101
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Arce M, Gutiérrez-Mendoza D. Fungal Paronychia. Clinical, Diagnosis and Treatment Aspects. CURRENT FUNGAL INFECTION REPORTS 2017. [DOI: 10.1007/s12281-017-0286-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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102
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Aggarwal P, Kashyap B, Kalita JM. A study to compare and classify etiological agents of onychomycosis. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2017. [DOI: 10.1016/j.injms.2017.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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103
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Watanabe S, Kishida H, Okubo A. Efficacy and safety of luliconazole 5% nail solution for the treatment of onychomycosis: A multicenter, double-blind, randomized phase III study. J Dermatol 2017; 44:753-759. [DOI: 10.1111/1346-8138.13816] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 01/30/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Shinichi Watanabe
- Department of Dermatology; Teikyo University School of Medicine; Tokyo Japan
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104
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Velasquez-Agudelo V, Cardona-Arias JA. Meta-analysis of the utility of culture, biopsy, and direct KOH examination for the diagnosis of onychomycosis. BMC Infect Dis 2017; 17:166. [PMID: 28222676 PMCID: PMC5320683 DOI: 10.1186/s12879-017-2258-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 02/10/2017] [Indexed: 12/14/2022] Open
Abstract
Background Onychomycosis is a highly prevalent disease worldwide. There is no standard test for its diagnosis, which remains costly, wasteful, and is sometimes delayed. The diagnostic tests for this disease are few and discordant. The objective was to evaluate the diagnostic validity, performance, and accuracy of culture, nail clipping with Periodic Acid-Schiff –PAS- staining (biopsy), and direct potassium hydroxide (KOH) examination for the study of onychomycosis. Methods A systematic review was conducted via meta-analysis using 5 databases and 21 search strategies. An ex ante protocol was applied with inclusion and exclusion criteria. Quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool, and the sensitivity, specificity, predictive values, likelihood ratios, diagnostic odds ratios, receiver operating characteristic (ROC) curves, and proportion of correctly diagnosed patients were evaluated with the meta-analysis of studies of evaluations of diagnostic and screening tests (Meta-DiSc) and Epidat using a random effects model. Results The efficiency or accuracy of the three tests is influenced by the methodological quality of the studies. These values are lower for KOH and culture and higher for biopsy in moderate quality studies. Conclusion The diagnostic tests evaluated in this meta-analysis independently showed acceptable validity, performance, and efficiency, with nail clipping with PAS staining outperforming the other two tests.
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Affiliation(s)
- Verónica Velasquez-Agudelo
- Biological Research Corporation (Corporación para Investigaciones Biológicas - CIB), Medellín, Colombia.,Experimental Medical Mycology Research Group, CIB, Medellín, Colombia
| | - Jaiberth Antonio Cardona-Arias
- School of Microbiology, University of Antioquia (Universidad de Antioquia), Calle 67 Número 53 - 108, Bloque 5, oficina 103, Medellín, Colombia. .,Faculty of Medicine, Cooperative University of Colombia (Universidad Cooperativa de Colombia), Medellín, Colombia.
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105
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106
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Feng X, Xiong X, Ran Y. Efficacy and tolerability of amorolfine 5% nail lacquer in combination with systemic antifungal agents for onychomycosis: A meta-analysis and systematic review. Dermatol Ther 2017; 30. [PMID: 28097731 DOI: 10.1111/dth.12457] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 10/25/2016] [Accepted: 11/15/2016] [Indexed: 02/05/2023]
Abstract
The efficacy and safety of amorolfine 5% nail lacquer in combination with systemic antifungal agents in the treatment of the onychomycosis were evaluated. According to our meta-analysis, combination treatment of amorolfine 5% nail lacquer and systemic antifungals can result in higher percentage of complete clearance of onychomycosis. It showed that the experimental combination group was more effective than monotherapy of the systemic antifungals [OR (odds ratio) = 1.97, 95%CI (95% confidence interval) = 1.44-2.69], and no more adverse events happened with the addition of amorolfine 5% nail lacquer (OR = .96, 95%CI = .56-1.63, p = .95). This effect strengthens the fact that amorolfine 5% nail lacquer in combination with systemic antifungal agents was better than the monotherapy of systemic antifungals like itraconazole and terbinafine.
