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- Title
Deep facial mycosis due to <italic>Trichophyton verrucosum</italic>—molecular genetic identification of the dermatophyte in paraffin‐embedded tissue—case report and review of the literature.
- Authors
Wollina, Uwe; Hansel, Gesine; Uhrlaß, Silke; Krüger, Constanze; Schönlebe, Jacqueline; Hipler, Uta‐Christina; Nenoff, Pietro
- Abstract
Summary: 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 <italic>Staphylococcus haemolyticus</italic> and <italic>Candida parapsilosis</italic>. 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 <italic>Trichophyton</italic> (<italic>T</italic>.) <italic>verrucosum</italic>. 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 <italic>T</italic>. <italic>verrucosum</italic>. NAAT are also used as culture confirmation tests for identification of rare dermatophytes like <italic>T</italic>. <italic>verrucosum</italic>. Today, singleplex and multiplex quantitative real‐time PCR (qRT‐PCR) assays for the detection of the most common dermatophytes including <italic>T</italic>. <italic>verrucosum</italic> in clinical specimens are available. Recently, an ITS2 PCR assay has been successfully used for direct detection of <italic>T</italic>. <italic>verrucosum</italic> 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.
- Subjects
RINGWORM; MOLECULAR genetics; HISTOLOGY; MOLECULAR diagnosis; DERMATOPHYTES
- Publication
Mycoses, 2018, Vol 61, Issue 3, p152
- ISSN
0933-7407
- Publication type
Article
- DOI
10.1111/myc.12719