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Fungal toenail infection

Raza Aly, Tate Winter, Steve Hall, Tracey Vlahovic
Dermatophytoma is a little-known, difficult to treat fungal infection that complicates onychomycosis. First described by Roberts and Evans in the late 1990's, dermatophytoma presents as a dense concentration of fungal hyphae within or under the nail plate and is generally white or yellow/brown in color, and linear (streaks) or round (patches) in shape; primary etiologic organisms are dermatophytes. Oral antifungals have limited success in treating dermatophytoma owing to difficulties accessing and penetrating what is hypothesized to be a fungal biofilm...
March 1, 2018: Journal of Drugs in Dermatology: JDD
M Babayani, S Salari, S J Hashemi, P Ghasemi Nejad Almani, A Fattahi
OBJECTIVE: Onychomycosis (OM) or fungal nail infection is one of the most common fungal infections, which is increasingly prevalent. OM is caused by dermatophytes spp, yeasts and non-dermatophyte moulds (NDMs). The purpose of this study was to identify and determine the prevalence rates, predisposing factors and causative agents of OM using clinical symptoms and microscopic morphometric findings. MATERIALS AND METHODS: In the present study, 180 patients suspected of OM were evaluated by direct microscopy using KOH 20%, culturing in Mycosel and Sabouraud dextrose agar media and Olysia software for identifying the causative fungi of OM...
February 12, 2018: Journal de Mycologie Médicale
Sanne Kreijkamp-Kaspers, Kate L Hawke, Mieke L van Driel
Clinical Question: Which oral antifungal medication is associated with the highest clinical (ie, normal appearance of the toenail) and mycological (negative culture, microscopy, or both) cure rates vs placebo or other antifungals when used to treat fungal infections? Bottom Line: Both terbinafine and azole-based medications were associated with higher clinical and mycological cure rates compared with placebo (high-quality evidence). Azoles were associated with lower cure rates than terbinafine when compared directly...
January 23, 2018: JAMA: the Journal of the American Medical Association
Hari Pankaj Vanam, P Narsimha Rao, Kalyani Mohanram, Prakash Peralam Yegneswaran, Shiva Prakash Mandya Rudramurthy
The genus Tritirachium is a mitosporic fungus which inhabits in soil and decaying plant material and also a notable insect pathogen. Human infections with Tritirachium species though rare were previously reported to cause corneal ulcers, otomycosis, onychomycosis, and dermatomycosis of the scalp and hence may be considered as a potential pathogen. Here we report a case of distal lateral subungual onychomycosis involving right great toenail in a 22-year-old female, wherein direct potassium hydroxide preparations, fungal cultures, and molecular sequencing of the isolate established Tritirachium oryzae as the etiological agent...
November 21, 2017: Mycopathologia
Raza Aly, Aditya K Gupta, Tate Winter, Lee T Zane, Tracey Vlahovic
Toenail onychomycosis is a chronic fungal infection that often requires prolonged treatment in order to effectively manage pathogenic organisms and obtain a clear nail. Traditionally, certain clinical features of onychomycosis, including the presence of substantial lateral disease, focal fungal masses, yellow/brown streaks, and extensive nail involvement (ie, >50%), indicate a poor treatment prognosis and have proven difficult-to-treat with oral or traditional topical therapies. Owing to the novel features of topical tavaborole, we sought to understand the potential utility of tavaborole in difficult-to-treat onychomycosis...
October 1, 2017: Journal of Drugs in Dermatology: JDD
Graciela Araújo Do Espírito-Santo, Diniz Pereira Leite, Hugo Dias Hoffmann-Santos, Luciana Basili Dias, Rosane Christine Hahn
Onychomycosis is an infection of the nail plate by fungal microorganisms. This infection has an important social impact on women and men and poses a major challenge for its treatment. The traditional treatment of onychomycosis involves the use of topical and oral antifungal agents. However, the presence of adverse effects frequently associated with oral antifungals, their high cost, and their potential interactions with other drugs reflect some of the problems associated with conventional therapy. The current report details the evaluation of a 1340nm laser as monotherapy for toenails affected by onychomycosis...
