Prevalence of Toenail Onychomycosis in Patients with Type 2 Diabetes Mellitus and Evaluation of Risk Factors

Gülcan, Aynur; Gülcan, Erim; Öksüz, Şükrü; Şahi̇n, İdris; Kaya, Demet

doi:10.7547/1010049

Cited by 32 publications

(26 citation statements)

References 32 publications

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“…In the present study, T.schönleini was not isolated from specimens, and, T.violaceum was isolated very rare (0.6%), however T. rubrum was the most frequent dermatophyte isolated followed by T. mentagrophytes, suggesting the changes in epidemiology of dermatophytosis in Turkey in last 60 years. Similar findings were reported from Marmara [25], Easter Thrace [26], Middle Blacksea regions [27], and South Central Turkey [28], and Central Anatolia [29,30]. This seems to be in accordance with the change in dermatophyte spectrum in dermatomycoses in Central and North Europe as underlined by Seebacher [17,18].…”

Section: Resultssupporting

confidence: 78%

Causative Agents of Superficial Mycoses in Outpatients Attending Cerrahpaşa Medical Faculty Hospital, in İstanbul, Turkey (01 April 2010 –01 June 2014)

2015

J Turk Acad Dermatol

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Section: Resultssupporting

confidence: 78%

Causative Agents of Superficial Mycoses in Outpatients Attending Cerrahpaşa Medical Faculty Hospital, in İstanbul, Turkey (01 April 2010 –01 June 2014)

2015

J Turk Acad Dermatol

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“…Pc 4-PDT also demonstrated an excellent safety profile in a phase 1 trial on cutaneous neoplasms (25). Although the susceptibility of T. rubrum to PDT using other photosensitizers has been extensively investigated in vitro, the mechanism of phototoxicity has not been clearly defined (2,9,(26)(27)(28). In this study, we showed that a common dose of Pc 4-PDT can induce cell death in microconidia (terbinafine-sensitive and -resistant strains of T. rubrum).…”

mentioning

confidence: 89%

“…Trichophyton rubrum is the main culprit of superficial mycosis of the nail (onychomycosis), which is often long lasting and has a high incidence of recurrence. Onychomycosis affects 10% of the general population, 20% of the population older than 60 years, 50% of people older than 70 years, and 30% of diabetic patients, and it can often result in pain, disability, and psychosocial stress, therefore significantly reducing quality of life (1)(2)(3). The conventional treatments involve excruciating surgical nail avulsion and toxic systemic antifungal drugs.…”

mentioning

confidence: 99%

Silicon Phthalocyanine 4 Phototoxicity in Trichophyton rubrum

Lam

Dimaano

Oyetakin-White

et al. 2014

Antimicrob Agents Chemother

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dTrichophyton rubrum is the leading pathogen that causes long-lasting skin and nail dermatophyte infections. Currently, topical treatment consists of terbinafine for the skin and ciclopirox for the nails, whereas systemic agents, such as oral terbinafine and itraconazole, are also prescribed. These systemic drugs have severe side effects, including liver toxicity. Topical therapies, however, are sometimes ineffective. This led us to investigate alternative treatment options, such as photodynamic therapy (PDT). Although PDT is traditionally recognized as a therapeutic option for treating a wide range of medical conditions, including agerelated macular degeneration and malignant cancers, its antimicrobial properties have also received considerable attention. However, the mechanism(s) underlying the susceptibility of dermatophytic fungi to PDT is relatively unknown. As a noninvasive treatment, PDT uses a photosensitizing drug and light, which, in the presence of oxygen, results in cellular destruction. In this study, we investigated the mechanism of cytotoxicity of PDT in vitro using the silicon phthalocyanine (Pc) 4 [SiPc(OSi(CH 3 ) 2 (CH 2 ) 3 N(CH 3 ) 2 )(OH)] in T. rubrum. Confocal microscopy revealed that Pc 4 binds to cytoplasmic organelles, and upon irradiation, reactive oxygen species (ROS) are generated. The impairment of fungal metabolic activities as measured by an XTT (2,3-bis[2-methoxy-4-nitro-5-sulfophenyl]-2H-tetrazolium-5-carboxyanilide inner salt) assay indicated that 1.0 M Pc 4 followed by 670 to 675 nm light at 2.0 J/cm 2 reduced the overall cell survival rate, which was substantiated by a dry weight assay. In addition, we found that this therapeutic approach is effective against terbinafine-sensitive (24602) and terbinafine-resistant (MRL666) strains. These data suggest that Pc 4-PDT may have utility as a treatment for dermatophytosis. Utilizing mainly keratin for their source of energy, dermatophytes can cause dermatophytosis or tinea of the skin, hair, and nails that impact the quality of life of infected patients, especially in immunocompromised individuals. Trichophyton rubrum is the main culprit of superficial mycosis of the nail (onychomycosis), which is often long lasting and has a high incidence of recurrence. Onychomycosis affects 10% of the general population, 20% of the population older than 60 years, 50% of people older than 70 years, and 30% of diabetic patients, and it can often result in pain, disability, and psychosocial stress, therefore significantly reducing quality of life (1-3). The conventional treatments involve excruciating surgical nail avulsion and toxic systemic antifungal drugs. Topical therapy is a less invasive and hence more attractive treatment for the eradication of fungal infection. However, dismal patient compliance often contributes to the high rate of unsuccessful treatment (4). It is for these reasons that alternative therapeutic agents need to be developed that can effectively target T. rubrum without significantly harming the host.In vitro studies have dem...

