Skip to main content

Advertisement

SpringerLink
Log in

Dermatophytosis, Trends in Epidemiology and Diagnostic Approach

  • Clinical Mycology Lab Issues (K Lagrou, Section Editor)
  • Published:
Current Fungal Infection Reports Aims and scope Submit manuscript

Abstract

Dermatophytes are amongst the most common fungal agents causing superficial skin infections. The epidemiology of dermatophytosis has changed during the last century under the influence of socioeconomic factors, modern life, intensification of travel, migration of populations from the southern to the northern hemisphere. As result, Trichophyton rubrum has become the most frequent species worldwide, causing mainly tinea pedis and tinea unguium, while Microsporum canis is still the main agent in tinea corporis and capitis in Mediterranean countries. However, the prevalence of anthropophilic dermatophytes causing tinea capitis in young children is increasing overall in the big cities of Europe and America, causing epidemics and becoming a public health concern. This review summarizes the current status of dermatophyte infection in Europe, Africa, Asia and America and gives an overview of the most recent molecular methods currently available for the laboratory diagnosis of dermatophytosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Ghannoum MA, Hajjeh RA, Scher R, Konnikov N, Gupta AK, Summerbell R, et al. A large-scale North American study of fungal isolates from nails: the frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns. J Am Acad Dermatol. 2000;43:641–8.

    CAS  PubMed  Google Scholar 

  2. Gupta AK, Jain HC, Lynde CW, Macdonald P, Cooper EA, Summerbell RC. Prevalence and epidemiology of onychomycosis in patients visiting physicians' offices: a multicenter Canadian survey of 15,000 patients. J Am Acad Dermatol. 2000;43:244–8.

    CAS  PubMed  Google Scholar 

  3. Roberts DT. Prevalence of dermatophyte onychomycosis in the United Kingdom: results of an omnibus survey. Br J Dermatol. 1992;126 Suppl 39:23–7.

    PubMed  Google Scholar 

  4. Sais G, Jucglà A, Peyrí J. Prevalence of dermatophyte onychomycosis in Spain: a cross-sectional study. Br J Dermatol. 1995;132:758–61.

    CAS  PubMed  Google Scholar 

  5. Heikkilä H, Stubb S. The prevalence of onychomycosis in Finland. Br J Dermatol. 1995;133:699–703.

    PubMed  Google Scholar 

  6. Nenoff P, Krüger C, Schaller J, Ginter-Hanselmayer G, Schulte-Beerbühl R, Tietz HJ. Mycology – an update part 2: dermatomycoses: clinical picture and diagnostics. J Dtsch Dermatol Ges. 2014;12:749–77. This paper is of major importance because it highlights the clinical picture and gives an overview of current diasgnostic methods in dermatophytosis.

    PubMed  Google Scholar 

  7. Farhi D, Savary J, Pansart S, Hesse S. Étude prospective des onychomycoses des pieds en France: prévalence, aspect clinique, impact et prise en charge en médecine générale. J Mycol Med. 2011;21:266–72.

    Google Scholar 

  8. Burzykowski T, Molenberghs G, Abeck D, Haneke E, Hay R, Katsambas A, et al. High prevalence of foot diseases in Europe: results of the Achilles Project. Mycoses. 2003;46:496–505.

    CAS  PubMed  Google Scholar 

  9. Woodfolk JA. Allergy and dermatophytes. Clin Microbiol Rev. 2005;18:30–43.

    PubMed Central  CAS  PubMed  Google Scholar 

  10. Al Hasan M, Fitzgerald SM, Saoudian M, Krishnaswamy G. Dermatology for the practicing allergist: tinea pedis and its complications. Clin Mol Allergy. 2004;2:5.

    PubMed Central  PubMed  Google Scholar 

  11. Zink A, Papanagiotou V, Todorova A, Seidl HP, Niedermeier A, Ring J, et al. Outbreak of Microsporum audouinii in Munich – the return of infectious fungi in Germany. Mycoses. 2014;57:765–70.

    PubMed  Google Scholar 

  12. Donghi D, Hauser V, Bosshard PP. Microsporum audouinii tinea capitis in a Swiss school: assessment and management of patients and asymptomatic carriers. Med Mycol. 2011;49:324–8.

    PubMed  Google Scholar 

  13. Richardson MD, Warnock DW. Fungal infection: diagnosis and management. 4th ed. Wiley-Blackwell: Chichester; 2012. This book is of major importance because it is a recent book on fungal infection including a lot of knowledge and appropriate references. It is a good introduction providing general knowledge on specific fungal diseases. It must be part of the library of every mycologist.

    Google Scholar 

  14. Monod M. Secreted proteases from dermatophytes. Mycopathologia. 2008;166:285–94.

    PubMed  Google Scholar 

  15. Zhang X, Wang Y, Chi W, Shi Y, Chen S, Lin D, et al. Metalloprotease genes of Trichophyton mentagrophytes are important for pathogenicity. Med Mycol. 2014;52:36–45.

