************************************
************************************
****** DATA-MEDICOS **********
************************************ 
TIÑA NEGRA 
TINEA NIGRA 
**************************************
****** DERMAGIC-EXPRESS No.32 ******** 
****** 26 ENERO DE 1.999 ********* 
26 JANUARY 1.999
**************************************
***************************************

EDITORIAL ESPANOL
=================

Hola amigos DERMAGICOS, el tema de hoy la TIÑA NEGRA, interesante patologia micotica, solicitada por el Dr: Hernan Vargas Montiel., presidente de la Sociedad Venezolana de Dermatologia, a proposito del Congreso Ibero latinoamericano de Micologia a efectuarse en España. 
Espero que estas interesantes referencias nos ilustren bien esta curiosa y benigna enfermedad. 

AGENTE CAUSAL DE TINEA NIGRA:
Exophiala werneckii
SINONIMOS:
Phaeoannellomyces werneckii 
Cladosporium werneckii (Horta)
Dematium werneckii (Dodge)
Pullularia werneckii (de Vries)
Aureobasidium mansonii (Cooke)
----------------------------

"" que tiene que ver la pitiriasis rosada con la legionella, picornavirus, herpesvirus 7 y Epstein Barr"" proxima edición !!!

Hasta una nueva oportunidad !!!

Dr. Jose Lapenta R.,,,


EDITORIAL ENGLISH
=================
Hello DERMAGICS friends, today's topic the tinea nigra, interesting fungus pathology, requested by the Dr: Hernan Vargas Montiel., president of the Venezuelan Society of Dermatology on purpose of the Ibero latinoamerican Congress of Micology to be made in Spain. 
I hope these interesting references illustrate us well this curious and benign illness. 

CAUSAL AGENT, TINEA NIGRA:
Exophiala werneckii
SYNONYMS:
Phaeoannellomyces werneckii 
Cladosporium werneckii (Horta)
Dematium werneckii (Dodge)
Pullularia werneckii (de Vries)
Aureobasidium mansonii (Cooke) 
------------------------

"what relationship exists between the pityriasis rosea and the legionella, picornavirus, herpesvirus 7 and Epstein Barr", next edition!! 

Until a new opportunity, !!!

Dr. José Lapenta R. 
======================================================================
DERMAGIC/EXPRESS(32)
====================================================================== TIÑA NEGRA / TINNEA NIGRA ====================================================================== 1.) Tinea nigra
2.) [Tinea nigra plantaris]
3.) Tinea nigra palmaris. Treatment with thiabendazole topically.
4.) [Tropic-subtropic fungus infections in Germany]
5.) The fine structure of Hortaea werneckii.
6.) Further studies on the phylogenesis of the genus Exophiala and Hortaea.
7.) Tinea nigra: report of four cases observed in Rio Grande do Sul
(Brazil) and a review of Brazilian literature.
8.) Tinea nigra masquerading as acral lentiginous melanoma.
9.) Association of anurans with pathogenic fungi.
10.) [Tinea nigra. 1st clinical case in Uruguay]
11.) Treatment of tinea nigra palmaris with miconazole.
12.) Polymerase chain reaction-mediated genotyping of Hortaea werneckii,
causative agent of tinea nigra.
13.) Tinea nigra: treatment with topical ketoconazole.
14.) Tinea nigra palmaris.
15.) Therapy of tinea nigra plantaris.
16.) [Tinea nigra. Apropos of a case diagnosed as melanoma of superficial
dissemination] 
17.) Tinea nigra palmaris: differentiation from malignant melanoma or junctional nevi. 
18.) Tinea nigra palmaris from South India. 
19.) Cell-surface hydrophobicity and lipolysis as essential factors in human tinea nigra. 
20.) Tinea nigra infection in Canada. 
21.) Nature and identification of Exophiala werneckii. 
22.) Fruiting organs of Cladosporium werneckii. 
23.) Exophiala werneckii v. Arx
24.) Exophiala, species.
=======================================================================
1.) Tinea nigra
=======================================================================
The University of Texas Medical Branch at Galveston, Texas, USA 
Synonyms
--------
Pityriasis nigra, tinea nigra palmaris Definition

Tinea nigra is a superficial, asymptomatic fungal infection of the stratum
corneum characterized by brown to black nonscaly macules. The palmar
surfaces are most often affected, but lesions may occur on the plantar and
other surfaces of the skin. 
Mycology
--------
Phaeoannellomyces werneckii 

Natural habitat
--------------
Plants, soil and Foods with a high salt content
=======================================================================
2.) [Tinea nigra plantaris]
TT [Tinea nigra plantaris.]
=======================================================================
SO - Hautarzt 1977 Aug;28(8):412-5
AU - Dorn M; Krempl-Lamprecht L
PT - JOURNAL ARTICLE
AB - A second case of tinea nigra occuring in Germany is recorded. The
patient was a 33 year old women, who supposedly acquired the infection in
Israel, which was not diagnosed until two years after the onset. Scrapings
from a dark macule on her sole yielded Cladosporium werneckii. The lesion
cleared with topical treatment of a keratinolytic ointment and a
haloprogin-cream.

