Medicine › Epidemiology

Nail Diseases and Treatments

Works Count: 77479

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This cluster of papers covers the epidemiological trends, diagnosis, and management of fungal skin infections, with a focus on onychomycosis, dermatophytes, Malassezia, and associated conditions such as seborrheic dermatitis and tinea capitis. It also discusses antifungal susceptibility patterns, virulence traits, and the global burden of these infections.

Keywords

Onychomycosis; Dermatophytes; Malassezia; Epidemiology; Antifungal Therapy; Diagnosis; Nail Infections; Seborrheic Dermatitis; Tinea Capitis; Virulence Traits

Physiology and Biochemistry of the Skin

1954-11-06

Stephen Rothman

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor … Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal

Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: a multicentre survey

1998-10-01

Aditya K. Gupta , Konnikov , MacDonald +5 more

The number of individuals diagnosed with diabetes mellitus is increasing. The diabetic may present with complications involving all systems of the body. While onychomycosis is often observed in diabetics, there … The number of individuals diagnosed with diabetes mellitus is increasing. The diabetic may present with complications involving all systems of the body. While onychomycosis is often observed in diabetics, there have been no large studies on the prevalence of the condition in this patient group. We examined the prevalence of onychomycosis in diabetics attending diabetes and dermatology clinics in London, Ontario, Canada and Boston, MA, U.S.A. Diabetic subjects seen in dermatology offices were for unrelated dermatoses; those referred specifically for the management of onychomycosis were excluded from the sample. A total of 550 diabetic subjects was evaluated (283 males and 267 females), age 56.1 ± 0.7 years (mean ± SEM). Patients with type I diabetes constituted 34% of the sample. The racial origin was: 531 Caucasians, 17 Asians, one African-American and one American-Indian. Abnormal-appearing nails and mycological evidence of onychomycosis (mostly due to dermatophytes) were present in 253 (46%) and 144 (26%), respectively, of 550 subjects. The development of onychomycosis was significantly correlated with age (P < 0.0001) and male gender (P < 0.0001). Males were 2.99 times more likely to have onychomycosis compared with females (95% confidence interval, CI 1.94–4 61). After controlling for age and sex, the risk odds ratio for diabetic subjects to have toenail onychomycosis was 2.77 times compared with normal individuals (95% CI 2.15–3.57). After controlling for age and sex, a stepwise logistic regression demonstrated that significant predictors for onychomycosis included a family history of onychomycosis (P = 0.0001), concurrent intake of immunosuppressive therapy (P = 0.035) and peripheral vascular disease (P = 0.023). Toenail onychomycosis was present in 26% of the sample and is projected to affect approximately one-third of subjects with diabetes. Predisposing factors include increasing age, male gender, family history of onychomycosis, concurrent intake of immunosuppressive agents and peripheral vascular disease.

REVIEW ARTICLE: Toenail onychomycosis: an important global disease burden

2010-09-13

Jackson Thomas , Glenn A. Jacobson , Christian Narkowicz +3 more

Onychomycosis is a fungal infection of the nail plate or nail bed. It does not usually cure itself and it can trigger more infectious lesions in other parts of the … Onychomycosis is a fungal infection of the nail plate or nail bed. It does not usually cure itself and it can trigger more infectious lesions in other parts of the body. The reported prevalence of onychomycosis is increasing in Western countries, presumably due to lifestyle changes and the ageing of the population. Approximately 10% of the general population, 20% of the population aged>60 years, up to 50% of people aged>70 years and up to one-third of diabetic individuals have onychomycosis. Care should be taken for the accurate diagnosis and timely treatment of toenail onychomycosis to prevent complications. Current treatment options have relatively limited therapeutic success, particularly long-term. Oral medications are associated with high recurrence rates and treatment failure, and are not suitable for many cases due to potential adverse effects. Topical medications are recommended only for mild to moderate cases. The cost of therapies may also be prohibitive in some cases. In the light of these issues, more research is warranted for the investigation and development of more effective and economical options for the treatment and prophylaxis of toenail onychomycosis. In patient populations such as diabetic individuals, where onychomycosis can provoke lower extremity complications, professional podiatry care of toenails and feet should be encouraged.

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Movements of the subtalar and transverse tarsal joints

1941-08-01

John T. Manter

Prevalence of dermatophyte onychomycosis in the United Kingdom: Results of an omnibus survey

1992-02-01

David T. Roberts

Journal Article Prevalence of dermatophyte onychomycosis in the United Kingdom: Results of an omnibus survey Get access D.T. ROBERTS D.T. ROBERTS Department of Dermatology, Southern General Hospital, Glasgow, Scotland, UK … Journal Article Prevalence of dermatophyte onychomycosis in the United Kingdom: Results of an omnibus survey Get access D.T. ROBERTS D.T. ROBERTS Department of Dermatology, Southern General Hospital, Glasgow, Scotland, UK Dr D.T.Roberts, Department of Dermatology, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, Scotland, UK. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 126, Issue s39, 1 February 1992, Pages 23–27, https://doi.org/10.1111/j.1365-2133.1992.tb00005.x Published: 01 February 1992

Cytokine Modulation of Keratinocyte Cytokines

1990-06-01

John C. Ansel , Paul Perry , Jeffrey Brown +5 more

The genus Malassezia with description of four new species

1996-05-01

E. Guého , Gillian Midgley , Jacques Guillot

Survey of the prevalence, diagnosis and treatment of dermatological conditions in small animals in general practice

2006-04-01

Peter Hill , Alan Ka-Lun Lo , Cristian Eden +7 more

A survey was made of the prevalence, diagnosis and treatment of dermatological conditions in small animals in general practice in the UK . Out of 3707 small animal consultations in … A survey was made of the prevalence, diagnosis and treatment of dermatological conditions in small animals in general practice in the UK . Out of 3707 small animal consultations in general practice that were observed and recorded, 795 (21·4 per cent) involved animals that had a dermatological problem. In dogs and exotic species, pruritus was the most common presenting sign, accounting for 30 to 40 per cent of the dermatological consultations. In cats, cutaneous swellings were the most common presentation (36 per cent). A diagnosis or recommendation for treatment was made on the basis of the presenting clinical signs and physical examination alone in 576 (72 per cent) of the cases, and various diagnostic tests were performed in the other cases. In dogs, parasitic infestations, bacterial infections and neoplasia accounted for the majority of the diagnoses. In cats, parasites and bacterial infections were the most common. In exotic species, parasites accounted for over 80 per cent of the dermatological diagnoses. In dogs, the most common final diagnoses were otitis, pyoderma, anal sac impaction, flea infestation and atopic dermatitis. In cats, abscesses, flea infestation, and otitis were the most common diagnoses. In exotic species, the most common diagnosis was an unspecified mite infestation. Systemic antibiotics were prescribed in 196 cases (25 per cent), systemic glucocorticoids were prescribed in 162 cases (20 per cent) and treatment with an ectoparasiticide was prescribed in 167 cases (21 per cent).

Skin diseases associated with Malassezia species

2004-11-01

Aditya K. Gupta , Roma Batra , Robyn Bluhm +2 more

Dermatophytoses in Animals

2008-05-13

René Chermette , Laerte Ferreiro , Jacques Guillot

The Use of Ketoconazole as an Inhibitor of Steroid Production

1987-09-24

John A. Oates , Alastair J.J. Wood , Nicoletta Sonino

Ketoconazole is an imidazole derivative that is chemically related to miconazole (Fig. 1). It is an oral antimycotic agent with broad-spectrum activity and low toxicity.1 2 3 The drug is … Ketoconazole is an imidazole derivative that is chemically related to miconazole (Fig. 1). It is an oral antimycotic agent with broad-spectrum activity and low toxicity.1 2 3 The drug is considered to represent an important innovation in the treatment of fungal disease and has been used extensively in clinical practice for the past five years. The development of gynecomastia in some patients treated for mycosis first led to the investigation of the drug's effect on the production of testosterone.4 , 5 Thereafter, ketoconazole was shown to be a potent inhibitor of gonadal and adrenal steroid synthesis in vitro and in vivo.5 6 7 8 9 10 The finding of . . .

A large-scale North American study of fungal isolates from nails: The frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns

2000-10-01

Mahmoud A. Ghannoum , Rana Hajjeh , Richard Scher +7 more

Immunology of Diseases Associated withMalasseziaSpecies

2002-01-01

H. R. Ashbee , E. G. V. Evans

SUMMARY Malassezia species are members of the human cutaneous commensal flora, in addition to causing a wide range of cutaneous and systemic diseases in suitably predisposed individuals. Studies examining cellular … SUMMARY Malassezia species are members of the human cutaneous commensal flora, in addition to causing a wide range of cutaneous and systemic diseases in suitably predisposed individuals. Studies examining cellular and humoral immune responses specific to Malassezia species in patients with Malassezia-associated diseases and healthy controls have generally been unable to define significant differences in their immune response. The use of varied antigenic preparations and strains from different Malassezia classifications may partly be responsible for this, although these problems can now be overcome by using techniques based on recent work defining some important antigens and also a new taxonomy for the genus. The finding that the genus Malassezia is immunomodulatory is important in understanding its ability to cause disease. Stimulation of the reticuloendothelial system and activation of the complement cascade contrasts with its ability to suppress cytokine release and downregulate phagocytic uptake and killing. The lipid-rich layer around the yeast appears to be pivotal in this alteration of phenotype. Defining the nonspecific immune response to Malassezia species and the way in which the organisms modulate it may well be the key to understanding how Malassezia species can exist as both commensals and pathogens.