    CAS  PubMed  Google Scholar 

  16. Nenoff P, Krüger C, Ginter-Hanselmayer G, Tietz HJ. Mycology – an update. Part 1: dermatomycoses: causative agents, epidemiology and pathogenesis. J Dtsch Dermatol Ges. 2014;12:188–210. This reference is of major importance because it is recent (2014), it is very detailed and it points out the characteristics of the most important dermatophytes. It also gives details of the pathogenesis and the epidemiological features of dermatophytosis. Long but easy to read.

    PubMed  Google Scholar 

  17. Chang SJ, Hsu SC, Tien KJ, Hsiao JY, Lin SR, Chen HC, et al. Metabolic syndrome associated with toenail onychomycosis in Taiwanese with diabetes mellitus. Int J Dermatol. 2008;47:467–72.

    CAS  PubMed  Google Scholar 

  18. Saunte DM, Holgersen JB, Haedersdal M, Strauss G, Bitsch M, Svendsen OL, et al. Prevalence of toe nail onychomycosis in diabetic patients. Acta Derm Venereol. 2006;86:425–8.

    PubMed  Google Scholar 

  19. Takehara K, Oe M, Tsunemi Y, Nagase T, Ohashi Y, Iizaka S, et al. Factors associated with presence and severity of toenail onychomycosis in patients with diabetes: a cross-sectional study. Int J Nurs Stud. 2011;48:1101–8.

    PubMed  Google Scholar 

  20. Scheen A, Van Gaal L. Combating the dual burden: therapeutic targeting of common pathways in obesity and type 2 diabetes. Lancet Diabetes Endocrinol. 2014;2:911–22.

    CAS  PubMed  Google Scholar 

  21. Seebacher C, Bouchara JP, Mignon B. Updates on the epidemiology of dermatophyte infections. Mycopathologia. 2008;166:335–52. Although this paper is older (2008), it is of major importance. It is the most important reference on the topic because the authors explain deeply and with a lot of references the evolution of dermatophytosis epidemiology in the world, with emphasis on Germany.

    PubMed  Google Scholar 

  22. Ilkit M, Durdu M. Tinea pedis: the etiology and global epidemiology of a common fungal infection. Crit Rev Microbiol. 2015;41:374–88.

    PubMed  Google Scholar 

  23. Drakensjö IT, Chryssanthou E. Epidemiology of dermatophyte infections in Stockholm, Sweden: a retrospective study from 2005-2009. Med Mycol. 2011;49:484–8.

    PubMed  Google Scholar 

  24. Borman AM, Campbell CK, Fraser M, Johnson EM. Analysis of the dermatophyte species isolated in the British Isles between 1980 and 2005 and review of worldwide dermatophyte trends over the last three decades. Med Mycol. 2007;45:131–41.

    PubMed  Google Scholar 

  25. Budak A, Bogusz B, Tokarczyk M, Trojanowska D. Dermatophytes isolated from superficial fungal infections in Krakow, Poland, between 1995 and 2010. Mycoses. 2013;56:422–8.

    PubMed  Google Scholar 

  26. Buchvald J, Simaljaková M. Epidemiology of dermatomycoses in Slovakia. Epidemiol Mikrobiol Imunol. 2002;51:71–3.

    CAS  PubMed  Google Scholar 

  27. Ghannoum MA, Mukherjee PK, Warshaw EM, Evans S, Korman NJ, Tavakkol A. Molecular analysis of dermatophytes suggests spread of infection among household members. Cutis. 2013;91:237–45.

    PubMed  Google Scholar 

  28. Daniel CR, Jellinek NJ. The pedal fungus reservoir. Arch Dermatol. 2006;142:1344–6.

    PubMed  Google Scholar 

  29. Ginter-Hanselmayer G, Seebacher C. Treatment of tinea capitis – a critical appraisal. J Dtsch Dermatol Ges. 2011;9:109–14.

    PubMed  Google Scholar 

  30. Elsner P, Hartmann AA, Kohlbeck M. Dermatophytoses in Würzburg 1976-1985. Mykosen. 1987;30:584–8.

    CAS  PubMed  Google Scholar 

  31. Maraki S, Tselentis Y. Dermatophytoses in Crete, Greece, between 1992 and 1996. Mycoses. 1998;41:175–8.

    CAS  PubMed  Google Scholar 

  32. Maraki S, Nioti E, Mantadakis E, Tselentis Y. A 7-year survey of dermatophytoses in Crete, Greece. Mycoses. 2007;50:481–4.

    PubMed  Google Scholar 

  33. Maraki S. Epidemiology of dermatophytoses in Crete, Greece between 2004 and 2010. G Ital Dermatol Venereol. 2012;147:315–9.

    CAS  PubMed  Google Scholar 

  34. Fortuño B, Torres L, Simal E, Seoane A, Uriel JA, Santacruz C. Dermatophytes isolated in our clinics. 5-year-study in Zaragoza. Enferm Infecc Microbiol Clin. 1997;15:536–9.