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Affiliation(s)
- Xiaowei Feng
- Department of Dermatovenerology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, 637000, China
| | - Xincai Xiong
- Department of Dermatovenerology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, 637000, China
| | - Yuping Ran
- Departments of Dermatovenerology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China
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107
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Pegorie M, Denning DW, Welfare W. Estimating the burden of invasive and serious fungal disease in the United Kingdom. J Infect 2017; 74:60-71. [DOI: 10.1016/j.jinf.2016.10.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 10/17/2016] [Accepted: 10/18/2016] [Indexed: 01/07/2023]
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108
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Kaul S, Yadav S, Dogra S. Treatment of Dermatophytosis in Elderly, Children, and Pregnant Women. Indian Dermatol Online J 2017; 8:310-318. [PMID: 28979861 PMCID: PMC5621188 DOI: 10.4103/idoj.idoj_169_17] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Dermatophytic infection of the skin and its appendages is a common occurrence. Though usually straightforward, treatment of dermatophytosis becomes notably challenging in certain population groups - pregnant women, children, and elderly. Treatment with topical azoles/allylamines alone is effective in limited cutaneous disease in all three groups. Terbinafine is the preferred oral agent in elderly population for treatment of extensive cutaneous disease and onychomycosis due to its lack of cardiac complications and lower propensity for drug interactions. If required, additional physical/mechanical modalities can be employed for symptomatic onychomycosis. Data for systemic therapy in children mainly pertains to the treatment of tinea capitis. At present, very little data exists regarding the safety of systemic antifungals in pregnancy and there is an effort to restrict treatment to topical therapies because of their negligible systemic absorption.
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Affiliation(s)
- Subuhi Kaul
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | - Savita Yadav
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, PGIMER, Chandigarh, India
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109
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Ahmed SA, Hofmüller W, Seibold M, de Hoog GS, Harak H, Tammer I, van Diepeningen AD, Behrens-Baumann W. Tintelnotia,a new genus inPhaeosphaeriaceaeharbouring agents of cornea and nail infections in humans. Mycoses 2016; 60:244-253. [DOI: 10.1111/myc.12588] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/09/2016] [Accepted: 11/09/2016] [Indexed: 11/30/2022]
Affiliation(s)
- S. A. Ahmed
- Faculty of Medical Laboratory Sciences; University of Khartoum; Khartoum Sudan
| | - W. Hofmüller
- Department of Ophthalmology; Otto von Guericke University; Magdeburg Germany
| | | | - G. S. de Hoog
- CBS-KNAW Fungal Biodiversity Centre; Utrecht The Netherlands
- Institute of Biodiversity and Ecosystem Dynamics; University of Amsterdam; Amsterdam The Netherlands
| | - H. Harak
- Sesto San Giovanni Hospital; Milan Italy
| | - I. Tammer
- Department of Medical Microbiology; Otto von Guericke University; Magdeburg Germany
| | | | - W. Behrens-Baumann
- Department of Ophthalmology; Otto von Guericke University; Magdeburg Germany
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110
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Wlodek C, Trickey A, Berker D, Johnson E. Trends in laboratory‐diagnosed onychomycosis between 2006 and 2014 in the South West of England. Br J Dermatol 2016; 176:237-240. [DOI: 10.1111/bjd.14804] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. Wlodek
- Bristol Royal Infirmary Upper Maudlin Street Bristol BS2 8HW U.K
| | - A. Trickey
- School of Social and Community Medicine University of Bristol Bristol U.K
| | - D. Berker
- Bristol Royal Infirmary Upper Maudlin Street Bristol BS2 8HW U.K
| | - E.M. Johnson
- Public Health England Mycology Reference Laboratory Bristol U.K
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111
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Wlodek C, Trickey A, de Berker D, Johnson E. Trends in Pediatric Laboratory-Diagnosed Onychomycosis Between 2006 and 2014 in the Southwest of England. Pediatr Dermatol 2016; 33:e358-e359. [PMID: 27654021 DOI: 10.1111/pde.12989] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This is the largest study of laboratory-diagnosed onychomycosis in England for children younger than 17 years. The most common (91.5%) cultured organism in this population was Trichophyton rubrum. Candida species were isolated only from fingernails, and the majority were from children younger than 5 years. Continued analysis of fungal pathogens is vital to identify changing trends.
