Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Dermatology AND Tinea unguium [keywords]
- Aspergillus pragensis sp. nov. discovered during molecular reidentification of clinical isolates belonging to Aspergillus section Candidi. [JOURNAL ARTICLE]
- Med Mycol 2014 Jun 20.
The identity of nine clinical isolates recovered from Czech patients and presumptively identified as Aspergillus sp. section Candidi based on colony morphology was revised using sequences of β-tubulin, calmodulin gene sequence, and internal transcribed spacer rDNA. Six isolates were from suspected and proven onychomycosis, one from otitis externa, and two associated with probable invasive aspergillosis. The results showed that one Aspergillus candidus isolate was the cause of otitis externa, and both isolates obtained from sputa of patients with probable invasive aspergillosis were reidentified as A. carneus (sect. Terrei) and A. flavus (sect. Flavi). Three isolates from nail scrapings were identified as A. tritici, a verified agent of nondermatophyte onychomycosis. One isolate from toenail was determined to be A. candidus and the two isolates belonged to a hitherto undescribed species, Aspergillus pragensis sp. nov. This species is well supported by phylogenetic analysis based on β-tubulin and calmodulin gene and is distinguishable from other members of sect. Candidi by red-brown reverse on malt extract agar, slow growth on Czapek-Dox agar and inability to grow at 37°C. A secondary metabolite analysis was also provided with comparison of metabolite spectrum to other species. Section Candidi now encompasses five species for which a dichotomous key based on colony characteristics is provided. All clinical isolates were tested for susceptibilities to selected antifungal agents using the Etest and disc diffusion method. Overall sect. Candidi members are highly susceptible to common antifungals.
- Comorbidity of Tinea Pedis and Onychomycosis and Evaluation of Risk Factors in Latino Immigrant Poultry Processing and Other Manual Laborers. [JOURNAL ARTICLE]
- South Med J 2014 Jun; 107(6):374-379.
Latino immigrant workers experience elevated rates of skin disease that result from their working and living conditions. Working in manual occupations exposes workers to a variety of challenges, including occlusive shoes, vigorous physical activity, and wet conditions. These challenges predispose workers to fungal infection. The objectives of this article are to examine the comorbidity of tinea pedis and onychomycosis and to identify possible risk factors among Latino immigrant poultry and nonpoultry workers in western North Carolina.Data were obtained from a cross-sectional study conducted between June 2009 and November 2010 in rural western North Carolina among 518 manual Latino immigrant workers to assess their occupational injuries. Participants completed a face-to-face interview and a dermatologic examination.Nearly one-third of the participants (32%) were diagnosed as having onychomycosis and more than one-third (37.8%) were diagnosed as having tinea pedis. There was a greater prevalence of tinea pedis in men than women (71.3% vs 28.7%, respectively). Of the 518 participants, 121 (23.5%) had both conditions. Participants who reported the use of occlusive shoes as "always" or "most of the time" had a higher prevalence of comorbid onychomycosis and tinea pedis than the rest of the group.Comorbidity of tinea pedis and onychomycosis is common among immigrant Latino men and women who perform manual labor. Further studies confirming the presence and type of dermatophyte should be conducted.
- Can persistent toenail fungus be successfully treated with a laser? [Journal Article]
- Med Mycol J 2014; 55(2):J65-71.
Onychomycosis is a common disease seen in dermatology practice. Most patients with onychomycosis opt for treatment due to the social stigma attached to the unsightly appearance, as well as the pain that can at times make walking difficult. However, in many cases, onychomycosis is resistant to oral antifungal medication, which is the first-line therapy for this disease. In recent years, we have attempted a new treatment method using a long-pulsed 1,064nm Nd :YAG laser (Cutera Inc., Brisbane, CA, USA) in refractory cases with onychomycosis. Using 1) a laser beam with a spot size of 5.0 mm and 2) sequential irradiation at low fluence, we 3) applied the laser to the infected lesions in a motion similar to showering, while maintaining a distance of several centimeters from the skin (Laser Genesis(TM)). Treatment efficacy was assessed using nail turbidity scores on a five-point scale. Improvement in onychomycosis was noted in more than 68.8% of all cases, thus demonstrating the high efficacy of this method. No major adverse reactions were observed during the treatment period. Since its mechanism of action clearly differs from that of antifungal agents, it can be considered a useful treatment option for cases with onychomycosis resistant to antifungal therapy. Future studies should examine "combined therapy" with oral / topical antifungal agents and this laser treatment, which may provide a significant improvement in the level of satisfaction among patients with onychomycosis.
- A retrospective cohort study of tinea pedis and tinea unguium in inpatients in a psychiatric hospital. [Journal Article]
- Med Mycol J 2014; 55(2):E35-41.
We conducted a retrospective cohort study on clinical and mycological features of tinea pedis and tinea unguium in psychiatric inpatients in Japan. Of the 317 inpatients (152 with schizophrenia and 165 with depression), 46.1% had tinea pedis and 23.7% had tinea unguium. Of those with tinea pedis, 48.6% also had tinea unguium. The most common clinical type of tinea pedis was the combination of interdigital type and hyperkeratotic type. The mean clinical score of tinea pedis was 5.9, and that of tinea unguium based on the Scoring Clinical Index for Onychomycosis (SCIO) was 15.8. The main causative species of tinea pedis were Trichophyton rubrum (68.4%) and T. mentagrophytes (26.3%). No statistically significant differences were observed in incidence rates of tinea pedis or tinea unguium between men and women or between patients with schizophrenia and those with depression. As for incidence rates by age, patients with depression showed a single peak for tinea pedis and / or tinea unguium in their 50's, while patients with schizophrenia exhibited twin peaks for tinea pedis and / or tinea unguium in their 50's and 70's. Both tinea pedis and tinea unguium tended to become more severe in patients with chronic schizophrenia. Our study suggests that schizophrenia and depression, like diabetes mellitus and HIV infections, should be regarded as risk factors for tinea pedis and tinea unguium.