    PubMed  Google Scholar 

  35. García-Martos P, García-Agudo L, Agudo-Pérez E, Gil de Sola F, Linares M. Dermatophytoses due to anthropophilic fungi in Cadiz, Spain, between 1997 and 2008. Actas Dermosifiliogr. 2010;101:242–7.

    PubMed  Google Scholar 

  36. Panasiti V, Devirgiliis V, Borroni RG, Mancini M, Curzio M, Rossi M, et al. Epidemiology of dermatophytic infections in Rome, Italy: a retrospective study from 2002 to 2004. Med Mycol. 2007;45:57–60.

    CAS  PubMed  Google Scholar 

  37. Foster KW, Ghannoum MA, Elewski BE. Epidemiologic surveillance of cutaneous fungal infection in the United States from 1999 to 2002. J Am Acad Dermatol. 2004;50:748–52.

    PubMed  Google Scholar 

  38. Sinski JT, Flouras K. A survey of dermatophytes isolated from human patients in the United States from 1979 to 1981 with chronological listings of worldwide incidence of five dermatophytes often isolated in the United States. Mycopathologia. 1984;85:97–120.

    CAS  PubMed  Google Scholar 

  39. Sinski JT, Kelley LM. A survey of dermatophytes isolated from human patients in the United States from 1982 to 1984. Mycopathologia. 1987;98:35–40.

    CAS  PubMed  Google Scholar 

  40. Sinski JT, Kelley LM. A survey of dermatophytes from human patients in the United States from 1985 to 1987. Mycopathologia. 1991;114:117–26.

    CAS  PubMed  Google Scholar 

  41. Weitzman I, Chin NX, Kunjukunju N, Della-Latta P. A survey of dermatophytes isolated from human patients in the United States from 1993 to 1995. J Am Acad Dermatol. 1998;39:255–61.

    CAS  PubMed  Google Scholar 

  42. Bronson DM, Desai DR, Barsky S, Foley SM. An epidemic of infection with Trichophyton tonsurans revealed in a 20-year survey of fungal infections in Chicago. J Am Acad Dermatol. 1983;8:322–30.

    CAS  PubMed  Google Scholar 

  43. Rippon JW. Forty four years of dermatophytes in a Chicago clinic (1944-1988). Mycopathologia. 1992;119:25–8.

    CAS  PubMed  Google Scholar 

  44. Shroba J, Olson-Burgess C, Preuett B, Abdel-Rahman SM. A large outbreak of Trichophyton tonsurans among health care workers in a pediatric hospital. Am J Infect Control. 2009;37:43–8.

    PubMed Central  PubMed  Google Scholar 

  45. Raccurt CP, Dorsainvil D, Boncy M, Boncy J, Auguste G. The emergence of Trichophyton tonsurans in Port-au-Prince, Haiti. Med Mycol. 2009;47:197–200.

    PubMed  Google Scholar 

  46. Arenas R, Torres E, Amaya M, Rivera ER, Espinal A, Polanco M, et al. Emergence of Microsporum audouinii and Trichophyton tonsurans as causative organisms of tinea capitis in the Dominican Republic. Actas Dermosifiliogr. 2010;101:330–5.

    CAS  PubMed  Google Scholar 

  47. López-Martínez R, Manzano-Gayosso P, Hernández-Hernández F, Bazán-Mora E, Méndez-Tovar LJ. Dynamics of dermatophytosis frequency in Mexico: an analysis of 2084 cases. Med Mycol. 2010;48:476–9.

    PubMed  Google Scholar 

  48. Naseri A, Fata A, Najafzadeh MJ, Shokri H. Surveillance of dermatophytosis in northeast of Iran (Mashhad) and review of published studies. Mycopathologia. 2013;176:247–53.

    PubMed  Google Scholar 

  49. Falahati M, Akhlaghi L, Lari AR, Alaghehbandan R. Epidemiology of dermatophytoses in an area south of Tehran, Iran. Mycopathologia. 2003;156:279–87.

    PubMed  Google Scholar 

  50. Rezaei-Matehkolaei A, Makimura K, De Hoog S, Shidfar MR, Zaini F, Eshraghian M, et al. Molecular epidemiology of dermatophytosis in Tehran, Iran, a clinical and microbial survey. Med Mycol. 2013;51:203–7.

    CAS  PubMed  Google Scholar 

  51. Araj GF, Racoubian ES, Daher NK. Etiologic agents of dermatophyte infection in Lebanon. J Med Liban. 2004;52:59–63.

    PubMed  Google Scholar 

  52. Farah FS, Kurban AK, Chaglassian HT, Alami SY. Survey of the pathogenic dermatophytes in Lebanon. J Med Liban. 1962;15:75–9.

