title: Occurrence of Scopulariopsis and Scedosporium in nails and keratinous skin. A 5-year retrospective multi-center study.
abstract: A 5-year retrospective multicenter study was performed for microascaceous moulds (Microascaceae, Ascomycetes) in Finnish clinical specimens. The files from 1993-1997 of six clinical mycology laboratories in Finland were searched for reports of these fungi, mainly Scopulariopsis and Scedosporium anamorphs in keratinous specimens. From the 521 primary findings, 165 cases were selected for further study based on direct microscopy, colony numbers and accompanying fungi. The clinical records of 148 cases (141 Scopulariopsis, 7 Scedosporium) were studied. Of the nail infections from which Scopulariopsis was recovered, 39 cases were further separated which showed clinical or laboratory-based evidence of dermatophytosis. In the remaining 90 'non-dermatophyte' nail cases, Scopulariopsis spp. were the only documented fungal agents (c. 6 cases/million/year). The patients were mainly elderly, 66% of whom had problems involving their big toe nails. For 74% of them, the nail problem was mentioned as their reason for visiting the physician. However, only 18% had documented benefit from treatment. The Scopulariopsis nail infections seem to be treatment-resistant and the pathogenesis and etiological role of Scopulariopsis remain poorly understood.
authors.affiliation: Herbarium, University of Turku, Turku, Finland. jouni.issakainen@kolumbus.fi
authors.forename: Jouni
authors.initials: J
authors.lastname: Issakainen
authors.forename: Hannele
authors.initials: H
authors.lastname: Heikkilä
authors.forename: Eeva
authors.initials: E
authors.lastname: Vainio
authors.forename: Pirkko
authors.initials: P
authors.lastname: Koukila-Kähkölä
authors.forename: Mirja
authors.initials: M
authors.lastname: Castren
authors.forename: Oili
authors.initials: O
authors.lastname: Liimatainen
authors.forename: Tarja
authors.initials: T
authors.lastname: Ojanen
authors.forename: Markku
authors.initials: M
authors.lastname: Koskela
authors.forename: Olli
authors.initials: O
authors.lastname: Meurman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001203:Ascomycota / Q000302:isolation & purification*; D002648:Child; D003881:Dermatomycoses / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D009262:Nails / Q000382:microbiology* / Q000473:pathology; D012189:Retrospective Studies; D012867:Skin / Q000382:microbiology* / Q000473:pathology; D016896:Treatment Outcome