=======================================================================
3.) Tinea nigra palmaris. Treatment with thiabendazole topically.
=======================================================================
SO - Arch Dermatol 1975 Jul;111(7):904-5
AU - Carr JF; Lewis CW
PT - JOURNAL ARTICLE
AB - A patient had tinea nigra palmaris that had not responed to
toinaftate or salicylic acid ointment during a period of seven years.
Thiabendazole suspension, 10 percent applied twice daily, cleared the
lesion in two weeks.

=======================================================================
4.) [Tropic-subtropic fungus infections in Germany]
TT - [Tropisch-subtropische Pilzinfektionen in Deutschland.]
=======================================================================
SO - Hautarzt 1978 Jan;29(1):17-21
AU - Krempl-Lamprecht L
PT - JOURNAL ARTICLE
AB - Observations by the author and other workers on exotic mycoses in
Germany are used in order to establish several groups of patients. The
following mycoses from tropical and subtropical areas and their causative
agents are mentioned: Tinea nigra (Cladosporium werneckii), south American
blastomycosis (Paracoccidioides brasiliensis), coccidioidomycosis
(Coccidioides immitis), histoplasmosis (Histoplasma capsulatum), mycetoma
(Madurella mycetomi), dermatophytosis/tinea capitis (Trichophyton
soudanense, Trichophyton violaceum, Microsporum ferrugineum),
sporotrichosis (Sporothrix schenckii), chromomycosis (Fonsecaea pedrosoi).

=======================================================================
5.) The fine structure of Hortaea werneckii.
=======================================================================
SO - Mycoses 1993 Nov-Dec;36(11-12):343-50
AU - Mittag H
AD - Abteilung fur Dermatologie mit Schwerpunkt Histopathologie und
Elektronenmikroskopie der Haut, Philipps-Universitat Marburg, Germany.
PT - JOURNAL ARTICLE
AB - Hortaea werneckii (strain CBS 107.67) was examined by light and
transmission electron microscopy (TEM). Special attention was paid to the
wall architecture, the septum with a simple pore apparatus, the annellidic
type of collar and the nuclei. Two-celled organisms showed signs of
distoseptation; nuclear events appeared to be rather synchronous in both
cells. The fine structural results provided evidence of endogenous conidia
development.

=======================================================================
6.) Further studies on the phylogenesis of the genus Exophiala and Hortaea.
=======================================================================
SO - Mycopathologia 1985 Nov;92(2):101-9
AU - Nishimura K; Miyaji M
PT - JOURNAL ARTICLE
AB - The conidial ontogenesis of the pathogenic black yeasts is studied at
an ultrastructural level and their phylogenesis is discussed. Five cultures
of Exophiala dermatitidis, four of E. jeanselmei, one of E. moniliae, one
of E. spinifera and six of H. werneckii were observed using a scanning
electron microscope. The conidial ontogenesis of the Exophiala species is
not pleomorphic but only annellidic. There are definite differences in
morphology of annellated tips among the Exophiala species. The ontogenesis
of Hortaea werneckii consists of a combination of sympodial and annellidic
conidiogenesis. Its sympodial anamorph is unique and the annellidic
anamorph is considered to be a homology of the sympodial one.

=======================================================================
7.) Tinea nigra: report of four cases observed in Rio Grande do Sul
(Brazil) and a review of Brazilian literature.
=======================================================================
SO - Mycopathologia 1994 Jun;126(3):157-62
AU - Severo LC; Bassanesi MC; Londero AT
AD - Instituto Especiolizodo em Pesquisa e Diagnostico, Santa Casa, Porto
Alegre, RS, Brazil.
PT - JOURNAL ARTICLE; REVIEW (44 references); REVIEW OF REPORTED CASES
AB - Four cases of Tinea Nigra by Exophiala werneckii, observed in Porto
Alegre, RS, during the period 1981-1992 were related. A boy presented
bilateral palmar lesions, one girl had plantar lesions and the remaining
two girls had lesions on the palms. Three cases were autochthonous and the
remaining patient was infected during a trip to Chile. A review of
Brazilian literature and comments on the epidemiology and clinical aspects
of the mycosis is presented.

