Dermatologie (Heidelberg, Germany)最新文献

Zoophilic dermatophytes are fungi that mainly infect animals, but can also be transmitted to humans. Transmission usually occurs through direct contact with infected animals or contaminated materials such as animal hair, blankets or brushes. Zoophilic dermatophytes cause classic symptoms of tinea infections in humans: ring-shaped, reddened skin lesions with scaly edges and central paling. The inflammatory reaction is usually stronger with zoophilic pathogens than with anthropophilic fungi because the human defense system recognizes them as foreign more clearly. Children, animal owners, farmers or veterinarians are affected most frequently. Diagnosis is made by microscopic examination and fungal culture, and molecular diagnostics if necessary. Treatment requires topical antimycotics and in case of extensive or deep infections additional systemic therapy, e.g., with terbinafine or itraconazole. Simultaneous treatment of the infected animal and prevention of transmission is crucial to prevent reinfection. Hygiene measures and education are key prevention strategies.

Tinea capitis is a common fungal infection of the scalp predominantly affecting children. It is often misdiagnosed due to its clinical resemblance to other dermatological conditions such as psoriasis and seborrheic dermatitis. This case report presents a 4-year-old boy who was initially misdiagnosed and treated for psoriasis but later correctly diagnosed with tinea capitis caused by Microsporum canis. The diagnosis was confirmed through microbiological culture and histopathological examination after local corticosteroid treatments failed to show improvement. Subsequently, it was discovered that the entire family, including the boy's sister, mother, and father, had also developed dermatophytosis due to zoonotic transmission of Microsporum canis from the family cat. The patient and his family were successfully treated with terbinafine, and the family cat was treated by a veterinarian. This case underscores the importance of thorough diagnostic procedures, including consideration of pet and familial exposure, to prevent misdiagnosis, reduce the transmission of tinea capitis to other family members and ensure successful treatment outcomes.

Sexually transmitted dermatophytosis caused by Trichophyton (T.) mentagrophytes ITS genotype VII is an emerging sexual health issue for men who have sex with men. We report a case suggesting transmission during the incubation period, in the absence of visible lesions. This case highlights the need to consider asymptomatic phases in transmission dynamics of the pathogen.

A 58-year-old man who worked as varnisher and application technician for many years developed 4 months after changing employer and occupation (now working as plant operator for mortar bottling plants) vesicular hand eczema and eczema on his limbs for the first time. The patient underwent a tertiary individual prevention (TIP: an in-patient treatment financed by German statutory occupational accident insurance). The patient had pronounced atopic skin diathesis which, however, had never manifested itself in the form of eczema. Type IV hypersensitivity to epoxy resin and epoxy resin components was diagnosed which is why spreading contact dermatitis was suspected. The pulpitis seen during TIP was classified as partly atopic partly allergic in origin. Nonetheless after complete healing and resuming work at an epoxy resin-free workplace, he developed vesicular atopic hand eczema. Therefore, even if type IV allergy is identified, allergic contact dermatitis cannot automatically be assumed. Even after many years of professional activity, atopy on the hands can manifest itself in the form of vesicular hand eczema.