Treatment of Tinea Capitis

Cognet

et al. 2020

JoF

Dermatophytes are filamentous keratinophilic fungi which affect nails, skin, and hair. Their variable distribution in the world justifies local epidemiological studies. During recent decades, few studies have been published regarding the epidemiology and etiology of dermatophytosis in Romania. The aim of this study was to identify the dermatophytes isolated from superficial fungal infections. To the best of our knowledge, this is the first such study conducted in the area of North-Western Romania. Over the past four years, samples collected from outpatients with suggestive lesions for dermatophytoses (nails, skin, hair), who addressed several private practice dermatologists from Cluj-Napoca, Romania, were sent to a specialized laboratory and examined by microscopy and culture. A total of 350 samples from 322 patients were examined. One hundred samples (28.6%) collected from 90 patients (27.9%) were positive by direct microscopy and/or culture. Among the 63 positive cultures (18%), 44 dermatophytes (69.8%), 2 molds (3.2%), and 17 yeasts (27%) were isolated. The main dermatophyte species identified were Trichophyton rubrum (mostly from onychomycosis) and Microsporum canis (from tinea capitis and tinea corporis in children). Yeasts (Candida species) were isolated from nails, especially from women.

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dermatophytes and Dermatophytosis in Cluj-Napoca, Romania—A 4-Year Cross-Sectional Study

Cognet

et al. 2020

JoF

“…Similar antifungal treatments are used worldwide for the most of them; however, there are some variations and country-specific guidelines should be consulted [ 1 , 9 ]. Most superficial infections caused by dermatophytes are successfully treated with terbinafine [ 1 , 12 ]. This antimycotic belongs to the allylamine group and is recommended as the first-line oral medication for the treatment of such infections [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

Intrinsic resistance to terbinafine among human and animal isolates of Trichophyton mentagrophytes related to amino acid substitution in the squalene epoxidase

et al. 2020

Background Dermatomycoses are the most common fungal infections in the world affecting a significant part of the human and animal population. The majority of zoophilic infections in humans are caused by Trichophyton mentagrophytes. Currently, the first-line drug for both oral and topical therapy is terbinafine. However, an increasing number of cases that are difficult to be cured with this drug have been noted in Europe and Asia. Resistance to terbinafine and other allylamines is very rare and usually correlated with point mutations in the squalene epoxidase gene resulting in single amino acid substitutions in the enzyme, which is crucial in the ergosterol synthesis pathway. Purpose Here, we report terbinafine-resistant T. mentagrophytes isolates among which one was an etiological factor of tinea capitis in a man and three were obtained from asymptomatic foxes in Poland. Methods We used the CLSI protocol to determine antifungal susceptibility profiles of naftifine, amphotericin B, griseofulvin, ketoconazole, miconazole, itraconazole, voriconazole, and ciclopirox. Moreover, the squalene epoxidase gene of the terbinafine-resistant strains was sequenced and analysed. Results In the genomes of all four resistant strains exhibiting elevated MICs to terbinafine (16 to 32 µg/ml), single-point mutations leading to Leu393Phe substitution in the squalene epoxidase enzyme were revealed. Among the other tested substances, a MIC50 value of 1 µg/ml was shown only for griseofulvin. Conclusion Finally, our study revealed that the terbinafine resistance phenomenon might not be acquired by exposure to the drug but can be intrinsic. This is evidenced by the description of the terbinafine-resistant strains isolated from the asymptomatic animals.

“…Most superficial infections caused by dermatophytes are successfully treated with terbinafine. 33,34 This antimycotic belongs to the allylamine group and is recommended as the first-line medication for the treatment of such infections and even sporotrichosis. 35,36 However, to the best of our knowledge, terbinafine resistance in T. mentagrophytes isolates and closely related…”

Section: Discussionmentioning

confidence: 99%

Therapeutic efficacy of topically used luliconazole vs. terbinafine 1% creams

Gnat

Dyląg

Łagowski

et al. 2021

Mycoses

Dermatophytoses are the most common agents of superficial fungal infections in the world, affecting a substantial part of the human population. 1,2 The increased frequency of fungal infectious diseases recorded in the last several years can be attributed to environmental factors, lifestyle and adaptation of fungi to the environment. For example, improper hygiene, occlusive footwear, socioeconomic conditions, new types of professions, animal breeding in flats, frequent trips to warm climate regions, civilisation diseases such as diabetes mellitus, increasing resistance of pathogens to antifungal substances and even climate change have been attributed to this notable increase in the prevalence of fungal infections. [3][4][5][6][7][8] In recent years, the introduction of new antifungal agents has provided major advances in the therapy of dermatophytosis. 3,8,9 One of such drugs, luliconazole, was first approved for therapy in Japan in 2005.Later, it was approved in India and the United States in 2010 and 2013, respectively. 10,11 This drug has an imidazole moiety introduced into the ketene dithioacetate structure, which effectively interferes with ergosterol biosynthesis by inhibition of sterol 14 α-demethylase. 11,12