- Efficacy of Fluconazole at a 400 mg Dose Weekly for the Treatment of Onychomycosis. [JOURNAL ARTICLE]
- Acta Derm Venereol 2014 Jun 17.
Abstract is missing (Short Communication).
- Skin diseases reported by workers from UNESP campus at Rubião Jr, Botucatu-SP (Brazil). [JOURNAL ARTICLE]
- An Bras Dermatol 2014 Jun; 89(3):529-531.
There are few populational studies to estimate the dimension of dermatological diseases. We performed a survey with 515 employees from UNESP campus, Botucatu (SP), exploring demographic data, medical appointments and dermatological diagnoses. Additionally, we induced questions about prevalent diseases. Appointments to the dermatologist were reported by 77% of subjects. The main dermatoses spontaneously reported were mycoses, allergies, nevi and viral warts. There were association of juvenile acne and males (OR=2.3), melasma and females (OR=8.0), and onychomycosis with older age (OR=1.05). Surveys are important to know the demand for dermatology care, besides directing formulation of public health policy and medical education.
- Trichophyton rubrum DNA strain switching increases in onychomycosis patients failing antifungal treatments. [JOURNAL ARTICLE]
- Br J Dermatol 2014 Jun 6.
The dermatophyte Trichophyton rubrum (T. rubrum) is responsible for approximately 80% of onychomycosis cases. Genetic strain typing was developed to help elucidate its epidemiology and pathogenicity.To determine T. rubrum DNA strain types in North American onychomycosis patients and to track them prior to and after the course of treatments.T. rubrum DNA strain types were determined by restriction fragment length polymorphisms in ribosomal DNA and Southern blotting from toenails that were cultured from 50 North American onychomycosis patients prior to treatment. A portion of patients were subsequently typed from oral terbinafine (n=6), laser (n=9) or placebo (n=8) treatment groups. Three European DNA strains were obtained for comparison. Terbinafine group DNA strains were tested for in vitro susceptibility to terbinafine.Six DNA strain types (A to F) accounted for 94% of T. rubrum DNA strains and corresponded to European isolates. Three DNA strains (6%) novel to North America were detected. DNA strain type switching occurred in all treatment groups: terbinafine (83%), laser (56%) and placebo (25%). Most of the switches (50%) observed in the terbinafine group coincided with mycological cures followed by relapse. Patients treated with laser therapy or placebo exhibited no intermittent cures. DNA strains from the terbinafine group were all susceptible to terbinafine in vitro.Nine T. rubrum DNA strains were identified in a North American population: three novel and six predominant to a European population. Although DNA strain type switching in onychomycosis is a natural phenomenon with presence in the placebo group, increases following the course of failed onychomycosis treatment suggest an antifungal-induced response. This article is protected by copyright. All rights reserved.
- The spectrum of cutaneous infection in diabetic patients with hepatitis C virus infection: a single-center study from egypt. [Journal Article]
- Indian J Dermatol 2014 May; 59(3):247-51.
Hepatitis-C virus (HCV) infection and diabetes mellitus (DM) have a significant association with skin disorders.The aim of this study was to assess the impact of HCV infection on the pattern of cutaneous infections among diabetic patients.A prospective study included diabetic patients who attended Al-Hussein University hospital, Cairo during the period from 2008 to 2010. Patients were examined for skin infections, and investigated for HCV infection.SPSS (version 11.5).The study included 163 patients (102 males and 61 females) with a mean age of 46.2 ± 4.83 years. Ninety five patients (58.3%) were HCV+ve (group A) while 68 patients (41.8%) were HCV-ve (group B). Skin infections in group A included fungal (48.4%), viral (26.3%), bacterial (22.1%) and parasitic (3.2%) while in group B, the spectrum included bacterial (41.2%), fungal (39.7%), viral (11.7%) and parasitic (7.4%). Onychomycosis was the commonest infection in group A (25.2%) compared with folliculitis in group B (19.1%). Cutaneous infections in HCV+ patients were more characterized by increased severity, aggressive course, resistance to treatment and rapid relapse.HCV infection has a significant impact in increasing and changing the spectrum of skin infections in diabetic patients. Severe and resistant infections in diabetics could be an important sign of HCV infection.
- Nail disorders in infants and children. [JOURNAL ARTICLE]
- Curr Opin Pediatr 2014 May 30.
Nail diseases in infants and children are an uncommon cause of consultation and are often difficult to diagnose and to manage. This review will cover nail diseases that are most commonly seen in clinical practice, including congenital and hereditary disorders and inflammatory, infective, and neoplastic nail diseases. The purpose of the review is to help the reader to recognize nail disorders at an early age and to manage them appropriately.Two recent large studies have reported the clinical findings of genetic disorders involving the nails, that is, pachyonychia congenita and epidermolysis bullosa. Only a few articles gave a comprehensive review of a disease, as occurred for onychomycosis, while the majority of the reports published in the recent literature involve single cases.Nail diseases in children and neonates are not easy to diagnose by nonexperts. Basic knowledge of the anatomy and biology of the nail facilitates their diagnosis as the understanding of their pathophysiology. This review gives hints at the most common nail diseases that affect infants and children.
- Pseudo-clubbing complicated by dermatophyte onychomycosis. [Journal Article]
- Ann Dermatol 2014 Apr; 26(2):271-3.