    CAS  PubMed  Google Scholar 

  53. Abanmi A, Bakheshwain S, El Khizzi N, Zouman AR, Hantirah S, Al Harthi F, et al. Characteristics of superficial fungal infections in the Riyadh region of Saudi Arabia. Int J Dermatol. 2008;47:229–35.

    PubMed  Google Scholar 

  54. Sahin I, Oksuz S, Kaya D, Sencan I, Cetinkaya R. Dermatophytes in the rural area of Duzce, Turkey. Mycoses. 2004;47:470–4.

    PubMed  Google Scholar 

  55. Coulibaly O, Thera MA, Piarroux R, Doumbo OK, Ranque S. High dermatophyte contamination levels in hairdressing salons of a West African suburban community. Mycoses. 2015;58:65–8.

    CAS  PubMed  Google Scholar 

  56. Nweze EI. Dermatophytosis in Western Africa: a review. Pak J Biol Sci. 2010;13:649–56.

    CAS  PubMed  Google Scholar 

  57. Ngwogu AC, Otokunefor TV. Epidemiology of dermatophytoses in a rural community in Eastern Nigeria and review of literature from Africa. Mycopathologia. 2007;164:149–58.

    PubMed  Google Scholar 

  58. Nweze EI, Okafor JI. Prevalence of dermatophytic fungal infections in children: a recent study in Anambra state, Nigeria. Mycopathologia. 2005;160:239–43.

    CAS  PubMed  Google Scholar 

  59. Ndiaye M, Diongue K, Seck MC, Badiane AS, Diallo MA, Deme AB, et al. Epidemiological profile of Tinea capitis in Dakar (Senegal). A 6-year retrospective study (2008-2013). J Mycol Med. 2015;25:169–76.

    CAS  PubMed  Google Scholar 

  60. Woldeamanuel Y, Mengistu Y, Chryssanthou E, Petrini B. Dermatophytosis in Tulugudu Island, Ethiopia. Med Mycol. 2005;43:79–82.

    PubMed  Google Scholar 

  61. Woldeamanuel Y, Leekassa R, Chryssanthou E, Mengistu Y, Petrini B. Clinico-mycological profile of dermatophytosis in a reference centre for leprosy and dermatological diseases in Addis Ababa. Mycopathologia. 2006;161:167–72.

    CAS  PubMed  Google Scholar 

  62. Thakur R. Spectrum of dermatophyte infections in Botswana. Clin Cosmet Investig Dermatol. 2015;8:127–33.

    PubMed Central  PubMed  Google Scholar 

  63. Hanumanthappa SB, Sarojini SB, Shilpashree SB, Muddapur SB. Clinicomycological study of 150 cases of dermatophytosis in a tertiary care hospital in South India. Indian J Dermatol. 2012;57:322–3.

    PubMed Central  CAS  PubMed  Google Scholar 

  64. Balakumar S, Rajan S, Thirunalasundari T, Jeeva S. Epidemiology of dermatophytosis in and around Tiruchirapalli, Tamilnadu, India. Asian Pac J Trop Dis. 2012;2:286–9.

    Google Scholar 

  65. Sei Y. 2006 Epidemiological survey of dermatomycoses in Japan. Med Mycol J. 2012;53:185–92.

    PubMed  Google Scholar 

  66. Hiruma J, Ogawa Y, Hiruma M. Trichophyton tonsurans infection in Japan: epidemiology, clinical features, diagnosis and infection control. J Dermatol. 2015;42:245–9.

    PubMed  Google Scholar 

  67. Ginter-Hanselmayer G, Weger W, Ilkit M, Smolle J. Epidemiology of tinea capitis in Europe: current state and changing patterns. Mycoses. 2007;50 Suppl 2:6–13.

    PubMed  Google Scholar 

  68. Binder B, Lackner HK, Poessl BD, Propst E, Weger W, Smolle J, et al. Prevalence of tinea capitis in Southeastern Austria between 1985 and 2008: up-to-date picture of the current situation. Mycoses. 2011;54:243–7.

    PubMed  Google Scholar 

  69. Mapelli ET, Cerri A, Bombonato C, Menni S. Tinea capitis in the paediatric population in Milan, Italy: the emergence of Trichophyton violaceum. Mycopathologia. 2013;176:243–6.

    PubMed  Google Scholar 

  70. Sberna F, Farella V, Geti V, Tavíti F, Agostini G, Vannini P, et al. Epidemiology of the dermatophytoses in the Florence area of Italy: 1985-1990. Trichophyton mentagrophytes, epidermophyton floccosum and microsporum gypseum infections. Mycopathologia. 1993;122:153–62.

    CAS  PubMed  Google Scholar 

  71. Mercantini R, Moretto D, Palamara G, Mercantini P, Marsella R. Epidemiology of dermatophytoses observed in Rome, Italy, between 1985 and 1993. Mycoses. 1995;38:415–9.

