European Journal of Dermatology最新文献

Dermatophytomas are hyperkeratotic fungal masses located in subungual areas or on hairless skin, characterized by dense whitish or yellowish areas forming longitudinal streaks or patches, while in hairless skin an exacerbation of the erythematousquamous area is observed. "Dermatophytoma" has been applied to fungal masses caused by dermatophytes, yeasts, and other moulds. In this study, we differentiate between fungal masses caused by dermatophytes (referred to as dermatophytomas) and those caused by non-dermatophyte fungi, which we term "fungal conglomerates". To analyse clinical and mycological data from patients diagnosed with dermatophytomas or fungal conglomerates. Conducted at the Mycology Section of a tertiary hospital, this study included patients diagnosed with dermatophytomas and fungal conglomerates based on clinical history. In total, 606 cases were analysed, with Trichophyton rubrum (35.97%) as the principal agent. Females comprised 64.7%, toenails and fingernails were affected in 86.1%, and total dystrophic onychomycosis was the predominant form, identified in 61.4%. Hypertension (14.3%), type 2 diabetes, dyslipidaemia, and metabolic syndrome (11.39%) were the principal comorbidities. The multiple ordinal regression model for type of fungal pathology (dermatophytomas and fungal conglomerates) adjusted for age revealed that the groups ≤18 and 19-65 years had a higher risk (OR=3.616 and OR=2.143) of dermatophytomas than those ≥66 years. Hypertension was associated with a higher proportion of dermatophytomas compared to fungal conglomerates (OR=5.470). This study underscores the clinical relevance of dermatophytomas and fungal conglomerates, predominantly affecting toenails. T. rubrum and total dystrophic onychomycosis were frequently observed. The high prevalence of associated comorbidities (hypertension and diabetes mellitus) highlights the need for comprehensive management strategies to prevent recurrence.

Morphea is a rare inflammatory disease affecting the skin and connective tissue leading to sclerosis and atrophy. To analyse a cohort of adult patients suffering from morphea regarding demographics and clinical subtype. The medical records of patients (≥18 years old) diagnosed with morphea (L94.0 to L94.1) who presented at the Department of Dermatology, Venereology and Allergology at the Charité-Universitätsmedizin Berlin between 2017 and 2023 were assessed (n=479). Most patients were female (n=390; 81%), aged between 60 and 69 years (n=101; 21%). Unspecified morphea (n=232; 48%) was most commonly coded as multilocular morphea in 149 cases and linear morphea in 29 cases. The most frequently reported comorbidities were hypertension, diabetes mellitus, and hypothyroidism. Autoimmune diseases, such as genital lichen sclerosus, Sjögren's disease and rheumatoid arthritis, were also not infrequent. Antinuclear antibody (ANA) assessment was available for 105/128 patients; 56/105 patients had a positive ANA titre (at least 1:80). Overall, 68/128 patients were treated topically, while 47/128 patients received systemic treatment. Twelve patients were treated with two or more systemic therapies. Topical corticosteroids and methotrexate were most commonly used. Mild side effects occurred only in methotrexate-treated patients (n=6). Morphea is a heterogeneous clinical disease requiring individualised treatment depending on subtype and localisation. Defined severity criteria and standardised assessment tools are needed to identify patients who require systemic treatment and ensure that treatment efficacy is comparable among patients.