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Fungal toenail infection

Tamara Angelo, Lívia Neves Borgheti-Cardoso, Guilherme Martins Gelfuso, Stephânia Fleury Taveira, Tais Gratieri
Onychomycosis is a fungal infection of the fingernails or toenails caused by dermatophytes, nondermatophytes, moulds, and yeasts. This condition affects around 10-30% people worldwide, negatively influencing patients' quality of life, with severe outcomes in some cases. Since the nail unit acts as a barrier to exogenous substances, its physiological features hampers drug penetration, turning the onychomycosis treatment a challenge. Currently, there are several oral and topical therapies available; nevertheless, cure rates are still low and relapse rates achieves 10-53%...
October 4, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Ling-I Hsu, Yu-Wen Cheng, Chien-Jen Chen, Meei-Maan Wu, Kuang-Hung Hsu, Hung-Yi Chiou, Chih-Hung Lee
Long-term arsenic exposure results in atherosclerosis and cancers, along with aberrant immune responses. Animal-based and epidemiological studies indicate that arsenic exposure increases susceptibility to viral and bacterial infections. This study aimed to assess whether arsenic exposure is associated with the development of fungal infection, which is substantially attributed to as a cause of aberrant immunity. Based on two well-established cohorts from two basins in southwestern (SW; high arsenic area) and northeastern (NE; low arsenic area) Taiwan (n=297 and 2738, respectively), the arsenic exposure in well water was estimated using HPLC-ICP-MS...
September 29, 2016: Environment International
Yasemin Oz, Iman Qoraan, Ali Oz, Ilknur Balta
BACKGROUND: Diabetes patients are particularly susceptible to fungal infections because their vascular and immunological systems are compromised. OBJECTIVES: The present study aimed to determine prevalences of tinea pedis and onychomycosis, factors predisposing to their development, and antifungal susceptibilities of causative fungal species against fluconazole, itraconazole, and terbinafine in patients with type 2 diabetes mellitus (DM). METHODS: Study groups were defined according to hemoglobin A1C rates of ≥6...
September 26, 2016: International Journal of Dermatology
W P Silva-Rocha, M F de Azevedo, G M Chaves
OBJECTIVE: Dermatomycoses are superficial fungal infections which affect the skin, hair and nails of humans and animals. Male and female patients of all ages are affected by this condition. The main etiological agents of dermatomycoses are the dermatophytes fungi of the genera Trichophyton, Microsporum and Epidermophyton, while the main yeasts belong to the genera Candida, Malassezia and Trichosporon. The variation in the distribution of dermatomycoses worldwide justify the conduction of epidemiological studies in order to contribute for the better understanding of patterns of mycological cutaneous infections...
September 20, 2016: Journal de Mycologie Médicale
Ivan Bristow, Robert Baran, Michelle Score
Onychomycosis continues to be a common and intractable problem in adults, often responding poorly to topical treatment due to limited drug penetration of the nail plate. Improving penetration has been attempted previously by chemical and physical means with some success. The authors present three cases of toenail onychomycosis treated topical terbinafine 1% solution using controlled micro-penetration of the nail using a novel intelligent nail drill system which is able to drill nail plate without penetrating the delicate nail bed beneath...
August 1, 2016: Journal of Drugs in Dermatology: JDD
Eleonora Dubljanin, Aleksandar Džamić, Isidora Vujčić, Sandra Š Grujičić, Valentina A Arsenijević, Sanja Mitrović, Ivana Čolović Čalovski
Onychomycosis is a fungal infection of the fingernails and/or toenails caused by dermatophytes, yeasts and non-dermatophyte moulds. The epidemiology of onychomycosis in Serbia is yet to be fully established. This epidemiological study was aimed at evaluating the epidemiology of onychomycosis in a sample of the Serbian patients at risk of onychomycosis, to determine the fungal aetiological agents and to identify the possible risk factors. The study population included 374 patients from six centres in Serbia with suspected onychomycosis...
July 29, 2016: Mycoses
Sofia Maraki, Viktoria Eirini Mavromanolaki
Onychomycosis is a chronic fungal nail infection caused by dermatophytes, yeasts or non-dermatophyte moulds (NDMs). It occurs worldwide and accounts for about 50% of all nail disorders. The incidence of the disease and the prevalence of pathogens involved vary in different geographical areas and change with time. This study was undertaken to determine the epidemiology of onychomycosis in Crete, Greece during a 12-year period. Mycologic nail investigation (direct microscopy and cultures) was performed in samples taken from 3417 patients with clinical suspicion of onychomycosis...
