Update on therapy for superficial mycoses: review article part I

Abstract

Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets.

Topical antifungal‐corticosteroid combination therapy for the treatment of superficial mycoses: conclusions of an expert panel meeting

“…Superficial fungal infections affect the human hair, nails, epidermis and mucosa, and are most commonly caused by dermatophytes, which are obligate pathogens requiring keratin for survival . Less frequently, they can be caused by non‐dermatophyte moulds or Candida species .…”

“…The clinical picture of dermatomycoses is variable due to the degree of keratin destruction by the fungus and the inflammatory response of the host. It has been observed that the more adapted the dermatophyte is to its human host, the milder the resulting inflammatory response will be . For example, anthropophilic dermatophytes cause little inflammation but can cause recurrent or chronic infections, while zoophilic and geophilic dermatophytes tend to induce acute and highly inflammatory responses .…”

Antidermatophytic Activity of the Fruticose Lichen <em>Usnea orientalis</em>

“…Usnea orientalis Motyka (fruticose and corticolous lichen) was used ethno-medicinally in urinary tract problems, swelling, and edema [4]. Cutaneous infections caused by fungi generally produce boggy nodular swelling called kerion [5]. Cutaneous mycoses (skin infection) caused by filamentous keratinophilic fungi known as dermatophytes, composed of the three genera Trichophyton, Microsporum, and Epidermophyton [6].…”

“…Apart from wide prevalence, the dermatophytes have exhibited resistance against griseofulvin, terbinafine, and fluconazole [6,[11][12][13][14]. Although the prevalence of drug resistance in dermatophytes is rare, recurrence in patients is common with 60%-80% [15]. Based on the aforementioned literature, the new biological source in the form of U. orientalis was screened for its antidermatophytic property.…”

Synthesis and anticandidal evaluation of new benzothiazole derivatives with hydrazone moiety

“…The polyene amphotericin B, lipopeptide caspofungin and terbinafine as well as some azole compounds are most commonly used drugs in the treatment of fungal infections by acting with different mechanisms of action [4][5][6] . In fungal therapy, tolciclate and tolnaftate are the other effective antifungal entities, which also include sulfur atom in their structure 7 . However, the fungicidal activity of sulfurated compounds has been known since long before 8 .…”