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Discovery of a New Boron-Containing Antifungal Agent, 5-Fluoro-1,3-dihydro-1-hydroxy-2,1- benzoxaborole (AN2690), for the Potential Treatment of Onychomycosis

2006-06-27

Stephen J. Baker , Yong-Kang Zhang , Tsutomu Akama +7 more

A structure-activity relationship investigation for a more efficacious therapy to treat onychomycosis, a fungal infection of the toe and fingernails, led to the discovery of a boron-containing small molecule, 5-fluoro-1,3-dihydro-1-hydroxy-2,1-benzoxaborole … A structure-activity relationship investigation for a more efficacious therapy to treat onychomycosis, a fungal infection of the toe and fingernails, led to the discovery of a boron-containing small molecule, 5-fluoro-1,3-dihydro-1-hydroxy-2,1-benzoxaborole (AN2690), which is currently in clinical trials for onychomycosis topical treatment.

Psoriasis of the nail: Anatomy, pathology, clinical presentation, and a review of the literature on therapy

2007-06-16

Michael M. Jiaravuthisan , Denis Sasseville , Ronald Vender +2 more

The Retaining Ligaments of the Cheek

1989-01-01

David W. Furnas

The zygomatic ligaments (McGregor's patch) anchor the skin of the cheek to the inferior border of the zygoma just posterior to the origin of the zygomaticus minor muscle. The mandibular … The zygomatic ligaments (McGregor's patch) anchor the skin of the cheek to the inferior border of the zygoma just posterior to the origin of the zygomaticus minor muscle. The mandibular ligaments tether the overlying skin to the anterior mandible. Both these ligaments are obstacles to surgical maneuvers intended to advance the overlying skin. They also restrain the facial skin against gravitational changes, and they delineate the anterior border of the "jowl" area. The platysma-auricular ligament is a thin fascial sheet that extends from the postero-superior border of the platysma and that is intimately attached to the periauricular skin; it serves as a surgical guide to the posterosuperior border of the platysma. The anterior platysma-cutaneous ligaments are variable fascial condensations that anchor the SMAS and platysma to the dermis. They can cause anatomic disorientation with dissection of false planes into the dermis. These four ligaments are useful as anatomic landmarks during facial dissections. The tethering effects of the zygomatic and mandibular ligaments must be interrupted if a maximum upward movement of the facial skin is desired.

Updates on the Epidemiology of Dermatophyte Infections

2008-05-13

C Seebacher , Jean-Philippe Bouchara , Bernard Mignon

The keratinocyte handbook

1995-11-20

Hans Smola , Thomas Krieg

British Association of Dermatologists' guidelines for the management of cutaneous warts 2014

2014-10-01

Jane Sterling , Sam Gibbs , S. S. Haque Hussain +7 more

analyses, randomized controlled trials (RCTs) and non-RCTs, case series, case reports and open studies involving warts, published in the English language from January 1999 to March 2014; search terms and … analyses, randomized controlled trials (RCTs) and non-RCTs, case series, case reports and open studies involving warts, published in the English language from January 1999 to March 2014; search terms and strategies are detailed in the Supporting Information.The Allied and Complementary Medicine Database was also searched for 'warts' with the same time restriction.Additional relevant references were also isolated from citations in the reviewed literature.Each author screened their set of identified titles, and those relevant for first-round inclusion were selected for further scrutiny.Working in pairs, the authors then reviewed the abstracts for the shortlisted references, and the full papers of relevant material were obtained; disagreements in the final selections were resolved by discussion among the entire development group.The structure of the 2001 guidelines was then discussed and re-evaluated, with headings and subheadings decided; different coauthors were allocated separate subsections.Each coauthor then performed a detailed appraisal of the selected literature, and all subsections were subsequently collated and edited to produce the final guideline. Limitations of the guidelineThis document has been prepared on behalf of the BAD and is based on the best data available when the document was prepared.It is recognized that under certain conditions it may be necessary to deviate from the guidelines and that the results of future studies may require some of the recommendations herein to be changed.Failure to adhere to these guidelines should not necessarily be considered negligent, nor should adherence to these recommendations constitute a defence against a claim of negligence. Plans for guideline revisionThe proposed revision for this set of recommendations is scheduled for 2019; where necessary, important interim changes will be updated on the BAD website.

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Prevalence and epidemiology of onychomycosis in patients visiting physicians’ offices: A multicenter Canadian survey of 15,000 patients

2000-08-01

Aditya K. Gupta , Hem C. Jain , Charles Lynde +3 more

Comparison of diagnostic methods in the evaluation of onychomycosis

2003-08-01

Jeffrey M Weinberg , Evelyn K. Koestenblatt , William D Tutrone +2 more

Epidemiology of superficial fungal infections

2010-03-01

Mahreen Ameen

Terminology of Contact Dermatitis

1971-04-01

D. S. Wilkson

Deep Dermatophytosis and Inherited CARD9 Deficiency

2013-10-16

Fanny Lanternier , Saad Pathan , Quentin B. Vincent +7 more

Deep dermatophytosis is a severe and sometimes life-threatening fungal infection caused by dermatophytes. It is characterized by extensive dermal and subcutaneous tissue invasion and by frequent dissemination to the lymph … Deep dermatophytosis is a severe and sometimes life-threatening fungal infection caused by dermatophytes. It is characterized by extensive dermal and subcutaneous tissue invasion and by frequent dissemination to the lymph nodes and, occasionally, the central nervous system. The condition is different from common superficial dermatophyte infection and has been reported in patients with no known immunodeficiency. Patients are mostly from North African, consanguineous, multiplex families, which strongly suggests a mendelian genetic cause.We studied the clinical features of deep dermatophytosis in 17 patients with no known immunodeficiency from eight unrelated Tunisian, Algerian, and Moroccan families. Because CARD9 (caspase recruitment domain-containing protein 9) deficiency has been reported in an Iranian family with invasive fungal infections, we also sequenced CARD9 in the patients.Four patients died, at 28, 29, 37, and 39 years of age, with clinically active deep dermatophytosis. No other severe infections, fungal or otherwise, were reported in the surviving patients, who ranged in age from 37 to 75 years. The 15 Algerian and Tunisian patients, from seven unrelated families, had a homozygous Q289X CARD9 allele, due to a founder effect. The 2 Moroccan siblings were homozygous for the R101C CARD9 allele. Both alleles are rare deleterious variants. The familial segregation of these alleles was consistent with autosomal recessive inheritance and complete clinical penetrance.All the patients with deep dermatophytosis had autosomal recessive CARD9 deficiency. Deep dermatophytosis appears to be an important clinical manifestation of CARD9 deficiency. (Funded by Agence Nationale pour la Recherche and others.).

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Superficial fungal infections

2004-09-01

Robert A. Schwartz

Prevalence of Foot and Ankle Conditions in a Multiethnic Community Sample of Older Adults

2004-02-20

Julie E. Dunn

The prevalence of foot and ankle disorders was determined in a community-based, multiethnic (non-Hispanic White, African American, and Puerto Rican) random sample of 784 community-dwelling adults aged 65 or more … The prevalence of foot and ankle disorders was determined in a community-based, multiethnic (non-Hispanic White, African American, and Puerto Rican) random sample of 784 community-dwelling adults aged 65 or more years in 2001-2002 in Springfield, Massachusetts. Overall, the five most common conditions were toenail disorders (74.9%), lesser toe deformities (60.0%), corns and calluses (58.2%), bunions (37.1%), and signs of fungal infection, cracks/fissures, or maceration between toes (36.3%); 30.9% had some tenderness to palpation of the foot or ankle, and 14.9% had ankle joint pain on most days in the past 4 weeks. Toenail conditions, fungal symptoms, and ulcers or lacerations were more common in men, while bunions and corns and calluses were more common in women (p < 0.001). Significant racial/ethnic differences, independent of education or gender, were found for the prevalence of most toe deformities and flat feet, as well as for corns and calluses, fungal signs, edema, ankle joint pain, tenderness to palpation, and sensory loss. Foot and ankle disorders are common in these older adults. Examination of their prevalence in different segments of the community may inform future studies to determine etiology and means of prevention.

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Onychomycosis: Pathogenesis, Diagnosis, and Management

1998-07-01

Boni E. Elewski

Although not life-threatening, onychomycosis (a fungal infection of the nail, usually caused by a dermatophyte) constitutes an important public health problem because of its high prevalence (about 10% of the … Although not life-threatening, onychomycosis (a fungal infection of the nail, usually caused by a dermatophyte) constitutes an important public health problem because of its high prevalence (about 10% of the U.S. population) and associated morbidity. The disease can have certain negative consequences for patients, such as pain, and can potentially undermine work and social lives. This review discusses the etiology, classification, diagnosis, and treatment of onychomycosis. Four types of onychomycosis are recognized based on the site and pattern of fungal invasion. Dermatophyte fungi are the predominant pathogens, but yeasts (especially Candida albicans) and nondermatophyte molds may also be implicated. Accurate diagnosis requires direct microscopy and fungal culture. The differential diagnosis includes psoriasis, lichen planus, onychogryphosis, and nail trauma. Onychomycosis is more difficult to treat than most dermatophytoses because of the inherent slow growth of the nail. Older antifungal agents (ketoconazole and griseofulvin) are unsuitable for onychomycosis because of their relatively poor efficacy and potential adverse effects. Three recently developed antimycotic agents (fluconazole, itraconazole, and terbinafine) offer high cure rates and good safety profiles. In addition, the short treatment times (< 3 months) and intermittent dosing schedules are likely to enhance compliance and reduce the costs of therapy.

