Cutaneous manifestations of deep mycoses in Nigeria: a systematic review.

IF 3.8 Q2 INFECTIOUS DISEASES
Therapeutic Advances in Infectious Disease Pub Date : 2024-10-11 eCollection Date: 2024-01-01 DOI:10.1177/20499361241286973
Thelma E Bassey, Ikechukwu Okekemba, Walter O Egbara, Promise Owai, Love E Okafor, David E Elem, Geraldine L Edim, Asukwo Onukak, Bassey E Ekeng
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引用次数: 0

Abstract

Background: Deep mycoses are serious fungal diseases commonly associated with the immunocompromised but can also present in the immunocompetent following severe exposure to fungal pathogens. Included in this group are subcutaneous and systemic fungal infections.

Objectives: Reviews highlighting skin involvement in patients with deep mycosis in the Nigerian setting are sparse in the literature. This systematic review summarized the clinical presentation, risk factors, and diagnosis of deep mycosis presenting with cutaneous manifestations in Nigerians.

Design: This was a systematic review conducted following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines.

Data sources and methods: PubMed, Google Scholar, and the African Journal Online database were searched from inception to February 2024 to identify published articles from Nigeria on deep mycoses with cutaneous manifestations. We included single case reports and case series on cutaneous involvement in deep fungal infections in Nigeria. Review articles, guidelines, meta-analyses, animal studies, and fungal studies not relating to the Nigerian setting were excluded.

Results: We identified 16 well-documented articles on deep cutaneous mycoses published in Nigeria over the past six decades which amounted to 137 cases; 102 (74.5%) cases were reported before the year 2000, while the remainder were published within the past two decades. The 137 cases were majorly histoplasmosis (n = 87, 63.5%) and eumycetoma (n = 19, 13.9%) and predominant risk factors, farming (n = 13, 9.5%) and diabetes mellitus (n = 3, 2.2%), The diagnosis of cases was predominantly via histopathology (n =131, 95.6%) with a few cases diagnosed by fungal culture (n = 15, 10.9%), and antigen assay (n = 1, 0.7%) respectively. Twenty-one (15.3%) were clinically diagnosed as cancers including a case of carcinoma of the skin, and one each (0.7%) as skin tuberculosis or neurofibromatosis but all histologically confirmed as deep cutaneous mycoses.

Conclusion: The decline of reports on deep cutaneous mycoses in recent times suggests neglect or a low index of suspicion from attending clinicians. This is further buttressed in the misdiagnosis of cases as other clinical entities. Ensuring a histological diagnosis of skin lesions, especially in at-risk patients will mitigate these gaps.

尼日利亚深部真菌病的皮肤表现:系统综述。
背景:深度真菌病是一种严重的真菌疾病,常见于免疫力低下的人群,但免疫力正常的人群在严重接触真菌病原体后也会发病。深部真菌病包括皮下真菌感染和全身真菌感染:在尼日利亚的文献中,关于深部真菌病患者皮肤受累情况的综述很少。这篇系统性综述总结了尼日利亚人中出现皮肤表现的深部真菌病的临床表现、风险因素和诊断:数据来源与方法:PubMed、Google Scholar、Africa Scholar、Africa Scholar、Africa Scholar、Africa Scholar、Africa Scholar、Africa Scholar、Africa Scholar 等:我们检索了PubMed、谷歌学术和非洲期刊在线数据库(African Journal Online)从开始到2024年2月的数据,以确定尼日利亚发表的关于深部真菌病伴皮肤表现的文章。我们纳入了尼日利亚深部真菌感染皮肤受累的单个病例报告和系列病例。综述文章、指南、荟萃分析、动物研究以及与尼日利亚环境无关的真菌研究均被排除在外:我们发现了过去六十年中在尼日利亚发表的 16 篇关于深部皮肤真菌病的文献,共计 137 个病例;其中 102 个(74.5%)病例是在 2000 年之前报道的,其余病例是在过去二十年中发表的。这 137 个病例主要是组织胞浆菌病(87 例,占 63.5%)和真菌瘤(19 例,占 13.9%),主要的危险因素是养殖业(13 例,占 9.5%)和糖尿病(3 例,占 2.2%),病例主要通过组织病理学诊断(131 例,占 95.6%),少数病例分别通过真菌培养(15 例,占 10.9%)和抗原检测(1 例,占 0.7%)诊断。21例(15.3%)临床诊断为癌症,包括一例皮肤癌,皮肤结核病和神经纤维瘤病各一例(0.7%),但经组织学证实均为深部皮肤真菌病:结论:近来有关深部皮肤真菌病的报告有所减少,这表明临床主治医生疏忽或怀疑程度低。将病例误诊为其他临床实体进一步证实了这一点。确保对皮肤病变进行组织学诊断,尤其是对高危患者进行组织学诊断,将缩小这些差距。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.30
自引率
8.80%
发文量
64
审稿时长
9 weeks
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