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Affiliation(s)
| | - Adam Trickey
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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112
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Li M, Chen Z, Yin S, Xue R, Chen Z, Huang H, Wei L, Lu C, De Hoog GS, Lai W, Feng P. Onychomycosis secondary to onychomadesis: an underdiagnosed manifestation. Mycoses 2016; 60:161-165. [PMID: 27618806 DOI: 10.1111/myc.12555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 08/11/2016] [Indexed: 11/30/2022]
Abstract
Onychomycosis is a rare nail disorder in early childhood, while onychomadesis is a periodic idiopathic, non-inflammatory disease that affects the nail matrix and is common in children especially in those who suffer from viral infections. In this study, we investigated recent cases of onychomycosis subsequent to periods of onychomadesis in children. Sixteen young children (six males, 10 females) with a mean age of 36.5 months were diagnosed with onychomadesis, and 13 of the patients had a history of viral infection prior to nail changes. Direct microscopy of nail scaling was positive in 11 cases (68.8%), and culture was positive in the same number of cases. Four Candida species were isolated: Candida glabrata was the most frequent, found in eight cases (72.7%), while C. albicans, C. parapsilosis and C. tropicalis, each were encountered in a single case. All children were treated successfully with or without topical bifonazole therapy.
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Affiliation(s)
- Meirong Li
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhuanggui Chen
- Department of Pediatrics, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Songchao Yin
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ruzeng Xue
- Guangdong Provincial Dermatology Hospital, Guangzhou, China
| | - Zhirui Chen
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huaiqiu Huang
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ling Wei
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chun Lu
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Gerit Sybren De Hoog
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.,Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands.,Peking University Health Science Center, Research Center for Medical Mycology, Beijing, China.,Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wei Lai
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Peiying Feng
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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113
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Solís-Arias MP, García-Romero MT. Onychomycosis in children. A review. Int J Dermatol 2016; 56:123-130. [DOI: 10.1111/ijd.13392] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 04/04/2016] [Accepted: 05/11/2016] [Indexed: 11/30/2022]
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114
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Treating Common Fungal Infections in Children. CURRENT PEDIATRICS REPORTS 2016. [DOI: 10.1007/s40124-016-0110-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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115
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Dubljanin E, Džamić A, Vujčić I, Grujičić SŠ, Arsenijević VA, Mitrović S, Čalovski IČ. Epidemiology of onychomycosis in Serbia: a laboratory-based survey and risk factor identification. Mycoses 2016; 60:25-32. [PMID: 27469902 DOI: 10.1111/myc.12537] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/21/2016] [Accepted: 06/25/2016] [Indexed: 01/19/2023]
Abstract
Onychomycosis is a fungal infection of the fingernails and/or toenails caused by dermatophytes, yeasts and non-dermatophyte moulds. The epidemiology of onychomycosis in Serbia is yet to be fully established. This epidemiological study was aimed at evaluating the epidemiology of onychomycosis in a sample of the Serbian patients at risk of onychomycosis, to determine the fungal aetiological agents and to identify the possible risk factors. The study population included 374 patients from six centres in Serbia with suspected onychomycosis. Demographic data, data about comorbidities, lifestyle, clinical aspects of onychomycosis, trauma, excessive perspiration and personal and family history of previous onychomycosis were studied. Laboratory confirmation of diagnosis was done by direct microscopy, fungal culture and PCR. Diagnosis of onychomycosis was confirmed in 50.8% of patients, who tested positive to at least one laboratory test (direct microscopy, fungal culture or PCR). Trichophyton rubrum was predominant both on toenails (85.98%) and on fingernails (38.46%). Independent risk factors for onychomycosis were: old age (OR = 2.285; P < 0.001), family history of previous onychomycosis and/or tinea pedis (OR = 2.452; P = 0.005), excessive perspiration (OR = 2.165; P = 0.002) and higher degree of hyperkeratosis (OR = 1.755; P = 0.020). This is a first epidemiological study of onychomycosis from Serbia.
