Therapy of Skin, Hair and Nail Fungal Infections

Hay, Roderick J.

doi:10.3390/jof4030099

Cited by 82 publications

(75 citation statements)

References 88 publications

(99 reference statements)

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“…160 The inclusion criteria and definitions of efficacy outcomes between drugs and medical devices differ, which makes it difficult to compare the treatments. 161 A similar off-label therapy to laser treatments is photodynamic therapy (PDT). PDT works by irradiating specific wavelengths of light onto topically applied photosensitizers such as 5aminolevulinic acid, methyl aminolevulinate or methylene blue.…”

Section: Novel Topical Therapiesmentioning

confidence: 99%

Onychomycosis: a review

Gupta

Stec

Summerbell

et al. 2020

Acad Dermatol Venereol

170

245

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Onychomycosis is a fungal infection of the nail, causing discoloration and thickening of the affected nail plate, and is the most common nail infection worldwide. Onychomycosis was initially thought to be predominantly caused by dermatophytes; however, new research has revealed that mixed infections and those caused by non‐dermatophyte moulds (NDMs) are more prevalent than previously thought, especially in warmer climates. Microscopy and fungal culture are the gold standard techniques for onychomycosis diagnosis, but high false‐negative rates have pushed for more accurate methods, such as histology and PCR. As NDMs are skin and laboratory contaminants, their presence as an infectious agent requires multiple confirmations and repeated sampling. There are several treatment options available, including oral antifungals, topicals and devices. Oral antifungals have higher cure rates and shorter treatment periods than topical treatments, but have adverse side effects such as hepatotoxicity and drug interactions. Terbinafine, itraconazole and fluconazole are most commonly used, with new oral antifungals such as fosravuconazole being evaluated. Topical treatments, such as efinaconazole, tavaborole, ciclopirox and amorolfine have less serious side effects, but also have generally lower cure rates and much longer treatment regimens. New topical formulations are being investigated as faster‐acting alternatives to the currently available topical treatments. Devices such as lasers have shown promise in improving the cosmetic appearance of the nail, but due to a high variation of study methods and definitions of cure, their effectiveness for onychomycosis has yet to be sufficiently proven. Recurrence rates for onychomycosis are high; once infected, patients should seek medical treatment as soon as possible and sanitize their shoes and socks. Prophylactic application of topicals and avoiding walking barefoot in public places may help prevent recurrence.

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Section: Novel Topical Therapiesmentioning

confidence: 99%

Onychomycosis: a review

Gupta

Stec

Summerbell

et al. 2020

Acad Dermatol Venereol

170

245

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“…There has been no progress in the development of new antifungals with anti-dermatophyte activity with oral administration route in recent years (Gupta et al, 2017). Although newer oral drugs, such as pramiconazole, ravuconazole, and albaconazole have been tested in vitro or by phase 1 to 2 clinical trials in dermatophyte infections (tinea corporis and onychomycosis), at present, they are not marketed for these indications (Hay, 2018). Even with this available arsenal, recurrences and reinfections are of great concern, especially in tinea pedis and onychomycosis, with reports of variation between 10 and 50% (Gupta et al, 2016(Gupta et al, , 2017.…”

Section: Introductionmentioning

confidence: 99%

Incorporation of Nonyl 3,4-Dihydroxybenzoate Into Nanostructured Lipid Systems: Effective Alternative for Maintaining Anti-Dermatophytic and Antibiofilm Activities and Reducing Toxicity at High Concentrations

et al. 2020

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Anti-Dermatophyte Biofilm of Nonyl 3,4-Dihydroxybenzoate Microemulsion respectively. Polarized light microscopy results confirmed the formation of NLS of the microemulsion type. Nonyl incorporated into NLS showed minimum inhibitory concentration (MIC) values, ranging from 2 to 15.6 mg/L. The toxicity tests presented cell viability higher than 80% in all tested concentrations, as well as, a significantly increased of the survival of Caenorhabditis elegans and zebrafish models. Anti-biofilm tests proved the efficacy of the incorporation. These findings contribute significantly to the search for new antifungals and allow the systemic administration of the compound, since the incorporation can increase the solubility of non-polar compounds, improve bioavailability, effectiveness and reduce toxicity.

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“…Fungal infections that affect the skin are commonly observed in all regions of the world and occur in a commensal manner, where fungal growth is related to superficial conditions of the epidermis, or pathogenically, resulting in the degradation of epidermal keratin and interaction with the host immune system . Dermatophytes and yeast of the genus Candida and Malassezia are aetiological agents most commonly observed in superficial cutaneous mycoses .…”

Section: Alternative Methods That Simulate Fungal Infectionsmentioning

confidence: 99%

Fungal infection models: Current progress of ex vivo methods

Quatrin

Lana

Kaminski

2019

Mycoses

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| INTRODUC TI ONThe principles developed by Russell and Burch in 1959, concerning the use of animals in research, have been updated in recent decades, and cover the use of tissues from dead animals as alternatives to in vivo methods. 1 In vivo tests generally involve a large number of specimens to obtain representative results, and the well-being of these animals has become an ethical issue to be respected. 2 The term ex vivo refers to the use of living tissues, which are removed from an organism in vivo, for the application in experiments that will be performed in an artificial environment. 3The murine models used to evaluate the therapeutic profile of new antifungal agents are addressed in several studies, such as induction of keratitis, onychomycosis, and systemic, vaginal, pulmonary and cutaneous infections. 4-9 However, it is important to maintain a balance between qualified science and animal well-being, using rational and ethical ways of research. In this scenario, ex vivo models that simulate fungal infections in nails, mucous membranes and skin are promising alternatives that have been showing considerable results. [10][11][12] In order to demonstrate new perspectives in the evaluation of antifungal therapy, we will approach a critical review of the main ex vivo techniques used in the simulation and treatment of mycoses, providing an adaptation of the widely used in vivo methods. | ME THODS | Data source SummaryExperimental alternative ex vivo models that simulate infectious processes in vivo are of fundamental importance for the evaluation of new drugs, since in some cases, their execution does not depend on the approval of an ethics committee in research.Although studies using alternative infectious models to evaluate the efficacy of antifungal molecules have been increasingly described and reported, there is no critical consensus that establishes the most appropriate ones regarding the type of infection. Numerous studies contemplate ex vivo protocols of fungal infections on nails, corneas, dentinal tubules and skin and reveal counterpoints and concordances not yet finely confronted. In this minireview, we propose a critical analysis of the main ex vivo models of fungal infections for the evaluation of new antifungal candidates for both topical and systemic use, as opposed to the advantages and disadvantages of the traditional in vivo models employed in preclinical research. K E Y W O R D S dentinal tubule infections, ex vivo models, mucosal infections, onychomycosis, skin infection, systemic infections | 861 MACIEL QUATRIN ET AL. How to cite this article: Maciel Quatrin P, Flores Dalla Lana D, Andrzejewski Kaminski TF, Meneghello Fuentefria A. Fungal infection models: Current progress of ex vivo methods.

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Therapy of Skin, Hair and Nail Fungal Infections

Cited by 82 publications

References 88 publications

Onychomycosis: a review

Onychomycosis: a review

Incorporation of Nonyl 3,4-Dihydroxybenzoate Into Nanostructured Lipid Systems: Effective Alternative for Maintaining Anti-Dermatophytic and Antibiofilm Activities and Reducing Toxicity at High Concentrations

Fungal infection models: Current progress of ex vivo methods

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