August 2017: Journal of Clinical and Aesthetic Dermatology
Aditya K Gupta, Sarah G Versteeg, Neil H Shear
BACKGROUND: Onychomycosis can be investigated by sampling. Information gleaned includes nail bed involvement, nail plate penetration, fungal viability, and species identification. Testing samples can confirm a diagnosis. While diagnostic testing is considered useful in directing therapy, a substantial number of clinicians do not confirm diagnosis prior to treatment. OBJECTIVES: The aim of this study is to quantify the benefit of confirmatory testing prior to treating toenail onychomycosis...
September 1, 2017: Journal of Cutaneous Medicine and Surgery
Elisa M Difonzo, Federica Scarfì, Massimiliano Galeone
BACKGROUND: In order to treat onychomycosis, topical and systemic medications are available. The choice of a systemic or topic treatment depends on numerous factors, such as patient's age, the presence of comorbidity, responsible fungal species, the clinical form of onychomycosis, its location (fingernails or toenails), the number of nails affected and the percentage of the nail plate infected. As for topical medications, given that nail plate has an insufficiently permeable structure, it is necessary to use appropriate formulae that create in the surface of the nail plate a film able, in turn, to function both as an active ingredient's deposit and moisturising agent in nail's superficial layers in order to facilitate the spread of the active ingredient...
October 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Ali Hadi, Dana Stern
A 34-year-old man from Djibouti presented with a 14-year history of relapsing and remitting transverse white bands on the fingernails with sparing of the toenails. Examination revealed several transverse, white bands following the contour of the lunula on seven of his fingernails that did not fade upon compression of the digits (Figure). There was no onycholysis. No other skin lesions were noted. The patient reported having lived for 4 years (2000-2004) in a house that had well water as its primary water supply...
2017: Skinmed
Avner Shemer, Aditya K Gupta, Adaia Kamshov, Meir Babaev, Renata Farhi, C Ralph Daniel, Kelly A Foley
Recurrence rates are high for onychomycosis, with prophylactic topical antifungal use proposed to counter recurrence. Although this is a reasonable action for many clinicians, few studies have been conducted on the efficacy of topical prophylaxis. A retrospective chart review (2010-2015) was conducted in patients receiving oral terbinafine or itraconazole for toenail onychomycosis. Following complete cure, a topical antifungal (amorolfine, bifonazole, ciclopirox olamine, or terbinafine spray) was used weekly as prophylaxis...
August 30, 2017: Dermatologic Therapy
Sanne Kreijkamp-Kaspers, Kate Hawke, Linda Guo, George Kerin, Sally Em Bell-Syer, Parker Magin, Sophie V Bell-Syer, Mieke L van Driel
BACKGROUND: Fungal infection of the toenails, also called onychomycosis, is a common problem that causes damage to the nail's structure and physical appearance. For those severely affected, it can interfere with normal daily activities. Treatment is taken orally or applied topically; however, traditionally topical treatments have low success rates due to the nail's physical properties. Oral treatments also appear to have shorter treatment times and better cure rates. Our review will assist those needing to make an evidence-based choice for treatment...
July 14, 2017: Cochrane Database of Systematic Reviews
Nazir Asifa, Kanth Farhath
INTRODUCTION: Onychomycosis is a common nail ailment associated with significant physical and psychological morbidity. It is caused by dermatophytes, nondermatophytic molds, and yeasts. Increased prevalence in the recent years is attributed to enhanced longevity, comorbid conditions such as diabetes, avid sports participation, and emergence of HIV. AIMS AND OBJECTIVES: This study was undertaken to identify the mycological profile and etiological agents associated with this infection...
July 2017: Journal of Laboratory Physicians
Antonio M S Filho, Carlucci G Ventura, Paulo R Criado, Gilda B Del Negro, Roseli S Freitas, Olinda C Luiz, Mauro C Giudice, Elias D Neto, Gil Benard
BACKGROUND/AIM: Onychomycosis (OM) is one of the commonest superficial fungal infections. Patients undergoing hemodialysis (HD) treatment and kidney transplant recipients (KTR) are considered at risk of contracting fungal infections, but the few published data do not reach the conclusion of whether they are predisposed to OM. This study aimed to determine the prevalence and etiology of OM in these patients and to determine the antifungal susceptibility profile of the isolated fungal species...
