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Athlete's foot [keywords]
- Not only athlete's foot survives in feet. [JOURNAL ARTICLE]
- Arch Dis Child Educ Pract Ed 2014 Oct 23.
- A retrospective chart review of the clinical efficacy of Nd:YAG 1064 nm laser for toenail onychomycosis. [JOURNAL ARTICLE]
- J Dermatolog Treat 2014 Oct 20.:1-9.
Abstract Cosmetic improvement in nail appearance is a great concern to patients with onychomycosis. Although oral and topical treatments for onychomycosis can potentially eradicate the infection, unsightly nails may remain despite negative mycology. Laser-based devices have been approved for the temporary clearance of nails with onychomycosis, thus providing a means of improving the aesthetic appearance of the nails. A retrospective chart review of patients treated with a Nd:YAG 1064 nm laser and debridement for onychomycosis, and terbinafine 1% cream for associated tinea pedis, between July 2012 and February 2014 was performed to ascertain the proportion of patients who achieved clinical outcomes. A temporary improvement in the appearance of the target nail was observed in 78% of patients and the affected area of the nail plate was reduced by at least 50% from baseline in 46% of patients. It appears that patients whose great toenails are potentially infected with non-dermatophyte molds may particularly benefit from laser therapy. Higher clinical outcome rates were observed with administration of four or more treatments, but additional observations and/or studies are needed to optimize the regimen of laser therapy to improve the cosmetic appearance of infected nails.
- Luliconazole for the treatment of fungal infections: an evidence-based review. [Journal Article, Review]
- Core Evid 2014.:113-24.
Luliconazole is an imidazole antifungal agent with a unique structure, as the imidazole moiety is incorporated into the ketene dithioacetate structure. Luliconazole is the R-enantiomer, and has more potent antifungal activity than lanoconazole, which is a racemic mixture. In this review, we summarize the in vitro data, animal studies, and clinical trial data relating to the use of topical luliconazole. Preclinical studies have demonstrated excellent activity against dermatophytes. Further, in vitro/in vivo studies have also shown favorable activity against Candida albicans, Malassezia spp., and Aspergillus fumigatus. Luliconazole, although belonging to the azole group, has strong fungicidal activity against Trichophyton spp., similar to that of terbinafine. The strong clinical antifungal activity of luliconazole is possibly attributable to a combination of strong in vitro antifungal activity and favorable pharmacokinetic properties in the skin. Clinical trials have demonstrated its superiority over placebo in dermatophytosis, and its antifungal activity to be at par or even better than that of terbinafine. Application of luliconazole 1% cream once daily is effective even in short-term use (one week for tinea corporis/cruris and 2 weeks for tinea pedis). A Phase I/IIa study has shown excellent local tolerability and a lack of systemic side effects with use of topical luliconazole solution for onychomycosis. Further studies to evaluate its efficacy in onychomycosis are underway. Luliconazole 1% cream was approved in Japan in 2005 for the treatment of tinea infections. It has recently been approved by US Food and Drug Administration for the treatment of interdigital tinea pedis, tinea cruris, and tinea corporis. Topical luliconazole has a favorable safety profile, with only mild application site reactions reported occasionally.
- Nodular amyloidosis clinical recognition of an unusual entity. [Journal Article]
- J Am Podiatr Med Assoc 2014 Sep; 104(5):544-7.
Nodular amyloidosis is a protein deposition disorder that is important to recognize in the clinical setting. Identification and differentiation from primary systemic amyloidosis, which has an identical cutaneous presentation, but serious systemic implications, is of particular significance. Our case report highlights two patients who presented with isolated involvement of the plantar surface and ungual phalanges, each with concomitant tinea pedis. Recognition and diagnosis of cutaneous amyloidosis enables discrimination from systemic disease, and if found, prompt institution of appropriate treatment.
- Prevalence and risk factors of tinea capitis and tinea pedis in school children in Turkey. [Journal Article]
- J Pak Med Assoc 2014 May; 64(5):514-8.
To evaluate the prevalence and risk factors of tinea capitis and tinea pedis in school children in Turkey.The study included 8122 students from 24 schools in the rural and urban areas around Kayseri,Turkey. We asked every student for their personal identification and also for their sanitation in order to get an idea about dermatophytosis. Samples taken from suspicious lesions were collected and inoculated onto Sabouraud dextrose agar slants. For identification of grown fungi, macroscopic appearance of colonies, microscopic examination and biochemical tests were used.There were 41 (0.5%) suspicious lesions in feet and 31 (0.3%) in scalp and 22 (0.2%) students were diagnosed as tinea pedis and 9 (0.1%) as tinea capitis by fungal culture. The predominant etiologic agents in feet were Trichophyton rubrum 8 (36%), Trichophyton mentagrophytes 1 (4%), Rhodotorula 8 (36%), Trichosporon 2 (9%), Candida glabrata 2 (9%), Candida albicans 1 (4%), while Trichophyton verrucosum 8 (88%) and Trichophyton mentagrophytes 1 (12%) were identified in scalp samples. School settlement was found as risk factors on the frequency of tinea pedis and capitis. Age and gender were also found as risk factors on the frequency of tinea pedis.The results of this study demonstrate a low prevalence of tinea capitis and tinea pedis in school children of central Anatolia of Turkey. School settlenment is a very important factor affecting the prevalence of tinea capitis and pedis in school children in central Anatolia of Turkey.
- Dermatophyte Infections in Primorsko-Goranska County, Croatia: a 21-year Survey. [Journal Article]
- Acta Dermatovenerol Croat 2014 Sep; 22(3):175-9.