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COURTSHIP INDROSOPHILA

2000-12-01

Ralph J. Greenspan , Jean‐François Ferveur

▪ Abstract Courtship is a complex behavior in Drosophila that recruits a wide range of genes for its realization, including those concerning sex determination, ion channels, and circadian rhythms. Results … ▪ Abstract Courtship is a complex behavior in Drosophila that recruits a wide range of genes for its realization, including those concerning sex determination, ion channels, and circadian rhythms. Results from different experimental approaches—behavioral and genetic comparisons between species, analysis of mutants and mosaics, and identification of specific sensory stimuli—sketch the outlines of a set of pleiotropic genes acting on a distributed system in the brain to produce the species-specific sequence of responses and actions.

Microbial Ecology of the Skin

1988-10-01

Rudolf R. Roth , William D. James

Human coronavirus (HCoV) infection causes respiratory diseases with mild to severe outcomes. In the last 15 years, we have witnessed the emergence of two zoonotic, highly pathogenic HCoVs: severe acute … Human coronavirus (HCoV) infection causes respiratory diseases with mild to severe outcomes. In the last 15 years, we have witnessed the emergence of two zoonotic, highly pathogenic HCoVs: severe acute respiratory syndrome coronavirus (SARS-CoV) and ...Read More

Tinea capitis: A current perspective

2000-01-01

Boni E. Elewski

Epidemiological trends in skin mycoses worldwide

2008-08-28

Blanka Havlíčková , V. Czaika , Markus Friedrich

Summary Fungal infections of the skin and nails are a common global problem. The high prevalence of superficial mycotic infections shows that 20–25% of the world’s population has skin mycoses, … Summary Fungal infections of the skin and nails are a common global problem. The high prevalence of superficial mycotic infections shows that 20–25% of the world’s population has skin mycoses, making these one of the most frequent forms of infection. Pathogens responsible for skin mycoses are primarily anthropophilic and zoophilic dermatophytes from the genera Trichophyton (T.) , Microsporum (M.) and Epidermophyton (E.) . There appears to be considerable inter‐ and intra‐continental variability in the global incidence of these fungal infections. Trichophyton rubrum , T. interdigitale ( mentagrophytes var. interdigitale ), M. canis , M. audouinii , T. tonsurans and T. verrucosum are the most common, but the attack rates and incidence of specific mycoses can vary widely. Local socio‐economic conditions and cultural practices can also influence the prevalence of a particular infection in a given area. For example, tinea pedis (athlete’s foot) is more prevalent in developed countries than in emerging economies and is likely to be caused by the anthropophilic germ T. rubrum . In poorer countries, scalp infections (tinea capitis) caused by T. soudanense or M. audouinii are more prevalent. This review summarises current epidemiological trends for fungal infections and focuses on dermatomycosis of glabrous skin on different continents.

Update in Antifungal Therapy of Dermatophytosis

2008-05-13

Aditya K. Gupta , Elizabeth A. Cooper

The Malassezia Genus in Skin and Systemic Diseases

2012-01-01

Georgios Gaitanis , Prokopios Magiatis , Markus Hantschke +2 more

In the last 15 years, the genus Malassezia has been a topic of intense basic research on taxonomy, physiology, biochemistry, ecology, immunology, and metabolomics. Currently, the genus encompasses 14 species. … In the last 15 years, the genus Malassezia has been a topic of intense basic research on taxonomy, physiology, biochemistry, ecology, immunology, and metabolomics. Currently, the genus encompasses 14 species. The 1996 revision of the genus resulted in seven accepted taxa: M. furfur, M. pachydermatis, M. sympodialis, M. globosa, M. obtusa, M. restricta, and M. slooffiae. In the last decade, seven new taxa isolated from healthy and lesional human and animal skin have been accepted: M. dermatis, M. japonica, M. yamatoensis, M. nana, M. caprae, M. equina, and M. cuniculi. However, forthcoming multidisciplinary research is expected to show the etiopathological relationships between these new species and skin diseases. Hitherto, basic and clinical research has established etiological links between Malassezia yeasts, pityriasis versicolor, and sepsis of neonates and immunocompromised individuals. Their role in aggravating seborrheic dermatitis, dandruff, folliculitis, and onychomycosis, though often supported by histopathological evidence and favorable antifungal therapeutic outcomes, remains under investigation. A close association between skin and Malassezia IgE binding allergens in atopic eczema has been shown, while laboratory data support a role in psoriasis exacerbations. Finally, metabolomic research resulted in the proposal of a hypothesis on the contribution of Malassezia-synthesized aryl hydrocarbon receptor (AhR) ligands to basal cell carcinoma through UV radiation-induced carcinogenesis.

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Dandruff-associated Malassezia genomes reveal convergent and divergent virulence traits shared with plant and human fungal pathogens

2007-11-14

Jun Xu , Charles W. Saunders , Ping Hu +7 more

Fungi in the genus Malassezia are ubiquitous skin residents of humans and other warm-blooded animals. Malassezia are involved in disorders including dandruff and seborrheic dermatitis, which together affect >50% of … Fungi in the genus Malassezia are ubiquitous skin residents of humans and other warm-blooded animals. Malassezia are involved in disorders including dandruff and seborrheic dermatitis, which together affect >50% of humans. Despite the importance of Malassezia in common skin diseases, remarkably little is known at the molecular level. We describe the genome, secretory proteome, and expression of selected genes of Malassezia globosa. Further, we report a comparative survey of the genome and secretory proteome of Malassezia restricta, a close relative implicated in similar skin disorders. Adaptation to the skin environment and associated pathogenicity may be due to unique metabolic limitations and capabilities. For example, the lipid dependence of M. globosa can be explained by the apparent absence of a fatty acid synthase gene. The inability to synthesize fatty acids may be complemented by the presence of multiple secreted lipases to aid in harvesting host lipids. In addition, an abundance of genes encoding secreted hydrolases (e.g., lipases, phospholipases, aspartyl proteases, and acid sphingomyelinases) was found in the M. globosa genome. In contrast, the phylogenetically closely related plant pathogen Ustilago maydis encodes a different arsenal of extracellular hydrolases with more copies of glycosyl hydrolase genes. M. globosa shares a similar arsenal of extracellular hydrolases with the phylogenetically distant human pathogen, Candida albicans, which occupies a similar niche, indicating the importance of host-specific adaptation. The M. globosa genome sequence also revealed the presence of mating-type genes, providing an indication that Malassezia may be capable of sex.

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CHROMagar Candida, a new differential isolation medium for presumptive identification of clinically important Candida species

1994-08-01

Frank C. Odds , R Bernaerts

CHROMagar Candida is a novel, differential culture medium that is claimed to facilitate the isolation and presumptive identification of some clinically important yeast species. We evaluated the use of this … CHROMagar Candida is a novel, differential culture medium that is claimed to facilitate the isolation and presumptive identification of some clinically important yeast species. We evaluated the use of this medium with 726 yeast isolates, including 82 isolated directly on the medium from clinical material. After 2 days of incubation at 37 degrees C, 285 C. albicans isolates gave distinctive green colonies that were not seen with any of 441 other yeast isolates representing 21 different species. A total of 54 C. tropicalis isolates also developed distinctive dark blue-gray colonies with a halo of dark brownish purple in the surrounding agar. C. krusei isolates (n = 43) also formed highly characteristic rough, spreading colonies with pale pink centers and a white edge that was otherwise encountered only rarely with isolates of C. norvegensis. Trichosporon spp. (n = 34) formed small, pale colonies that became larger and characteristically rough with prolonged incubation. Most of the other 310 yeasts studied formed colonies with a color that ranged from white to pink to purple with a brownish tint. The only exceptions were found among isolates identified as Geotrichum sp. or Pichia sp., some of which formed colonies with a gray to blue color and which in two instances formed a green pigment or a dark halo in the agar. The specificity and sensitivity of the new medium for the presumptive identification of C. albicans, C. krusei, and C. tropicalis exceeded 99% for all three species. A blinded reading test involving four personnel and 57 yeast isolates representing nine clinically important species confirmed that colonial appearance after 48 h of incubation on CHROMagar Candida afforded the correct presumptive recognition of C. albicans, C. tropicalis, C, krusei, and Trichosporon spp. None of nine bacterial isolates grew on CHROMagar Candida within 72 h, and bacteria (Escherichia coli) grew from only 4 of 104 vaginal, 100 oral, and 99 anorectal swabs. The new medium supported the growth of 19 of 23 dermatophyte fungi tested and 41 of 43 other molds representing a broad range of fungal pathogens and contaminants. In parallel cultures of 348 clinical specimens set up on Sabourand agar and CHROMagar Candida, both media grew yeasts in the same 78 instances. CHROMagar Candida is recommended as a useful isolation medium capable of the presumptive identification of the yeast species most commonly isolated from clinical material and facilitating recognition of mixed yeast cultures.

