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Smith S, Houpt K, Rich P, LaMarca A, Weinberg JM, Alferez TS, Atillasoy E, Opper C. Short-duration oral terbinafine for the treatment of tinea pedis in HIV-positive patients. Cutis 2001; 68:30-9. [PMID: 11499332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Management of tinea pedis in patients who have the human immunodeficiency virus (HIV) is problematic; in those patients, dermatophytoses may be more difficult to treat than in the general population. This prospective, open-label, multicenter, randomized study evaluated the efficacy and safety of a short course of oral terbinafine for tinea pedis in patients who are HIV positive. Twenty-seven patients were randomized to receive oral terbinafine 250 mg once daily for 2 or 4 weeks; 17 patients with positive initial cultures and follow-up cultures were evaluable for efficacy at week 8. Mycological cure (defined as negative potassium hydroxide [KOH] microscopy and culture results) occurred in 47% (8) of patients; and modified mycological cure (defined as negative follow-up cultures) occurred in 65% (11) of patients. All 27 patients were evaluated for safety. Clinical cure (defined as minimal residual signs and symptoms) occurred in 82% (14) of patients. Oral terbinafine was well tolerated, indicating that regimens of 2 or 4 weeks are safe and effective for the treatment of tinea pedis in patients who are HIV positive.
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Romano C, Massai L, Asta F, Signorini AM. Prevalence of dermatophytic skin and nail infections in diabetic patients. Mycoses 2001; 44:83-6. [PMID: 11413928 DOI: 10.1046/j.1439-0507.2001.00624.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To determine whether there is a higher frequency of mycotic infections due to dermatophytes in diabetics, 171 diabetic outpatients and 276 controls were recruited in the period 1997-98. Patients with suspicious lesions underwent mycological examination which was positive in seven diabetics and 17 controls. In diabetics the most frequent infection was tinea pedis, followed by distal subungual onychomycosis; the most frequently isolated fungus was Trichophyton mentagrophytes. The results of the study did not show a prevalence of dermatophyte infections in diabetics. No correlation was found between dermatophytosis and duration or type of diabetes and its complications, blood sugar levels or levels of glycosylated haemoglobin. None of the diabetic patients with dermatophytosis had complications related to diabetes and basal blood sugar and glycosylated haemoglobin levels indicated good metabolic control.
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Abstract
During a 2-year period 30 adults were selected out of a group of patients diagnosed with erysipelas, who, except for tinea pedis, were apparently otherwise healthy patients. Clinical and epidemiological studies were performed to establish how tinea pedis and erysipelas are related. Thirteen of 30 patients with a diagnosis of erysipelas were found to have tinea pedis due to Trichophyton mentagrophytes and Trichophyton rubrum. In seven of the patients (23%) tinea pedis was found to be the unique predisposing factor for erysipelas. Tinea pedis may be a risk factor for streptococcal infections such as erysipelas, mainly in tropical countries, where tinea pedis is a frequent disease.
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Tosti A, Piraccini BM, Stinchi C, Colombo MD. Relapses of onychomycosis after successful treatment with systemic antifungals: a three-year follow-up. Dermatology 2000; 197:162-6. [PMID: 9732167 DOI: 10.1159/000017990] [Citation(s) in RCA: 118] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Data about relapses of onychomycosis after treatment with the new systemic antifungals vary among the different studies, with figures ranging from 3 to 20% for terbinafine and from 21 to 27% for itraconazole, depending on the follow-up duration. OBJECTIVE To determine the prevalence of relapses of onychomycosis cured by terbinafine compared with that of onychomycosis cured by itraconazole. METHODS We followed up 47 patients whose toenail onychomycosis had been mycologically cured in an open randomized study comparing intermittent itraconazole treatment with continuous terbinafine treatment and intermittent terbinafine therapy. Patients were examined every 3 months for up to 3 years after the end of therapy. At each visit clinical and mycologic (direct microscopy and cultures) evaluations were performed. RESULTS Eight of the 36 patients (22.2%) who completed the study had a relapse of onychomycosis during the follow-up period, including 2 patients of the terbinafine 250 mg group, 2 patients of the terbinafine 500 mg group and 4 patients in the itraconazole 400 mg group. As the original infection, the relapse was caused in all cases by Trichophyton rubrum. CONCLUSIONS This study shows that 22.2% of patients with onychomycosis successfully treated with systemic antifungals experienced a relapse. The relapse rate increased from 8. 3% at month 12 to 19.4% at month 24 and to 22.2% at month 36. Relapses were more common in patients treated with pulse itraconazole (4/11) than in patients treated with continuous (2/12) or intermittent (2/13) terbinafine. Statistical analysis did not reveal any significant difference between relapse rates in the three groups.
