Varijacije u kliničkoj slici i epidemiologiji dubokih dermatomikoza vlasišta [The clinical pattern variations and epidemiology of deep seated tinea capitis]

Abstract

Tinea capitis caused by Microsporum canis is usually noninflammatory. However, progressive number of severe kerion like tinea capitis (TC) due to M. canis has been recently registered. Providing that the same fungal species might evoke different clinical patterns, interspecies polymorphism within M. canis isolates might have been responsible for this phenomenon. The aim of this study was to examine genotypic variability among isolates of M. canis from patients with superficial and deep seated tinea capitis. Sixty strains of M. canis from patients with both superficial and deep seated tinea capitis have been isolated and identified to the species level using standard and advanced mycological procedure techniques. Morphological identification was confirmed by molecular methods PCR-RFLP (Polymerase Chain Reaction-Restriction Fragment Length Polymorphism). After amplification of ITS1-5.8S-ITS2 region, the PCR product was exposed to restriction enzyme HinfI. All strains of M. canis had identical pattern on gel electrophoresis. For sub typing of M. canis isolates the RAPD (Random Amplified Polimorphic DNA) has been perfomed using (ACA)5 and (GACA)4 primers. After RAPD amplification with (ACA)4 primer, among all M. canis isolates only one RAPD profile was determined, whereas using (GACA)4 primer two different band patterns were confirmed. According to the results of the epidemiological part of our study M. canis remained the main causative agent of TC in Croatia. The incidence of TC remained high during the ten-years period (2006-2015), but decrease in the incidence of TC was observed in the first 5 years, with stable incidence of TC during the last 5 years of the study period. A statistically significant increase of TC among all fungal skin infections during the last 3 years was observed. The association between RAPD profiles and certain clinical type of tinea capitis was not determined by the use of GACA4 primer . Results of most molecular studies show that there is no clonal differentiation within M. canis. Moreover, using the same (GACA)4 primer M. canis was found not to be genotypically unique. However, furhter investigations on larger group of patiens might be required in order to elucidate this problem more precisely