Correspondence
Tinea Barbae: Man and Boxer
N Engl J Med 1998; 339:272July 23, 1998
- Article
To the Editor:
The images of tinea barbae in a man, provided by Glaser and Riordan (March 12 issue),1 are accompanied by a picture of the man's dog, which at first glance appears to have the canine counterpart of his master's skin condition. The lesion on the dog, however, is much more likely to be a Staphylococcus intermedius folliculitis or possibly a Malassezia pachydermatis infection. Although Trichophyton mentagrophytes variant mentagrophytes was cultured from the man's skin lesion, no laboratory results are given for the dog. The dog may or may not have been the carrier of the dermatophyte, which could have been acquired by contact with infected hair or scale from other animals (particularly rodents), in the soil, or on fomites.2
Also, with regard to zoonotic M. pachydermatis infection, the editorial on nosocomial zoonoses, by Marcus and Marcus (March 12 issue),3 states, “All the infected dogs should have been treated to eliminate the presumed origin of infection.” However, this might not be a realistic approach to the control of M. pachydermatis infection, because the organism is part of the normal skin flora in dogs. Although associated with otitis and dermatitis in dogs, it can be present in the skin of apparently normal dogs as well.
3 ReferencesMelissa Behr, D.V.M.
New Mexico Veterinary Diagnostic Services, Albuquerque, NM 87196-4700Thomas P. Lewis, II, D.V.M.
Dermatology Clinic for Animals, Albuquerque, NM 871101
Glaser DA ,Riordan AT . Tinea barbae: man and beast. N Engl J Med 1998;338:735-735
Full Text | Web of Science | Medline2
Scott DW, Miller WH, Griffin CE. Muller and Kirk's small animal dermatology. 5th ed. Philadelphia: W.B. Saunders, 1995:333-5.
3
Marcus LC ,Marcus E . Nosocomial zoonoses. N Engl J Med 1998;338:757-759
Full Text | Web of Science | Medline
To the Editor:
Being a boxer owner, I independently surveyed seven other boxer owners about the proper identification of the dog shown in the Images in Clinical Medicine. All of us agreed that the dog appeared to be a boxer, not a bull mastiff.
In addition, how was it known that this was truly a case of anthropozoonosis? There are many examples of zooanthroponosis (infections transmitted from humans to animals), especially infections involving dermatophytes.1,2
2 ReferencesGary W. Barone, M.D.
University of Arkansas for Medical Sciences, Little Rock, AR 722051
Jacobs PH . Dermatophytes that infect animals and humans. Cutis 1988;42:330-331
Web of Science | Medline2
Scott DW ,Horn RT Jr . Zoonotic dermatoses of dogs and cats. Vet Clin North Am Small Anim Pract 1987;17:117-144
Web of Science | Medline
To the Editor:
We would like to correct an error in the Images in Clinical Medicine article. The beast in question was identified as a bull mastiff. The picture provided is that of a boxer, a breed whose standard was first adopted in Germany in 1902. To quote an early aficionado of this breed, the boxer “is what he is and not because he looks like what he ought to be.”1 This statement refers to the gentle nature of the animal in spite of his pugnacious facial features. The dog in the image is what he is — namely, a boxer, not a bull mastiff, as the authors allege.
1 ReferencesMarc J. Kahn, M.D.
Chris M. Kahn, R.T.
Tulane University School of Medicine, New Orleans, LA 70112Author/Editor Response
Dr. Glaser replies:
To the Editor: I appreciate the insight provided by Drs. Behr and Lewis through their excellent veterinary differential diagnosis. Tinea barbae in humans is a zoophilic infection usually arising from animal sources.1 T. mentagrophytes variant mentagrophytes was cultured from our patient and is also classified as a zoophilic dermatophyte.2 An extensive review of our patient's history revealed no contact with any rodents or other animals, except for his dog, and he clearly recalled face-to-face contact with his dog's lesion before the onset of his own eruption. We were told by the patient that the dog was treated for “ringworm” (but we do not have the culture results), and we believe our assumption that the infection in this man was acquired from direct contact with his dog's lesion is the correct one.
Finally, we would be barking up the wrong tree if we disagreed with the expert opinions of both Barone and Kahn and Kahn. Since we are not experienced in identifying dogs, we reported only what the patient claimed the dog to be.
2 ReferencesDee Anna Glaser, M.D.
Saint Louis University Health Sciences Center, St. Louis, MO 63104
