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Superficial and Mucosal Fungal Infections
Published in Johan A. Maertens, Kieren A. Marr, Diagnosis of Fungal Infections, 2007
Peter G. Pappas, Bethany Bergamo
Tinea cruris involves the medial upper thighs and the inguinal, pubic, perineal, and perianal area. Other names include jock itch, ringworm of the groin, and tinea inguinalis. Tinea cruris has a worldwide distribution, though more common in warm and moist environments. T. rubrum is the most common pathogen, although E. folliculosum and T. mentagrophytes are also important causes.
Radiant Health
Published in Alan Perkins, Life and Death Rays, 2021
In the same way that the use of X-rays for beauty treatments had undesirable effects, mass X-ray epilation treatment carried out for improving health and hygiene resulted in equally bad consequences for many thousands of people. Ringworm, also known as dermatophytosis, is not in fact a worm as the name suggests but a fungal infection that can affect the body and scalp of both humans and animals. Ringworm is caused by three different types of fungus and can occur after contact with soil or an infected individual. The infection produces patches with a characteristic round shape resembling a circular worm, hence the name. Ringworm of the groin inner thighs and buttocks is known as ‘jock itch’. Athlete’s foot is the common name for ringworm of the foot, which commonly occurs in people who go barefoot in gym showers, locker rooms and swimming pools. Ringworm of the scalp (tinea capitis) is a more disfiguring condition that was particularly common in children up until the 1960s, causing unsightly itchy, scaling bald patches. Ringworm was commonly associated with poor diet, poverty and neglect. Visible ringworm infections were viewed with disgust. The afflicted were considered unclean and stigmatised as people feared infection. Although it was never a reportable disease, in Russia, France and some countries of Central and Southern Europe, the incidence of ringworm was so severe that special schools were established for children with infectious scalps. As mentioned in a previous chapter thallium salts had previously been used to treat ringworm. In addition to manual removal of hair the topical treatments for curing ringworm included carbolic acid, sulphur, wood tar and mercuric chloride that caused painful burning to both the affected areas and the surrounding normal skin, often resulting in further infection. The answer for an inexpensive and effective cure was found with X-ray irradiation. It is thought that two doctors in Vienna, Freund and Schiff, were the first to try X-rays to treat ringworm cases but it was Raimond Sabouraud, a French dermatologist, who gained the reputation for pioneering the X-ray treatment of infected scalps. This method had been systematically developed to reduce the radiological damage to skin whilst delivering a course of irradiation to cause epilation. X-rays had two advantages over the use of fungicides in that they reduced treatment times from years to months and produced a permanent cure.
The Integumentary (Dermatologic) System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Numerous topical dosage forms are available. Wet dressings provide evaporative cooling, which causes constriction or narrowing of the blood vessels. Wet dressings are utilized to soothe and cool inflammation, dry oozing lesions, soften crusts, and aid in cleaning and draining of wounds. They are most useful for acute inflammatory lesions, erosions, and ulcerations. Agents used include normal saline and solutions of aluminum acetate, potassium permanganate, silver nitrate, and acetic acid. Other forms of topical administration are baths, powders, emulsions, gels, creams, ointments, and aerosols. Ointment bases are most useful for chronic scaling lesions that are lichenified (having thickened layers that appear in patches; named for lichen, a moss-like plant that grows in patches on rocks and other surfaces). Ointments are used for their occlusive properties. Gels are colloidal suspensions that have set to form a jelly-like substance and are used similarly to ointments. Powders are used primarily to decrease friction and irritation in intertriginous areas (literally, "between triangles"; areas where two skin surfaces touch, such as between fingers and under the arms). Powders, therefore, are often used to treat athlete's foot, jock itch, and diaper rash. They are also utilized for prevention of decubitus ulcers or bedsores. Lotions are used to treat superficial skin disorders or if significant inflammation and tenderness are present, such as in acute contact dermatitis. Liquid oil-in-water or water-in-oil emulsions are useful in conditions where dry skin predominates. They are utilized as vehicles for insoluble medications. Creams, which are semisolid, oil-in-water emulsions, are the vehicles used most often in dermatology. They are useful for application on nonirritable chronic skin conditions. Aerosols are useful if direct contact with the skin causes pain.
