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Li Zhang, Hui Xu, Yuling Shi, Jing Yu, Yunjiao Tao, Xiuli Li
BACKGROUND: Although standard itraconazole pulse therapy is a well-established regimen for toenail onychomycosis, the cure rate for onychomycosis remains low. OBJECTIVES: To evaluate the efficacy and safety of different cycles of itraconazole pulse therapy, determine the optimal dosage and number of cycles for onychomycosis. PATIENTS/METHODS: A total of 90 outpatients of our hospital with onychomycosis were randomized into three treatment groups: 1) standard itraconazole pulse therapy (200mg twice per day, one week each month for three pulses); 2) long-term pulse therapy (200mg twice per day, one week each month for six pulses); 3) low-dose and long-term pulse therapy (200mg/day, one week per month for six pulses) and were followed-up for 15 months...
June 12, 2018: Mycoses
Fang Wang, Peng Yang, Jin-Sil Choi, Petar Antovski, Yazhen Zhu, Xiaobin Xu, Ting-Hao Kuo, Li-En Lin, Diane N H Kim, Pin-Cheng Huang, Haoxiang Xu, Chin-Fa Lee, Changchun Wang, Cheng-Chih Hsu, Kai Chen, Paul S Weiss, Hsian-Rong Tseng
The existing approaches to onychomycosis demonstrate limited success since the commonly used oral administration and topical cream only achieve temporary effective drug concentration at the fungal infection sites. An ideal therapeutic approach for onychomycosis should have (i) the ability to introduce anti-fungal drugs directly to the infected sites; (ii) finite intradermal sustainable release to maintain effective drug levels over prolonged time; (iii) a reporter system for monitoring maintenance of drug level; and (iv) minimum level of inflammatory responses at or around the fungal infection sites...
May 31, 2018: ACS Nano
Laura Sante, Milagros Cuervo, Ana de Andrés Del Rosario, María Lecuona
No abstract text is available yet for this article.
May 19, 2018: Enfermedades Infecciosas y Microbiología Clínica
Yasuyuki Ishii, Yuko Ito, Shunji Matsuki, Kasumi Sanpei, Osamu Ogawa, Kenji Takeda, Edgar L Schuck, Naoto Uemura
BFE1224, prodrug of ravuconazole, is a novel, once-daily, oral, triazole antifungal drug, and currently in development for the treatment of onychomycosis. The clinical drug-drug interaction (DDI) potential of BFE1224 with cytochrome P450 (CYP) and transporter was assessed by using two types of cocktails in healthy subjects in separate clinical studies. The CYP and transporter cocktails consisted of caffeine/tolbutamide/omeprazole/dextromethorphan/midazolam used in study 1 and digoxin/rosuvastatin used in study 2...
May 16, 2018: Clinical and Translational Science
Samia Ali Ibrahim, Waleed Albalat, Howyda Mohamed Ebrahim
No abstract text is available yet for this article.
May 16, 2018: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
Boni E Elewski, Antonella Tosti, Tina Lin
Background: Clinical studies with topical onychomycosis agents typically involve daily application over 48 weeks. Some patients are cured earlier; however, individual data are limited. Objective: The aim of this study was to assess baseline demographics/disposition of onychomycosis patients completely cured at week 24 following daily efinaconazole treatment. Methods: We conducted a week-24 case review of 2 identical, multicenter, randomized, double-blind, vehicle-controlled studies on 1,655 patients with mild-to-moderate onychomycosis...
April 2018: Skin Appendage Disorders
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
Marie-Pierre Hayette, Laurence Seidel, Caroline Adjetey, Rajae Darfouf, Marie Wéry, Raphaël Boreux, Rosalie Sacheli, Pierrette Melin, Jorge Arrese
Onychomycosis represents one of the most frequent mycoses in the world. Causative agents are mainly dermatophytes, but yeasts and nondermatophyte moulds can also be involved. Conventional diagnostic methods include direct microscopy (or histology) and culturing. However, molecular methods are becoming increasingly popular in this field. The DermaGenius® (DG) Nail multiplex assay (PathoNostics, The Netherlands) is a new commercial real-time polymerase chain reaction (PCR) kit, which can detect Trichophyton rubrum, Trichophyton interdigitale and Candida albicans directly in nails...
May 11, 2018: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Jacob Tolstrup, Gregor Borut Jemec, Rasmus Krøger Hare, Maiken Cavling Arendrup, Ditte Marie Saunte
Onychomycosis is a frequent disorder, which accounts for approximately 50% of nail changes. Many patients are treated for onychomycosis without a mycological verification being done. The patients may be in risk of being treated for a non-existent fungal infection with lack of effect and potential adverse events. This review highlights the importance of choosing the correct sampling and diagnostic methods, as genus and/or species identification is essential when choosing the optimal treatment strategies.
May 14, 2018: Ugeskrift for Laeger
Nathan Stasko, Kimberly McHale, Stanley J Hollenbach, Megan Martin, Ryan Doxey
Cutaneous and superficial fungal infections affecting the skin, nails, and hair of humans are caused primarily by dermatophytes of the genera Trichophyton, and Epidermophyton, or by yeasts of the genera Candida and Malassezia Onychomycosis is a common fungal infection of the nail frequently coexisting with tinea pedis, the most prevalent mycotic skin infection. Efficacy rates for current topical onychomycosis therapies are hampered by low drug penetration across the nail plate that is theoretically obviated with nitric oxide (NO)-based topical therapies...