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Onychomycosis caused by nondermatophytic molds: Clinical features and response to treatment of 59 cases☆, ☆☆

2000-02-01

Antonellá Tosti , Bianca Maria Piraccini , Sandra Lorenzi

Management of tinea corporis, tinea cruris, and tinea pedis: A comprehensive review

2016-01-01

Rahul Mahajan , AlokKumar Sahoo

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 … 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.

Seborrheic Dermatitis and Dandruff: A Comprehensive Review

2015-01-01

Luis J. Borda , Tongyu C. Wikramanayake

Seborrheic Dermatitis (SD) and dandruff are of a continuous spectrum of the same disease that affects the seborrheic areas of the body.Dandruff is restricted to the scalp, and involves itchy, … Seborrheic Dermatitis (SD) and dandruff are of a continuous spectrum of the same disease that affects the seborrheic areas of the body.Dandruff is restricted to the scalp, and involves itchy, flaking skin without visible inflammation.SD can affect the scalp as well as other seborrheic areas, and involves itchy and flaking or scaling skin, inflammation and pruritus.Various intrinsic and environmental factors, such as sebaceous secretions, skin surface fungal colonization, individual susceptibility, and interactions between these factors, all contribute to the pathogenesis of SD and dandruff.In this review, we summarize the current knowledge on SD and dandruff, including epidemiology, burden of disease, clinical presentations and diagnosis, treatment, genetic studies in humans and animal models, and predisposing factors.Genetic and biochemical studies and investigations in animal models provide further insight on the pathophysiology and strategies for better treatment.

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GOLGI APPARATUS AND LYSOSOMES.

1964-09-01

Novikoff Ab , Edward Essner , Nelson Quintana

Antifungal agents: An overview. Part II

1994-06-01

Aditya K. Gupta , Daniel N. Sauder , N H Shear

Toward a Novel Multilocus Phylogenetic Taxonomy for the Dermatophytes

2016-10-25

Sybren de Hoog , Karolina Dukik , Michel Monod +7 more

Type and reference strains of members of the onygenalean family Arthrodermataceae have been sequenced for rDNA ITS and partial LSU, the ribosomal 60S protein, and fragments of β-tubulin and translation … Type and reference strains of members of the onygenalean family Arthrodermataceae have been sequenced for rDNA ITS and partial LSU, the ribosomal 60S protein, and fragments of β-tubulin and translation elongation factor 3. The resulting phylogenetic trees showed a large degree of correspondence, and topologies matched those of earlier published phylogenies demonstrating that the phylogenetic representation of dermatophytes and dermatophyte-like fungi has reached an acceptable level of stability. All trees showed Trichophyton to be polyphyletic. In the present paper, Trichophyton is restricted to mainly the derived clade, resulting in classification of nearly all anthropophilic dermatophytes in Trichophyton and Epidermophyton, along with some zoophilic species that regularly infect humans. Microsporum is restricted to some species around M. canis, while the geophilic species and zoophilic species that are more remote from the human sphere are divided over Arthroderma, Lophophyton and Nannizzia. A new genus Guarromyces is proposed for Keratinomyces ceretanicus. Thirteen new combinations are proposed; in an overview of all described species it is noted that the largest number of novelties was introduced during the decades 1920-1940, when morphological characters were used in addition to clinical features. Species are neo- or epi-typified where necessary, which was the case in Arthroderma curreyi, Epidermophyton floccosum, Lophophyton gallinae, Trichophyton equinum, T. mentagrophytes, T. quinckeanum, T. schoenleinii, T. soudanense, and T. verrucosum. In the newly proposed taxonomy, Trichophyton contains 16 species, Epidermophyton one species, Nannizzia 9 species, Microsporum 3 species, Lophophyton 1 species, Arthroderma 21 species and Ctenomyces 1 species, but more detailed studies remain needed to establish species borderlines. Each species now has a single valid name. Two new genera are introduced: Guarromyces and Paraphyton. The number of genera has increased, but species that are relevant to routine diagnostics now belong to smaller groups, which enhances their identification.

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Terbinafine Resistance of Trichophyton Clinical Isolates Caused by Specific Point Mutations in the Squalene Epoxidase Gene

2017-04-18

Tsuyoshi Yamada , Mari Maeda , Mohamed Mahdi Alshahni +6 more

Terbinafine is one of the allylamine antifungal agents whose target is squalene epoxidase (SQLE). This agent has been extensively used in the therapy of dermatophyte infections. The incidence of patients … Terbinafine is one of the allylamine antifungal agents whose target is squalene epoxidase (SQLE). This agent has been extensively used in the therapy of dermatophyte infections. The incidence of patients with tinea pedis or unguium tolerant to terbinafine treatment prompted us to screen the terbinafine resistance of all Trichophyton clinical isolates from the laboratory of the Centre Hospitalier Universitaire Vaudois collected over a 3-year period and to identify their mechanism of resistance. Among 2,056 tested isolates, 17 (≈1%) showed reduced terbinafine susceptibility, and all of these were found to harbor SQLE gene alleles with different single point mutations, leading to single amino acid substitutions at one of four positions (Leu393, Phe397, Phe415, and His440) of the SQLE protein. Point mutations leading to the corresponding amino acid substitutions were introduced into the endogenous SQLE gene of a terbinafine-sensitive Arthroderma vanbreuseghemii (formerly Trichophyton mentagrophytes) strain. All of the generated A. vanbreuseghemii transformants expressing mutated SQLE proteins exhibited obvious terbinafine-resistant phenotypes compared to the phenotypes of the parent strain and of transformants expressing wild-type SQLE proteins. Nearly identical phenotypes were also observed in A. vanbreuseghemii transformants expressing mutant forms of Trichophyton rubrum SQLE proteins. Considering that the genome size of dermatophytes is about 22 Mb, the frequency of terbinafine-resistant clinical isolates was strikingly high. Increased exposure to antifungal drugs could favor the generation of resistant strains.

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Current and Emerging Topical Antibacterials and Antiseptics: Agents, Action, and Resistance Patterns

2017-06-08

Deborah A. Williamson , Glen P. Carter , Benjamin P. Howden

Bacterial skin infections represent some of the most common infectious diseases globally. Prevention and treatment of skin infections can involve application of a topical antimicrobial, which may be an antibiotic … Bacterial skin infections represent some of the most common infectious diseases globally. Prevention and treatment of skin infections can involve application of a topical antimicrobial, which may be an antibiotic (such as mupirocin or fusidic acid) or an antiseptic (such as chlorhexidine or alcohol). However, there is limited evidence to support the widespread prophylactic or therapeutic use of topical agents. Challenges involved in the use of topical antimicrobials include increasing rates of bacterial resistance, local hypersensitivity reactions (particularly to older agents, such as bacitracin), and concerns about the indiscriminate use of antiseptics potentially coselecting for antibiotic resistance. We review the evidence for the major clinical uses of topical antibiotics and antiseptics. In addition, we review the mechanisms of action of common topical agents and define the clinical and molecular epidemiology of antimicrobial resistance in these agents. Moreover, we review the potential use of newer and emerging agents, such as retapamulin and ebselen, and discuss the role of antiseptic agents in preventing bacterial skin infections. A comprehensive understanding of the clinical efficacy and drivers of resistance to topical agents will inform the optimal use of these agents to preserve their activity in the future.

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High terbinafine resistance in Trichophyton interdigitale isolates in Delhi, India harbouring mutations in the squalene epoxidase gene

2018-03-26

Ashutosh Singh , Aradhana Masih , Ananta Khurana +5 more

Summary In the last few years, infections caused by dermatophytes along with a concomitant increase in the number of difficult to treat cases have increasingly been recognised, indicating that dermatophytosis … Summary In the last few years, infections caused by dermatophytes along with a concomitant increase in the number of difficult to treat cases have increasingly been recognised, indicating that dermatophytosis remains a challenging public health problem. The majority of infections are caused by Trichophyton rubrum and Trichophyton mentagrophytes complex. Terbinafine, an allylamine antifungal used orally and topically is considered to be a first‐line drug in the therapy of dermatophyte infections. Terbinafine resistance has been predominately attributed to point mutations in the squalene epoxidase ( SQLE ) target gene a key enzyme in the ergosterol biosynthetic pathway leading to single amino acid substitutions. Here, we report the largest series of 20 terbinafine‐resistant Trichophyton interdigitale isolates obtained predominately from cases of tinea corporis/cruris in three hospitals in Delhi, India exhibiting elevated MIC s (4 to ≥32 μg/mL) to terbinafine and all harbouring single‐point mutations Leu393Phe or Phe397Leu in the SQLE gene. In 12 (60%) T. interdigitale isolates, the Phe397Leu substitution was observed, whereas in the remaining 8 (40%) isolates the substitution Leu393Phe was reported for the first time in T. interdigitale . Furthermore, 10 susceptible T. interdigitale isolates (0.125‐2 μg/mL) had a wild‐type genotype. Remarkably, considerably high terbinafine resistance rate of 32% was observed among 63 T. interdigitale isolates identified by sequencing of the internal transcribed spacer region. This high level of terbinafine resistance of Indian dermatophyte isolates is worrisome warranting antifungal susceptibility testing and mutation analysis for monitoring this emerging resistance.