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“…De ce fait, elle a été supposée comme facteur favorisant les mycoses des pieds; cette association n'a pas été notée dans ce travail ni d'autres études similaires [10, 12, 22]. Dans une étude récente, la prévalence de l'onychomycose était significativement corrélée à l'existence d'une rétinopathie [23]. Enfin, aucune relation n'a été mise en évidence entre l'hypertension artérielle, l'insuffisance coronarienne et la néphropathie diabétique et la mycose des pieds [15, 22].…”

Section: Discussionunclassified

Quels agents incriminés dans les mycoses du pied ? Enquête auprès des diabétiques consultant au CHU Mohammed VI de Marrakech

Chegour¹,

Ansari²,

Mghari³

et al. 2014

Pan Afr Med J

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Les infections mycosiques du pied constituent un motif fréquent de consultation chez les diabétiques, le diabète constituant à la fois un facteur favorisant et aggravant les lésions cutanéomuqueuses. L'objectif de ce travail était d'identifier la flore mycologique locale responsable des lésions du pied chez le diabétique et déterminer les facteurs favorisant la survenue de mycoses. Il s'agissait d'une étude transversale intéressant des diabétiques suivis en consultation; un prélèvement mycologique, avec examen direct et culture, a été réalisé devant toute suspicion clinique de lésion mycosique. Quatre-vingt-deux patients ont été inclus. L'hémoglobine glycosylée moyenne a été de9,2% ± 2,23. Un intertrigo inter orteil a été noté dans 90,2% des cas; l'examen mycologique était positif dans 64,8% des cas, avec 18 cas de Trichophyton rubrum et 11 cas de Candida albicans. Une atteinte unguéale a été suspectée chez 65,9% patients; la culture a mis en évidence un Trichosporon pathogène chez sept patients, un Candida albicansdans six cas, un Trichophyton rubrum dans quatre cas, avec trois cas de Trichophyton mentagrophytes et deux cas de Scytalidium dimidiatum. L’étude analytique, après confirmation mycologique, en fonction des principales caractéristiques des patients a montré que l'atteinte mycosique du pied est significativement corrélée au déséquilibre glycémique. Ce travail a montré la prédominance du Trichophyton rubrum dans les lésions d'intertrigo inter orteil et du Trichosporon dans les onychomycoses, avec une prédominance globale plus globale plus élevée du TR.

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Prevalence of Toenail Onychomycosis in Patients with Type 2 Diabetes Mellitus and Evaluation of Risk Factors

Cited by 32 publications

References 32 publications

Causative Agents of Superficial Mycoses in Outpatients Attending Cerrahpaşa Medical Faculty Hospital, in İstanbul, Turkey (01 April 2010 –01 June 2014)

Causative Agents of Superficial Mycoses in Outpatients Attending Cerrahpaşa Medical Faculty Hospital, in İstanbul, Turkey (01 April 2010 –01 June 2014)

Silicon Phthalocyanine 4 Phototoxicity in Trichophyton rubrum

Quels agents incriminés dans les mycoses du pied ? Enquête auprès des diabétiques consultant au CHU Mohammed VI de Marrakech

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