    CAS  PubMed  Google Scholar 

  72. Hällgren J, Petrini B, Wahlgren CF. Increasing tinea capitis prevalence in Stockholm reflects immigration. Med Mycol. 2004;42:505–9.

    PubMed  Google Scholar 

  73. Leiva-Salinas M, Marin-Cabanas I, Betlloch I, Tesfasmariam A, Reyes F, Belinchon I, et al. Tinea capitis in schoolchildren in a rural area in southern Ethiopia. Int J Dermatol. 2015;54:800–5.

    PubMed  Google Scholar 

  74. Kieliger S, Glatz M, Cozzio A, Bosshard PP. Tinea capitis and tinea faciei in the Zurich area – an 8-year survey of trends in the epidemiology and treatment patterns. J Eur Acad Dermatol Venereol. 2015;29:1524–9.

    CAS  PubMed  Google Scholar 

  75. Kolivras A, Lateur N, De Maubeuge J, Scheers C, Wiame L, Song M. Tinea capitis in Brussels: epidemiology and new management strategy. Dermatology. 2003;206:384–7.

    PubMed  Google Scholar 

  76. Detandt M, Planard C, Verstraeten C, Nolard N. Tinea capitis in nurseries and schools: an epidemiological survey. Mycoses. 2002;45:11–2.

    Google Scholar 

  77. Sacheli R, Dimo L, Graide H, Meex C, Descy J, Huynen P, et al. DNA fingerprinting using Diversilab system for genotyping characterization of Microsporum audouinii and Trichophyton violaceum (abstract P124). Mycoses. 2013;56 Suppl 3:55–167.

    Google Scholar 

  78. Fuller LC, Child FC, Midgley G, Higgins EM. Scalp ringworm in south-east London and an analysis of a cohort of patients from a paediatric dermatology department. Br J Dermatol. 2003;148:985–8.

    CAS  PubMed  Google Scholar 

  79. Child FJ, Fuller LC, Higgins EM, Du Vivier AW. A study of the spectrum of skin disease occurring in a black population in south-east London. Br J Dermatol. 1999;141:512–7.

    CAS  PubMed  Google Scholar 

  80. Hay RJ, Robles W, Midgley G, Moore MK, European Confederation of Medical Mycology Working Party on Tinea Capitits. Tinea capitis in Europe: new perspective on an old problem. J Eur Acad Dermatol Venereol. 2001;15:229–33.

    CAS  PubMed  Google Scholar 

  81. Leeming JG, Elliott TS. The emergence of Trichophyton tonsurans tinea capitis in Birmingham, UK. Br J Dermatol. 1995;133:929–31.

    CAS  PubMed  Google Scholar 

  82. Gray RM, Champagne C, Waghorn D, Ong E, Grabczynska SA, Morris J. Management of a Trichophyton tonsurans outbreak in a day-care center. Pediatr Dermatol. 2015;32:91–6.

    PubMed  Google Scholar 

  83. del Boz J, Crespo V, Rivas-Ruiz F, de Troya M. A 30-year survey of paediatric tinea capitis in southern Spain. J Eur Acad Dermatol Venereol. 2011;25:170–4.

    PubMed  Google Scholar 

  84. del Boz-González J. Tinea capitis: trends in Spain. Actas Dermosifiliogr. 2012;103:288–93.

    PubMed  Google Scholar 

  85. Cuétara MS, Del Palacio A, Noriega M, Pereiro AR. Prevalence of undetected tinea capitis in a prospective school survey in Madrid: emergence of new causative fungi. Br J Dermatol. 1998;138:658–60.

    PubMed  Google Scholar 

  86. Juncosa T, Aguilera P, Jaen A, Vicente A, Aguilar AC, Fumadó V. Trichophyton violaceum: an emerging pathogen. Enferm Infecc Microbiol Clin. 2008;26:502–4.

    PubMed  Google Scholar 

  87. Triviño-Duran L, Torres-Rodriguez JM, Martinez-Roig A, Cortina C, Belver V, Perez-Gonzalez M, et al. Prevalence of tinea capitis and tinea pedis in Barcelona schoolchildren. Pediatr Infect Dis J. 2005;24:137–41.

    PubMed  Google Scholar 

  88. Alshawa K, Lacroix C, Benderdouche M, Mingui A, Derouin F, Feuilhade de Chauvin M. Increasing incidence of Trichophyton tonsurans in Paris, France: a 15-year retrospective study. Br J Dermatol. 2012;166:1149–50.

    CAS  PubMed  Google Scholar 

  89. Reichert-Pénétrat S, Contet-Audonneau N, Barbaud A, Schurra JP, Fortier B, Schmutz JL. Epidemiology of dermatophytoses in children living in northeast France: a 5-year study. Pediatr Dermatol. 2002;19:103–5.