Ein neues Verfahren zu der klinischen Untersuchung der Schweißabsonderung

1928-01-01

Victor Minor

The dermatophytes

1995-04-01

Irene Weitzman , Richard C. Summerbell

The etiologic agents of the dermatophytoses (ringworm) are classified in three anamorphic (asexual or imperfect) genera, Epidermophyton, Microsporum, and Trichophyton. Species capable of reproducing sexually belong in the teleomorphic genus, … The etiologic agents of the dermatophytoses (ringworm) are classified in three anamorphic (asexual or imperfect) genera, Epidermophyton, Microsporum, and Trichophyton. Species capable of reproducing sexually belong in the teleomorphic genus, Arthroderma, of the Ascomycota. On the basis of primary habitat association, they may be grouped as geophilic (soil associated), zoophilic, and anthropophilic. Adaptation to growth on humans by most geophilic species resulted in diminished loss of sporulation, sexuality, and other soil-associated characteristics. The dermatophytes have the ability to invade keratinized tissue (skin, hair, and nails) but are usually restricted to the nonliving cornified layer of the epidermis because of their inability to penetrate viable tissue of an immunocompetent host. However, invasion does elicit a host response ranging from mild to severe. Acid proteinases, elastase, keratinases, and other proteinases reportedly act as virulence factors. The development of cell-mediated immunity correlated with delayed hypersensitivity and an inflammatory response is associated with clinical cure, whereas the lack of or a defective cell-mediated immunity predisposes the host to chronic or recurrent dermatophyte infection. Chronic dermatophytosis is mostly caused by Trichophyton rubrum, and there is some evidence that mannan produced by this fungus suppresses or diminishes the inflammatory response. Since dermatophytes cause a communicable disease, modes of transmission and control are discussed as well as a survey of recent trends in therapy. Collection of specimens, culture media, and tests for identification are also presented. Genetic studies have led to an understanding of incompatibility mechanisms, pleomorphism and variation, resistance to griseofulvin, and virulence. Molecular biology has contributed to our knowledge of the taxonomy and phylogenetic relationships of dermatophytes.

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FRACTURES OF THE ANKLE

1950-05-01

N. Lauge-Hansen

Pfingstexkursion Alter Bessin

2018-01-01

Registry-Migration.Gbif.Org

This dataset holds the observations recorded during the GEO Biodiversity Day "Pfingstexkursion Alter Bessin" in Insel Hiddensee This dataset holds the observations recorded during the GEO Biodiversity Day "Pfingstexkursion Alter Bessin" in Insel Hiddensee

Fungal atlas

2024-01-01

Finbif

Fungal atlas is a citizen science project to map Finnish fungi. More information in Finnish: https://sieniatlas.fi/ Data quality: Experts are monitoring the observations and help with identifications. Fungal atlas is a citizen science project to map Finnish fungi. More information in Finnish: https://sieniatlas.fi/ Data quality: Experts are monitoring the observations and help with identifications.

Clinical case of Majocchi's granuloma

2025-06-25

R. F. Sayfullin , K. K. Rumyantseva , Альбина Ирековна Булгакова +2 more | CHILDREN INFECTIONS

Fungal infections of the skin, due to their variety of clinical presentations, often cause difficulty in making a diagnosis. Majocca's granuloma (GM) is a rare form of fungal skin infection … Fungal infections of the skin, due to their variety of clinical presentations, often cause difficulty in making a diagnosis. Majocca's granuloma (GM) is a rare form of fungal skin infection that is caused by dermatophytes in over 95% of cases. Long-term superficial dermatophyte, systemic or local immunosuppression, and disruption of the integrity of the skin barrier are risk factors for developing Majocca granulomas. Improper treatment with topical glucocorticosteroids and antibiotics can worsen the condition. We present the case of a ten-year-old immunocompetent boy who developed Majocca granulema after mechanical skin injury. Late diagnosis and incorrect treatment tactics using local glucocorticosteroids at the prehospital stage probably led to the progression of manifestations in the primary focus and further dissemination of the pathogen, with the development of folliculitis and skin lesions. Due to low sensitivity of GM laboratory tests, even after skin microscopy using potassium hydroxide (KOH) and genome-wide double sequencing, no etiological agent could be identified in our patient. The patient was discharged from hospital with clinical improvement after taking systemic antifungal drugs. Against the background of a break in treatment and a violation of the care recommendations, the patient developed a recurrence of the disease, which was prevented by long-term administration of terbinafine.

Optimizing Antibiotic Choice, Administration, and Duration in NSTI Treatment

2025-06-24

David Howell , Rachael Edgin , Aliya Rehman +1 more | Bioengineering

Necrotizing soft tissue infections (NSTIs) are serious and aggressive infections which can result in significant morbidity and mortality. Both prompt surgical intervention and early antibiotics can decrease patient mortality. Based … Necrotizing soft tissue infections (NSTIs) are serious and aggressive infections which can result in significant morbidity and mortality. Both prompt surgical intervention and early antibiotics can decrease patient mortality. Based on microbiology, NSTIs can be categorized into four different types. Type I is polymicrobial, caused by a mix of both anaerobic and aerobic bacteria. Type II is monomicrobial, usually caused by either Streptococcus or Staphylococcus. Type III infections are caused by Gram-negative bacteria, often marine-related organisms, such as Vibrio. Lastly, Type IV infections are caused by fungi, and they are often associated with trauma. Despite the possibility of all these different pathogens in NSTI, early therapy often consists of a broad Gram-positive antimicrobial such as linezolid or vancomycin, and a broad Gram-negative agent such as piperacillin/tazobactam. Multiple factors including patient comorbidities, environmental exposures, and clinical presentation must also be considered when choosing antimicrobial agents and dosing. Adjunct medical therapies such as intravenous immunoglobulin (IVIG) and the antibiotics clindamycin and linezolid that are aimed at toxin suppression may be utilized to improve outcomes. Microbiological data are critical for optimizing the antimicrobial regimen.

Dermatophytosis in context of Trichophyton rubrum: host defense mechanisms, virulence factors, and treatment innovations

2025-06-24

Khushboo Arya , Saumya Chaturvedi , Sana Akhtar Usmani +6 more | Molecular Biology Reports

Fungal Parotitis: Clinical Case Report

2025-06-24

Federico Álvarez , R. Suárez‐Fernández , EA Lucio +1 more | International Journal of Oral and Maxillofacial Surgery

Arthroderma onychocola plus Arthroderma quadrifidum auf atopischem Ekzem

2025-06-24

Jochen Brasch , Karin Voss , Katharina Antonia Langen +1 more | Deleted Journal

Occasionally, tinea is a differential diagnostic option in lesions of nummular atopic eczema. Mycological diagnostics can yield quite unexpected results. Evaluation of the detection of rare geophilic dermatophytes on atopic … Occasionally, tinea is a differential diagnostic option in lesions of nummular atopic eczema. Mycological diagnostics can yield quite unexpected results. Evaluation of the detection of rare geophilic dermatophytes on atopic eczema, using mycological data and its clinical interpretation. Detailed conventional and genetic mycological work-up of scales collected from atopic eczema; correlation of the findings with the clinical context and the pertinent literature. On a lesion of nummular atopic dermatitis two rare geophilic dermatophytes were detected synchronously: Arthroderma (A.) onychocola and A. quadrifidum. This was only the third isolation of A. onychocola ever and the first one on glabrous skin and in Germany. The strain grew on human stratum corneum and perforated hair. A. quadrifidum did not show unusual features. No pathogenetic relevance of this twofold colonization was noted regarding the atopic eczema. Obviously, A. onychocola is more prevalent than has been assumed up to now. Geophilic dermatophytes detected on atopic dermatitis are not necessarily pathogenetically relevant for eczema-such a colonization needs to be critically interpreted in relation to its clinical context. The determinants that allow geophilic dermatophytes to persist on human skin are still not understood.

Resistenzentwicklung bei Hautpilzen

2025-06-24

Anke Burmester , Cornelia Wiegand | Deleted Journal

The growing prevalence of resistant dermatophyte isolates, particularly from Trichophyton indotineae (synonym: T. mentagrophytes ITS genotype VIII) but also from T. rubrum may lead to increasing numbers of difficult-to-treat dermatomycoses. … The growing prevalence of resistant dermatophyte isolates, particularly from Trichophyton indotineae (synonym: T. mentagrophytes ITS genotype VIII) but also from T. rubrum may lead to increasing numbers of difficult-to-treat dermatomycoses. Terbinafine resistance in T. indotineae or T. rubrum is caused by point mutations that alter specific positions in the Erg1 gene encoding squalene epoxidase, thereby, preventing effective binding of terbinafine to the enzyme. In T. indotineae, two different forms of genomic amplification of Erg11B that lead to azole resistance have been identified. Like Erg11A, Erg11B encodes a form of sterol-14-α-demethylase, whose enzymatic activity is inhibited by azole binding. In T. indotineae as well as in T. rubrum, point mutations in Erg11B have been identified that result in altered amino acid sequences and prevent binding of specific classes of azoles. Another resistance mechanism involves increased expression of transporter proteins responsible for drug efflux. The combination of these various mechanisms presents a major challenge for diagnostics and requires adaptation of both the diagnostic approach and the subsequent therapeutic strategies.

