PMID- 23679236
OWN - NLM
STAT- MEDLINE
DCOM- 20140818
LR  - 20141118
IS  - 1525-1470 (Electronic)
IS  - 0736-8046 (Linking)
VI  - 30
IP  - 6
DP  - 2013 Nov-Dec
TI  - Refractory Trichophyton rubrum infection in lamellar ichthyosis.
PG  - e200-3
LID - 10.1111/pde.12160 [doi]
AB  - A 10-month-old boy with congenital lamellar ichthyosis presented with a chronic 
      Trichophyton rubrum infection. There was no history of atopy or 
      immunosuppression, and examination revealed high total immunoglobulin E (IgE) 
      with a positive specific IgE for T. rubrum. Multiple treatments with fluconazole 
      were necessary to control the infection. T. rubrum is present worldwide and is 
      responsible for the vast majority of chronic dermatophytosis. Lamellar ichthyosis 
      is a risk factor for chronic dermatophytosis because of excessive keratin and the 
      barrier defect. A delayed-type hypersensitivity reaction to T. rubrum is 
      associated with cure, whereas immediate hypersensitivity and IgE are not 
      protective and may lead to chronic infection. Atopy and the Th2 profile therefore 
      seem to be associated with chronic dermatophytosis. The association between 
      ichthyosis and atopy is well documented. T. rubrum also has an interesting 
      ability to evade immunity, which helps explain the chronic infection. Finally, in 
      ichthyosis, it is likely that fluconazole has difficulty penetrating the 
      acanthotic stratum corneum, which explains treatment failure. We report this case 
      to alert clinicians to the possible association between lamellar ichthyosis and 
      chronic dermatophytosis and to report the difficulties of management.
CI  - (c) 2013 Wiley Periodicals, Inc.
FAU - Scheers, Christel
AU  - Scheers C
AD  - Department of Dermatology, CHU St Pierre, Universite Libre de Bruxelles, 
      Brussels, Belgium.
FAU - Andre, Josette
AU  - Andre J
FAU - Thompson, Curtis
AU  - Thompson C
FAU - Rebuffat, Elisabeth
AU  - Rebuffat E
FAU - Harag, Saadia
AU  - Harag S
FAU - Kolivras, Athanassios
AU  - Kolivras A
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20130516
PL  - United States
TA  - Pediatr Dermatol
JT  - Pediatric dermatology
JID - 8406799
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Chronic Disease
MH  - Humans
MH  - Hypersensitivity, Delayed/immunology/*microbiology
MH  - Ichthyosis, Lamellar/*complications
MH  - Immunoglobulin E/immunology
MH  - Infant
MH  - Male
MH  - Tinea/*complications/immunology/*pathology
MH  - Trichophyton/*immunology
EDAT- 2013/05/18 06:00
MHDA- 2014/08/19 06:00
CRDT- 2013/05/18 06:00
PHST- 2013/05/18 06:00 [entrez]
PHST- 2013/05/18 06:00 [pubmed]
PHST- 2014/08/19 06:00 [medline]
AID - 10.1111/pde.12160 [doi]
PST - ppublish
SO  - Pediatr Dermatol. 2013 Nov-Dec;30(6):e200-3. doi: 10.1111/pde.12160. Epub 2013 
      May 16.