation tests for identification of rare dermatophytes like T. verrucosum. Today, singleplex and multiplex quantitative real-time PCR (qRT-PCR) assays for the detection of the most common dermatophytes including T. verrucosum in clinical specimens are available. Recently, an ITS2 PCR assay has been successfully used for direct detection of T. verrucosum in paraffin-embedded formalin-fixed skin tissue. The PCR is fast and highly specific. The sensitivity of direct molecular detection of the dermatophytes both in native clinical material, and in paraffin-embedded skin tissue can been increased.

Authors+Show Affiliations

Department of Dermatology and Allergology, Municipal Hospital Dresden, Academic Teaching Hospital Friedrichstadt, Dresden, Germany.Department of Dermatology and Allergology, Municipal Hospital Dresden, Academic Teaching Hospital Friedrichstadt, Dresden, Germany.Laboratory for Medial Microbiology, Mölbis, Germany.Laboratory for Medial Microbiology, Mölbis, Germany.Institute of Pathology "Georg Schmorl", Municipal Hospital Dresden, Academic Teaching Hospital Friedrichstadt, Dresden, Germany.Department of Dermatology, Medical Faculty, University of Jena, Jena, Germany.Laboratory for Medial Microbiology, Mölbis, Germany.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

29082569

Citation

Wollina, Uwe, et al. "Deep Facial Mycosis Due to Trichophyton Verrucosum-molecular Genetic Identification of the Dermatophyte in Paraffin-embedded Tissue-case Report and Review of the Literature." Mycoses, vol. 61, no. 3, 2018, pp. 152-158.
Wollina U, Hansel G, Uhrlaβ S, et al. Deep facial mycosis due to Trichophyton verrucosum-molecular genetic identification of the dermatophyte in paraffin-embedded tissue-case report and review of the literature. Mycoses. 2018;61(3):152-158.
Wollina, U., Hansel, G., Uhrlaβ, S., Krüger, C., Schönlebe, J., Hipler, U. C., & Nenoff, P. (2018). Deep facial mycosis due to Trichophyton verrucosum-molecular genetic identification of the dermatophyte in paraffin-embedded tissue-case report and review of the literature. Mycoses, 61(3), 152-158. https://doi.org/10.1111/myc.12719
Wollina U, et al. Deep Facial Mycosis Due to Trichophyton Verrucosum-molecular Genetic Identification of the Dermatophyte in Paraffin-embedded Tissue-case Report and Review of the Literature. Mycoses. 2018;61(3):152-158. PubMed PMID: 29082569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deep facial mycosis due to Trichophyton verrucosum-molecular genetic identification of the dermatophyte in paraffin-embedded tissue-case report and review of the literature. AU - Wollina,Uwe, AU - Hansel,Gesine, AU - Uhrlaβ,Silke, AU - Krüger,Constanze, AU - Schönlebe,Jacqueline, AU - Hipler,Uta-Christina, AU - Nenoff,Pietro, Y1 - 2017/11/15/ PY - 2017/10/17/received PY - 2017/10/19/accepted PY - 2017/10/31/pubmed PY - 2018/10/12/medline PY - 2017/10/31/entrez KW - Trichophyton verrucosum KW - ITS2-sequencing; terbinafine KW - kerion celsi KW - real-time PCR KW - sycosis barbae KW - tinea barbae profunda SP - 152 EP - 158 JF - Mycoses JO - Mycoses VL - 61 IS - 3 N2 - Deep trichophytosis is relatively uncommon. The infection of the bearded area is also known as sycosis barbae or tinea barbae and can be caused by various fungal species, most often zoophilic fungi. We report on an 80-year-old male patient with severe sycosis barbae who had no animal contact and was treated with systemic antibiosis without improvement. Microbial and mycological investigations using swabs from oozing lesions revealed Staphylococcus haemolyticus and Candida parapsilosis. Histology demonstrated fungal elements in hair follicles. Paraffin-embedded material was subjected to further mycological analysis. For molecular diagnostics DNA was prepared from paraffin sections for real-time polymerase chain reaction (RT-PCR). For sequencing, DNA was isolated from paraffin-embedded skin tissue and the ITS region of the rDNA was selected. Sequencing of the ITS2 region of rRNA revealed a 100% accordance with Trichophyton (T.) verrucosum. Treatment with oral terbinafine achieved a complete remission. Sycosis barbae is an important differential diagnosis for infections of the bearded area. Nucleic acid amplification techniques (NAAT) are more and more used for direct examination of dermatophytes in clinical samples, eg T. verrucosum. NAAT are also used as culture confirmation tests for identification of rare dermatophytes like T. verrucosum. Today, singleplex and multiplex quantitative real-time PCR (qRT-PCR) assays for the detection of the most common dermatophytes including T. verrucosum in clinical specimens are available. Recently, an ITS2 PCR assay has been successfully used for direct detection of T. verrucosum in paraffin-embedded formalin-fixed skin tissue. The PCR is fast and highly specific. The sensitivity of direct molecular detection of the dermatophytes both in native clinical material, and in paraffin-embedded skin tissue can been increased. SN - 1439-0507 UR - https://www.unboundmedicine.com/medline/citation/29082569/Deep_facial_mycosis_due_to_Trichophyton_verrucosum_molecular_genetic_identification_of_the_dermatophyte_in_paraffin_embedded_tissue_case_report_and_review_of_the_literature_ L2 - https://doi.org/10.1111/myc.12719 DB - PRIME DP - Unbound Medicine ER -