This study examined the frequency of dermatophytoses in the Primorsko-Goranska County, a north-western part of Croatia, over a period of 21 years (1988-2008). All fungal samples were microscopically examined with 20% potassium hydroxide (KOH) solution. Fungal infections were confirmed in 26.9% cases. Out of these, dermatophytes were isolated in 38.3%, Candida spp. infection in 55.1% cases, while non-dermatophyte molds were identified in 6.6% isolates. The most frequently isolated dermatophyte was Trichophyton (T.) mentagrophytes var. interdigitalis (55.4%), followed by Mycrosporum (M.) canis (36.9%), T. violaceum (3.2%), M. gypseum (2.2%), and T. verrucosum (1.3%). Epidermophyton (E.) floccosum (0.9%) and T. rubrum (0.1%) were identified only sporadically. The most common dermatophytosis diagnosed in the 21-year period was tinea pedis (26.2%) followed by tinea capitis (21.8%) and tinea corporis (20.1%). Toenail onychomycosis (14.5%) was more common than fingernail onychomycosis (2.0%). T. mentagrophytes var. interdigitalis was the major pathogen causing tinea pedis (86.6%) as well as toenail onychomycosis (93.9%), while M. canis was most frequently isolated in tinea capitis (98.6%), tinea corporis (62.1%), and tinea faciei (40.2%). With regard to age and sex, T. mentagrophytes var. interdigitalis infections were predominant in middle-aged men. M. canis affected mostly children up to 9 years with a slight predominance in girls. Data from epidemiological trend analysis such as presented in our study are important for evidence-based public health measures for the prevention and control of dermatophytoses.
- Mycology - an update Part 2: Dermatomycoses: Clinical picture and diagnostics. [Journal Article]
- J Dtsch Dermatol Ges 2014 Sep; 12(9):749-77.
Most fungal infections of the skin are caused by dermatophytes, both in Germany and globally. Tinea pedis is the most frequent fungal infection in Western industrial countries. Tinea pedis frequently leads to tinea unguium, while in the elderly, both may then spread causing tinea corporis. A variety of body sites may be affected, including tinea glutealis, tinea faciei and tinea capitis. The latter rarely occurs in adults, but is the most frequent fungal infection in childhood. Following antifungal treatment of tinea unguium and also tinea capitis a dermatophytid or hyperergic reaction to dermatophyte antigens may occur. Yeast infections affect the mucous membranes both of the gastro-intestinal system and the genital tract as candidiasis mostly due to Candida albicans. Cutaneous candidiasis affects predominantely the intertriginous regions such as groins and the inframammary area, but also the intertriginous space of fingers and toes. In contrast, pityriasis versicolor is a superficial epidermal fungal infection primarily on the the trunk. Mold infections are rare in dermatology; they play a role nearly exclusively in nondermatophyte-mold (NDM) onychomycosis. The diagnosis of dermatomycoses comprises the microscopic detection of fungi using the potassium hydroxide preparation or alternatively the fluorescence optical Blankophor preparation together with culture. The histological fungal detection with PAS staining possesses a high sensitivity, and it should play a more important role in particular for diagnosis of onychomycosis. Molecular biological methods, based on the amplification of fungal DNA with use of specific primers for the distinct causative agents are on the rise. With PCR, such as dermatophyte-PCR-ELISA, fungi can be detected directly in clinical material in a highly specific and sensitive manner without prior culture. Today, molecular methods, such as Matrix Assisted Laser Desorption/Ionization Time-Of-Flight Mass Spectrometry (MALDI TOF MS) as culture confirmation assay, complete the conventional mycological diagnostics.
- "Sunlight is said to be the best of disinfectants"*: the efficacy of sun exposure for reducing fungal contamination in used clothes. [Journal Article]
- Isr Med Assoc J 2014 Jul; 16(7):431-3.
Tinea pedis is a common chronic skin disease; the role of contaminated clothes as a possible source of infection or re-infection has not been fully understood. The ability of ultraviolet light to inactivate microorganisms has long been known and UV is used in many applications.To evaluate the effectivity of sun exposure in reducing fungal contamination in used clothes.Fifty-two contaminated socks proven by fungal culture from patients with tinea pedis were studied. The samples were divided into two groups: group A underwent sun exposure for 3 consecutive days and group B remained indoors. At the end of each day fungal cultures of the samples were performed.Overall, there was an increase in the percentage of negative cultures with time. The change was significantly higher in socks that were left in the sun (chi-square for linear trend = 37.449, P < 0.0001).Sun exposure of contaminated clothes was effective in lowering the contamination rate. This finding enhances the current trends of energy saving and environmental protection, which recommend low temperature laundry.
- Recurrent lymphangitic cellulitis syndrome: A quintessential example of an immunocompromised district. [JOURNAL ARTICLE]
- Clin Dermatol 2014 September - October; 32(5):621-627.
Recurrent lymphangitic cellulitis syndrome (RLCS) occurs when a disordered lymphatic system renders a leg vulnerable to recurrent infection. The underlying immunologic defect is the result of accidental or iatrogenic penetrating wounds on the medial aspect of the thigh or lower limb overlying the greater saphenous vein, because the primary lymphatic drainage vessels are adjacent to this structure. Cracking/fissuring of the skin associated with chronic fungal infection of the feet ("athlete's foot"), most commonly mixed bacterial/fungal interdigital involvement, provides a portal of entry for opportunistic organisms. Bacteria and their products are cleared more slowly in the lymphatic-disrupted and therefore immunologically impaired limb, producing broad areas of dermatitis and around the scars quite distinct from other forms of superficial infection. This rarely develop in otherwise normal limbs. The dermatitis of RLCS and its systemic effects clear with antibiotics but recur intermittently until the tinea pedis is eradicated. The contralateral limb with normal lymphatic structures never develops clinical evidence of infection even though bilateral tinea infection is almost always present. This confirms the central role of an anatomically induced immunocompromised district (ICD) in this syndrome.