    PubMed  Google Scholar 

  90. De Chauvin MF. New diagnostic techniques. J Eur Acad Dermatol Venereol. 2005;19:20–4.

    Google Scholar 

  91. Chabasse D, Pihet M. Méthodes de diagnostic d’une onychomycose. J Mycol Med. 2014;24:269–78.

    CAS  PubMed  Google Scholar 

  92. Piérard GE, Arresse JE, Piérard-Franchimont C, Quatresooz P. Onychomycosis under the microscope. Liège: University Medical Center; 2002.

    Google Scholar 

  93. Garg J, Tilak R, Singh S, Gulati AK, Garg A, Prakash P, et al. Evaluation of pan-dermatophyte nested PCR in diagnosis of onychomycosis. J Clin Microbiol. 2007;45:3443–5.

    PubMed Central  CAS  PubMed  Google Scholar 

  94. Garg J, Tilak R, Garg A, Prakash P, Gulati AK, Nath G. Rapid detection of dermatophytes from skin and hair. BMC Res Notes. 2009;2:60.

    PubMed Central  PubMed  Google Scholar 

  95. Uchida T, Makimura K, Ishihara K, Goto H, Tajiri Y, Okuma M, et al. Comparative study of direct polymerase chain reaction, microscopic examination and culture-based morphological methods for detection and identification of dermatophytes in nail and skin samples. J Dermatol. 2009;36:202–8.

    CAS  PubMed  Google Scholar 

  96. Nagao K, Sugita T, Ouchi T, Nishikawa T. Identification of Trichophyton rubrum by nested PCR analysis from paraffin embedded specimen in trichophytia profunda acuta of the glabrous skin. Nihon Ishinkin Gakkai Zasshi. 2005;46:129–32.

    PubMed  Google Scholar 

  97. Arabatzis M, Bruijnesteijn van Coppenraet LE, Kuijper EJ, de Hoog GS, Lavrijsen AP, Templeton K, et al. Diagnosis of common dermatophyte infections by a novel multiplex real-time polymerase chain reaction detection/identification scheme. Br J Dermatol. 2007;157:681–9.

    CAS  PubMed  Google Scholar 

  98. Bergmans AM, van der Ent M, Klaassen A, Bohm N, Andriesse GI, Wintermans RG. Evaluation of a single-tube real-time PCR for detection and identification of 11 dermatophyte species in clinical material. Clin Microbiol Infect. 2010;16:704–10.

    CAS  PubMed  Google Scholar 

  99. Wisselink GJ, van Zanten E, Kooistra-Smid AM. Trapped in keratin; a comparison of dermatophyte detection in nail, skin and hair samples directly from clinical samples using culture and real-time PCR. J Microbiol Methods. 2011;85:62–6.

    CAS  PubMed  Google Scholar 

  100. Dhib I, Fathallah A, Yaacoub A, Hadj Slama F, Said MB, Zemni R. Multiplex PCR assay for the detection of common dermatophyte nail infections. Mycoses. 2014;57:19–26. This is a recent paper about detection by multiplex PCR of commonly encountered dermatophytes directly on nail specimens. The efficiency of the method is good. The sensitivity of the PCR was higher than mycological examination (97 % vs. 81.1 %).

    CAS  PubMed  Google Scholar 

  101. Bergmans AM, Schouls LM, van der Ent M, Klaassen A, Bohm N, Wintermans RG. Validation of PCR-reverse line blot, a method for rapid detection and identification of nine dermatophyte species in nail, skin and hair samples. Clin Microbiol Infect. 2008;14:778–88.

    CAS  PubMed  Google Scholar 

  102. Beifuss B, Bezold G, Gottlober P, Borelli C, Wagener J, Schaller M, et al. Direct detection of five common dermatophyte species in clinical samples using a rapid and sensitive 24-h PCR-ELISA technique open to protocol transfer. Mycoses. 2011;54:137–45.

    CAS  PubMed  Google Scholar 

  103. Winter I, Uhrlass S, Kruger C, Herrmann J, Bezold G, Winter A, et al. Molecular biological detection of dermatophytes in clinical samples when onychomycosis or tinea pedis is suspected. A prospective study comparing conventional dermatomycological diagnostics and polymerase chain reaction. Hautarzt. 2013;64:283–9.

    CAS  PubMed  Google Scholar 

  104. Elavarashi E, Kindo AJ, Kalyani J. Optimization of PCR-RFLP directly from the skin and nails in cases of dermatophytosis, targeting the ITS and the 18S ribosomal DNA regions. J Clin Diagn Res. 2013;7:646–51. This paper describes the PCR RFLP as an efficient method for detecting dermatophytes on skin and nail specimens. However, no strain variations were detected among the T. rubrum and the T. mentagrophytes strains, showing the limits of this method compared to others such as the Diversilab system for example.

    PubMed Central  CAS  PubMed  Google Scholar 

  105. Brillowska-Dabrowska A, Saunte DM, Arendrup MC. Five-hour diagnosis of dermatophyte nail infections with specific detection of Trichophyton rubrum. J Clin Microbiol. 2007;45:1200–4.

