Aspergillus species are the most common pathogenic fungi involved in otomycosis, an infection of the outer ear canal. In this study, we examined the incidence of Aspergillus infections and the antifungal susceptibilities of 30 Aspergillus species isolates from patients with otomycosis who visited Saiseikai Utsunomiya Hospital between August 2013 and July 2016. Based on the morphological test results, the strains were identified as Aspergillus niger sensu lato (20 strains), A. terreus sensu lato (7 strains), and A. fumigatus sensu lato (3 strains). In contrast, the molecular identifications based on analyzing the isolates' partial β-tubulin gene sequences revealed them to be A. niger sensu stricto (12 strains), A. tubingensis (8 strains), A. terreus sensu stricto (7 strains), and A. fumigatus sensu stricto (3 strains). The antifungal susceptibility test results indicated that strains of A. tubingensis and A. niger sensu stricto displayed lower susceptibilities to ravuconazole, compared with the other isolates. The Aspergillus strains from this study showed low minimum inhibitory concentrations toward the azole-based drugs efinaconazole, lanoconazole, and luliconazole. Therefore, these topical therapeutic agents may be effective for the treatment of otomycosis.

Onychomycosis is the most frequent nail disease, with an estimated prevalence of 2-8%. Current treatment strategies include the use of oral and topical antifungals, despite low cure rates following these treatments. The objectives of this study were to assess the therapeutic response of patients with onychomycosis to 1,064-nm Nd:YAG laser treatment, the clinical evaluation method available for this therapy, and the possible side effects of this treatment. Twenty patients with onychomycosis underwent laser therapy. A total of 34 nails with onychomycosis were assessed according to the Onychomycosis Severity Index (OSI). This index generates scores that classify onychomycosis as mild, moderate, or severe. The OSI was determined before treatment and after a mean follow-up period of 8 months. The comparison between the initial and the final OSI for all 34 nails treated with laser therapy showed a significant difference; however, a low association was shown between these variables. A general reduction in the area of involvement and in the OSI numerical scores was observed. These data show a trend toward improvement in onychomycosis treated with 1,064-nm Nd:YAG laser. The OSI allowed an adequate clinical assessment of the response to laser therapy. Laser treatment did not cause marked discomfort in most patients, indicating that laser is a well-tolerated procedure.

The treatment of dermatophytosis has improved considerably over the past several decades following the introduction of the oral antifungals such as azoles and amphotericin B. However, these drugs have had limited success because the treated fungi often develop drug resistance, resulting in recurrence when applied in various topical formulations. Thus, there are constant needs for new topical agents that are effective against dermatophytosis. Dipyrithione is an attractive candidate to become an antifungal agent due to its broad spectrum of antimicrobial activities. In this study, we determined that dipyrithione could potently inhibit the growth of Trichophyton rubrum, which is the most common cause of dermatophytosis. The MIC50 value of dipyrithione against T. rubrum was measured as 6.03 μM, as compared with miconazole (MIC50: 1.38 μM). Additionally, the compound caused morphological changes in the fungi, which was examined using the morphological interference assay. The in vivo experiment further revealed that dipyrithione had a healing effect on the skin of guinea pigs infected with T. rubrum. Our studies have demonstrated that dipyrithione had a potent antifungal activity in vitro and in vivo, suggesting that it could be formulated as a potential antifungal lead compound in search for novel therapeutic agents against dermatophytosis.

Darier's disease, an autosomal dominant genodermatosis, arises from a mutation in the ATP2A2 gene that codes for sarco/endoplasmic reticulum Ca2+-ATPase in the endoplasmic reticulum and is characterized by greasy keratotic papules commonly found in seborrheic regions. Conventional treatments, including topical corticosteroids, antibiotics, antifungals and retinoids, often have limited efficacy. The present article reports the novel use of oral magnesium chloride supplementation (300 mg daily) in the treatment of Darier disease. After 5 years of limited improvement using conventional therapies, significant improvements in neck lesions were observed within 1 month of starting oral magnesium chloride. This suggests that oral magnesium chloride may be an effective therapeutic option for Darier disease, although further in vitro and clinical trials are necessary to evaluate its clinical efficacy.

Staphylococcus aureus is a major human pathogen that is responsible for both hospital- and community-acquired infections. Stilbenes are polyphenol compounds of plant origin known to possess a variety of pharmacological properties, such as antibacterial, antiviral, and antifungal effects. This study reports the in vitro growth-inhibitory potential of eight naturally occurring stilbenes against six standard strains and two clinical isolates of S. aureus, using a broth microdilution method, and expressing the results as minimum inhibitory concentrations (MICs). Pterostilbene (MICs = 32-128 μg/ml), piceatannol (MICs = 64-256 μg/ml), and pinostilbene (MICs = 128 μg/ml) are among the active compounds that possess the strongest activity against all microorganisms tested, followed by 3'-hydroxypterostilbene, isorhapontigenin, oxyresveratrol, and rhapontigenin with MICs 128-256 μg/ml. Resveratrol (MIC = 256 μg/ml) exhibited only weak inhibitory effect. Furthermore, structure-activity relationships were studied. Hydroxyl groups at ortho-position (B-3' and -4') played crucial roles for the inhibitory effect of hydroxystilbene piceatannol. Compounds with methoxy groups at ring A (3'-hydroxypterostilbene, pinostilbene, and pterostilbene) produced stronger effect against S. aureus than their analogues (isorhapontigenin and rhapontigenin) with methoxy groups at ring B. These findings provide arguments for further investigation of stilbenes as prospective leading structures for development of novel antistaphylococcal agents for topical treatment of skin infections.