Dermatophytosis
Mahmoud A. Ghannoum, John R. Perfect in Antifungal Therapy, 2019
Tinea cruris, or “jock itch,” is an invasion of the hair follicles that can easily be confused with cutaneous candidal infection. It is most commonly caused by T. rubrum and often occurs during the summer, in young men, and in persons with tight-fitting clothing. Tinea cruris forms an erythematous, pruritic patch on the intertriginous inguinal folds and medial thighs with characteristic sparing of the scrotum and penis (Figure 15.8). The patch spreads peripherally with partial central clearing and may have small follicular papules, pustules, or vesicles along the advancing border. Infections with Candida species may closely resemble tinea cruris; however, it may be distinguished by their moist appearance, presence of satellite lesions, and possible scrotal involvement. Mechanical intertrigo, or “chafing,” may also be misdiagnosed as tinea cruris; however, it is usually sharply demarcated, tender, and lacking scale. Erythrasma can be distinguished by Wood’s lamp examination, under which it fluoresces coral red. Lastly, inverse psoriasis and seborrheic dermatitis may be difficult to distinguish from tinea cruris without biopsy if other lesions outside the genital region are absent. Concurrent tinea pedis infection or onychomycosis can predispose to recurrence, suggesting possible transfer of organisms [4].
Differential diagnoses of psoriasis
M. Alan Menter, Caitriona Ryan in Psoriasis, 2017
Onychomycosis is a fungal infection of the nails (Figure 12.101) caused by dermatophytes, yeasts, and molds. Onychomycosis most commonly affects adults. It is typically limited to one or a few digits, whereas psoriasis is usually more widespread.6 Toenails (Figure 12.102) are more commonly affected than fingernails (Figure 12.103). Clinically, onychomycosis presents as a thickened nail plate with subungual hyperkeratosis, which can lead to total nail dystrophy.6 Patients may have coexisting dermatophyte infection, usually tinea pedis or tinea cruris.6 Differentiation between psoriasis of the nails and onychomycosis is often difficult.6 In onychomycosis the features usually present in the toes (Figure 12.104), whereas fingernails are more commonly affected in psoriasis.6 Many of the histological features of psoriasis may be seen in onychomycosis including psoriasiform hyperplasia, thinned rete ridges, thinned suprapapillary plates, dilated capillaries, parakeratosis, and neutrophils within the nail bed.6,69
Antifungal Activity of Seaweeds and their Extracts
Leonel Pereira in Therapeutic and Nutritional Uses of Algae, 2018
It is an anthropophilic dermatophyte with a worldwide distribution which often causes tinea pedis, tinea cruris, tinea corporis, and onychomycosis. It is not known to invade hair in vivo and no specific growth requirements have been reported. Colonies are usually slow-growing, greenish-brown or khaki-colored with a suede-like surface, raised and folded in the center, with a flat periphery and submerged fringe of growth. Older cultures may develop white pleomorphic tufts of mycelium. A deep yellowish-brown reverse pigment is usually present. Microscopic morphology shows characteristic smooth, thin-walled macroconidia which are often produced in clusters growing directly from the hyphae (Ellis 2016g).
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.
Related Knowledge Centers
- Dermatophytosis
- Skin Condition
- Athlete'S Foot
- Onychomycosis
- Candidal Intertrigo
- Erythrasma
- Inverse Psoriasis
- Seborrhoeic Dermatitis
- Antifungal
- Anus