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Kawada A, Aragane Y, Maeda A, Yudate T, Tezuka T, Hiruma M. Tinea barbae due to Trichophyton rubrum with possible involvement of autoinoculation. Br J Dermatol 2000; 142:1064-5. [PMID: 10809886 DOI: 10.1046/j.1365-2133.2000.03510.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Garau M, Tena D, Serrano R, Domínguez-Gil B, Carrillo A, del Palacio A. [Subcutaneous infection in the foot of an immunosuppressed patient]. Enferm Infecc Microbiol Clin 1999; 17:361-3. [PMID: 10535192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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32
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Singri P, Brodell RT. 'Two feet-one hand' syndrome. A recurring infection with a peculiar connection. Postgrad Med 1999; 106:83-4. [PMID: 10456041 DOI: 10.3810/pgm.1999.08.663] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Klein PA, Clark RA, Nicol NH. Acute infection with Trichophyton rubrum associated with flares of atopic dermatitis. Cutis 1999; 63:171-2. [PMID: 10190071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Trichophyton rubrum has been implicated as a potential trigger in flares of atopic dermatitis. We describe a patient with atopic dermatitis who presented with a history of multiple flares and concurrent acute tinea pedis and onychomycosis. Symptoms of atopic dermatitis and culture-positive acute infection with T. rubrum resolved during each flare using systemic antifungals. Flares of atopic dermatitis may be triggered by acute T. rubrum infections. Antifungal therapy should be considered in these patients.
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Abstract
Ascending cellulitis of the leg is a common emergency. An audit was conducted in two district general hospitals to determine how it is managed and the long-term morbidity, and to formulate a treatment strategy. Case notes were reviewed for 92 patients admitted to hospital under adult specialties. Mean duration of inpatient therapy was 10 days. A likely portal of entry was identified in 51/92 cases, of which the commonest were minor injuries and tinea pedis. Pathogens were rarely identified, group G streptococci being the single most frequent organism. Benzylpenicillin was administered in only 43 cases. Long-term morbidity, identified in 8 of 70 patients with over six months' follow-up, included persistent oedema (6) and leg ulceration (2); an additional 19 patients had either suffered previous episodes or experienced a further episode subsequently. Ascending cellulitis of the leg has substantial short-term and long-term morbidity. Important but often neglected therapeutic suggestions are the inclusion of benzylpenicillin in all cases without a contraindication, assessment and treatment of tinea pedis, use of support hosiery, and serological testing for streptococci to confirm the diagnosis in retrospect. The high frequency of recurrent episodes suggests that longer courses of penicillin, or penicillin prophylaxis, might be useful.
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Reuber M, Misch K, Patel V. Bipolar affective disorder, stress fractures, fungal dermopathy and 'tree frog fingers'. Postgrad Med J 1998; 74:123-5. [PMID: 9616500 PMCID: PMC2360803 DOI: 10.1136/pgmj.74.868.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ploysangam T, Lucky AW. Childhood white superficial onychomycosis caused by Trichophyton rubrum: report of seven cases and review of the literature. J Am Acad Dermatol 1997; 36:29-32. [PMID: 8996257 DOI: 10.1016/s0190-9622(97)70321-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although white superficial onychomycosis (WSO) is well recognized in adults and considered to be mainly caused by Trichophyton mentagrophytes, childhood WSO is rare. WSO caused by Trichophyton rubrum in prepubertal children has never been reported. OBJECTIVE Our purpose was to describe the existence of WSO in children and to emphasize that T. rubrum may be its main cause. METHODS Seven children with WSO seen between 1988 and 1993 were examined. Only patients who had a positive potassium hydroxide preparation and a positive fungal culture were included. RESULTS Seven healthy prepubertal children, 2 to 9 years of age, were identified with WSO. All cases were proved to be caused by T. rubrum. Six patients had associated tinea pedis, and five had a family history of tinea pedis. Topical antifungal therapy was partially effective in some cases. CONCLUSION This report documents the existence of WSO in prepubertal children. All cultures grew T. rubrum. Although onychomycosis is not as common in prepubertal children as in adults, it may be underrecognized.
