Dermatology mycology diagnostics in Ireland: National deficits identified in 2022 that are relevant internationally.

Background: Conventional testing methods for dermatophytes are time-consuming, and resource limitations in our institution have prompted curtailed access to these diagnostics.

Objectives: Evaluation of our hospital's dermatological mycology diagnostic services and similar services nationally.

Methods: This was a retrospective observational study on skin, hair and nail mycology samples in our institution comparing twenty five-year periods (2011-2015 and 2016-2021), including analysis of dermatology clinic data and correspondence related to fungal infection.

Epidemiology of dermatomycoses and onychomycoses in Ireland (2001-2020): A single-institution review.

Background: Fungal skin infections are recognised as one of the most common health disorders globally, and dermatophyte infections of the skin, hair and nails are the most common fungal infections. Dermatophytes can be classified as anthropophilic, zoophilic or geophilic species based on their primary habitat association, and this classification makes epidemiological analysis useful for the prevention and control of these infections. The Irish contribution to the epidemiology of these infections has been scant, with just two papers (both reporting paediatric tinea capitis only) published in the last 20 years, and none in the last seven.

Tinea capitis with multiple isolates: The interaction of nature, animal and child.

Tinea capitis is an infection of the scalp and hair commonly seen in the pediatric population. Detection of multiple dermatophytes is unusual, and true mixed infections have been rarely reported. Herein, we describe an 8-year-old girl with tinea capitis revealing three different dermatophyte isolates that highlight the clinical challenge posed by this phenomenon.

Systemic evaluation of cutaneous sarcoidosis: 15-year dermatology experience at University Hospital Limerick.

Sarcoidosis is a multisystem granulomatous disease that can affect almost any organ including the skin, liver, ocular, cardiac, renal, nervous, musculoskeletal and endocrine systems. Systemic evaluation is indicated in all patients diagnosed with cutaneous sarcoidosis, as it is associated with asymptomatic systemic disease in 30%-40% of patients. Guidelines recommend that patients diagnosed with sarcoidosis undergo baseline and surveillance investigations including full blood count (FBC), renal and liver profile, Vitamin D, serum calcium, electrocardiography (ECG), chest radiography, pulmonary function tests (PFTs) and ophthalmology examination to assess for systemic involvement.

Vitamin D and melanoma.

Recreational sun exposure and sunburn are causal for melanoma but the risk is strongly genetically determined. Health promotion advice about sun protection should be aimed at susceptible individuals (pale skin, freckles, large numbers of melanocytic nevi and a family history). We discuss here the evidence that sun-sensitive people have lower vitamin D levels and that, in practice, it is very difficult for such individuals to achieve sufficient levels without supplementation in the UK at least.

An inherited variant in the gene coding for vitamin D-binding protein and survival from cutaneous melanoma: a BioGenoMEL study.

An association between low serum vitamin D levels and poorer melanoma survival has been reported. We have studied inheritance of a polymorphism of the GC gene, rs2282679, coding for the vitamin D-binding protein, which is associated with lower serum levels of vitamin D, in a meta-analysis of 3137 melanoma patients. The aim was to investigate evidence for a causal relationship between vitamin D and outcome (Mendelian randomization).

Do vitamin A serum levels moderate outcome or the protective effect of vitamin D on outcome from malignant melanoma?

Background & Aims: Low serum vitamin D levels (25-OH-vit D2/3) are reported to be associated with thicker melanomas and poorer outcome. Vitamin A metabolites and vitamin D bind to the same heterodimeric receptor. We report a study testing the hypothesis that high vitamin A levels may reduce the protective effect of vitamin D on outcome.

Photoletter to the editor: Oral ulceration in pyoderma gangrenosum.

A 65-year-old woman presented with widespread necrotising cutaneous ulceration and oral involvement. Past history included rheumatoid arthritis, and a left nephrectomy.Examination revealed multiple violaceous undermined ulcers.

Melanoma and vitamin D.

Vitamin D is a fat-soluble steroid hormone, which is essential to health and for which epidemiological studies suggest a role in autoimmune disease, infections, cardiovascular disease and cancer. It is ingested in foods such as oily fish and supplements, so that average levels vary between countries, but most individuals worldwide make most of their vitamin D as a result of the effects of sun exposure on the skin. Many studies in different populations around the world have in recent years shown that sub-optimal levels of vitamin D (<70 nmol/L) are common.