July 19, 2016: Mycoses
Aditya K Gupta, Sarah G Versteeg
INTRODUCTION: Onychomycosis is a fungal nail infection that accounts for half of all nail diseases. Oral drugs on the market have adverse effects, while it is difficult for traditional topical drugs to penetrate the nail plate to reach the diseased nail bed. Tavaborole is a new drug that addresses the unmet needs of currently available treatments. Tavaborole (5%) is FDA approved for treating toenail onychomycosis and has shown antifungal activities against yeast, moulds and dermatophytes...
September 2016: Expert Review of Clinical Pharmacology
G Gupta, K A Foley, A K Gupta
Onychomycosis is a stubborn fungal infection of the nails that can be difficult to effectively manage. One of the challenges with topical therapies is penetrating the nail plate to reach the site of infection. As the first antifungal in a boron-containing class of drugs with a novel mechanism of action, tavaborole is able to penetrate the nail plate more effectively than ciclopirox and amorolfine lacquers. In Phase II/III clinical trials, tavaborole was shown to be safe and clinically effective. Tavaborole 5% solution was approved by the US FDA for the treatment of toenail onychomycosis in July 2014 and is an important addition to the topical treatment arsenal against this stubborn infection...
November 2015: Skin Therapy Letter
Matilde Iorizzo, Ilona Hartmane, Andra Derveniece, Ingmars Mikazans
This was a randomized, controlled, parallel-group clinical trial with a blinded evaluator, designed to compare the efficacy and safety of the nail lacquer P-3051 with amorolfine 5% in the treatment of mild-to-moderate toenail onychomycosis. Patients were treated for 48 weeks with P-3051 daily, or twice weekly with amorolfine 5%. Out of 120 evaluable patients, 60 (50.0%) received P-3051 and 60 (50.0%) amorolfine 5%. At baseline, the two groups were homogeneous in terms of race, pathogens, number of affected toenails and severity of the infected target nail area...
February 2016: Skin Appendage Disorders
Boni E Elewski, Aditya K Gupta, Ted Rosen, Bryan D Caldwell, David M Pariser, Leon H Kircik, Neal Bhatia, Antonella Tosti
BACKGROUND: There is no general agreement as to what constitutes cure or treatment success in onychomycosis. Regulatory guidelines differ in the United States and Europe, and outcomes reported in clinical trials do not consistently report secondary endpoints.<br/> METHODS: We reviewed definitions of onychomycosis cure to develop a less stringent and more practical approach to assess improvement and treatment success.<br/> RESULTS: Complete cure (totally clear nail and mycologic cure) remains an important regulatory standard...
May 1, 2016: Journal of Drugs in Dermatology: JDD
Nida Akhtar, Hemlata Sharma, Kamla Pathak
Onychomycosis constitutes the most common fungal infection of the nail (skin beneath the nail bed) that affects the finger as well as toe nails. It is an infection that is initiated by yeasts, dermatophytes, and nondermatophyte molds. Nail lacquers are topical solutions intended only for use on fingernails as well as toenails and have been found to be useful in the treatment of onychomycosis. Thus, in the present review an attempt has been made to focus on the treatment aspects of onychomycosis and the ungual delivery of antifungals via nail lacquer...
2016: Scientifica
Gabriela Moreno-Coutiño, Ramón Fernández-Martínez, Elisa Crystal Sánchez-Moreno, Adriana Lozano-Platonoff, Claudia Ivette Rodríguez-Salinas, Abraham Rosas-González, Carlos Abilio Sánchez-Mojica, Roberto Arenas
BACKGROUND: Peripheral artery disease (PAD) is quite common, particularly among the elderly. In advanced phases, it has an important impact in the quality of life, so it is recommended to identify this disease on early stages. Onychodystrophy is a deformity of the nail plate of any origin. Up to 50% are caused by fungal infection, the rest is mainly secondary to inflammatory processes. Nail inspection is a very accessible task, and valuation of PAD with the ankle-brachial index (ABI) is a noninvasive affordable technique...