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Affiliation(s)
- Eleonora Dubljanin
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Džamić
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Belgrade, Serbia
| | - Isidora Vujčić
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Belgrade, Serbia
| | - Sandra Š Grujičić
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Belgrade, Serbia
| | - Valentina A Arsenijević
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Belgrade, Serbia
| | - Sanja Mitrović
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Belgrade, Serbia
| | - Ivana Čolović Čalovski
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Belgrade, Serbia
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116
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Gasser J, Pagani E, Vittadello F, Nobile C, Zampieri P, Eisendle K. Frequency, type and treatment of fungal pathogens in toenail onychomycosis in the central Alpine region of South Tyrol, northern Italy - a 10-year retrospective study from 2004 to 2013. Mycoses 2016; 59:760-764. [PMID: 27402300 DOI: 10.1111/myc.12528] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 05/25/2016] [Indexed: 11/29/2022]
Abstract
Onychomycosis is one of the most common dermatological diseases, primarily caused by dermatophytes, and sometimes, also by yeast and moulds. This study aims to clarify the frequency of isolated pathogens from mycotic toenails in the reference centre of the central Alpine mountain region of South Tyrol, northern Italy. Age and gender differences, types of pathogens and initial therapy used were also investigated. This is a retrospective study from 2004 to 2013 on the files of all patients with suspected onychomycosis in whom a cultural pathogen detection was performed. A total of 1565 patients were studied (943 women; 622 men), with a median age of 55 years. Fungal pathogens could be detected by culture in 49.5%. Significantly more pathogens could be grown in men (63.8%) than in women (39.9%, P < 0.0001). The most common pathogens grown were dermatophytes (53.3%), especially T. rubrum and T. interdigitale, followed by moulds (24.7%) and yeast (22%). Therapies prescribed were topical in 64.2% and systemic in 35.8% of the cases. Topical treatment was more frequent in older patients (P < 0.05). In northern Italy, dermatophytes are the most common causative agents for onychomycosis. Fungal pathogens were more commonly found in men than in women and topical treatment was more frequent in older patients.
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Affiliation(s)
- Julia Gasser
- College of Health-Care Professions Claudiana, Bolzano/Bozen, Italy
| | - Elisabetta Pagani
- Laboratory of Microbiology and Virology, Bolzano Health District, Bolzano/Bozen, Italy
| | - Fabio Vittadello
- College of Health-Care Professions Claudiana, Bolzano/Bozen, Italy
| | - Carla Nobile
- Department of Dermatology, Venereology and Allergology, General Hospital Bruneck, Italy
| | - Pierfrancesco Zampieri
- Department of Dermatology, Venereology and Allergology, General Hospital Meran/Merano, Italy
| | - Klaus Eisendle
- College of Health-Care Professions Claudiana, Bolzano/Bozen, Italy.,Department of Dermatology, Venereology and Allergology, Academic Teaching Department of Medical University Innsbruck, Central Teaching Hospital Bolzano/Bozen, Italy
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117
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Hui X, Jung EC, Zhu H, Maibach HI. Antifungal ME1111 in vitro human onychopharmacokinetics. Drug Dev Ind Pharm 2016; 43:22-29. [DOI: 10.1080/03639045.2016.1201098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Xiaoying Hui
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Eui Chang Jung
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Hanjiang Zhu
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Howard I. Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
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118
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Onychomycosis: Evaluation, Treatment Options, Managing Recurrence, and Patient Outcomes. Clin Podiatr Med Surg 2016; 33:305-18. [PMID: 27215153 DOI: 10.1016/j.cpm.2016.02.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Onychomycosis is the most common nail disease seen in podiatric practice. Effective long-term management remains problematic. We need to treat onychomycosis effectively to prevent its progression into a severe, debilitating, and painful condition, and to manage recurrence. With new agents now available and greater discussion on management strategies, this article reviews the appropriate evaluation of the disease, treatment options, and optimal patient outcomes.