    PubMed Central  CAS  PubMed  Google Scholar 

  106. Kondori N, Abrahamsson AL, Ataollahy N, Wenneras C. Comparison of a new commercial test, dermatophyte-PCR kit, with conventional methods for rapid detection and identification of Trichophyton rubrum in nail specimens. Med Mycol. 2010;48:1005–8.

    CAS  PubMed  Google Scholar 

  107. Dingemans G, van den Bosch M, Hayette M-P, Goethel S, Rusu V, Sacheli R, et al. Development of a new commercial qPCR assay to detect and differentiate dermatophyte infections of the skin, nails and hair. Presented at the European Congress of Clinical Microbiology and Infectious Diseases, 10–13 May 2014, Barcelona.

  108. Savin C, Huck S, Rolland C, Benderdouche M, Faure O, Noacco G, et al. Multicenter evaluation of a commercial PCR-enzyme-linked immunosorbent assay diagnostic kit (Onychodiag) for diagnosis of dermatophytic onychomycosis. J Clin Microbiol. 2007;45:1205–10.

    PubMed Central  CAS  PubMed  Google Scholar 

  109. Liu D, Coloe S, Baird R, Pedersen J. Molecular determination of dermatophyte fungi using the arbitrarily primed polymerase chain reaction. Br J Dermatol. 1997;137:351–5.

    CAS  PubMed  Google Scholar 

  110. Liu D, Coloe S, Baird R, Pedersen J. Application of PCR to the identification of dermatophyte fungi. J Med Microbiol. 2000;49:493–7.

    CAS  PubMed  Google Scholar 

  111. Liu D, Coloe S, Baird R, Pedersen J. PCR identification of Trichophyton mentagrophytes var. interdigitale and T. mentagrophytes var. mentagrophytes dermatophytes with a random primer. J Med Microbiol. 1997;46:1043–6.

    CAS  PubMed  Google Scholar 

  112. Liu D, Pearce L, Lilley G, Coloe S, Baird R, Pedersen J. PCR identification of dermatophyte fungi Trichophyton rubrum, T. soudanense and T. gourvilii. J Med Microbiol. 2002;51:117–22.

    CAS  PubMed  Google Scholar 

  113. Liu D, Coloe S, Pedersen J, Baird R. Use of arbitrarily primed polymerase chain reaction to differentiate Trichophyton dermatophytes. FEMS Microbiol Lett. 1996;136:147–50.

    CAS  PubMed  Google Scholar 

  114. Faggi E, Pini G, Campisi E. PCR fingerprinting for identification of common species of dermatophytes. J Clin Microbiol. 2002;40:4804–5.

    PubMed Central  CAS  PubMed  Google Scholar 

  115. Faggi E, Pini G, Campisi E, Bertellini C, Difonzo E, Mancianti F. Application of PCR to distinguish common species of dermatophytes. J Clin Microbiol. 2001;39:3382–5.

    PubMed Central  CAS  PubMed  Google Scholar 

  116. Khosravi A, Behzad F, Sabokbar A, Shokri H, Haddadi S, Masoudi-Nejad A. Molecular typing of Epidermophyton floccosum isolated from patients with dermatophytosis by RAPD-PCR. J Basic Microbiol. 2010;50 Suppl 1:S68–73.

    PubMed  Google Scholar 

  117. Graser Y, el Fari M, Presber W, Sterry W, Tietz HJ. Identification of common dermatophytes (Trichophyton, Microsporum, Epidermophyton) using polymerase chain reactions. Br J Dermatol. 1998;138:576–82.

    CAS  PubMed  Google Scholar 

  118. Pounder JI, Williams S, Hansen D, Healy M, Reece K, Woods GL. Repetitive-sequence-PCR-based DNA fingerprinting using the Diversilab system for identification of commonly encountered dermatophytes. J Clin Microbiol. 2005;43:2141–7.

    PubMed Central  CAS  PubMed  Google Scholar 

  119. Kamiya A, Kikuchi A, Tomita Y, Kanbe T. PCR and PCR-RFLP techniques targeting the DNA topoisomerase II gene for rapid clinical diagnosis of the etiologic agent of dermatophytosis. J Dermatol Sci. 2004;34:35–48.

    CAS  PubMed  Google Scholar 

  120. Machouart-Dubach M, Lacroix C, de Chauvin MF, Le Gall I, Giudicelli C, Lorenzo F, et al. Rapid discrimination among dermatophytes, Scytalidium spp., and other fungi with a PCR-restriction fragment length polymorphism ribotyping method. J Clin Microbiol. 2001;39:685–90.

    PubMed Central  CAS  PubMed  Google Scholar 

  121. Jackson CJ, Barton RC, Evans EG. Species identification and strain differentiation of dermatophyte fungi by analysis of ribosomal-DNA intergenic spacer regions. J Clin Microbiol. 1999;37:931–6.