A telomere-to-telomere genome assembly for Malassezia pachydermatis ATCC 14522 (CBS 1879)

2025-06-24

Lois L. Hoyer , Clarissa P. Souza , Chien‐Che Hung +2 more | Microbiology Resource Announcements

Pacific Biosciences (PacBio) long-read sequencing was used to generate a telomere-to-telomere genome assembly for the Malassezia pachydermatis type strain ATCC 14522 (CBS 1879). The assembly included six chromosomes. The nuclear … Pacific Biosciences (PacBio) long-read sequencing was used to generate a telomere-to-telomere genome assembly for the Malassezia pachydermatis type strain ATCC 14522 (CBS 1879). The assembly included six chromosomes. The nuclear genome was 8.4 Mb, with a GC content of 55.3%, and 4,519 predicted genes.

In vitro susceptibility profiles of 16 antifungal drugs against Trichophyton indotineae

2025-06-23

Wenting Xie , Xue Kong , Hailin Zheng +5 more | Microbiology Spectrum

The worldwide emergence of Trichophyton indotineae has garnered significant attention due to its growing resistance to conventional antifungal therapies, posing significant challenges to the effective management of dermatophytosis. The in … The worldwide emergence of Trichophyton indotineae has garnered significant attention due to its growing resistance to conventional antifungal therapies, posing significant challenges to the effective management of dermatophytosis. The in vitro activities of 16 antifungals were tested against 37 T. indotineae isolates using the broth microdilution method according to Clinical and Laboratory Standards Institute protocol M38-A3. Luliconazole and amorolfine exhibited low MICs, while itraconazole showed moderately decreased susceptibility, making them preferred treatment options. Echinocandins demonstrated favourable in vitro activity against T. indotineae, but their potential as therapeutic alternatives for recalcitrant dermatophytosis remains uncertain due to pharmacokinetic and pharmacodynamic limitations. In contrast, terbinafine, fluconazole, griseofulvin, oteseconazole, isavuconazole, ravuconazole, and amphotericin B exhibited elevated MICs for many strains, with strong correlations between certain azoles, indicating potential cross-resistance. A difference in the susceptibility to terbinafine and voriconazole between Chinese and Indian isolates was observed. These findings could provide valuable insights into antifungal resistance patterns and help guide treatment strategies for T. indotineae infections. Trichophyton indotineae is a novel emerging dermatophyte that has rapidly spread globally in recent years. Its resistance to first-line antifungal agents, particularly terbinafine and fluconazole, has significantly limited treatment options, emphasizing the urgent need for alternative therapies. This study provides comprehensive antifungal susceptibility data for 16 available antifungal agents, offering valuable insights into potential treatment strategies.

Tinea capitis in Hainan: a prospective study

2025-06-23

Wenai Zheng , Feng Qiao , Xianxu Yang +5 more | Frontiers in Cellular and Infection Microbiology

Objective Tinea capitis, a chronic inflammatory disease of the scalp and hair shafts caused by dermatophyte infections, manifests clinically as erythematous lesions, scaling, alopecia, and pustule formation. Hainan, a tropical … Objective Tinea capitis, a chronic inflammatory disease of the scalp and hair shafts caused by dermatophyte infections, manifests clinically as erythematous lesions, scaling, alopecia, and pustule formation. Hainan, a tropical island province in China, exhibits distinctive climatic conditions and demographic contact patterns that could shape its pathogen spectrum. However, comprehensive epidemiological data remain scarce. This study analyzes the epidemiological characteristics and pathogen spectrum of tinea capitis in Hainan, China. Methods This study was undertaken across 11 coastal and inland dermatological centers in Hainan Province (January 2023 to December 2024). A total of 76 tinea capitis patients diagnosed via mycological examination (fungal fluorescence microscopy, fungal culture with species identification) and corroborated by dermatoscopic evaluation were consecutively enrolled. Data on demographic characteristics, exposure history, and clinical manifestations were systematically collated using standardized case report forms. Pathogen subtyping was performed via integrated morphological identification supplemented by molecular biological analysis of the ITS region. Results Among 76 enrolled patients, minors (≤15 years) accounted for 80.26% (61/76), with ≤10-year-olds representing 91.8% (56/61) of pediatric cases. The overall male-to-female ratio was recorded as 1:1.05 (37 males vs. 39 females), while pediatric patients (≤15 years) exhibited a 1.07:1 ratio (31 males vs. 29 females). Animal contact history was reported in 31 cases (40.79%), scalp trauma in 3 cases (3.95%), and co-occurring superficial fungal infections in 12 cases (15.79%). Fungal elements were detected via direct microscopic examination in 64 cases (84.21%). Fungal cultures obtained 45 positive isolates (19 strains in 2023, 26 in 2024), with kerion (inflammatory tinea capitis) exhibiting the highest culture positivity rate, followed by tinea alba. The primary pathogens identified were zoophilic Microsporum canis (M . canis ) (20 cases, 43.79%) and anthropophilic Trichophyton rubrum (T. rubrum ) (9 strains, 19.57%). Clinical manifestations comprised kerion (44 cases, 57.89%), tinea alba (27 cases, 35.53%), and black dot tinea (5 cases, 6.58%). Kerion cases were predominantly linked to M. canis and T. mentagrophytes (interdigital subtype), whereas tinea alba demonstrated infections by M. canis and T. rubrum . Black dot lesions were additionally observed in M. canis infections. Conclusion The primary affected group is children ≤10 years old, with the most common pathogenic fungus being zoophilic M. canis , and clinical classification is predominantly kerion. Dermatologists should pay attention to different transmission routes and pathogen spectra.

Surgical Treatment of Digital Mucous Cysts with Autografting of the Overlying Skin: A Retrospective Observational Study of 29 Cases

2025-06-23

Nilton Gióia Di Chiacchio , Nilton Di Chiacchio , Jorge Ocampo-Gaza +2 more | Skin Appendage Disorders

Introduction: Digital mucous cysts (DMCs) are benign lesions commonly involving the distal interphalangeal joint and proximal nail folds. Although recurrence is common, surgical excision remains the most effective treatment. This … Introduction: Digital mucous cysts (DMCs) are benign lesions commonly involving the distal interphalangeal joint and proximal nail folds. Although recurrence is common, surgical excision remains the most effective treatment. This study assessed the recurrence rate of DMCs following surgical excision with autografting of the overlying skin. Methods: This was a retrospective, observational, and descriptive study based on photographic and medical record review of 29 patients treated between 2008 and 2024, with a minimum follow-up of six months and a mean follow-up of 74.4 months. The surgical procedure involved excision of the DMC, autografting of the overlying skin, and application of Brown’s dressing for 10 days to ensure sustained local pressure. Recurrence was defined as clinical reappearance of the cyst. Results: The cohort had a mean age of 61 years, with 89.7% being female. The recurrence rate was 6.9% (2/29), with both recurrences occurring early (at 3 and 10 months). Notably, no recurrences were observed in toe lesions, despite their high proportion (12/29 cases). Conclusion: Surgical excision followed by autografting of the overlying skin and application of Brown’s dressing resulted in a low recurrence rate. Sustained local pressure appears to promote fibrosis, contributing to long-term cyst resolution.

Five-Year Retrospective Analysis of Superficial Fungal Infections: Insights from Hospital Experience

2025-06-22

Nikoleta Djordjevski , Elizabeta Ristanović , Ana Ćirić +4 more | Journal of Fungi

This study aimed to assess the incidence and distribution of dermatomycetes in patients at the Medical Military Academy (MMA) with suspected superficial skin infections over a five-year period (October 2017 … This study aimed to assess the incidence and distribution of dermatomycetes in patients at the Medical Military Academy (MMA) with suspected superficial skin infections over a five-year period (October 2017 to October 2022) and to analyze variations in fungal infections based on factors such as gender, body part, and time, particularly influenced by the COVID-19 pandemic. A total of 3993 samples were analyzed. Collected data were statistically analyzed with two tests. A total of 1048 samples were positive for fungal infections. Over the study period, Trichophyton mentagrophytes and Trichophyton rubrum were the predominant taxa, while Microsporum canis and Candida albicans were frequently observed. Statistical analysis indicated significant annual variations for T. mentagrophytes, T. rubrum, and M. canis, with monthly differences for T. mentagrophytes in June and August and M. canis in October and December. Gender-based analysis showed that T. rubrum and T. mentagrophytes were more common in males, while M. canis, C. albicans, Candida spp., and Geotrichum candidum were more prevalent in females. Analysis by body part revealed that Trichophyton rubrum and Microsporum canis showed significant differences between surface types. These findings can help improve diagnostic, therapeutic, and preventative strategies.