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119
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Noriki S, Ishida H. Production of an anti-dermatophyte monoclonal antibody and its application: immunochromatographic detection of dermatophytes. Med Mycol 2016; 54:808-15. [PMID: 27250927 PMCID: PMC5057457 DOI: 10.1093/mmy/myw037] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 04/11/2016] [Indexed: 11/13/2022] Open
Abstract
Tinea refers to superficial infection with one of three fungal genera-Microsporum, Epidermophyton, or Trichophyton-that are collectively known as dermatophytes. These infections are among the most common diseases worldwide and cause chronic morbidity. They are usually diagnosed by direct microscopy and fungal culture, which are burdensome to perform in the clinical setting. To supplement conventional methods, we developed a new method that employs an immunochromatography test for detection of dermatophyte infections. First, anti-Trichophyton monoclonal antibodies (mAb) were produced in mice using a Trichophyton allergen solution as an immunogen. The mAb specificity was assessed by immunostaining alcohol fixed slide cultures and formalin fixed paraffin-embedded microbial samples. Both alcohol- and formalin-fixed samples of all seven species of Trichophyton tested displayed positive immunostaining. Immunochromatography test strips were created using the anti-Trichophyton mAb. The efficiency of the test strip was assessed in patients diagnosed with tinea unguium and in healthy volunteers. Of the 20 patient nails tested, 19 tested positive and one tested negative, whereas of the 17 volunteer nails, only one tested positive. However, KOH microscopic examination of the volunteer nail that tested positive revealed the existence of Trichophyton hyphae. Although the number of nails assayed was small, since the assay had a sensitivity of 95.0% (19/20) and a specificity of 94.1% (16/17), the obtained results were considered to be promising. Thus, while further investigation with a greater number of samples is necessary, this method could potentially be employed as a new diagnostic tool for Trichophyton in the future.
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Affiliation(s)
- Sakon Noriki
- Department of Pathology, University of Fukui, Fukui, Japan
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120
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Sahoo AK, Mahajan R. Management of tinea corporis, tinea cruris, and tinea pedis: A comprehensive review. Indian Dermatol Online J 2016; 7:77-86. [PMID: 27057486 PMCID: PMC4804599 DOI: 10.4103/2229-5178.178099] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The prevalence of superficial mycotic infection worldwide is 20–25% of which dermatophytes are the most common agents. Recent developments in understanding the pathophysiology of dermatophytosis have confirmed the central role of cell-mediated immunity in countering these infections. Hence, a lack of delayed hypersensitivity reaction in presence of a positive immediate hypersensitivity (IH) response to trichophytin antigen points toward the chronicity of disease. Diagnosis, though essentially clinical should be confirmed by laboratory-based investigations. Several new techniques such as polymerase chain reaction (PCR) and mass spectroscopy can help to identify the different dermatophyte strains. Management involves the use of topical antifungals in limited disease, and oral therapy is usually reserved for more extensive cases. The last few years have seen a significant rise in the incidence of chronic dermatophyte infections of skin which have proven difficult to treat. However, due to the lack of updated national or international guidelines on the management of tinea corporis, cruris, and pedis, treatment with systemic antifungals is often empirical. The present review aims to revisit this important topic and will detail the recent advances in the pathophysiology and management of tinea corporis, tinea cruris, and tinea pedia while highlighting the lack of clarity of certain management issues.
