Inflammatory tinea pedis with bacterial superinfection effectively treated with isoconazole nitrate and diflucortolone valerate combination therapy

Friedrich, Markus

doi:10.1111/myc.12056

Cited by 11 publications

(9 citation statements)

References 10 publications

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“…However, it is not known why the elevated AMP concentrations fail to efficiently combat dermatophyte growth. Possibly, the enhanced secretion of AMPs in tinea pedis prevents bacterial superinfection and thus complication of the disease 48,49 . A greater insight into the role of AMPs in the pathogenesis of tinea pedis could reveal new therapeutic approaches or prevention options.…”

Section: Discussionmentioning

confidence: 99%

Expression of epidermal antimicrobial peptides is increased in tinea pedis

Pham

Rademacher

Hinrichs

et al. 2021

Mycoses

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Background Tinea pedis is often chronic or recurrent, but not all individuals are equally susceptible to this infection. Dermatophytes are able to induce the expression of antimicrobial peptides and proteins (AMPs) in human keratinocytes and certain AMPs can inhibit the growth of dermatophytes. Objective The focus of this study was to analyse the secretion of relevant AMPs, especially RNase 7, human beta‐defensin‐2 (hBD‐2) and the S‐100 protein psoriasin (S100A7), in patients with confirmed tinea pedis. Methods To verify the diagnosis, skin scales were obtained from all patients (n = 13) and the dermatophytes were identified by potassium hydroxide mount, culture and molecular analysis. To determine the AMP concentrations, the lesional skin area of the foot was rinsed with a buffer that was subsequently analysed by ELISA. The corresponding area of the other unaffected foot as well as defined healthy skin areas of the forearm and forehead and samples from age and gender‐matched healthy volunteers served as controls. Results In tinea pedis patients the AMP concentrations were higher in lesional skin than in non‐lesional skin and in healthy skin of controls. In particular, concentrations of hBD‐2 and psoriasin were significantly elevated. Conclusions The induction of AMPs in tinea pedis might be triggered directly by the dermatophytes; furthermore, attendant inflammation and/or differentiation processes may play a role. Our results indicate that there is no defect in the constitutive expression and induction of the analysed AMPs by dermatophytes in the epidermis of affected patients. However, it is not known why the elevated AMP concentrations fail to efficiently combat dermatophyte growth.

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Section: Discussionmentioning

confidence: 99%

Expression of epidermal antimicrobial peptides is increased in tinea pedis

Pham

Rademacher

Hinrichs

et al. 2021

Mycoses

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“…En cuanto al tratamiento, una revisión sistemática de Cochrane cita los azoles como la primera opción de tratamiento tópico para las micosis en los pies, y en segundo lugar el grupo de las alilaminas 10,11 , contrario a lo que se observó en esta serie donde la terbinafina fue el medicamento más formulado, seguido de un corticoide tópico en combinación con clioquinol. Aunque los corticoides tópicos son útiles para controlar el prurito y el dolor asociados a las micosis de los pies 23,24 , no existen estudios que apoyen su uso como monoterapia o como primera elección en este tipo de infección. Es probable que la elección de las alilaminas sobre los azoles tenga relación con el tipo de institución donde se desarrolló el estudio: un centro de referencia donde asisten pacientes que, en la mayoría de los casos, ya han utilizado tratamientos inadecuados o inefectivos.…”

Section: Discussionunclassified

Micosis en los pies: descripción clínico-epidemiológica en un centro de referencia de Bogotá, Colombia

Sabogal

Jiménez²,

Morales³

et al. 2018

Infect

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Objetivo: describir las características clínico-epidemiológicas de una población con diagnóstico de infección cutánea micótica en los pies confirmada por examen directo con KOH y cultivo en un centro de referencia de Bogotá, Colombia.Material y método: estudio observacional descriptivo en el que se incluyeron todos los pacientes con lesiones en los pies que fueron atendidos en el servicio de micología entre el año 2011 y el 2016. Se analizaron las características sociodemográficas, clínicas, etiologías y el perfil de tratamiento por medio de un análisis bivariado.Resultados: se incluyeron 305 pacientes, de los cuales el 82% residía en zona urbana de la ciudad de Bogotá. El hábito más frecuente fue bañarse descalzo, la forma clínica que predominó fue la interdigital y el 35% de los casos presentó de forma simultánea tiña del pie y onicomicosis. Los agentes etiológicos más comunes fueron los dermatofitos con el 95,2% de los casos.Discusión: la presentación clínica sugestiva de micosis, además del resultado positivo del examen directo y del cultivo, permiten hacer el diagnóstico de estas infecciones. Las características sociodemográficas de quienes sufren este tipo de micosis en Colombia se relacionan con su contagiosidad y tendencia a la cronicidad. La intervención de tales aspectos debe hacer parte de las estrategias para su prevención.

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“…It is recommended that an antifungal‐corticosteroid combination be administered at the initiation of therapy for 1–2 weeks, followed by antifungal monotherapy . This treatment regimen has been shown to be effective in inflammatory tinea corporis, inflammatory tinea cruris, inflammatory tinea pedis, or infections caused by zoophilic dermatophytes, which are known to trigger a strong inflammatory response.…”

Section: Antifungal‐corticosteroid Combination Therapymentioning

confidence: 99%

Topical antifungal‐corticosteroid combination therapy for the treatment of superficial mycoses: conclusions of an expert panel meeting

Schaller

Friedrich²,

Papini

et al. 2016

Mycoses

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Superficial fungal infections affect 20-25% of people worldwide and can cause considerable morbidity, particularly if an inflammatory component is present. As superficial fungal infections can be diverse, the treatment should be tailored to the individual needs of the patient and several factors should be taken into account when deciding on the most appropriate treatment option. These include the type, location and surface area of the infection, patient age, degree of inflammation and underlying comorbidities. Although several meta-analyses have shown that there are no significant differences between the numerous available topical antifungal agents with regard to mycological cure, agents differ in their specific intrinsic properties, which can affect their clinical use. The addition of a corticosteroid to an antifungal agent at the initiation of treatment can attenuate the inflammatory symptoms of the infection and is thought to increase patient compliance, reduce the risk of bacterial superinfection and enhance the efficacy of the antifungal agent. However, incorrect use of antifungal-corticosteroid therapy may be associated with treatment failure and adverse effects. This review summarises available treatment options for superficial fungal infections and provides general treatment recommendations based on the consensus outcomes of an Expert Panel meeting on the topical treatment of superficial mycoses.

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Inflammatory tinea pedis with bacterial superinfection effectively treated with isoconazole nitrate and diflucortolone valerate combination therapy

Cited by 11 publications

References 10 publications

Expression of epidermal antimicrobial peptides is increased in tinea pedis

Expression of epidermal antimicrobial peptides is increased in tinea pedis

Micosis en los pies: descripción clínico-epidemiológica en un centro de referencia de Bogotá, Colombia

Topical antifungal‐corticosteroid combination therapy for the treatment of superficial mycoses: conclusions of an expert panel meeting

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