2017: Nephron
Tobiloba Sojinrin, João Conde, Kangze Liu, James Curtin, Hugh J Byrne, Daxiang Cui, Furong Tian
Fungi, which are common in the environment, can cause a multitude of diseases. Warm, humid conditions allow fungi to grow and infect humans via the respiratory, digestive and reproductive tracts, genital area and other bodily interfaces. Fungi can be detected directly by microscopy, using the potassium hydroxide test, which is the gold standard and most popular method for fungal screening. However, this test requires trained personnel operating specialist equipment, including a fluorescent microscope and culture facilities...
June 2, 2017: Analytical and Bioanalytical Chemistry
Fran E Cook-Bolden, Tina Lin
Onychomycosis is a common progressive fungal infection of the nail bed, matrix, or plate leading to destruction and deformity of the toenails and fingernails. The prevalence of onychomycosis is increasing in the United States, particularly in the growing population of Latino patients. In this study, we evaluated the efficacy and safety of efinaconazole solution 10% in Latino patients with onychomycosis. Once-daily application of efinaconazole solution 10% may be an effective topical option for treatment of onychomycosis in this patient population...
April 2017: Cutis; Cutaneous Medicine for the Practitioner
T Goto, G Nakagami, K Takehara, T Nakamura, M Kawashima, Y Tsunemi, H Sanada
OBJECTIVE: The aim of this study was to examine the accuracy of visual diagnosis of tinea pedis (Athlete's foot) and tinea unguium (fungal nail infection), as well as to provide information on skin abnormalities that could help identify these diseases in aged care facilities (long-term care facilities (LTCFs) and nursing homes). METHOD: A multicentre, cross-sectional observational study was conducted in a LTCF and two nursing homes. A dermatologist observed the skin abnormalities in the participants' interdigital and plantar areas, to screen for tinea pedis, and in the participants' toenails, to screen for tinea unguium...
April 2, 2017: Journal of Wound Care
Antonio Zalacain, Alejandra Merlos, Elena Planell, Erica G Cantadori, Teresa Vinuesa, Miguel Viñas
Onychomycoses are fungal infections of the fingernails or toenails having a prevalence of 3% among adults and accounts for 50% of nail infections. It is caused by dermatophytes, non-dermatophyte filamentous fungi, and yeasts. Compressions and microtraumas significantly contribute to onychomycosis. Laser and photodynamic therapies are being proposed to treat onychomycosis. Laser light (1064 nm) was used to treat onychomycosis in 156 affected toenails. Patients were clinically followed up for 9 months after treatment...
April 4, 2017: Lasers in Medical Science
S R Lipner, G Friedman, R K Scher
Onychomycosis is a fungal infection of the nail unit, and is the most common of the nail disorders. Current therapies for onychomycosis have less than ideal efficacy and have the potential for adverse effects. As previous studies have shown that nonthermal plasma inhibits the in vitro growth of Trichophyton rubrum, we conducted a pilot study on 19 participants with toenail onychomycosis. The primary endpoint was safety of the device, and secondary outcome measures were clinical efficacy and mycological cure...
April 2017: Clinical and Experimental Dermatology
Carolina Barbosa de Sousa Padilha, Laila Klotz de Almeida Balassiano, Julyana Calegari Pinto, Flávia Crespo Schueler de Souza, Bernard Kawa Kac, Curt Mafra Treu
Although subungual squamous cell carcinoma is rare, it is the most common primary malignant neoplasms in this location. The higher incidence occurs in the fingernails, but involvement of the toenails is also possible. Subungual squamous cell carcinoma often looks like other more common benign lesions, such as fungal infection, onychomycosis, or viral wart. These factors, together with a general lack of awareness of this disease among physicians, often result in delayed diagnosis. Therefore, it is underdiagnosed, with few reports in the literature...
November 2016: Anais Brasileiros de Dermatologia
Pierre Halteh, Richard K Scher, Shari R Lipner
Onychomycosis is a fungal infection of the nail unit that may lead to dystrophy and disfigurement over time. It accounts for up to 50% of all nail conditions, with toenails affected more commonly than fingernails. Onychomycosis may affect quality of life and increase the prevalence and severity of foot ulcers in patients with diabetes. Available oral agents approved by the US Food and Drug Administration (FDA) for the treatment of onychomycosis include terbinafine and itraconazole, which have demonstrated good efficacy but are associated with the risk of systemic side effects and drug-drug interactions...
November 2016: Cutis; Cutaneous Medicine for the Practitioner
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