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Affiliation(s)
- Alok Kumar Sahoo
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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121
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Monedero Mira MJ, Sales MB, Domingo CG, Monedero Mira MJ, Saura BP, Mallen GR, Porcar LT. Tratamiento empírico de las infecciones del adulto. FMC : FORMACION MEDICA CONTINUADA EN ATENCION PRIMARIA 2016; 23:9-71. [PMID: 32288498 PMCID: PMC7144499 DOI: 10.1016/j.fmc.2015.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 12/15/2015] [Accepted: 12/20/2015] [Indexed: 12/12/2022]
Affiliation(s)
- María José Monedero Mira
- Médico especialista en Medicina Familiar y Comunitaria, CS Rafalafena, Castellón. Profesor asociado de Medicina, Facultad de Ciencias de la Salud, Universitat Jaume I, Castellón, España
| | - Manuel Batalla Sales
- Médico especialista en Medicina Familiar y Comunitaria, CS Rafalafena, Castellón. Profesor asociado de Medicina, Facultad de Ciencias de la Salud, Universitat Jaume I, Castellón, España
| | | | - María José Monedero Mira
- Médico especialista en Medicina Familiar y Comunitaria, CS Rafalafena, Castellón. Profesor asociado de Medicina, Facultad de Ciencias de la Salud, Universitat Jaume I, Castellón, España
| | - Belén Persiva Saura
- Médico especialista en Medicina Familiar y Comunitaria, CS Rafalafena, Castellón, España
| | | | - Lledó Tárrega Porcar
- Médico especialista en Medicina Familiar y Comunitaria, CS Rafalafena, Castellón, España
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122
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Tsunemi Y, Hiruma M. Clinical study of Dermatophyte Test Strip, an immunochromatographic method, to detect tinea unguium dermatophytes. J Dermatol 2016; 43:1417-1423. [PMID: 26992478 DOI: 10.1111/1346-8138.13348] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/31/2016] [Indexed: 11/25/2022]
Abstract
The Dermatophyte Test Strip visualizes mycotic antigens by immunochromatography. It allows easy and fast detection of dermatophytes. A multicenter, single-arm, comparative clinical study was designed to evaluate the capacity of Dermatophyte Test Strip to detect dermatophytes in suspected tinea unguium specimens in comparison with direct microscopy and polymerase chain reaction (PCR). Signed consent was obtained from 222 subjects and all subjects completed the study. With the Dermatophyte Test Strip, dermatophytes were detected in 201 of 222 (90.5%) specimens but not in 21 of 222 (9.5%) specimens. With direct microscopy, dermatophytes were detected in 170 of 222 (76.6%) specimens but not in 52 of 222 (23.4%). Of the 45 specimens that showed inconsistent results between the two methods, PCR gave further results for 40 specimens, of which 37 (92.5%) specimens were positive and three (7.5%) were negative for dermatophytes. The positive concordance rate, negative concordance rate and overall concordance rate between the Dermatophyte Test Strip and direct microscopy were 81.1%, 66.7% and 79.7%, respectively. When inconsistent results were corrected using the results of PCR, these rates were 97.5%, 71.4% and 95.0%, respectively. When five specimens that could not be tested by PCR because no piece for the PCR test was left were excluded from analysis, these rates were 99.0%, 78.9% and 97.2%, respectively. The present results indicate good detection capacity of the Dermatophyte Test Strip. The Dermatophyte Test Strip provides a reliable, convenient and quick method to test for tinea unguium.
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Affiliation(s)
- Yuichiro Tsunemi
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Masataro Hiruma
- Ochanomizu Institute for Medical Mycology and Allergology, Tokyo, Japan
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Childs-Kean LM, Jourjy J. Antifungal Penetration into the Nail and New Topicals for Onychomycosis. CURRENT FUNGAL INFECTION REPORTS 2016. [DOI: 10.1007/s12281-016-0250-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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124
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Araiza-Santibáñez J, Tirado-Sánchez A, González-Rodríguez A, Vázquez-Escorcia L, Ponce-Olivera R, Bonifaz A. Onychomycosis in the elderly. A 2-year retrospective study of 138 cases. REVISTA MÉDICA DEL HOSPITAL GENERAL DE MÉXICO 2016. [DOI: 10.1016/j.hgmx.2015.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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125
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Tsunemi Y. A questionnaire survey on drug selection by subtype and severity of onychomycosis and drug evaluation. ACTA ACUST UNITED AC 2016. [DOI: 10.3812/jocd.33.630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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126
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Abstract
Nail disorders are a common presenting complaint for both the primary care physician and the dermatologist. Nail diagnoses are broad in scope and include infectious, inflammatory, and neoplastic conditions. Onychomycosis is an especially common nail condition, and treatment should always be preceded by appropriate fungal studies for confirmation of diagnosis. Inflammatory conditions of the nail unit can mimic onychomycosis, and a dermatologist can assist with diagnosis and treatment recommendations. Likewise, subungual tumors often require biopsy, and should be evaluated by a dermatologist who is experienced in nail evaluation and treatment.