Antifungal Resistance in Dermatophytes: An Emerging Threat to Global Public Health

2025-06-21

Gerardo García‐González , Gloria M. González , Alexandro Bonifáz | Current Fungal Infection Reports

Uncovering hidden resistance in common dermatophytes through terbinafine era surveillance

2025-06-21

C.-C. Chen , Shiuan‐Chih Chen | Journal of the European Academy of Dermatology and Venereology

Emerging Trichophyton mentagrophytes genotype VII in the United Kingdom

2025-06-20

Alireza Abdolrasouli , Carmel Curtis , Bruce Macrae +7 more | Journal of the European Academy of Dermatology and Venereology

Knowledge and Practices of the Jeddah Population Towards Tinea Pedis: A Cross-Sectional Study

2025-06-20

Alhassan H Hobani , Nouf Alhammadi , Ghadi Ali Hussin Shamakhi +7 more | Cureus

CLINICOMYCOLOGICAL CORRELATION OF DERMATOPHYTOSIS: A CROSS-SECTIONAL STUDY

2025-06-20

Mohit Joshi | Journal of Population Therapeutics and Clinical Pharmacology

Integration of YOLOv8 and FastAPI for Early Detection of Nail Diseases

2025-06-20

Ferdinand Linggo Pakpahan , Joni Satrio Sembiring , Tivanez Ballerina Abellista +1 more | SinkrOn

Nails are important indicators of various health conditions, including fungal infections (onychomycosis), autoimmune disorders (psoriasis), and subungual melanoma (black line). However, early detection of these diseases remains limited due to … Nails are important indicators of various health conditions, including fungal infections (onychomycosis), autoimmune disorders (psoriasis), and subungual melanoma (black line). However, early detection of these diseases remains limited due to low accessibility and public awareness. This study aims to develop an end-to-end, web-based early detection system for nail diseases by integrating the YOLOv8 object detection algorithm with the FastAPI framework. A total of 600 annotated nail images obtained from Kaggle were categorized into four classes: healthy nail, psoriasis, black line, and onychomycosis. The model was trained using PyTorch on Google Colab with GPU acceleration and evaluated using precision, recall, and mean Average Precision ([email protected]). The model achieved a precision of 93%, recall of 88%, and [email protected] of 89%. Manual testing on 100 images via the deployed web application showed an overall accuracy of 97%. Class-wise accuracy reached 100% for healthy nail and psoriasis, 92% for black line, and 96% for onychomycosis. These results demonstrate that the system performs reliably across various conditions. The main contribution of this study is the implementation of a real-time, web-integrated nail disease detection system that is accessible to both medical professionals and the general public. Future research may focus on expanding the dataset, optimizing model robustness under varied lighting and background conditions, and conducting clinical validation.

Efficacy and Safety of Fractional CO2 Laser Therapy for Onychomycosis: A Systematic Review and Meta-Analysis

2025-06-20

Grace Xiong , Jia Bai , Jeemin Kim +1 more | Dermatologic Surgery

Illuminating erythrasma: The significance of Wood’s lamp fluorescence

2025-06-19

M K Khan , Sonika Garg , Gajanand M. Antakanavar +1 more | Cosmoderma

Clinical isolates of the anthropophilic dermatophyte Trichophyton tonsurans exhibit transcriptional regulation of multidrug efflux transporters that induce antifungal resistance

2025-06-18

Suman Samaddar , Moqbel Ali Moqbel Redhwan , Mohan Muttanahally Eraiah +1 more | Molecular Biology Reports

The Rare Presentation of Deep Dermatophytosis‐Trichophyton in an Immunosuppressed Patient

2025-06-17

Jidapa Triwatcharikorn , Nitina Yeesibsean , Jirapon Jesrichai +1 more | JEADV Clinical Practice

ABSTRACT Dermatophytes typically cause superficial skin infections characterized by an active border. However, they can present atypically invading deeper in immunocompromised patients. We present a case of a 72‐year‐old woman … ABSTRACT Dermatophytes typically cause superficial skin infections characterized by an active border. However, they can present atypically invading deeper in immunocompromised patients. We present a case of a 72‐year‐old woman with bullous pemphigoid who had received oral prednisolone for 3 months and developed umbilicated papules. Trichophyton was cultured from the lesions. Atypical dermatophytosis should be strongly suspected in patients with skin lesions who are on immunosuppressive therapy.

A Scoping Review of Pruritic Papular Eruption in People Living With HIV

2025-06-17

Vincent Pecora , Yagiz Matthew Akiska , Adam Friedman | Journal of Cutaneous Medicine and Surgery

Pruritic papular eruption (PPE) is a chronic, intensely itchy skin condition commonly seen in people living with HIV (PLH). While PPE is well documented in regions with high HIV prevalence, … Pruritic papular eruption (PPE) is a chronic, intensely itchy skin condition commonly seen in people living with HIV (PLH). While PPE is well documented in regions with high HIV prevalence, its clinical presentation, risk factors, and treatment strategies in the United States remain poorly characterized. Thus, this study aims to fill critical gaps in understanding PPE among PLH in the United States by investigating its epidemiology, clinical features, and risk factors. A comprehensive literature search across PubMed, Google Scholar, and Cochrane identified 8 papers documenting 11 patients with PPE. Our results showed that the most commonly affected areas included the arms (82%), chest (45%), back (45%), face (36%), neck (36%), and anal cleft (18%). Seven patients (64%) had a concurrent bacterial or fungal infection with Candida albicans (42.9%) and Treponema pallidum (42.9%). Candida lesions were most commonly seen in the oral mucosa and inguinal or anal clefts. Overgrowth of commensal organisms such as Demodex folliculorum was also noted in or around the pilosebaceous units for 28.6% of patients. The most common treatment strategies include antiretroviral therapy and adjuvant corticosteroid or ultraviolet B phototherapy which helped relieve the pruritis associated with papulonodular lesions. These findings highlight how PPE may serve as a marker for severe immunosuppression among PLH. In HIV patients who present with a rapid onset of pruritic lesions, PPE should be a key consideration in the differential diagnosis. In these patients, thorough physical examination and further diagnostic evaluation for potentially associated infections is warranted.

IMPLANTAÇÃO DO AMBULATÓRIO DE PEQUENAS CIRURGIAS DERMATOLÓGICAS EM UNIDADE DE ATENÇÃO SECUNDÁRIA DO SUS

2025-06-16

Lorena Silva de Carvalho , Maraya de Jesus Semblano Bittencourt , Rafael Oliveira Chaves | Revista Políticas Públicas & Cidades

Os elevados custos de hospitalização para o tratamento de doenças ressaltam a importância da abordagem precoce de tumores e outras patologias dermatológicas. A demora no atendimento agrava o quadro clínico … Os elevados custos de hospitalização para o tratamento de doenças ressaltam a importância da abordagem precoce de tumores e outras patologias dermatológicas. A demora no atendimento agrava o quadro clínico e, consequentemente, aumenta os custos para o Sistema Único de Saúde (SUS) do Brasil. Objetiva-se descrever a experiência de implantação do Ambulatório de Pequenas Cirurgias Dermatológicas no Centro de Especialidades Médicas e Odontológicas de Belém/Pará (CEMO), uma unidade de atenção secundária do SUS. A implantação do ambulatório foi realizada principalmente com a utilização dos recursos humanos e da infraestrutura já existentes no centro de atendimento. Além disso, foi elaborado um protocolo e um fluxo de atendimento para a realização de biópsias de pele com finalidade diagnóstica, aplicação de medicamentos intradérmicos, tratamento de afecções ungueais cirúrgicas e manejo de cânceres de pele ou outros tumores em estágio inicial. A criação do ambulatório permitiu a redução da demanda cirúrgica dermatológica, a diminuição do tempo de espera para o tratamento de determinadas doenças dermatológicas e a redução dos custos associados à hospitalização no nível de atenção terciária do SUS. Portanto, o Ambulatório de Pequenas Cirurgias Dermatológicas mostrou-se uma estratégia eficaz para melhorar a assistência dermatológica no sistema público de saúde, favorecendo o diagnóstico precoce e otimizando o uso dos recursos.

Sexually Transmitted Psoriasis-like Kerion of the Pubis and Vulva

2025-06-16

Stefano Veraldi , Paolo Bortoluzzi , Francesca Germiniasi +1 more | Acta Dermato Venereologica

Characterization of Biofilm Formation by the Dermatophyte Nannizzia gypsea

2025-06-14

Bruno B. A. Arantes , Ana Karla Lima Freire Cabral , Kelvin Sousa dos Santos +7 more | Journal of Fungi

Dermatophytosis is a fungal infection that affects the skin, hair, and nails, impacting approximately 25% of the global population. Nannizzia gypsea is a geophilic fungus that can cause infections in … Dermatophytosis is a fungal infection that affects the skin, hair, and nails, impacting approximately 25% of the global population. Nannizzia gypsea is a geophilic fungus that can cause infections in humans and animals. Several studies have been conducted regarding its virulence, or ability to cause disease. This species may produce keratinolytic enzymes and form biofilms, which can increase resistance to treatment. Thus, this study focuses on investigating the biofilm formation of N. gypsea isolated from canine dermatophytosis using an ex vivo hair model, its biofilm extracellular matrix macromolecular contents, and the expression of genes involved in the colonization of keratinized surfaces. The biofilm was analyzed for metabolic activity using the XTT reduction assay, crystal violet staining to measure biofilm biomass, scanning electron microscopy (SEM), and the presence of polysaccharides, proteins, and extracellular DNA in the biofilm extracellular matrix. The virulence genes subtilisin 7, fungalysin (extracellular metalloproteinase), and efflux pump (Multidrug and Toxin Extrusion Protein 2) were evaluated by qPCR, comparing the planktonic and biofilm phenotypes. N. gypsea formed a robust biofilm, which matured after 5 days. Scanning electron microscopy (SEM) revealed the presence of an extensive extracellular matrix. In the hair model, the characteristic ectothrix parasitism of the species is observable. The gene expression analysis revealed a higher expression of all evaluated genes in the biofilm form compared to the planktonic form. Thus, N. gypsea exhibits a biofilm characterized by a robust extracellular matrix and high gene expression of factors related to pathogenesis and resistance.

