Candidal Intertrigo Research Articles

Econazole Nitrate-Loaded MCM-41 for an Antifungal Topical Powder Formulation

The aim of this article was to prepare a topical powder for the treatment of fungal infections, such as Candida intertrigo and tinea pedis. Thus, an econazole nitrate (ECO) formulation with improved drug dissolution and proper moisture adsorption was designed. ECO was melt with the mesoporous silicate MCM-41 (drug/MCM-41 1/3) and the resulting inclusion compound was characterized by X-ray powder diffraction (XRPD) and differential scanning calorimetry (DSC). The drug loading was confirmed by the decrease of specific surface area and pore volume between MCM-41 and the inclusion compound. Formulations containing the inclusion compound were prepared and submitted to in vitro dissolution test and in vitro antifungal activity. A remarkable dissolution rate improvement as well as a higher antifungal activity was observed for the inclusion compound if compared to a commercial product. Moisture sorption properties for MCM-41 and formulations were evaluated as well.

Treatment of candidal intertrigo with a topical combination of isoconazole nitrate and diflucortolone valerate

Treatment of candidal intertrigo with a topical combination of isoconazole nitrate and diflucortolone valerate

Asymptomatic Inguinal Micropapules in a Patient Treated With Chemotherapy

The patient was a 32-year-old woman diagnosed 18 months earlier with nodular sclerosing Hodgkin lymphoma, Ann Arbor stage IIIA (supradiaphragmatic and infradiaphragmatic lymph node involvement and absence of B symptoms). She had initially been treated with 6 cycles of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine). On recurrence of the lymphoma, she was treated with 2 cycles of c-MOPP (cyclophosphamide, vincristine, prednisone, and procarbazine), which was substituted by GPD (gemcitabine, cisplatin, and dexamethasone) due to neurological toxicity (paraesthesias). It was then decided to perform autologous peripheral blood hematopoietic stem cell transplantation after conditioning with melphalan and whole-body irradiation. On day 5 after transplantation, asymptomatic skin lesions developed in both inguinal regions, initially diagnosed as candidal intertrigo. Ten days later, due to persistence of the lesions despite systemic antifungal treatment, the patient was referred to dermatology.

Utilisation des antifongiques topiques

Topical antifungal agents are not absorbed when given orally. They act by direct contact on the fungus, this type of action requires the simultaneous presence of antifungal and fungus for a minimum of time. There are a large number of compounds belonging to different families of antifungals: polyens, azoles, allylamine and morpholine and antiseptic substances. The treatment of oropharyngeal candidiasis is based on topical antifungal agents: amphotericin B or nystatin, imidazoles such as clotrimazole or miconazole. Systemic antifungal agents are indicated in case or poor compliance to topical agents, in prophylaxis of highly relapsing disease, in oesophageal candidiasis and in Candida onychomycosis. A topical antifungal agent is the first choice to treat Candida intertrigo. In any case predisposing factors should be eradicated or amended. Infection to Malassezia spp. are treated topically with azoles or selenium sulphur. Oral ketoconazole is an alternative in severe cases. Dermatophytosis requires a systemic antifungal treatment such as terbinafine in chronic, dry, moccassin type palmoplantar infection and for onychomycosis. Intertrigo and tinea corporis are treated with topical agents such as azoles, terbinafine or tolnaftate. Tinea capitis responds to oral griseofulvine, however a topical antifungal must be added to eradicate contagious conidia. Whatever the localisation is, an other superficial site of infection must be looked for and a source of infection should be investigated and eradicated.