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Affiliation(s)
- Lauren K Biesbroeck
- Division of Dermatology, University of Washington School of Medicine, 1959 Northeast Pacific Street, BB-1353, Box 356524, Seattle, WA 98195-6524, USA.
| | - Philip Fleckman
- Division of Dermatology, University of Washington School of Medicine, 1959 Northeast Pacific Street, BB-1353, Box 356524, Seattle, WA 98195-6524, USA
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127
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Yong A. Resin lacquer: a cheaper alternative to amorolfine for onychomycosis? Br J Dermatol 2015; 173:888-9. [DOI: 10.1111/bjd.13982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A.S.W. Yong
- Division of Dermatology; Department of Medicine; University Malaya Medical Centre; Jalan Universiti; 50603 Kuala Lumpur Wilayah Persekutuan Malaysia
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128
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Auvinen T, Tiihonen R, Soini M, Wangel M, Sipponen A, Jokinen J. Efficacy of topical resin lacquer, amorolfine and oral terbinafine for treating toenail onychomycosis: a prospective, randomized, controlled, investigator-blinded, parallel-group clinical trial. Br J Dermatol 2015; 173:940-8. [DOI: 10.1111/bjd.13934] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2015] [Indexed: 11/28/2022]
Affiliation(s)
- T. Auvinen
- Department of Vascular Surgery, Heart Centre; Kuopio University Hospital; FI-70029 Kuopio Finland
| | - R. Tiihonen
- Department of Orthopaedics and Traumatology; Päijät-Häme Central Hospital; FI-15850 Lahti Finland
| | - M. Soini
- Department of Orthopaedics and Traumatology; Päijät-Häme Central Hospital; FI-15850 Lahti Finland
| | - M. Wangel
- Vääksy Medical Centre; FI-17200 Vääksy Finland
| | - A. Sipponen
- Department of Orthopaedics and Traumatology; Päijät-Häme Central Hospital; FI-15850 Lahti Finland
| | - J.J. Jokinen
- Department of Cardiac Surgery, Heart and Lung Centre; Helsinki University Hospital; FI-00029 Helsinki Finland
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129
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Schaller M, Braunsdorf C, Mailänder-Sanchez D, Jäckel A, Müller J, Borelli C. Comparison of user-friendliness and treatment cost of Loceryl® vs. Ciclopoli®--a patient's perspective. Mycoses 2015; 58:632-6. [PMID: 26393437 DOI: 10.1111/myc.12371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 07/22/2015] [Indexed: 11/28/2022]
Abstract
Topical monotherapy is a valid therapeutic approach in onychomycosis. Due to its lengthy course and its non-reimbursed product status, cost and compliance are important issues and non-pharmacological properties such as over-the-counter price and ease of use should be considered when deciding which product to recommend. We investigated surrogate parameters for patient-friendliness and treatment cost in Germany in a questionnaire-based prospective, comparative, intra-individual, open-label trial of the two common topical antifungal nail lacquers Loceryl(®) (amorolfine 5%) and Ciclopoli(®) (ciclopirox 8%) in eight patients with clinically diagnosed onychomycosis. The 2.5 ml bottle of Loceryl(®) covered a treatment period of 308 days, resulting in treatment costs of €0.10 per day in comparison to the 3.3 ml bottle of Ciclopoli(®), covering 127 days at €0.21 per day, given once-daily application for Ciclopoli(®) and once-weekly application for Loceryl(®) in accordance with regulatory approval. Six out of eight patients favoured the Loceryl(®) treatment regimen. Furthermore, four out of eight patients found Loceryl(®) easier to apply, whereas three preferred Ciclopoli(®). In total, seven out of eight stated a clear preference for Loceryl(®) over Ciclopoli(®). Loceryl(®) therapy is less expensive and less time-consuming. The therapeutic period that can be covered is longer and more patients stated a clear preference for Loceryl(®) in comparison to Ciclopoli(®). The differences are statistically significant, underlining probable clinical relevance.
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Affiliation(s)
- M Schaller
- Department of Dermatology, Eberhard-Karls University, Tübingen, Germany
| | - C Braunsdorf
- Department of Dermatology, Eberhard-Karls University, Tübingen, Germany
| | | | - A Jäckel
- Medical Department, Galderma Laboratorium GmbH, Düsseldorf, Germany
| | - J Müller
- Medical Department, Galderma Laboratorium GmbH, Düsseldorf, Germany
| | - C Borelli
- Department of Dermatology, Eberhard-Karls University, Tübingen, Germany
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