Topographical issues of dermatomycology

Sergeev A.Y., Arzumanian V.G., Zaborova V.A., Nelipa M.V., Kytko O.V., Sergeev I.A.

Novosibirsk State Research University, Novosibirsk, Russia
Mechnikov Research Institute for Vaccines and Sera, Moscow, Russia
Sechenov First Moscow State Medical University, Moscow, Russia
Moscow Institute of Physics and Technology, Dolgoprudny-Moscow, Russia

Modern data on the structure and function of skin and their topographical variations facilitate research on etiology and pathogenesis of cutaneous fungal infection. The main topographical regions of the skin are occupied by resident microbiota, including Candida spp. and lipophilic Malassezia yeasts. Diversity of topical mycobiome in adults is largely determined by physiological milieu of various topographical regions, such as skin folds, periorificial areas or seborrheic zones. Microbiome composition and the pathogenesis of fungal-associated dermatoses are also affected by the age and immune status of the host, as well as ecological changes. The diversity of pathogens and multiple nomenclature revisions have caused fungal skin infection classification to remain topographic, sparking scientific discussion. The prevalence of common forms of superficial fungal infections, such as onychomycosis, tinea pedis or tinea сapitis, adding to the significant global infectious burden, hinges on age and an array of climatic, geographical and social factors. Several forms of cutaneous mycoses occur predominantly or more commonly in athletes. Analysis of world literature within an 80-year time span shows periodic research interest shifts towards three major forms of superficial mycoses, not always correlating to their actual incidence rates. Both similarities and differences in fungal skin infection etiology, as well as possible combinations of clinical forms and the emergence of new and atypical variations should be accounted for in diagnostics and prophylaxis of antifungal resistance.