Sequence-Based Identification of a Zoophilic Strain of Trichophyton interdigitale in a Rare Case of Tinea Blepharo-Ciliaris Associated with Tinea Barbae.

Impaired hair at blepharo-ciliaris area by dermatophytes is a rare clinical entity. This infection is often misdiagnosed or underdiagnosed, being mistakenly referred to as an infection of bacterial origin. Herein, we present a rare case of tinea blepharo-ciliaris associated with tinea barbae in an adult male. Considering the two lesions of the patient, mycological examination was performed by phenotypic methods, including environmental electronic scanning microscopy. Trichophyton interdigitale zoophilic strain was identified as the etiological agent by direct examination of the hair, primary culture analysis of the developed colonies and PCR sequencing of the ITS1 region of the rDNA gene. Homology search showed 100% similarity with T. interdigitale (GenBank accession number: KC595993), Arthroderma vanbreuseghemii (GenBank accession number: JQ407190) and zoophilic strain of T. interdigitale (GenBank accession number: AY062119.1.). Four weeks of oral and local treatment with itraconazole (100 mg twice a day) and fluconazole 0.3% (eyedrops) induced complete remission. To our knowledge, this is the first report of tinea blepharo-ciliaris associated with tinea barbae in Romania.