Abstract P2-08-18: De-Escalating Axillary Surgery in Nigeria: a phase II Single Arm Trial Protocol

2025-06-13

Gregory Knapp , Olalekan Olasehinde , Rheann Brownstone +7 more | Clinical Cancer Research

Abstract Introduction: Breast cancer is the most common cancer and cause of cancer related mortality in Nigeria. The majority of women present with locally advanced disease. The current standard of … Abstract Introduction: Breast cancer is the most common cancer and cause of cancer related mortality in Nigeria. The majority of women present with locally advanced disease. The current standard of care for these women is neoadjuvant chemotherapy (NAC) followed by modified radical mastectomy, including complete axillary lymph node dissection (ALND). Within the last decade, the de-escalation of axillary surgery has been extended to women who present with clinically node positive (cN1) disease who are converted to clinically node negative (cN0) after NAC. In this setting, a sentinel lymph node biopsy (SLNB) is performed using a dual-tracer localization technique with methylene blue and Tc-99 sulfur colloid. This is prohibitive to axillary de-escalation in many low- and middle-income countries (LMICs) where the nuclear medicine infrastructure, to support access to Tc-99 sulfur colloid lymphoscintigraphy, is limited. To overcome the challenge posed by the dearth of Tc-99 radiocolloid in Nigeria, this study seeks to evaluate the feasibility and efficacy of pre-operative axillary ultrasound (aUS) and a single agent (methylene blue) SLNB to stage the axilla in women converted from cN1 to cN0 disease after NAC. Methods: This is a phase II, single arm trial being conducted at Obafemi Awolowo University Teaching Hospital (OAUTH) Ile-Ife, Nigeria. Initial inclusion criteria include: women ≥ 18-70 years of age, biopsy confirmed invasive carcinoma of the breast and clinically palpable N1 disease (cN1). Eligible patients have an aUS and if abnormal nodes are present the most suspicious undergoes core biopsy and clip placement. Patients with pathology confirmed TanyN1M0 disease will undergo NAC with curative intent as per institutional standards at the discretion of the treating surgeon. Patients with a clinical complete response (cN0) at the completion of NAC will have a pre-op aUS. At the time of the operation, 5ml of 1% methylene blue is injected in an intra-parenchymal fashion with a 5-minute message. A sentinel lymph node will be classified as blue and/or suspicious by the operating surgeon. Surgeons performing the procedure have obtained additional training in the SLNB technique. Each sentinel lymph node will be removed and labelled separately and sequentially. A completion ALND (level 1-2) will be performed as per institutional practice and the contents labelled separately. Performance of the pre-operative clinical exam, aUS, SLNB and clipped node will be determined for each eligible patient. The study as research ethics board approval from OAUTH and was registered on clinicaltrials.gov prior to study initiation (NCT06039956). Results: As of June 2024, 37 patients have met initial inclusion criteria and have been consented and enrolled into the study. Nine of these have completed NAC and 6 have gone on to receive surgery as per the study protocol with a methylene blue only SLNB followed by completion axillary dissection. We expected to enrol 50 patients within the first year of the study. Target enrolment is 210 patients, which assumes a pCR of 30% and a FNR of 20% with 80% power to report on performance characteristics of the study intervention with 95% confidence intervals. Discussion: Tc-99 sulfur colloid is not readily available in many LMICs. We have designed and commenced the implementation of a protocol to study the de-escalation of axillary surgery for women who present with locally advanced, node positive breast cancer in a low-resource environment using readily available technology. Citation Format: Gregory Knapp, Olalekan Olasehinde, Rheann Brownstone, Omisore Oluwatosin, Adewale Aderounmu, Funmilola Wuraola, Toyosi Teniola Sotala, Omolade Betiku, Anya Romanoff, Folasade Adeyemi, Victoria Mango, Marcia Edelweiss, T. Peter Kingham, Olusegun Alatise. De-Escalating Axillary Surgery in Nigeria: a phase II Single Arm Trial Protocol [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-08-18.

Brittle nails and hypertriglyceridaemia in a 9-year-old boy

2025-06-13

Mossaab Hassoun | Archives of Disease in Childhood Education & Practice

Intra‐Operative Onychoscopy of Subungual Epidermoid Inclusions

2025-06-13

G. Theodosiou , Peter C. Schalock , Åke Svensson | The Journal of Dermatology

ABSTRACT Subungual epidermoid inclusions (SEI) are small epithelial inclusions, sometimes solid but mostly with central keratinization of the onycholemmal type without a granular layer. Exceptionally, they become large enough to … ABSTRACT Subungual epidermoid inclusions (SEI) are small epithelial inclusions, sometimes solid but mostly with central keratinization of the onycholemmal type without a granular layer. Exceptionally, they become large enough to produce symptoms such as pain or swelling of the nail bed, resulting in subungual keratosis, onycholysis, or a dystrophic nail plate. Herein, we report a further case of SEI in a female patient with onychodystrophy of the great toe nail and highlight the onychoscopic features of SEI. Intra‐operative onychoscopy facilitates the detection of SEI during a nail bed biopsy and reduces the risk of obtaining inadequate specimens for histopathologic examination.

Lichen Planopilaris: The Alopecia We Cannot Overlook

2025-06-13

Ignacio Javier | Research Square (Research Square)

<title>Abstract</title> Lichen planopilaris (LPP) is a rare chronic inflammatory condition affecting the hair follicles, often resulting in scarring alopecia if not promptly diagnosed and managed. We present the case of … <title>Abstract</title> Lichen planopilaris (LPP) is a rare chronic inflammatory condition affecting the hair follicles, often resulting in scarring alopecia if not promptly diagnosed and managed. We present the case of a 65-year-old woman who visited primary care due to progressive hair loss, pruritus, and scalp inflammation. Initial empirical treatment with topical agents provided partial relief. Dermatology consultation confirmed the diagnosis of LPP, and systemic corticosteroid therapy was initiated. Early recognition and coordinated management with dermatology helped stabilize the condition. This case highlights the importance of early identification of inflammatory scalp conditions in primary care. Categories: Family/General Practice, Dermatology, Allergy/Immunology

HERBAL REMEDIES FOR ONYCHOMYCOSIS: TARGETING INFLAMMATION AND FUNGAL INFECTIONS

2025-06-12

Manish Sharma , Manmeen Kaur , Ravinesh Mishra +1 more | Journal of Population Therapeutics and Clinical Pharmacology

Climate Change, Natural Disasters, and Cutaneous Fungal Infections

2025-06-12

Aditya K. Gupta , Mary J. Thornbush , Tong Wang | International Journal of Dermatology

ABSTRACT Fungal infections are an important source of morbidity and mortality that can manifest as superficial or invasive diseases. Diagnostic techniques for human fungal pathogens remain problematic, and multi‐drug resistance … ABSTRACT Fungal infections are an important source of morbidity and mortality that can manifest as superficial or invasive diseases. Diagnostic techniques for human fungal pathogens remain problematic, and multi‐drug resistance is emerging. This review addresses the potential emergence of new fungal pathogens in changing environments and reported instances of cutaneous fungal infections after natural disasters. Global warming does more than increase the mean global temperature; it is associated with changing precipitation patterns and major climatic events. With natural disasters, niches are created for the proliferation of fungal pathogens affecting humans across previously existing geographical boundaries. Here, we reviewed reports of cutaneous fungal infections after natural disasters, including earthquakes, floods, tsunamis, hurricanes, and tornadoes. Of importance is the potential for thermal adaptation leading to the evolution of new human pathogens, exacerbated by the elevated environmental fungal levels in disaster situations. Studies have documented higher risks of contracting typical tinea infections, as well as opportunistic, trauma‐related infections by environmental fungi. The latter is especially concerning due to atypical clinical presentations that could lead to treatment delays, antifungal resistance, and systemic complications. These support the importance of considering climate change as affecting the adaptation of these pathogens and the consequences of this change for human populations. A One Health framework should be advocated to address the impact of climate change on dermatological care.

Langsam wachsender atypischer Nodus der Ellenbeuge

2025-06-11

Christina Naoum , Ferdinand Toberer | Deleted Journal

Development of a Novel Luliconazole SLN Gel for Enhanced Topical Antifungal Therapy

2025-06-11

Chandraprakash Rajwade | INTERANTIONAL JOURNAL OF SCIENTIFIC RESEARCH IN ENGINEERING AND MANAGEMENT

ABSTRACT Background: A common therapy for superficial fungal infections is luliconazole, a broad-spectrum imidazole antifungal medication. Its short skin retention period and restricted water solubility, however, limit its therapeutic effectiveness … ABSTRACT Background: A common therapy for superficial fungal infections is luliconazole, a broad-spectrum imidazole antifungal medication. Its short skin retention period and restricted water solubility, however, limit its therapeutic effectiveness when applied using traditional topical formulations. Objective: The goal of this study is to create and assess a new topical gel of luliconazole based on solid lipid nanoparticles (SLN) in order to improve skin penetration, extend retention, and offer controlled drug release. Methods: Stearic acid was used as the lipid matrix and Poloxamer 188 as the surfactant in the hot homogenization followed by ultrasonication procedure to create miconazole-loaded SLNs. To create a topical gel, the optimized SLN dispersion was mixed with a Carbopol 934 gel basis. Particle size, zeta potential, drug entrapment effectiveness, pH, viscosity, and in vitro drug release were all evaluated for the formulation. Keywords: Broad-spectrum, Solid lipid nanoparticles (SLN), Homogenization, Dispersion.