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Del Rosso JQ. Treatment of onychomycosis and tinea pedis with intermittent itraconazole therapy. THE JOURNAL OF THE AMERICAN OSTEOPATHIC ASSOCIATION 1996; 96:607-9. [PMID: 8936929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 40-year-old woman had a 10-year history of dermatophyte-related toenail onychomycosis (tinea unguium) and dry-type tinea pedis, which had failed to respond to previous therapy with topical antifungal agents or oral griseofulvin. The patient was successfully treated with four cycles of intermittent itraconazole therapy (that is, 400 mg/d for 1 week per month for 4 months). At the end of this time, the tinea pedis had resolved and the onychomycosis improved significantly after four cycles were completed. Twelve months after the onset of therapy, both conditions had resolved completely according to both clinical and mycologic criteria. Itraconazole was well tolerated, with no side effects reported. These observations suggest that itraconazole intermittent dosing is a highly effective therapy for the treatment of onychomycosis caused by dermatophyte organisms, because it provides a high cure rate after only a short course of therapy.
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Day MR, Day RD, Harkless LB. Cellulitis secondary to web space dermatophytosis. Clin Podiatr Med Surg 1996; 13:759-66. [PMID: 8902342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Cellulitis occurring in the lower extremity is encountered frequently and results from a breach of the skin and inoculation of opportunistic bacteria. It has been shown that when web space dermatophytosis is present, changes may occur in normal skin morphology and bacterial flora that can result in severe infection. Knowledge of the pathophysiology of interdigital dermatophytosis allows the clinician to choose the most appropriate empiric antibiotic therapy when treating a secondarily caused cellulitis of the lower extremity.
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Turner DP, Nagra RS, Large S, Seaton D. Recurrent cellulitis following coronary bypass surgery. J Hosp Infect 1995; 30:78-80. [PMID: 7665889 DOI: 10.1016/0195-6701(95)90255-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Staats CC, Vermeer BJ, Korstanje MJ. [Swimmer's eczema: intertrigo, erythrasma or a yeast or fungus infection?]. NEDERLANDS TIJDSCHRIFT VOOR GENEESKUNDE 1994; 138:2343-5. [PMID: 7969634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine the proportional contributions of tinea pedis, intertrigo, erythrasma and Candida to 'swimmer's eczema.' DESIGN Descriptive. SETTING Department of Dermatology, University Hospital Leiden, the Netherlands. METHOD General practitioners were encouraged to refer every patient with clinical signs of foot mycosis. Mycological tests (culture and microscopy) were performed. RESULTS A total of 296 patients with interdigital mycosis and 30 with tinea pedis of the moccasin type were included. In 56% of the patients with swimmer's eczema dermatophytes were recognised, 10% showed erythrasma and in 30% no cause could be found. Candida only played a minor role. Trichophyton mentagrophytes was found more often in swimmer's eczema than in tinea pedis of the moccasin type. CONCLUSION Swimmer's eczema has several causes, which can be determined with mycological tests. Microscopy is the most sensitive method in regard to demonstrating dermatophytes and erythrasma.
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Leib SL. [A case from practice (305). Recurrent erysipelas--tinea pedis et unginum--chronic venous insufficiency]. SCHWEIZERISCHE RUNDSCHAU FUR MEDIZIN PRAXIS = REVUE SUISSE DE MEDECINE PRAXIS 1994; 83:1089-90. [PMID: 7939076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Veien NK, Hattel T, Laurberg G. Plantar Trichophyton rubrum infections may cause dermatophytids on the hands. Acta Derm Venereol 1994; 74:403-4. [PMID: 7817685 DOI: 10.2340/0001555574403404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Over a 2-year period, we saw 37 patients with a diagnosis of dermatophytid on the hands based on 1) culture-proven dermatophytosis on one or both feet; 2) symmetrical, secondary vesicular eruptions on the fingers and/or palmar aspects of the hands; and 3) a resolution in both areas of involvement after treatment of the dermatophytosis on the foot. During the study period, 128 patients had culture-proven dermatophytosis of the feet caused by Trichophyton rubrum. Nine of these (7%) developed dermatophytid. Seventy-eight patients had dermatophytosis of the feet caused by Trichophyton mentagrophytes. Twenty-seven of these (35%) developed dermatophytid. One of 6 patients infected on the feet with Epidermophyton floccosum developed dermatophytid.
