頭部白癬は毛髪に皮膚糸状菌が寄生した状態と定義される.本邦では頭部白癬は頭部浅在性白癬を意味し,ケルスス禿瘡は別に記載されることが多いが,英語圏ではケルスス禿瘡,黄癬まで含めて頭部白癬と捉えられている.臨床的には脱毛斑を基本とし,様々な程度に炎症,鱗屑を伴い,黒点型では面皰様黒点の点在,ケルスス禿瘡では膿疱の多発が特徴的である.疫学的には戦前は男児の疾患と考えられていたが,その後 Microsporum canis 感染症の増加により女児と成人女性の比率が増え,さらに近年 Trichophyton tonsurans 感染症の流行によりその年齢,性別分布は大分変化が生じてきた.原因菌は Trichophyton 属,Microsporum 属の皮膚糸状菌で,人から人,動物から人へと感染する.治療にはイトラコナゾール，テルビナフィンなどの抗真菌剤の内服が必要である.

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Background: Tinea incognito is a dermatophytic infection in which topical or systemic steroids have modified the clinical appearance of the mycosis and mimicking other skin diseases. Objectives: A large retrospective study was carried out to identify the clinical aspects and type of dermatophytes involved in tinea incognito cases in Iran during 1993-2008. Patients: Out of 6325 subjects suspected to have dermatophytoses, 56 patients (29 males, 27 females, mean age 32.6 years) were affected with tinea incognito. Methods: The causative agents were identified macroscopically and microscopically after the clinical samples were subjected to potassium hydroxide examination and culture isolation. Results: The most common type of infection was tinea corporis (32.1%), which significantly affected male patients. The prevalence of the other tineas in decreasing order was as follows: tinea faciei (26.8%), tinea cruris (14.3%), tinea manuum (12.5%), tinea pedis (8.9%), and tinea capitis (5.4%). The clinical features were to some extent diverse, ranging from eczema-like, seborrhoeic dermatitis-like, pyoderma-like and folliculitis to alopecia on scalp, trunk and limbs. Trichophyton verrucosum was the most frequently isolated species representing 33.9% of isolates, followed by T.mentagrophytes (28.6%), T. rubrum (12.5%), Epidermophyton floccosum (10.7%), Microsporum canis (8.9%), T. violaceum (3.6%), and T. schoenleinii (1.8%). Conclusion: To the best of our knowledge, this is the first broad investigation dealing with tinea incognito in Iran. The etiological agents of tinea incognito in Iran are consistent with those of the general population.

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Breakthrough non- Aspergillus mold infections among patients receiving the anti-mold azole antifungal agents like voriconazole or posaconazole have been increasingly reported. We report a case of lung Scedosporium prolificans infection with multiple cavities in a 58-year-old man with monoclonal gammopathy of undetermined significance (MGUS) during voriconazole treatment for probable invasive aspergillosis. Cultures of repeated sputum specimens yielded the same fungus until his death 83 days after diagnosis. S. prolificans should be considered in patients with breakthrough infections receiving voriconazole.

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We herein describe five various cases of human infections by Nocardia cyriacigeorgica. The identification included conventional and molecular sequencing tests.
The current study provides further evidences that N. cyriacigeorgica species is a ubiquitous organism capable of establishing long-term infection in healthy and immunocompromised patients.

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