Dermatophytosis syndrome B35.3

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Trichophyton rubrum syndrome; Trichophyton-rubrum syndrome

History
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Zaias, 1996

Definition
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Recurrent, usually lifelong, chronic tinea of the soles of the feet and/or distal subungual tinea unguium and/or tinea corporis.

Pathogen
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Especially Trichophyton rubrum.

Classification
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Criteria for the Trichophyton rubrum syndrome (according to Korting):
  • Skin infestation with Trichophyton rubrum on hand, foot, nail and one other localization (except inguinal).
  • In each case positive native preparation
  • In each case positive culture from the material of at least three localisations.

Clinical features
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Usually less symptomatic, chronically persistent, extensive, scaly and itchy erythema on the feet, inguinal region and other body regions. Onychomyotic infestation of the foot and fingernails.

Diagnosis
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Mycological culture; clarification of an immunodeficiency.

General therapy
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Prevention and treatment of sources of infection such as infected animals e.g. cats, dogs, cows, guinea pigs.

External therapy
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S.u. Tinea, see below Antimycotics.

Internal therapy
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  • Indication for systemic therapy with broad-spectrum antifungal agents with very high corneal patency is always given. Duration of therapy 2-3 months or longer, until complete remission of symptoms. Trial with itraconazole (e.g. Sempera Kps.) 1mal/day 100 mg p.o.
  • Alternative: Fluconazole (e.g. Diflucan Kps.) 1-2 times/day 200-400 mg p.o.
  • Alternative: Terbinafine (e.g. Lamisil Tbl.) 1 time / day 250 mg p.o.
  • Alternative: Griseofulvin (e.g. Likuden Tbl.) 1 time / day 500 mg p.o., in severe cases 750-1000 mg/day p.o.

Prophylaxis
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S.u. Tinea.

Literature
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  1. Böhmer U et al (1999) Trichophyton-rubrum syndrome with tinea axillaris as partial manifestation. Dermatologist 50: 292-294
  2. Brasch J et al (1990) Pathogen and pathogenesis of dermatophytosis. Dermatologist 41: 9-15
  3. Drake LA et al (1996) Guidelines of care for superficial mycotic infection of the skin: Tinea corporis, tinea cruris, tinea faciei, tinea manuum tinea pedis. J Am Acad Dermatol 34: 282-286
  4. Kick G et al (2001) The definition of Trichophyton rubrum syndrome. Mycoses 44: 167-171
  5. Zaias N et al (1996) Chronic dermatophytosis caused by Trichophyton rubrum. J Am Acad Dermatol 35: 614-617

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Last updated on: 29.10.2020