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44
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Alteras I, Ingberg A, Segal R, Schvili D. The incidence of skin manifestations by dermatophytes in patients with psoriasis. Mycopathologia 1986; 95:37-9. [PMID: 3762658 DOI: 10.1007/bf00436320] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Thirty-four psoriatic patients (23 males, 11 females) were found to have skin manifestations of dermatophyte infection. Tinea pedis was observed in 20 cases, tinea cruris in 6 and tinea manuum in 2. T. rubrum was the causative agent in all of these with the exception of 2 cases caused by E. floccosum. Lesions of tinea corporis were found intermingled with psoriatic plaques in various areas of the body skin in 6 patients (4 males, 2 females); T. rubrum was isolated from 5 of these and M. canis from one. Twenty-one of these psoriatic patients also had lesions caused by C. albicans in the toe-webs and interdigital aspects of the fingers, the latter being associated with paronychia in 9 cases. These findings indicate that we should remain aware of the possibility of fungus manifestations in patients with psoriasis, which would not appear to be an exceptional occurrence.
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Svejgaard E, Christophersen J, Jelsdorf HM. Tinea pedis and erythrasma in Danish recruits. Clinical signs, prevalence, incidence, and correlation to atopy. J Am Acad Dermatol 1986; 14:993-9. [PMID: 3722494 DOI: 10.1016/s0190-9622(86)70122-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Prior to military service, 665 recruits were examined clinically and microbiologically for tinea pedis and erythrasma and 546 of these were reexamined at the end of military service. The prevalence of clinical signs, erythrasma, and dermatophyte infection at the first investigation was 58.8%, 51.3%, and 6.2%, respectively, and at the second investigation, 81.1%, 77.1%, and 7.0%, respectively. The incidence of tinea pedis was 4.2% during the 9 months of military service. Of those infected at the first visit 41% had persistent infection mainly due to Trichophyton rubrum, whereas new infections were largely caused by Trichophyton mentagrophytes. Some of those persistently infected had signs of chronicity at the follow-up visit, indicating that chronic dermatophytosis may become established in the early twenties. The prevalence of atopy was 15.0% in all the recruits but was almost 50% in those with persistent tinea pedis.
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Chapel J, Chapel TA. Disuse contractures in a patient with tinea manuum and irritant contact dermatitis. Cutis 1985; 36:55. [PMID: 3160548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Disuse contractures are reported in a patient with tinea manuum and irritant contact dermatitis. The case is presented to alert the physician to the potential for this problem in any patient with a chronic fissured dermatosis of the hands.
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47
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Nemkaeva RM. [Foot mycoses complicated by secondary infection]. VESTNIK DERMATOLOGII I VENEROLOGII 1985:55-6. [PMID: 3159167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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48
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Sheklakov ND, Kukoleva LI, Roĭtburg MF. [Periungual and subungual fibromas]. VESTNIK DERMATOLOGII I VENEROLOGII 1985:25-7. [PMID: 3993200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Nielsen PG. Amino acid analysis of the horny layer of the soles of patients with hereditary palmoplantar keratoderma. DERMATOLOGICA 1985; 171:305-7. [PMID: 2416605 DOI: 10.1159/000249442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The amino acid composition of keratin from soles of patients suffering from hereditary palmoplantar keratoderma of the Unna Thost variety was investigated. Patients were divided into two groups: those without dermatophytosis and those whose hereditary palmoplantar keratoderma was complicated with a dermatophyte infection. The amino acid composition of the horny layer was compared to that of control individuals and to a previously performed analysis of mammalian hair. However, no difference was found between the groups nor was any explanation as to why Trichophyton mentagrophytes occurred significantly more often in soles of patients with hereditary palmoplantar keratoderma made apparent.
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Shimoni Z, Turgeman Y, Flatau E, Kohn D. Changing patterns of erysipelas. ISRAEL JOURNAL OF MEDICAL SCIENCES 1984; 20:242-3. [PMID: 6724870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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