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Ringworm/Dermatophytosis/Tinea Infections
Published in Charles Theisler, Adjuvant Medical Care, 2023
Topical antifungal creams, liquids, or sprays such as clotrimazole (Lotrimin Ultra), econazole (Spectrazole), and terbinafine (Lamisil) are commonly recommended treatments for tinea corporis, tinea cruris, and tinea pedis. Ketoconazole should not be used to treat tinea infections.2
Ringworm
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Tinea cruris (jock itch) most commonly affects adolescent and young adult males and involves the portion of the upper thigh opposite the scrotum. The scrotum itself is usually spared in tinea cruris but involved in candidiasis. A Wood's lamp examination may be helpful to distinguish tinea from erythrasma because the causative organism of erythrasma (Corynebacterium minutissimum) exhibits a coral red fluorescence. However, results of the Wood's lamp examination can be falsely negative if the patient has bathed recently.
Skin infections
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
Tinea cruris or groin ringworm is very itchy and is for the most part a disorder of young men. Well-defined, itchy, red scaling patches occur asymmetrically on the medial aspects of both groins (Fig. 4.6). These gradually extend down the thigh and on to the scrotum unless treated. T. rubrum and E. floccosum are the causative fungi. Differential diagnosis includes seborrhoeic dermatitis or intertrigo – where the rash is symmetrical and does not have a well-defined border (see p. 123), and flexural psoriasis. When tinea cruris is extensive the possibility of host immunosuppression or human immunodeficiency virus (HIV) infection should be considered.
Evaluation of efficacy and safety of oral terbinafine and itraconazole combination therapy in the management of dermatophytosis
Published in Journal of Dermatological Treatment, 2020
Priyanka Sharma, Mala Bhalla, Gurvinder P. Thami, Jagdish Chander
In the present study, a combination of terbinafine 250 mg and itraconazole 200 mg daily was found to have a significantly higher clinical and mycological cure rate of 90% at 3 weeks as compared to monotherapy with the same drugs. The in vitro as well as clinical synergism between terbinafine and itraconazole has been well documented against isolates of Fonsecaea, Candida albicans, Aspergillus, Scedosporium, Fonsecaea, and various other dematiaceous molds (9–11). However, the clinical or in vitro synergism of this combination has not yet been established in the treatment of tinea cruris or corporis or dermatophyte isolates. The combination of terbinafine 250–1000 mg/day and itraconazole 200–400 mg/day for 2–7 months has also been found to be effective in the treatment resistant cases of chromoblastomycosis (10). Theoretically, inhibition of squalene epoxidase and lanosterol 14-demethylase by terbinafine and itraconazole, respectively, results in dual and sequential inhibition of fungal ergosterol biosynthesis which serves as a bioregulator of membrane fluidity and integrity of fungal cells (20).
Diagnostics and management approaches for Acanthamoeba keratitis
Published in Expert Opinion on Orphan Drugs, 2020
Nóra Szentmáry, Lei Shi, Loay Daas, Berthold Seitz
Miconazol (C18H14Cl4N2O) is an antifungal synthetic derivative of imidazole. It is used in the treatment of candidal skin and vaginal infections and selectively affects the integrity of fungal cell membranes. Miconazole is high in ergosterol content, differs in composition from mammalian cell membranes, and can only be found in individuals who used or took this drug. As an imidazole antifungal agent, it is applied topically or given by intravenous infusion and interacts with 14-α demethylase, a cytochrome P-450 enzyme, which is necessary to convert lanosterol to ergosterol. Within the fungal cell membrane, ergosterol is a vital component, and the inhibition of its synthesis results in increased cellular permeability which ultimately causes leakage of cellular contents. Miconazole may also inhibit endogenous respiration, interact with membrane phospholipids, inhibit the transformation of yeasts to mycelial forms, inhibit purine uptake, and impair triglyceride and/or phospholipid biosynthesis. The indications for use are topical application in the treatment of tinea pedis, tinea cruris, and tinea corporis caused by Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum, in the treatment of cutaneous candidiasis (moniliasis) and in the treatment of tinea versicolor.
Tofacitinib in the treatment of refractory eczemas – a case series
Published in Journal of Dermatological Treatment, 2022
Prasanna Duraisamy, Soumya Jagadeesan, Jacob Thomas
Eleven patients (91.6%) had a baseline PGA of 4 indicating a severe disease and one patient had a baseline PGA of 3 indicating a moderate disease. All 12 patients noted improvement following treatment. Ten patients had reduction in PGA to 0/1 (clear or almost clear) after one month of therapy. Two patients had reduction in PGA to 2 (from severe disease to mild disease). This improvement was maintained during follow-up visits. Adverse events noted during the treatment period included weight gain in one patient and infections in three patients (tinea cruris in one, scabies in one and perianal abscess in one). No hematological or biochemical abnormalities were noted during the treatment period. Characteristics of the patients in this series are shown in Table 1.