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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Patients who have sensory neuropathies have impaired sensation of pain. Therefore, they not know of foot trauma caused by shoes that do not fit correctly, weight bearing that is improper, hard objects inside shoes, or athlete’s foot and other infections. Since those with neuropathy cannot detect pain, they may walk in a way that causes trauma and necrosis to areas of the feet. According to the National Institute of Diabetes and Digestive and Kidney Diseases in 2018, 15% of diabetics develop foot ulcers, and of these, 12%–24% require amputation. The issue of diabetic foot ulcers is most concerning in Hispanic, African, and Native Americans since they have the highest prevalence of diabetes in the world.
Dermatomycoses
Published in Raimo E Suhonen, Rodney P R Dawber, David H Ellis, Fungal Infections of the Skin, Hair and Nails, 2020
Raimo E Suhonen, Rodney P R Dawber, David H Ellis
Tinea pedis (Figures 2.1–2.6) is a fungal infection of the foot that may involve the toe webs. It is often called athlete’s foot and is the most common fungal infection. Hot, moist climates are particularly conducive to clinical manifestation. Genetic predisposition is known to occur for plantar type of tinea pedis.
Superficial mycoses in the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
B. P. Glick, M. Zaiac, G. Rebell, N. Zaias
In adults, especially the elderly, the toe webs, groin, axillae and inframammary folds are most commonly involved. Inframammary intertrigo is perhaps the most common form of Candida infection presenting to the physician and dermatologist (Figure 7). Other areas less commonly involved include the belt line and buttocks. In the toe webs itching, redness and the development of erosions constitute an important episodic or chronic component of the ‘athlete’s foot’ syndrome. In addition, cutaneous candidiasis may be found in occupational skin disease in those patients whose hands are frequently immersed in water or irritated by detergents, resulting in chronic inflammation and infection of the perionychium and interdigital spaces. These findings are especially common in females. As our graying population grows and lives longer, it is probable that more and more geriatric occupational diseases will be seen and it may well be that Candida infections become a primary or secondary contributor to occupational skin disorders.
Innovative nanocompounds for cutaneous administration of classical antifungal drugs: a systematic review
Published in Journal of Dermatological Treatment, 2019
Rafael Silva Santos, Kahynna Cavalcante Loureiro, Polyana Santos Rezende, Luciana Nalone Andrade, Raquel de Melo Barbosa, Antonello Santini, Ana Cláudia Santos, Classius Ferreira da Silva, Eliana Barbosa Souto, Damião Pergentino de Sousa, Ricardo Guimarães Amaral, Patrícia Severino
Souto et al. (58) showed that SLN were able to sustain clotrimazole topical delivery for a period of 10 h, displaying desirable occlusive properties. Chen et al. (59) developed terbinafine-loaded SLN by using the microemulsion technique. The objective was to decrease the drug administration frequency and the duration of ‘athlete’s foot’ treatment. SLN were produced within the size range of 80–200 nm and remained stable for 56 days. In vivo assay using the hairless skin of nude mice was used to compare the SLN formulation with the marketed Lamisil OnceTM cream. Results demonstrate that SLN formulation increased the cutaneous penetration of terbinafine in the dermis attributed to a deeper SLN contact to the epidermis, allowing prolonged drug release (59). In work published by Vaghasiya et al. (64), terbinafine-loaded SLN gel exhibited skin retention and targeting abilities when compared to Daskil®, a commercial cream. SLN-based gel reduced the fungal burden of C. albicans in rats as compared to the commercial product in a shorter duration of time and thus, was considered more effective than the commercial counterpart. Similar conclusions were drawn by Wavikar and Vavia (65), in a terbinafine-loaded SLN gel producing enhanced skin deposition of the drug versus plain terbinafine, a 3-fold enhancement, and marketed terbinafine formulation, 2-fold enhancement. The developed formulations significantly increased the antifungal activity against C. albicans, showing efficient occlusion, and lack of any skin irritation in rabbits.
Consumer preferences of antifungal products for treatment and prevention of tinea pedis
Published in Journal of Dermatological Treatment, 2019
Tinea pedis is a common condition, either as a chief or as a secondary complaint in primary care and dermatologic practice, presenting with symptoms of itching, burning, and/or pain (11). Often, this condition precedes and/or occurs concurrently with onychomycosis (12). In addition, a history of tinea pedis more than doubles the risk of onychomycosis, with complete cure rates of onychomycosis shown to considerably improve with treatment of co-existing tinea pedis (5). After successful treatment of onychomycosis, treatment of tinea pedis is essential in preventing recurrences (5). Therefore, patients are advised to use antifungal sprays/powders in shoes, apply antifungal creams to the feet, and to treat all signs of athlete’s foot as soon as symptoms are evident (12).