Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4809
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Item Strategies to improve the diagnosis and clinical treatment of dermatophyte infections(2023) Durdu, Murat; Ilkit, Macit; 36329574Introduction Significant problems are associated with the diagnosis and treatment of dermatophyte infections, which constitute the most common fungal infections of the skin. Although this is a common problem in the community, there are no adequate guidelines for the management of all forms of dermatophyte infections. Even if dermatophytes are correctly diagnosed, they sometimes exhibit poor susceptibility to several antifungal compounds. Therefore, long-term treatment may be needed, especially in immunosuppressed patients, for whom antifungal pharmacotherapy may be inconvenient owing to allergies and undesirable drug interaction-related effects. Areas covered In this review article, problems related to the diagnosis and treatment of dermatophyte infections have been discussed, and suggestions to resolve these problems have been presented. Expert opinion Pretreatment microscopic or mycological examinations should be performed for dermatophyte infections. In treatment-refractory cases, antifungal-resistant strains should be determined using antifungal susceptibility testing or via molecular methods. Natural herbal, laser, and photodynamic treatments can be used as alternative treatments in patients who cannot tolerate topical and systemic antifungal treatments.Item Changing Concepts and Current Definition of Majocchi's Granuloma(2020) Durdu, Murat; Kandemir, Hazal; Ilkit, Macit; de Hoog, G. Sybren; 31297666Dermatophytic granuloma characterized by perifollicular granulomatous inflammation was first described by Domenico Majocchi and was later named after him, Majocchi's granuloma (MG). Although the initial description was related to a dermatophyte Trichophyton tonsurans, later reports linked MG to non-dermatophytes (Phoma, Aspergillus, Malbranchea), which led to a confusion of disease patterns caused by cutaneous pathogens and general opportunistic microorganisms. Furthermore, several causative agents of MG described in the literature were not confirmed as such. Our review addressed the following aspects: (1) significance of histopathological finding for MG diagnosis, (2) dermatophytes as exclusive agents of MG, (3) spectrum of etiological agents causing different types of invasive dermatophytic infections, and (4) treatment options.Item High accuracy of recognition of common forms of folliculitis by dermoscopy: An observational study(2019) Durdu, Murat; Errichetti, Enzo; Eskiocak, Ali Haydar; Ilkit, Macit; 0000-0003-1247-3932; 30914342; H-9068-2019Background: Clinical differentiation of folliculitis types is challenging. Dermoscopy supports the recognition of folliculitis etiology, but its diagnostic accuracy is not known. Objective: To assess the diagnostic accuracy of dermoscopy for folliculitis. Methods: This observational study included patients (N = 240) with folliculitis determined on the basis of clinical and dermoscopic assessments. A dermoscopic image of the most representative lesion was acquired for each patient. Etiology was determined on the basis of cytologic examination, culture, histologic examination, or manual hair removal (when ingrowing hair was detected) by dermatologist A. Dermoscopic images were evaluated according to predefined diagnostic criteria by dermatologist B, who was blinded to the clinical findings. Dermoscopic and definitive diagnoses were compared by dermatologist C. Results: Of the 240 folliculitis lesions examined, 90% were infections and 10% were noninfectious. Infectious folliculitis was caused by parasites (n = 71), fungi (n = 81), bacteria (n = 57), or 7 viruses (n = 7). Noninfectious folliculitis included pseudofolliculitis (n = 14), folliculitis decalvans (n = 7), and eosinophilic folliculitis (n = 3). The overall accuracy of dermoscopy was 73.7%. Dermoscopy showed good diagnostic accuracy for Demodex (88.1%), scabietic (89.7%), and dermatophytic folliculitis (100%), as well as for pseudofolliculitis (92.8%). Limitations: The diagnostic value of dermoscopy was calculated only for common folliculitis. Diagnostic reliability could not be calculated. Conclusion: Dermoscopy is a useful tool for assisting in the diagnosis of some forms of folliculitis.Item Majocchi's granuloma: current perspectives(2018) Durdu, Murat; Boral, Hazal; Ilkit, Macit; 0000-0003-1247-3932; 29861637; H-9068-2019Majocchi's granuloma (MG) is a rare fungal infection of the dermis that is mainly caused by dermatophytes (in >= 95% of cases); the most frequently identified cause is anthropophilic Trichophyton rubrum. In the rest of the cases, the causes are non-dermatophytic fungi such as Aspergillus species. This review aimed to provide information about the current perspectives on MG regarding its clinical characteristics, predisposing factors, laboratory diagnosis, and treatment strategies. Although the lower extremities were reported to be the most common site of infection, facial involvement has been predominant in the past 5 years. Our literature research showed that the most common predisposing factor (55%) is the use of topical steroid creams without potassium hydroxide examination during treatment of erythematous squamous dermatoses. A reliable diagnosis of MG is based on histopathological examination, including fungal culture and molecular analyses. MG should be treated not only with topical agents but also with systemic antifungal agents that are continued until the lesions are completely resolved. In systemic treatment, the most preferred drug is terbinafine, because of its efficacy, side effects, and safety.