March 2016: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
Aditya K Gupta, Maria Cernea
INTRODUCTION: Onychomycosis is a fungal nail infection that is difficult to treat due to poor accessibility of drugs into the nail plate. Although oral antifungals can reach the nail apparatus more readily, these therapies may not be suitable or desirable for some patients (e.g., multiple medications or immunocompromised). Efinaconazole 10% solution is a new topical antifungal recently approved and sold in Canada, the United States and Japan for the treatment of mild-to-moderate toenail onychomycosis...
2016: Expert Opinion on Pharmacotherapy
Nell Blake, Junjia Zhu, Giselle Hernandez, Paul Joseph Juliano
BACKGROUND: Onychomycosis is a fungal infection of the nail that can be caused by dermatophytes, yeasts, or nondermatophyte molds. To diagnose onychomycosis, a clinician must use the patient's history, physical findings, and diagnostic testing, which can include calcofluor white/potassium hydroxide (KOH) mount, fungal culture (FC), and periodic acid-Schiff (PAS) stain. Some insurance companies require authorization for antifungal medication and request laboratory results to confirm infection...
November 2015: Journal of the American Podiatric Medical Association
Sphoorthi Jinna, Justin Finch
Onychomycosis is a fungal nail plate infection that has been increasing in prevalence. A variety of oral and topical anti-fungal agents are currently available but their use is limited by their adverse effect profile, drug-drug interactions, and limited efficacy. Therefore, there is a great need for newer anti-fungal agents. Tavaborole is one of these newer agents and was approved by the US Food and Drug Administration in July 2014 for the topical treatment of mild to moderate toenail onychomycosis. Tavaborole is a novel, boron-based anti-fungal agent with greater nail plate penetration than its predecessors, due to its smaller molecular weight...
2015: Drug Design, Development and Therapy
Xueping Yue, Qing Li, Hongwei Wang, Yilin Sun, Aiping Wang, Qi Zhang, Cuiping Zhang
BACKGROUND: Trichophyton rubrum (T.rubrum) caused onychomycosis is the most common nail fungal disease. The common diagnostic methods are direct microscopic examination and fungal culture. In this study we used scanning electron microscopy (SEM) and transmission electron microscopy (TEM) to study the subungual ultrastructural changes in T. rubrum induced onychomycosis. METHODS: Six outpatients with onychomycosis were recruited and T.rubrum infection was confirmed by fungal culture...
2015: BMC Infectious Diseases
Vivian Tullio, Ornella Cervetti, Janira Roana, Michele Panzone, Daniela Scalas, Chiara Merlino, Valeria Allizond, Giuliana Banche, Narcisa Mandras, Anna Maria Cuffini
Dermatophytosis caused by Trichophyton rubrum is the most common cutaneous fungal infection in industrialized countries and worldwide with high recurrence and lack of treatment response. In addition, patients with cutaneous and concurrent toenail lesions are often misdiagnosed and therefore treated with an inappropriate therapy. In this study, we evaluated five previously misdiagnosed cases of T.rubrum chronic dermatophytosis sustained by two variants at sites distant from the primary lesion. Our patients were successfully treated by systemic and topical therapy, and 1 year after the end of therapy follow-up did not show any recurrence of infection...
2016: Advances in Experimental Medicine and Biology
Fernanda C Flores, Ruy C R Beck, Cristiane de B da Silva
Onychomycosis are fungal infections affecting finger and toenails mainly caused by dermatophyte fungi and some Candida species. Low cure rates and frequent recurrence, development of a fungal resistance front to various antimicrobial agents topical and systemic, and an ineffective topical treatment make onychomycosis difficult to treat. Essential oils are excellent candidates for the topical treatment for onychomycosis because the development of resistance by fungi is rare, and the presence of side effects is low...
February 2016: Mycopathologia
O Faure-Cognet, H Fricker-Hidalgo, H Pelloux, M T Leccia
BACKGROUND: Superficial fungal infections are predominantly caused by dermatophytes, but the spectrum of species involved is depending on geographic areas and lifestyle. Only few studies have recently described the French epidemiology of these infections, especially dermatophytosis. OBJECTIVES: To determine the epidemiological situation of superficial fungal infections and the spectrum of dermatophytes in Grenoble area. PATIENTS/METHODS: A retrospective study of mycological laboratory records from January 2001 to December 2011 was carried out among patients with suspected fungal infections in the Grenoble University Hospital...
February 2016: Mycopathologia
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