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The Fungi
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Dermatophytic infection is initiated by the deposition of fungal elements onto the skin, hair, or nails. These infectious units either gain a foothold and grow or are lost. Friction, abrasion, and moisture enhance the ability of the fungi to colonize. Conidia germinate and form hyphae which invade the tissue and hair follicles and then fragment, resulting in the production of arthroconidia (referred to as microco-nidia) (Figure 18.1). The microconidia germinate and produce more hyphae and the cycle continues until the infection is resolved. Infected hair grows out thick and brittle. Circular red skin lesions expand with healing in the center. To the early workers, this characteristic growth of the lesion suggested the presence of a worm growing within the skin, hence the name, ringworm. The periphery is the active area of fungal growth and of the host response to the fungal irritants. This inflammatory response results in the overproduction of keratin which causes the scali-ness and thickening of the skin characteristic of these infections. Infection is almost always limited to the stratum corneum although the intense itching and scratching may result in the development of secondary bacterial infections.
One disease protects from another disease
Published in Dinesh Kumar Jain, Homeopathy, 2022
These observations are very important because homeopathy is based on these observations. If we can prove that these observations are wrong, then undoubtedly we can say that homeopathy is also wrong. Kent observed that patients with diabetes, tuberculosis, and Bright's disease cannot suffer from any other infection like dysentery or smallpox. But what are the facts? “Diabetic patients also suffer from diarrhoea” (Foster, 1983, p. 675). Other diseases having dissimilar symptomatology also exist with diabetes and it is against the rule of homeopathy that diseases of dissimilar symptomatology cannot exist together in a patient. Malignant external otitis and rhinocerebral mucormycosis, which are characterized by periorbital and perinasal swelling, pain, blood nasal discharge, and increased lacrimation, also exist with diabetes. Diabetes is characterized by thirst, polydipsia, polyuria, nocturia, tiredness, loss of weight, white marks on clothing, impotence, pruritus vulvae, and paresthesia or pain in limbs. Emphysematous cholecystitis is a variant of gallbladder disease that tends to affect diabetic men. Infestations of the skin with candida and dermatophytes are common and bacterial infections of a variety of types also occur (Foster, 1983, pp. 677–678).
Superficial mycoses in the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
B. P. Glick, M. Zaiac, G. Rebell, N. Zaias
Treatment of dermatophyte infections includes control of local and environmental factors such as moisture and temperature as well as the use of topical and systemic antimycotic therapies. Single or few lesions of tinea infection can best be treated by topical antifungal creams or gels, which tend to serve as a drying agent. Currently available topical antimycotic therapies include topical azoles (e.g. ketoconazole, econazole, oxiconazole and others), ciclopirox olamine, allylamines, (e.g. naftifine, terbinafine) and the newer benzylamines (e.g. Mentax). Azoles are fungistatic and are applied b.i.d. typically for 2 to 4 weeks. Allylamine and benzylamine antimycotics are fungicidal and provide the advantage of reduced dosing frequency and overall duration of therapy, usually 1 to 2 weeks8,9.
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
Recurrence rate following itraconazole monotherapy has been found to be very low in the treatment of dermatophytosis in previous studies (15,17). However, in the present study, higher recurrence rate was noted with itraconazole as compared to terbinafine monotherapy which can be attributed to its fungistatic action. On the other hand, the fungicidal property of terbinafine and its ability to persist in stratum corneum for several months after stopping the treatment may be responsible for its low relapse rate (21). The combination therapy was found to have the lowest recurrence rate when compared to monotherapy with either of the drugs. One patient who had taken combination therapy showed recurrence of lesions at 9 weeks follow up who had positive family history of active dermatophytic infection that might have lead to re-infection rather than relapse of infection.
Strategies to improve the diagnosis and clinical treatment of dermatophyte infections
Published in Expert Review of Anti-infective Therapy, 2023
Dermatophyte infections are the most common fungal skin infections that affect not only the skin but also the hair and nails and, based on their anatomic localization, exhibit different clinical findings or mimic different dermatological diseases [1]. Owing to misdiagnosis based on their these clinical similarities patients with inflammatory diseases may receive antifungal treatment for several years, whereas those with dermatophyte infections may use steroid creams for years. Therefore, misdiagnosis and inappropriate treatment can lead to: (i) spread of the disease to other individuals, (ii) unnecessary treatment, and (iii) drug-related complications [2].
Biological investigation of N-methyl thiosemicarbazones as antimicrobial agents and bacterial carbonic anhydrases inhibitors
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2022
Ilaria D’Agostino, Githa Elizabeth Mathew, Paola Angelini, Roberto Venanzoni, Giancarlo Angeles Flores, Andrea Angeli, Simone Carradori, Beatrice Marinacci, Luigi Menghini, Mohamed A. Abdelgawad, Mohammed M. Ghoneim, Bijo Mathew, Claudiu T. Supuran
Antimicrobial resistance (AMR) has been defined as “a slow tsunami” able to fast blow all currently available antibiotic treatments1. The recent public health emergency of the COVID-19 pandemic contributed to the dramatic increase of the AMR phenomena2 due to the high rate of prescribed antibiotics in hospitalised patients, despite the causative agents being identified in less than one-third of the cases3. In addition, COVID-19 containment campaigns led to an overuse of sanitisers and biocides, promoting cross-resistance and reduction or loss of antibiotic sensitivity4,5. Several cases of secondary infections from the bacteria Pseudomonas aeruginosa and Staphylococcus aureus6,7 and the opportunistic fungi from Candida species8,9 were recorded and are alerting the scientific community. Moreover, besides systemic fungal infections, mycoses of skin, nails, and hair caused by dermatophytes are generating a great concern, since they are estimated to affect a large percentage of the global population10. Indeed, even if not lethal, these infections negatively impact the quality of life of patients and can become invasive in immunocompromised and predisposing conditions11. However, although the link between inflammatory skin conditions and COVID-19 is not proven, patients with a defective skin barrier are more susceptible to other infections, worsening the risk of contracting COVID-19-related diseases12. Furthermore, resistant phenotypes along with non-standardized treatment protocols impair the outcomes11, especially for diseases due to Trichophyton species, one of the commonest dermatophytes infecting mammals.