Olive oil and clove oil-based nanoemulsion for topical delivery of terbinafine hydrochloride: in vitro and ex vivo evaluation
Published in Drug Delivery, 2022
Uzma Gul, Muhammad Imran Khan, Asadullah Madni, Muhammad Farhan Sohail, Mubashar Rehman, Akhtar Rasul, Leena Peltonen
TF-HCl is used in the treatment of fungal nail infections and ringworm as well as in jock itch and athlete’s foot. Based on previous clinical findings, TF-HCl has a better therapeutic profile (low minimum inhibitory concentration (MIC) for various fungal species, short duration of therapy, and low relapse rate) when compared to other antifungals such as imidazoles, triazoles, polyene antimycotics, and pyrimidine analogs (Hinojosa et al., 2007).
Nanotechnological interventions in dermatophytosis: from oral to topical, a fresh perspective
Published in Expert Opinion on Drug Delivery, 2019
Riya Bangia, Gajanand Sharma, Sunil Dogra, Om Prakash Katare
Both oral and topical terbinafine can be highly efficacious in treating dermatophytosis and have been widely used. Food and Drug Administration (FDA) has approved this drug for the therapy of interdigital-type tinea pedis (athlete’s foot), tinea corporis (ringworm), and tinea cruris (jock itch). Studies suggest that terbinafine 1% cream can be used once daily and for a shorter duration [31,32].
Evaluation of topical econazole nitrate formulations with potential for treating Raynaud’s phenomenon
Published in Pharmaceutical Development and Technology, 2019
Dherya Bahl, Saloni Daftardar, Rinda Devi Bachu, Sai H. S. Boddu, Nezam Altorok, Bashar Kahaleh
For treating RP following topical application, drug molecules should penetrate the dermis in effective concentrations. The marketed cream of 1% EN is only approved for treating superficial fungal infections and partial seated fungal infections because of insufficient drug penetration into the deeper skin layers (Heel et al. 1978). The currently marketed topical EN product retains almost all the drug on the stratum corneum and about half on epidermal layer and does not penetrate to deeper layers or systemic circulation (only 1–3% of the dose was found to be absorbed) (Schaefer and Stüttgen 1976). This is mainly due to its extreme lipophilicity. Moreover, studies with increased occlusion of the formulation on the same surface area of skin reported no increase in absorption of the drug (Heel et al. 1978). Also, the current marketed EN formulation (1% cream) is FDA approved to treat tinea pedis (athlete’s foot), tinea cruris (jock itch), tinea corporis, and tinea versicolor (yeast infections), all of which are superficial fungal infections and not deep-seated fungal infections (Heel et al. 1978). This proves severely diminished penetration ability of the marketed topical formulation. Furthermore, in the commercial product, the drug is found to be partially insoluble, thus stability issues in the form of physical phase separation of the cream due to drug salting out effects have been reported in the past (Heel et al. 1978; Firooz et al. 2015). Thus, severe pharmaceutical and pharmacological deficits have been depicted in the commercial formulation. Thus, deficits in the commercial formulation and topically suitable properties of the drug provides room for improvement and gives way for a formulation base, which could incorporate a higher concentration of the drug as well as enhance the drug penetration into the target layers of the skin. The higher thickness of the stratum corneum near the digits of the hands makes the permeation of EN even more challenging. We hypothesize that a new topical formulation of EN that could accommodate a higher strength of the drug would enhance the drug absorption and produce an acute response to a RP attack. This present study intends to develop and evaluate topical formulations of EN with potential for treating RP. EN was incorporated into four different formulations (F1_topical solution, F2_HPMC dispersion, F3_VersaBase® cream, and F4_Lipoderm® Activemax™ Cream) at 3% w/w concentration, and the amounts of the drug penetrating from these preparations into the different layers of porcine ear skin were investigated. These results were further compared with the marketed 1% EN cream. To the best of our knowledge, this work will be a first-of-its-kind topical treatment, with an imidazole antifungal candidate to treat RP, as an additional indication.