Nondermatophyte mould onychomycosis

Gupta, Aditya K.; Summerbell, Richard C.; Venkataraman, Maanasa; Quinlan, Emma M

doi:10.1111/jdv.17240

Cited by 18 publications

(28 citation statements)

References 124 publications

(423 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, after the diagnostics were complemented by PCR/sequencing, the majority of cases in this group were ascribed to dermatophytes, followed by NDMs and yeasts. Similar to recent studies [ 28 , 36 ], NDMs accounted for approximately 30% of the causative fungal agents in our data, supporting the reported increase in NDM onychomycoses compared with that in older studies [ 2 , 15 ]. Fusarium spp.…”

Section: Discussionsupporting

confidence: 92%

“…Most importantly, the selection of the appropriate antimycotic drug depends on the causative fungal pathogen [ 8 , 11 , 12 ]. In particular, NDM onychomycoses are recalcitrant to terbinafine and azoles, and treatment by topical amphotericin B should be considered as first-line therapy [ 13 , 14 , 15 ]. Drug resistance is also an increasingly recognized concern with some dermatophytes, especially Trichophyton rubrum and Trichophyton mentagrophytes [ 16 , 17 , 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Identification of Dermatophyte and Non-Dermatophyte Agents in Onychomycosis by PCR and DNA Sequencing—A Retrospective Comparison of Diagnostic Tools

Pospischil¹,

Reinhardt²,

Bontems³

et al. 2022

JoF

View full text Add to dashboard Cite

Rapid and reliable fungal identification is crucial to delineate infectious diseases, and to establish appropriate treatment for onychomycosis. Compared to conventional diagnostic methods, molecular techniques are faster and feature higher accuracy in fungal identification. However, in current clinical practice, molecular mycology is not widely available, and its practical applicability is still under discussion. This study summarizes the results of 16,094 consecutive nail specimens with clinical suspicion of onychomycosis. We performed PCR/sequencing on all primary nail specimens for which conventional mycological diagnostics remained inconclusive. In specimens with a positive direct microscopy but negative or contaminated culture, molecular mycology proved superior and specified a fungal agent in 65% (587/898). In 75% (443/587), the identified pathogen was a dermatophyte. Positive cultures for dermatophytes, yeasts and non-dermatophyte molds (NDMs) were concordant with primary-specimen-DNA PCR/sequencing in 83% (10/12), 34% (22/65) and 45% (76/169), respectively. Among NDMs, agreement was high for Fusarium spp. (32/40; 80%), but low for Penicillium spp. (5/25; 20%) and Alternaria spp. (1/20; 5%). This study underlines the improvement in diagnostic yield by fungal primary-specimen-DNA PCR/sequencing in the event of a negative or contaminated culture, as well as its significance for the diagnosis of dermatophyte and non-dermatophyte onychomycosis. Molecular mycology methods like PCR and DNA sequencing should complement conventional diagnostics in cases of equivocal findings, suspected NDM onychomycosis or treatment-resistant nail pathologies.

show abstract

“…Onychomycosis caused by nondermatophyte molds and mixed infections are difficult to treat and may be contributing to growing antifungal resistance [51, 52]. Some nondermatophytes and Candida species have demonstrated resistance to terbinafine [50].…”

Section: Discussionmentioning

confidence: 99%

Complementary and Alternative Therapies for Onychomycosis: A Systematic Review of the Clinical Evidence

Nickles

Lio

2022

Skin Appendage Disord

View full text Add to dashboard Cite

Introduction: Onychomycosis is notoriously difficult to treat. While oral antifungals are the most efficacious treatment for onychomycosis, they are contraindicated in certain patient populations, and patients may desire lower risk and accessible alternatives to systemic agents. In this study, we examine the clinical evidence supporting the use of complementary and alternative therapies in the treatment of onychomycosis. Methods: PubMed, Embase, and Cochrane Library were searched for clinical trials, observational studies, and case reports/case series, examining the efficacy of a complementary or alternative therapy for the treatment of onychomycosis. Results: We identified 17 articles studying a complementary and alternative therapy for onychomycosis, including tea tree oil (n = 5), Ageratina pichinchensis (n = 3), Arthrospira maxima (n = 2), natural coniferous resin lacquer (n = 2), Vicks VapoRub® (n = 2), propolis extract (n = 2), and ozonized sunflower oil (n = 1). Conclusion: Given the rise of antifungal resistance, complementary and alternative therapies should continue to be studied as adjunctive or alternative therapy for onychomycosis. While preliminary evidence exists for several complementary and alternative therapies in the treatment of onychomycosis, large-scale, randomized, placebo-controlled trials are needed prior to endorsing their use to patients.