Candidal intertrigo: Treatment with filter paper soaked in Castellani′s paint

Candidal intertrigo: Treatment with filter paper soaked in Castellani′s paint

Tinea cruris in Routine Urology Practice

Introduction: Tinea cruris is almost exclusively a male dermatophytosis. This infection is also sexually transmitted, and may cause epidemics in public areas such as common bathing facilities, dormitories and among military recruits. It has been aimed to investigate the prevalence and the causative agents of tinea cruris and tinea pedis in patients who were admitted to the Department of Urology with various pathologies. Materials and Methods: Direct microscopy and cultures of the epithelial scrapings were performed to identify the causative agent in patients who were admitted to the Department of Urology. Results: Out of a total of 155 cases examined, 39 (25.1%) were mycologically proven cases of dermatomycosis. In 11 (28.2%) of the patients tinea pedis, in 3 (7.7%) tinea cruris and in 10 (25.6%) Candida intertrigo were detected. In the remaining 15 (38.5%) cases, only direct microscopic examinations were found positive. The most common causative agent was Candida albicans (33.4%) followed by Trichophyton rubrum (29.1%), Trichophyton mentagrophytes var. interdigitale (29.1%), Candida glabrata (4.2%) and Candida tropicalis (4.2%).Conclusion: The investigation of genital dermatomycosis should be a part of routine urological examination and the clinical diagnosis should be confirmed by mycological methods.

Superficial Fungal Infections Seen at the National Skin Centre, Singapore

Cutaneous fungal infections are common in Singapore. The National Skin Centre is a tertiary referral centre for dermatological diseases in the country, and sees more than 2,500 cases of superficial fungal infections annually. This study analyses data collated from the centre's medical record office as well as fungal culture results from the mycology laboratory. From 1999 to 2003, there were a total of 12,903 cases of superficial fungal infections seen at the centre. The majority of patients (n=9335) (72.3%) were males. The most common infection was tinea pedis (n=3516) (27.3%), followed by pityriasis versicolor (n=3249) (25.2%) and tinea cruris (n=1745) (13.5%). Candidal infections were also common (n=1430), the majority of which were cases of candidal intertrigo. There were very few cases of tinea capitis, which is uncommon in Singapore. The number of cases of onychomycosis has shown a rising trend over the past 5 years. Trichophyton rubrum was the most prevalent fungal pathogen isolated from all cases of superficial fungal infections of the skin, except for tinea pedis, where Trichophyton interdigitale was the most frequently isolated organism. Dermatophytes remain the most commonly isolated fungal pathogens isolated in toenail onychomycosis, whilst Candida species accounted for the majority of isolates in fingernail onychomycosis. Current epidemiologic trends of superficial fungal infections in Singapore show some similarities to recent studies from the United Kingdom and United States.

Prevalence and Risk Factors for Superficial Fungal Infections among Italian Navy Cadets

Background: Limited studies on the prevalence and risk factors for superficial mycoses are available. Objective: The aim of this paper was to evaluate the prevalence and risk factors for superficial mycoses (dermatophytes and Candida spp.) in a sample of young Italian people resident at a military school. Methods: A total of 1,024 young cadets from the Italian Navy Petty Officers School in Taranto, including 975 (95.21%) males and 49 (4.79%) females, mean age 22.5 ± 3.0 years (range 18–30), were consecutively examined by the same observer. A complete dermatological examination was performed on all the subjects, and skin scrapings for microscopy and fungal culture were obtained from suspected lesions. All the subjects completed a questionnaire providing information on sports practice, swimming-pool attendance, marching, wearing shower sandals, frequent use of ‘gummed’ shoes, history of severe traumas to the nails, presence of hyperhidrosis and history of superficial mycoses. The affected subjects were also asked if they were aware of their condition. Data were analysed by the Statistical Analysis System, version 8.0. The Fisher exact test and odds ratios were calculated. Results: A total of 33 subjects (3.2%) were found to suffer from a mycologically confirmed fungal infection (3% by dermatophytes and 0.2% by Candida albicans): tinea pedis/Candida intertrigo of the feet was suspected in 126 (12.1%) subjects and confirmed in 30 (2.9%), including 28 cases of tinea pedis and 2 cases of Candida intertrigo; tinea cruris/Candida intertrigo of the groin was suspected in 28 (2.7%) subjects, but confirmed in only 1 case (0.1%); onychomycosis was suspected in 64 (6.1%) subjects and confirmed in 2 cases (0.2%). The organism most frequently responsible in tinea pedis was Trichophyton mentagrophytes var. interdigitale (82.1%). The same species (50%) and T. mentagrophytes var. mentagrophytes (50%) were associated with tinea unguium, Epidermophyton floccosum was the only species detected in tinea cruris. Non-dermatophytic filamentous fungi (Penicillium spp., Fusarium spp., Aspergillus spp. and Paecilomyces spp.), not considered pathogenic, were isolated in 48 samples. None of the risk factors analysed were significantly associated with fungal infection. Only 2 subjects out of the 33 people affected were aware of their condition. They both had tinea pedis. Conclusion: The prevalence of mycoses in sailors living in an Italian military school was lower than rates detected in other military populations. This may be due to the cadets’ lifestyle and environmental conditions. The most frequent infection was tinea pedis, mainly caused by T. interdigitale. None of the investigated risk factors were significantly associated with the disease, and most of the affected individuals were not aware of their condition.

