Superficial fungal infection (SFI) is one of the commonest infections worldwide, with a prevalence rate of more than 20%. Fungal infections of skin, hair, onychomycosis and otomycosis are all included as SFI’s. Mostly, SFI is caused by dermatophyte moulds followed by infections by yeast genera Malassezia and Candida. Additionally, in the immunocompetent, there has been an increase of SFI caused by non-Candida yeasts and non-dermatophyte moulds such as Aspergillus species, Mucorales, hyalohyphomycetes, and dematiaceous fungi. Moreover, in immunodeficient patients, a skin infection caused by these fungi may be the source of systemic dissemination, resulting in fungemia and invasive infection.
The standard procedure for the diagnosis of SFI usually requires isolation and identification of the infecting pathogen. Efforts to overcome the problems encountered with conventional methods, which are time-consuming and need expert knowledge, have focused on designing and adopting new non-culture methods. Development, standardization, and commercialization of molecular tests, such as multiplex PCR molecular platforms, which enable rapid determination of fungi directly from patients’ material, are of great importance in diagnosing SFI. On the other hand, at the same time as designing new non-culture methods, other studies have investigated the possibility of applying different techniques in order to simplify and facilitate fungal diagnosis. Recently, for instance, there have been the first reports applying a new imaging tool, dynamic full-field optical coherence tomography (D-FF-OCT), that can be used for the visualization and differentiation of microscopic filamentous fungi, as well as the development of a neural network model that will aid identification of moulds, and thus accelerate the diagnostic process.
Identifying causes of SFI facilitates the key further step, the choice of therapy. Although fungal resistance has not reached the scale of multidrug resistance amongst bacteriae, the increasing numbers of reports of resistance to antifungal drugs amongst dermatophytes and other fungi, published in the last few years, has raised the interest of researchers. Following on from this, studies have focused on identifying the most effective antimycotics and updating therapeutic guidelines for fungal infections. The effectiveness of antifungals depends on various factors, including characteristics of the fungi, host and drug, as well as the clinical presentation of the SFI. As there may be a disconnect between in vitro and in vivo effectiveness, laboratory results must be correlated with clinical response likewise fungi from treatment-refractory cases should be checked for in vitro sensitivity although this is only infrequently implemented.
This Research Topic focuses on new diagnostic procedures and problems in treating and monitoring superficial fungal infections. Through sharing their expertise and investigative data on the diagnosis and treatment of SFI, authors will be contributing to our current knowledge of successful management strategies as well as new diagnostic and therapeutic options.
Authors are encouraged to contribute original scientific articles, including clinical trials, reviews, and mini-reviews focusing on the following areas:
- Monitoring recalcitrant infections and resistance of dermatophytes to antifungals in vivo and in vitro
- Diagnostic and therapeutic options for superficial fungal infections caused by non-Candida yeast, Aspergillus species, Mucorales, hyalohyphomycetes, and dematiaceous fungi.
- Non-culture methods for prompt and direct detection of fungi in clinical samples
- New techniques in the procedure of identification of filamentous fungi
- Diagnostic procedures and treatment for otomycosis
Superficial fungal infection (SFI) is one of the commonest infections worldwide, with a prevalence rate of more than 20%. Fungal infections of skin, hair, onychomycosis and otomycosis are all included as SFI’s. Mostly, SFI is caused by dermatophyte moulds followed by infections by yeast genera Malassezia and Candida. Additionally, in the immunocompetent, there has been an increase of SFI caused by non-Candida yeasts and non-dermatophyte moulds such as Aspergillus species, Mucorales, hyalohyphomycetes, and dematiaceous fungi. Moreover, in immunodeficient patients, a skin infection caused by these fungi may be the source of systemic dissemination, resulting in fungemia and invasive infection.
The standard procedure for the diagnosis of SFI usually requires isolation and identification of the infecting pathogen. Efforts to overcome the problems encountered with conventional methods, which are time-consuming and need expert knowledge, have focused on designing and adopting new non-culture methods. Development, standardization, and commercialization of molecular tests, such as multiplex PCR molecular platforms, which enable rapid determination of fungi directly from patients’ material, are of great importance in diagnosing SFI. On the other hand, at the same time as designing new non-culture methods, other studies have investigated the possibility of applying different techniques in order to simplify and facilitate fungal diagnosis. Recently, for instance, there have been the first reports applying a new imaging tool, dynamic full-field optical coherence tomography (D-FF-OCT), that can be used for the visualization and differentiation of microscopic filamentous fungi, as well as the development of a neural network model that will aid identification of moulds, and thus accelerate the diagnostic process.
Identifying causes of SFI facilitates the key further step, the choice of therapy. Although fungal resistance has not reached the scale of multidrug resistance amongst bacteriae, the increasing numbers of reports of resistance to antifungal drugs amongst dermatophytes and other fungi, published in the last few years, has raised the interest of researchers. Following on from this, studies have focused on identifying the most effective antimycotics and updating therapeutic guidelines for fungal infections. The effectiveness of antifungals depends on various factors, including characteristics of the fungi, host and drug, as well as the clinical presentation of the SFI. As there may be a disconnect between in vitro and in vivo effectiveness, laboratory results must be correlated with clinical response likewise fungi from treatment-refractory cases should be checked for in vitro sensitivity although this is only infrequently implemented.
This Research Topic focuses on new diagnostic procedures and problems in treating and monitoring superficial fungal infections. Through sharing their expertise and investigative data on the diagnosis and treatment of SFI, authors will be contributing to our current knowledge of successful management strategies as well as new diagnostic and therapeutic options.
Authors are encouraged to contribute original scientific articles, including clinical trials, reviews, and mini-reviews focusing on the following areas:
- Monitoring recalcitrant infections and resistance of dermatophytes to antifungals in vivo and in vitro
- Diagnostic and therapeutic options for superficial fungal infections caused by non-Candida yeast, Aspergillus species, Mucorales, hyalohyphomycetes, and dematiaceous fungi.
- Non-culture methods for prompt and direct detection of fungi in clinical samples
- New techniques in the procedure of identification of filamentous fungi
- Diagnostic procedures and treatment for otomycosis