New therapeutic options in the management of superficial fungal diseases

Demirseren, Düriye Deniz

doi:10.1111/dth.12855

Cited by 7 publications

(7 citation statements)

References 13 publications

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“…It is thought that the fungal elements get decomposed by heat because temperatures exceeding 50°C lead directly to thermal killing. 18 Further fungicidal effect is achieved through the absorption of energy by fungal chromophores like xanthomegnin, chitin and melanin.…”

Section: Discussionmentioning

confidence: 99%

Fractional CO₂ laser with topical 1% terbinafine cream versus oral itraconazole in the management of onychomycosis: A randomized controlled trial

Ranjan¹,

Arora²,

Sharma

2022

IJDVL

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Background Onychomycosis accounts for 20-40% of all nail disorders. It is difficult to cure with resistance to anti-fungal drugs, their side effects and drug interactions limiting treatment options. Itraconazole is a widely accepted oral medication used for onychomycosis while fractional CO2 laser along with a topical anti-fungal has shown promising results for nail plate clearance in onychomycosis. Aim To compare the efficacy of fractional CO2 laser with 1% terbinafine cream versus itraconazole in the management of onychomycosis. Methods A prospective, randomised, single-centre, two-arm, parallel-group interventional study was conducted at Command Hospital Air Force, Bangalore. Onychomycosis cases confirmed by KOH mount/culture-positive were included. Patients were randomly divided into two groups. Group A received 4 sessions of fractional CO2 laser every fourth week with twice-daily application of 1% terbinafine cream; Group B received one-week pulse therapy with capsule itraconazole once every four-week for three pulses. The response was assessed by Onychomycosis Severity Index, a validated onychomycosis assessment scale, at baseline and at six months. Results Group A had 50 patients with a total of 98 nails. Clinical improvement was seen in 83/98 (84.7%) nails. The average reduction in Onychomycosis Severity Index was 8.65 (P < 0.05). Group B had 50 patients with a total of 136 nails. Clinical improvement was seen in 104/136 (76.5%) nails. The average reduction in Onychomycosis Severity Index was 7.37 (P < 0.05). Both groups showed statistically significant improvement measured by ‘Reduction in Onychomycosis Severity Index’ at six months; however, there was no significant difference between the two arms. Limitations The main limitations of the study are the small sample size and lack of long-term follow-up to assess recurrence of infection. Conclusion Fractional CO2 laser with 1% terbinafine cream is an effective and safe method for inducing nail clearance in onychomycosis and has efficacy similar to itraconazole pulse therapy.

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Section: Discussionmentioning

confidence: 99%

Fractional CO₂ laser with topical 1% terbinafine cream versus oral itraconazole in the management of onychomycosis: A randomized controlled trial

Ranjan¹,

Arora²,

Sharma

2022

IJDVL

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“…Lasers have a photothermal effect on fungi, and temperatures exceeding 50°C directly lead to thermal killing. High temperature creates toxic levels of adenosine triphosphate and oxygen, leading to the disruption of fungal mitochondrial membrane potential, and slows down the growth which eventually stops completely [5]. Recent trials have explored fractional CO 2 (FCO 2 ) lasers in combination with topical treatment and found it to be a viable option for management of onychomycosis [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Single-Session Fractional CO2 Laser following Urea Occlusion in Management of Onychomycosis: A Pilot Study