=======================================================================
8.) Tinea nigra masquerading as acral lentiginous melanoma.
=======================================================================
SO - J Dermatol Surg Oncol 1986 May;12(5):502-4
AU - Babel DE; Pelachyk JM; Hurley JP
PT - JOURNAL ARTICLE
AB - Tinea nigra is a superficial mycosis that may mimic serious
pigmentary lesions. A lesion recently encountered on the foot was suspected
of being a malignant melanoma. Histologic and mycologic studies, done after
a biopsy was obtained, demonstrated Exophilia werneckii in the stratum
corneum. Tinea nigra should be considered in the diagnosis of pigmented
lesions of the hands and feet. A KOH examination is a simple and rapid
means of demonstrating this entity.

=======================================================================
9.) Association of anurans with pathogenic fungi.
=======================================================================
SO - Mycopathologia 1985 Oct;92(1):37-43
AU - Mok WY; Morato de Carvalho C
PT - JOURNAL ARTICLE
AB - In a study of 450 Amazonian anurans, we isolated yeasts and
yeast-like fungi from 54 animals (Bufo granulosus, B. marinus,
Dendrophrynyscus sp., Hyla geographica, H. lanciformes, Ololygon rubra,
Adenomera hylaedactyla, Eleutherodactylus fenestratus, Leptodactylus
fuscus, L. ocellatus, L. pentadactylus). The internal organs of these
animals did not show any macroscopic anomaly nor histopathology. We
recovered 105 fungal isolates from the anuran liver, lung, kidney, spleen,
heart and gonad. The isolates were made up of 30 fungal species, 9 of which
(48 isolates, 46%) were fungi with known pathogenic potentials, namely:
Candida guilliermondii, C. parapsilosis, C. tropicalis, C. glabrata,
Geotrichum candidum, Aureobasidium pullulans, Wangiella dermatitidis,
Trichosporon cutaneum and Exophiala werneckii. Eleven animals harbored
identical fungi in more than one of their internal organs; seven animals
had more than one fungal species colonizing a single organ. Our findings
indicated probable natural subclinical infections of candidiasis,
geotrichosis or phaeohyphomycosis, and also symbiotic presence of
non-pathogenic fungi among neotropical anurans.

=======================================================================
10.) [Tinea nigra. 1st clinical case in Uruguay]
TT - [Tina negra. Primera observacion en el Uruguay.]
=======================================================================
SO - Mycopathologia 1984 Aug 30;87(1-2):81-3
AU - Conti-Diaz IA; Burgoa F; Civila E; Bonasse J; Miller A
PT - JOURNAL ARTICLE
AB - The first case in Uruguay of 'tinea nigra' is described in a
44-year-old male patient with a maculous pigmented lesion on the right
foot. It represents the most meridional case of the disease yet recorded in
South America. Exophiala werneckii was isolated in cultures (strain 1905 IHM).

=======================================================================
11.) Treatment of tinea nigra palmaris with miconazole.
=======================================================================
SO - Arch Dermatol 1980 Mar;116(3):321-2
AU - Marks JG Jr; King RD; Davis BM
PT - JOURNAL ARTICLE
AB - A patient with tinea nigra palmaris was successfully treated with 2%
miconazole nitrate cream. In vitro studies demonstrated sensitivity of the
causative agent, Exophiala werneckii, to this antifungal agent.

=======================================================================
12.) Polymerase chain reaction-mediated genotyping of Hortaea werneckii,
causative agent of tinea nigra.
=======================================================================
SO - Mycoses 1994 Sep-Oct;37(9-10):307-12
AU - Uijthof JM; de Cock AW; de Hoog GS; Quint WG; van Belkum A
AD - Centraalbureau voor Schimmelcultures (CBS) Baarn, The Netherlands.
PT - JOURNAL ARTICLE
AB - The black yeast Hortaea werneckii is known to be a causative agent of
human tinea nigra but is also found in the environment. Strains from
dissimilar sources were studied by polymerase chain reaction fingerprinting
of nuclear DNA, using primers annealing to repetitive and random sequences.
The seven groups found correspond to those known from restriction fragment
length polymorphism (RFLP) studies of the mitochondrial DNA of the same
strains. Two main groups contained strains from human as well as from
non-human sources. The human strains did not cluster, but were randomly
distributed over several populations. It was concluded that these strains
are not pathogenic. The factor common to both niches is a relatively high
salt concentration.