Dermatological findings correlated with CD4 lymphocyte counts in a prospective 3 year study of 1161 patients with human immunodeficiency virus disease predominantly acquired through intravenous drug abuse

Several prospective studies on dermatological findings in human immunodeficiency virus (HIV) type 1 infected patients have been published, mostly in populations in which the predominant risk factor for HIV infection is homosexuality. We attempted to identify cutaneous diseases associated with HIV-1 infection and to assess disease progression in a cohort of Spanish patients in whom the predominant cause of HIV infection was intravenous drug abuse. We prospectively examined 1161 HIV-1-positive patients for 38 months. Seventy-four per cent of patients were intravenous drug abusers, whereas heterosexual contact was the only risk factor in 14% and homosexuality in 9%. Centers for Disease Control stage II disease predominated (51%), whereas stage IV disease was less frequent (39%). The mean CD4 count was 353/mm3. We took patients' past and present medical history and performed a complete physical examination as well as taking photographs and carrying out the necessary diagnostic procedures. CD4 counts/mm3 were measured at each visit. A diagnosis of cutaneous disease was made in 799 patients (69%). Oral candidiasis and seborrhoeic dermatitis were the most common skin disorders, followed by xerosis, drug eruptions, dermatophytosis and the papular eruption of acquired immunodeficiency syndrome. Condyloma acuminatum, herpes zoster and herpes simplex were the most frequent viral infections. Conditions that have a statistically significant association with advanced stage and low CD4 levels include drug eruptions, xerosis, light reactions, diffuse alopecia, herpes simplex, oral candidiasis, psoriasis, oral hairy leucoplakia, molluscum contagiosum, Kaposi's sarcoma, furuncles, candidal intertrigo, folliculitis and ungual infection, as well as onychomycosis and tinea pedis or manuum. Dermatoses commonly associated with homosexuality, such as Kaposi's sarcoma and oral hairy leucoplakia, were rare in our patients.

Superficial fungal infections of the skin: Tinea corporis, tinea pedis, and Candida intertrigo

Tinea corporis, tinea pedis, and Candida intertrigo are common superficial fungal infections. Tinea corporis and tinea pedis are dermatophyte infections transmitted from domestic animals and the environment, respectively. Excessive sweating and poor circulation are the most important predisposing factors for tinea pedis. Candida intertrigo may occur in patients with conditions that alter host immunity, such as pregnancy, malignancy, diabetes mellitus, and glucocorticoid therapy. The presence of these infections is suspected from the location and appearance of the lesion, and the diagnosis is confirmed by examination of a potassium hydroxide preparation or by culture. Treatment is based on the severity and extent of the infection. Mild infections generally respond to topical antifungal agents, and more severe infections often require systemic therapy.

Biochemical and physiological parameters on the healthy skin surface of persons with candidal intertrigo and of persons with tinea cruris.

Biochemical and physiological tests were carried out on the skin surface of 20 patients with candidal intertrigo and 27 patients with tinea cruris. In all patients the test areas were free of efflorescences. The same tests were performed in 39 and 27 resectively healthy test persons of the same age and sex. The following striking findings came to light: 1. There was a significant decrease in the percentage amount of squalene in the skin surface lipids of the moniliasis group as compared with the control group. 2. There was a significant decrease in the reducing substances in the so called water solubles obtained with the phenol sulfuric acid method in the moniliasis group. The same results were obtained when only those moniliasis patients who were definitely not suffering from diabetes mellitus were taken into account. This is presumably a question of a reduction in the bound carbohydrates. 3. There were significantly more amino acids extractable from the skin surface of the tinea cruris patients than of the control persons. These results point to important predisposing factors for the susceptibility to candidal intertrigo and tinea cruris respectively.