Ranjan

Arora²,

Sharma

et al. 2023

Skin Appendage Disord

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Introduction: Onychomycosis is a common nail disorders. Antifungal resistance, interactions, and side effects limit treatment options. Fractional CO2 (FCO2) laser along with topical antifungal is effective in multiple monthly sessions. A modification reducing repeated visits and hence better compliance is preferable. Single-session FCO2 laser following urea occlusion is reported to be effective. Thus, we conducted a study to determine the efficacy of single-session FCO2 laser with 1% terbinafine cream with and without “urea cream occlusion” in managing onychomycosis. Methods: A prospective, randomized, parallel-group study was conducted at a tertiary centre. Onychomycosis was confirmed by positive fungal mount and culture. Patients were randomized into 2 groups and administered single-session FCO2 laser. Group A was treated after overnight urea cream occlusion and group B without occlusion. Both groups applied 1% terbinafine cream twice daily for 3 months. Response was assessed by improvement in Onychomycosis Severity Index (OSI) at 6 months. Results: Group A had 10 patients, 14 nails. Clinical improvement was seen in 12/14 (85.7%) nails. Average reduction in OSI was 10.78. Group B had 10 patients, 11 nails. Clinical improvement was seen in 5/11 (45.5%) nails. Average reduction in OSI was 1.73. “Reduction in OSI” was statistically significant (p < 0.05) only in group A. Conclusion: Single-session FCO2 laser following overnight urea cream occlusion, followed by 1% terbinafine cream, is effective for management of onychomycosis.

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“…Superficial fungal infections are very common in the world that effect the nails, skin and hair. Causative agents are dermatophytes, Candida species and Malassezia species (Demirseren, 2020). Only fully keratinized tissues, such as the stratum corneum, hair, and nails, have been invaded by superficial mycoses (Gamage et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…Oral medications like as itraconazole, terbinafine, fluconazole, and griseofulvin can be administered as continuous or pulse therapy in certain situations (Fernandes et al, 2020). Improved cleanliness, as well as the avoidance of moisture and occlusive clothes, are crucial for a successful treatment (Demirseren, 2020). The most critical factors are a weakened immune system and exposure to filaments or spores in the environment.…”

Section: Introductionmentioning

confidence: 99%

Gender difference about superficial Fungl infections among immunocompromised patients in Dhi Qar governorate 2021-2022

Wajid

Ibraheem

Al-Rubaye

2022

ijhs

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Superficial fungal infections are caused by many fungi, which can invade various aspects of the human body which effect the skin, hair, and nails, are widely observed in the world. Causative agents are Candida species, dermatophytes, and Malassezia species. This study aims to knowledge gender difference about superficial fungal infections among immune compromised patients in Dhi Qar Governorate. A non-probability (convenience sample) of 500 sample were selected throughout the use of non-probability sampling approach. The study was conducted in six health institutions affiliated to the Dhi Qar Health Department, in addition to the medical clinics in the governorate. A questionnaire as a means for data collection, it consist of four parts include demographic data, diseases that weaken the immune system (Diabetes, cancer, leukemia, genetic blood diseases and kidney failure) , locations of the superficial fungal infection and risk factors. Through questionnaire the, data were collected and analyzed through the application of descriptive and inferential statistical data analysis approach. Most of the study sample aged 44 years, 310 (62%) of them were males, 190(38%) of them were female, about 346(69.2%) of them were from urban residence, about 227(45.4%) of them were not working, most of them were married 309(61.8%).

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New therapeutic options in the management of superficial fungal diseases

Cited by 7 publications

References 13 publications

Fractional CO₂ laser with topical 1% terbinafine cream versus oral itraconazole in the management of onychomycosis: A randomized controlled trial

Fractional CO₂ laser with topical 1% terbinafine cream versus oral itraconazole in the management of onychomycosis: A randomized controlled trial

Single-Session Fractional CO2 Laser following Urea Occlusion in Management of Onychomycosis: A Pilot Study

Gender difference about superficial Fungl infections among immunocompromised patients in Dhi Qar governorate 2021-2022

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New therapeutic options in the management of superficial fungal diseases

Cited by 7 publications

References 13 publications

Fractional CO2 laser with topical 1% terbinafine cream versus oral itraconazole in the management of onychomycosis: A randomized controlled trial

Fractional CO2 laser with topical 1% terbinafine cream versus oral itraconazole in the management of onychomycosis: A randomized controlled trial

Single-Session Fractional CO2 Laser following Urea Occlusion in Management of Onychomycosis: A Pilot Study

Gender difference about superficial Fungl infections among immunocompromised patients in Dhi Qar governorate 2021-2022

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Fractional CO₂ laser with topical 1% terbinafine cream versus oral itraconazole in the management of onychomycosis: A randomized controlled trial

Fractional CO₂ laser with topical 1% terbinafine cream versus oral itraconazole in the management of onychomycosis: A randomized controlled trial