=======================================================================
13.) Tinea nigra: treatment with topical ketoconazole.
=======================================================================
SO - Cutis 1993 Oct;52(4):209-11
AU - Burke WA
AD - Department of Internal Medicine, East Carolina University, School of
Medicine, Greenville, North Carolina 27858-4354.
PT - JOURNAL ARTICLE
AB - Tinea nigra is a relatively uncommon fungal infection presenting as a
pigmented macule of the palms or soles. Since the lesion can easily mimic a
melanocytic process, it is important to recognize the infection before
recommending unnecessary surgical procedures. A case of tinea nigra that
responded to treatment with topical ketoconazole is presented.

=======================================================================
14.) Tinea nigra palmaris.
=======================================================================
SO - Clin Exp Dermatol 1993 Sep;18(5):481-2
AU - Hughes JR; Moore MK; Pembroke AC
AD - Department of Dermatology, King's College Hospital, London, UK.
PT - JOURNAL ARTICLE
AB - Tinea nigra is a clinically distinctive superficial mycosis of the
palms, and occasionally the soles, caused by Phaeoannellomyces werneckii. A
patient, resident in the United Kingdom, is described who acquired the
infection in Thailand. The condition cleared after treatment with topical
miconazole cream 2%.

=======================================================================
15.) Therapy of tinea nigra plantaris.
=======================================================================
SO - Int J Dermatol 1989 Jan-Feb;28(1):46-8
AU - Sayegh-Carreno R; Abramovits-Ackerman W; Giron GP
AD - Department of Dermatology, Central University of Venezuela, Caracas.
PT - JOURNAL ARTICLE
AB - Four cases of tinea nigra plantaris are presented. The therapeutic
approaches used by different dermatologists who treated these patients are
analyzed in order to obtain a meaningful conclusion on how to best manage
this infrequent entity. We conclude that the visible affected skin should
be scraped off before using either ciclopiroxolamine or an imidazole
topically; systemic therapy is not recommended.

=======================================================================
16.) [Tinea nigra. Apropos of a case diagnosed as melanoma of superficial
dissemination] 
=======================================================================
Author 
Macotela-Ru´iz E; L´opez Mart´inez R; Gonz´alez Mendoza A; Soberanes
Valenzuela G; Su´arez de la Torre R 
Source 
Prensa Med Mex, 43(3-4):110-2 1978 Mar-Apr 
Abstract 
The authors report a case of tinea nigra of left sole, diagnosticate at the
beginning as melanoma of superficial dissemination. The mycological studies
confirmed the dermatological diagnostic of tinea nigra by Cladosporium
werneckii. 

=======================================================================
17.) Tinea nigra palmaris: differentiation from malignant melanoma or junctional nevi. 
=======================================================================
Author 
Hall J; Perry VE 
Address 
Baylor College of Medicine, Houston, Texas, USA. 
Source 
Cutis, 62(1):45-6 1998 Jul 
Abstract 
Tinea nigra usually presents as a brown to black macule on the palmar or
plantar skin and is sometimes misdiagnosed as a malignant melanoma or as a
junctional nevus, prompting unnecessary surgical procedures and anguish for
the patient. Superficial scraping of the skin for microscopic inspection
with potassium hydroxide reveals pigmented hyphae, easily confirming the
diagnosis of tinea nigra. 

=======================================================================
18.) Tinea nigra palmaris from South India. 
=======================================================================
Author 
Dasgupta LR; Agarwal SC; Bedi BM 
Source 
Sabouraudia, 13 Pt 1():41-3 1975 Mar 
Abstract 
A middle aged woman was diagnosed as a case of tinea nigra palmaris in a
Pondicherry hospital. Ascraping from a dark patch on her palm yielded
Cladosporium werneckii. This is the first report of mycologically confirmed
tinea nigra palmaris from India. 