May 14, 2018: Antimicrobial Agents and Chemotherapy
Ryan R Riahi, Philip R Cohen, Leonard H Goldberg
Subungual amelanotic melanoma is rare. In addition, amelanotic melanoma can mimic non-melanocytic tumors. A 67-year-old woman had a four-year history of dystrophy of the left fourth fingernail. Periodic acid-Schiff staining of the nail plate demonstrated fungal hyphae, establishing a diagnosis of tinea unguium. The nail plate subsequently detached and the underlying nail bed showed a red, friable mass that was biopsied and confirmed a diagnosis of melanoma. In conclusion, additional morphologic change of a persistent nail dystrophy-even with a biopsy-confirmed diagnosis of onychomycosis-may require consideration for repeat evaluation, including a biopsy, to exclude the possibility of a subungual malignant tumor...
March 11, 2018: Curēus
Azam A Qureshi, Adam J Friedman
Reflex sympathetic dystrophy is a subtype of complex regional pain syndrome, a condition characterized by persistent post-injury extremity pain. Temperature and sweating changes, edema, mobility changes, and a variety of hair, nail, and skin sequelae have been described. Only 23 articles published since 1990 describe dermatologic changes in CRPS. Given this paucity of literature, we present a case to further elucidate cutaneous manifestations of CRPS. Our patient is a 52-year-old Caucasian woman with a 19-year history of reflex sympathetic dystrophy who has presented with several dermatologic complaints...
May 1, 2018: Journal of Drugs in Dermatology: JDD
Venkataramana Kandi
Tungiasis is an infection/infestation of the flea Tunga penetrans . These are bloodsucking ectoparasitic insects belonging to the phylum Arthropoda, and they do not possess wings, but they have long legs enabling them to jump up to 30 cm high. The fleas are usually present on the skin and in the hair of domestic and wild animals and are prevalent throughout the world. They may also be present in an environment consisting of dry sandy soils, and they infect people who walk barefoot and reside in flea-infested areas...
March 5, 2018: Curēus
Alessio Nocentini, Claudiu T Supuran, Jean-Yves Winum
Benzoxaborole is a versatile boron-heterocyclic scaffold which has found in the last 10 years a broad spectrum of applications in medicinal chemistry, due to its physicochemical and drug-like properties. Use of benzoxaborole moiety in the design of compounds led to the discovery of new classes of anti-bacterial, anti-fungal, anti-protozoal, anti-viral as well as anti-inflammatory agents with interesting drug development perspectives. Areas covered: This article reviews the patent literature as well as chemistry literature during the period 2010-2018 where in several benzoxaborole derivatives with therapeutic options were reported...
May 4, 2018: Expert Opinion on Therapeutic Patents
Junko Suzuki, Yoshihiro Imazu, Yoshitaka Yoneta, Katsunori Yamaura, Emiko Uchida
 In a superaging society, the medical paradigm should include both less coverage of medical-care work flow by human resources and high-quality care for patients. Strategies such as establishing medical-care teams and community medicine systems mainly for home medical care should be implemented. However, a well-organized system for home-based medical treatment of elderly patients is not yet in place, as evidenced by the lack of care, problems with long-term polypharmacy resulting from visits to multiple healthcare providers, and declines in their physical strength...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Katsunori Yamaura, Naoko Hayashi, Yoshihiro Imazu, Yoshitaka Yoneta, Emiko Uchida, Junko Suzuki
 There is an urgent need to promote home medical care in Japan because of the country's superaging society. Community pharmacists are expected to play an important role as part of home medical care teams. The prevalence of nail ringworm is high among home-care patients and can cause decreases in the quality of life, including difficulty in walking due to pain caused by nail deformation and inflammation around infected nails. Nail ringworm is typically treated with oral medication. However, the condition is left untreated in many elderly patients because of the risk of drug-drug interactions or concerns about severe liver damage...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Emiko Uchida, Yoshihiro Imazu, Yoshitaka Yoneta, Katsunori Yamaura, Junko Suzuki
 The aim of this study was to assess the effects of cooperation by visiting nurses and physicians experienced in general patient care, dermatology, and podiatry for the treatment of ringworm. Questionnaires were delivered to 1184 patients receiving home-based care by one of 14 participating visiting nursing establishments with a combined capacity of 3273 patients throughout five wards of the Tokyo metropolitan area. Responses were obtained from 691 patients (participation rate, 60.2%; average age, 80.2 years)...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Yoshitaka Yoneta, Yoshihiro Imazu, Emiko Uchida, Katsunori Yamaura, Junko Suzuki
 Patients usually consult a dermatologist for the treatment of onychomycosis. However, in the case of home care, visiting nurses may assist with bathing, which offers the opportunity to observe patients' feet for possible signs of onychomycosis without causing anxiety. It is estimated that more than 30% of patients receiving home care have onychomycosis. Before the approval of efinaconazole, healthcare personnel hesitated to treat onychomycosis because of: 1) possible side effects, especially liver dysfunction and pain due to repeated blood collection, as a major goal of home care is to minimize pain; and 2) the questionable efficacy of previously available antifungal medications...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Yoshihiro Imazu, Yoshitaka Yoneta, Emiko Uchida, Katsunori Yamaura, Junko Suzuki
No abstract text is available yet for this article.
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Junko Suzuki, Yoshihiro Imazu
No abstract text is available yet for this article.
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
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