Dermatomycosis : epidemiology, virulence and susceptibility of fungal agents, a literature review of the last twenty years

Abstract

Objective: This study aims to evaluate the epidemiology of superficial and cutaneous mycoses, their etiological agents, as well as the factors of susceptibility and resistance factors to antifungals used for their treatment, in the last 20 years, between 2000 and 2020. Methods and results: A literature review was conducted in online databases PubMed, Scielo and Scopus. The selected studies showed data on the prevalence of the species, the profile of the patients, the most affected sites of infection, the diagnostic method used and the susceptibility profile of the fungal species in relation to the most used antifungals. The most prevalent infection sites were skin, nail and hair and the most tested antifungals, against to isolated pathogens, were ketoconazole, fluconazole, cyclopirox and terbinafine. Conclusion: In recent years there has been an increase in cases of dermatomycosis caused by non-dermatophyte fungi. In this study, we observed that the most isolated non-dermatophyte fungi were the genera Candida spp., Malassezia spp., Fusarium spp. and Aspergillus spp. The drugs itraconazole and voriconazole were the most active agents against Candida species. Fusarium species demonstrated greater resistance to antifungals, with high MIC (minimal inhibitory concentration) concentrations for all antifungal agents.