=======================================================================
19.) Cell-surface hydrophobicity and lipolysis as essential factors in human tinea nigra. 
=======================================================================
Author 
G¨ottlich E; de Hoog GS; Yoshida S; Takeo K; Nishimura K; Miyaji M 
Address 
Research Center for Pathogenic Fungi and Microbial Toxicoses, Chiba
University, Japan. 
Source 
Mycoses, 38(11-12):489-94 1995 Nov-Dec 
Abstract 
Hydrophobic adhesion of cells of the black yeast Hortaea werneckii (Horta)
Nishimura & Miyaji, causative agent of human tinea nigra, was established
by microbial adhesion to hexadecane (MATH) and adhesion to polystyrene, and
compared with adhesion of other species of black yeasts. Additional
ecophysiological tests were performed. Hortaea werneckii cells proved to
have a high degree of hydrophobicity (98.5% MATH). The species is unable to
degrade keratin, but shows significant lipolytic activity. It is concluded
that H. werneckii is a commensal, that shows lipophilic adhesion to human
skin and survives by the assimilation of excretion products. 

=======================================================================
20.) Tinea nigra infection in Canada. 
=======================================================================
Author 
Kane J; Birkett B; Fischer JB 
Source 
Sabouraudia, 14(3):327-30 1976 Nov 
Abstract 
The first infection of tinea nigra known to occur in Canada is reported.
The infection occurred on the palm of a Canadian boy, 6 years of age, while
he was visiting in the Bahamas. Cultural studies identified the causative
fungus to be Cladosporium werneckii. 

=======================================================================
21.) Nature and identification of Exophiala werneckii. 
=======================================================================
Author 
Mok WY 
Source 
J Clin Microbiol, 16(5):976-8 1982 Nov 
Abstract 
The morphological and physiological characteristics of 44 isolates of
Exophiala werneckii recovered from human and environmental sources were
indistinguishable from 2 isolates that caused tinea nigra. Casein
hydrolysis and inability to decompose tyrosine differentiate E. werneckii
from Exophiala jeanselmei, Exophiala spinifera, and Wangiella dermatitidis. 

=======================================================================
22.) Fruiting organs of Cladosporium werneckii. 
=======================================================================
Author 
Volc´an G; Godoy GA; Battistini F; Alvarez A 
Source 
Sabouraudia, 14(2):115-22 1976 Jul 
Abstract 
Submerged mycelia of a strain of Cladosporium werneckii isolated from tinea
nigra palmaris, when cultured on enriched corn-meal agar media, developed
fruiting bodies resembling perithecia. 

=======================================================================
23.) Exophiala werneckii v. Arx
=======================================================================

(syns Cladosporium werneckii Horta, Dematium werneckii Dodge, Pullularia werneckii de Vries, Aureobasidium mansonii Cooke)

This organism is the causative agent of tinea nigra, a superficial phaeohyphomycosis characterised by dark macular patches on the palms or palmar aspects of the wrists and fingers (Ajello & Padhye 1980, McGinnis 1980). The use of the term tinea to describe the disease is misleading since it is not a form of ringworm (Roberts et al. 1984, McGinnis et al. 1985).

There is a great deal of confusion in the literature concerning the taxonomy of Exophiala werneckii and its relationship with Microsporum mansonii Castellani. McGinnis (1979) attempted to clarify the situation and concluded that the confusion arose when a case of pityriasis versicolor was misdiagnosed as tinea nigra. The organism responsible was named Microsporum mansonii by Castellani and later renamed Aureobasidium mansonii by Cooke. However, Cooke was actually naming the causative organism of tinea nigra, so his name is now considered to be a synonym of Exophiala werneckii. Since Castellani's name actually referred to the causative organism of pityriasis versicolor, it is now considered to be a synonym of Malassezia furfur Baillon.

=======================================================================
24.) Exophiala species
=======================================================================

Exophiala species are usually included among the fungi called "black yeasts". Conidia are typically borne at the tips of short annellides produced along the vegetative hyphae. The annellides are often difficult to see and to determine that they actually are annellides. Species of Phialophora are similar but produce their conidia on phialides rather than annellides. Species of Aureobasidium, another genus of black yeasts, produce conidia holoblastically on minute peg-like extensions of short hyphal branches or directly along the hyphae themselves. 

Some species of Exophiala are known to cause a subcuaneous disease in humans and other vertebrates. Although not normally life-threatening, these infections must be removed surgically or they may continue to grow for years. In handling these fungi, care must be taken not to accidentally inoculate oneself with contaminated instruments.

The natural habitats of Exophiala species are hard to pin down. They can be isolated from decaying plant material, wood, sewage sludge, soil, tree exudates and many other sources. They sometimes appear in unlikely places, such as in syrup-like solutions of polyvinyl alcohol. They are often most easily found by locating the small perithecia of the Exophiala holomorphs.
======================================================================
DATA-MEDICOS/DERMAGIC-EXPRESS No (32) 26/01/99 DR. JOSE LAPENTA R. 
======================================================================