    PubMed Central  CAS  PubMed  Google Scholar 

  122. Rezaei-Matehkolaei A, Makimura K, Shidfar M, Zaini F, Eshraghian M, Jalalizand N, et al. Use of single-enzyme PCR-restriction digestion barcode targeting the internal transcribed spacers (ITS rDNA) to identify dermatophyte species. Iran J Public Health. 2012;41:82–94.

    PubMed Central  CAS  PubMed  Google Scholar 

  123. Shin JH, Sung JH, Park SJ, Kim JA, Lee JH, Lee DY, et al. Species identification and strain differentiation of dermatophyte fungi using polymerase chain reaction amplification and restriction enzyme analysis. J Am Acad Dermatol. 2003;48:857–65.

    PubMed  Google Scholar 

  124. Ding J, Li J, Liu Z, Tan Z. Clinical identification of common species of dermatophytes by PCR and PCR-RFLP. J Huazhong Univ Sci Technolog Med Sci. 2004;24:642–4.

    CAS  PubMed  Google Scholar 

  125. Pryce TM, Palladino S, Kay ID, Coombs GW. Rapid identification of fungi by sequencing the ITS1 and ITS2 regions using an automated capillary electrophoresis system. Med Mycol. 2003;41:369–81.

    CAS  PubMed  Google Scholar 

  126. Romanelli AM, Fu J, Herrera ML, Wickes BL. A universal DNA extraction and PCR amplification method for fungal rDNA sequence-based identification. Mycoses. 2014;57:612–22.

    CAS  PubMed  Google Scholar 

  127. Fumeaux J, Mock M, Ninet B, Jan I, Bontems O, Lechenne B, et al. First report of Arthroderma benhamiae in Switzerland. Dermatology. 2004;208:244–50.

    PubMed  Google Scholar 

  128. Li HC, Bouchara JP, Hsu MM, Barton R, Su S, Chang TC. Identification of dermatophytes by sequence analysis of the rRNA gene internal transcribed spacer regions. J Med Microbiol. 2008;57:592–600.

    CAS  PubMed  Google Scholar 

  129. Op De Beeck M, Lievens B, Busschaert P, Declerck S, Vangronsveld J, Colpaert JV. Comparison and validation of some ITS primer pairs useful for fungal metabarcoding studies. PLoS One. 2014;9:e97629. This paper reviews several primers used for ITS amplification. The selected primer pairs include those that have been frequently used in fungal metabarcoding studies. The paper concludes that ITS86F/ITS4 primer pair forward as highly suitable for studying fungal diversity and community structures using DNA metabarcoding.

    Google Scholar 

  130. Ninet B, Jan I, Bontems O, Lechenne B, Jousson O, Panizzon R, et al. Identification of dermatophyte species by 28S ribosomal DNA sequencing with a commercial kit. J Clin Microbiol. 2003;41:826–30.

    PubMed Central  CAS  PubMed  Google Scholar 

  131. Jousson O, Lechenne B, Bontems O, Mignon B, Reichard U, Barblan J, et al. Secreted subtilisin gene family in Trichophyton rubrum. Gene. 2004;339:79–88.

    CAS  PubMed  Google Scholar 

  132. Dhib I, Fathallah A, Charfeddine IB, Meksi SG, Said MB, Slama F, et al. Evaluation of Chitine synthase (CHS1) polymerase chain reaction assay in diagnosis of dermatophyte onychomycosis. J Mycol Med. 2012;22:249–55.

    CAS  PubMed  Google Scholar 

  133. Kano R, Nakamura Y, Watari T, Watanabe S, Takahashi H, Tsujimoto H, et al. Molecular analysis of chitin synthase 1 (CHS1) gene sequences of Trichophyton mentagrophytes complex and T. rubrum. Curr Microbiol. 1998;37:236–9.

    CAS  PubMed  Google Scholar 

  134. Li HC, Bouchara JP, Hsu MM, Barton R, Chang TC. Identification of dermatophytes by an oligonucleotide array. J Clin Microbiol. 2007;45:3160–6.

    PubMed Central  CAS  PubMed  Google Scholar 

Download references

Compliance with Ethical Guidelines

Conflicts of Interest

Marie-Pierre Hayette and Rosalie Sacheli declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. National Reference Center for Mycosis, Department of Clinical Microbiology, University Hospital of Liège, Domaine du Sart Tilman B23, Avenue de l’Hôpital, 1, 4000, Liège, Belgium

    Marie-Pierre Hayette & Rosalie Sacheli

Authors
  1. Marie-Pierre Hayette
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rosalie Sacheli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marie-Pierre Hayette.

Additional information

This article is part of the Topical Collection on Clinical Mycology Lab Issues

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hayette, MP., Sacheli, R. Dermatophytosis, Trends in Epidemiology and Diagnostic Approach. Curr Fungal Infect Rep 9, 164–179 (2015). https://doi.org/10.1007/s12281-015-0231-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12281-015-0231-4

Keywords

Search

Navigation