show abstract

“…brevicaulis, which is important from a therapeutic point of view, as this fungus exhibits natural resistance to most of the antifungal drugs available today. ,− S. brevicaulis primarily causes onychomycosis in humans, but it has also been reported to cause deep infections, including disseminated mycoses. ,, New options for treating infections caused by this fungus are therefore desirable. The obtained results constitute the basis for further research on the mechanism of action of new β-glucans on this species.…”

Section: Introductionmentioning

confidence: 99%

Preliminary Studies on the Mechanism of Antifungal Activity of New Cationic β-Glucan Derivatives Obtained from Oats and Barley

et al. 2022

View full text Add to dashboard Cite

New chemical structures with antifungal properties are highly desirable from the point of view of modern pharmaceutical science, especially due to the increasingly widespread instances of drug resistance in the case of these diseases. One way to solve this problem is to use polymeric drugs, widely described as biocidal, positively charged macromolecules. In this work, we present the synthesis of new cationic β-glucan derivatives that show selective antifungal activity and at the same time low toxicity toward animal and human cells. Two β-glucans isolated from oats and barley and modified using glycidyltrimethylammonium chloride were obtained and evaluated for biocidal properties on the cells of mammals and pathogenic fungi and bacteria. These compounds were found to be nontoxic to fibroblast and bacterial cells but showed selective toxicity to certain species of filamentous fungi (Scopulariopsis brevicaulis) and yeasts (Cryptococcus neoformans). The most important aspect of this work is the attempt to explain the mechanisms of action of these compounds by studying their interaction with biological membranes. This was achieved by examining the interactions with model biological membranes representative of given families of microorganisms using Langmuir monolayers. The data obtained partly show correlations between the results for model systems and biological experiments and allow indicating that the selective antifungal activity of cationic β-glucans is related to their interaction with fungal biological membranes and partly lack of such interaction toward cells of other organisms. In addition, the obtained macromolecules were characterized by spectral methods (Fourier transform infrared (FTIR) and 1 H nuclear magnetic resonance (NMR) spectroscopies) to confirm that the desired structure was obtained, and their degree of modification and molecular weights were determined.

show abstract

“…Якщо порівнювати клінічну ефективність тербінафіну та ітраконазолу при лікуванні оніхомікозу, то терапія тербінафіном може забезпечити більш стійку клінічну ефективність, ніж ітраконазол у пацієнтів з повною первісною відповіддю на терапію [7]. Флуконазол, як і ітраконазол, активний відносно збудників дерматомікозів, спричинених дріжджовими патогенами (при цьому необхідно пам'ятати про високу вторинну резистентність C. glabrata та природну стійкість C. krusei), тоді як при дерматомікозах, що спричинені дерматоміцетами, можливий ризик неефективності терапії [14].…”

unclassified

Peculiarities of Onychomycosis Course and Treatment at Present

Suprun

2021

Act. Probl. of the Modern Med.

View full text Add to dashboard Cite

The article provides an overview of current data from the scientific literature on the epidemiological features of onychomycosis at present, including changes in the spectrum of pathogens, the nature of the course and clinical manifestations of fungal nail lesions. Current data on the characteristic manifestation of onychomycosis point out the importance of age factor: age-related changes in old population are associated with involutional processes in the skin and its appendages, decreased growth rate of nails, angiopathy, etc. This review demonstrated the relationship between chronic dermatoses and onychomycosis. In chronic dermatoses, including psoriasis, eczema, etc., there are fungal lesions of the nail plates, which cause not only the progression of trophic disorders, increased dryness of the skin and violation of its integrity, but also sensitization of the patient. Onychomycosis complicates the course of chronic dermatoses. In the absence of onychomycosis treatment there is a significant risk of complete destruction of the nail plates with further involvement of the adjacent skin in the pathological process and infection spreading. Three components of effective therapy are identified: accurate diagnosis, correctly selected therapy and compliance. This article also provides the brief description of existing treatment methods of onychomycosis ranging from monotherapy with systemic antifungals to the combined use of systemic and topical antifungals, as well as the use of non-medicinal methods, and in particular methods of ultraphonophoresis, electrophoresis and photodynamics.

show abstract

Nondermatophyte mould onychomycosis

Cited by 18 publications

References 124 publications

Identification of Dermatophyte and Non-Dermatophyte Agents in Onychomycosis by PCR and DNA Sequencing—A Retrospective Comparison of Diagnostic Tools

Complementary and Alternative Therapies for Onychomycosis: A Systematic Review of the Clinical Evidence

Preliminary Studies on the Mechanism of Antifungal Activity of New Cationic β-Glucan Derivatives Obtained from Oats and Barley

Peculiarities of Onychomycosis Course and Treatment at Present

Contact Info

Product

Resources

About