Dermatophytosis Research Articles

Infections in Patients with Atopic Dermatitis and the Influence of Treatment.

Atopic dermatitis (AD) is a T helper 2-mediated chronic inflammatory skin disease that affects children and adults. Patients with AD are prone to recurrent infections of the skin and other organs, which can severely worsen the disease course. This review summarises the current evidence on the aetiology, pathogenesis, treatment and prevention of infections in patients with AD. PubMed was searched for English-language research articles, systematic reviews, meta-analyses and guidelines published until February 2023 using the key term "atopic dermatitis" and terms relevant to infections. Patients with AD have an increased risk of bacterial, viral and fungal infections of the skin, mainly due to impaired barrier function, altered immune response and frequent scratching. The most common pathogens are Staphylococcus aureus and herpes simplex virus, which can cause impetigo, folliculitis, abscesses, eczema herpeticum and other complications. They also appear to increase susceptibility to systemic infections, including respiratory and urinary tract infections and sepsis. Certain systemic treatments for AD, such as mycophenolate mofetil and Janus kinase inhibitors, increase the risk of viral infections. Prevention and treatment of recurrent infections in patients with AD require a multifaceted approach that includes topical and systemic antimicrobials, skin care and effective control of AD symptoms (to break the itch-scratch cycle). Preventing and limiting the development of infections are important considerations in choosing an AD treatment.

P-1020. Randomized control trial to study the effectiveness of tablet Fluconazole, capsule Itraconazole and tablet Terbinafine in superficial dermatophytosis

Abstract Background According to the World Health Organization, dermatophytosis is a relatively frequent superficial fungal infection of the keratinizing structures of the body with a prevalence of 20% - 25% worldwide. The organism is more widespread in tropical areas, with India acting as the main infection hub, because it prefers a hot and humid climate. Tinea corporis is the most common kind of superficial dermatophytic infection, second most common is tinea cruris followed by tinea capitis, tinea unguium, tinea faciei, tinea manuum and tinea pedis. Hot, humid weather, overcrowding, poverty, poor cleanliness, lack of health-care facilities, immunosuppression, and irrational drug use are all risk factors for dermatophytosis. Fungal skin infection responding to Oral Itraconazole Clinical response of Dermatophyte infection to Oral Itraconazole at 4 and 8 weeks as compared to baseline Methods Total of 180 patients were included in the study and divided into 3 groups based on the day of visit to the hospital and antifungals Fluconazolee, itraconazole or Terbinafine were randomly prescribed to them (60 patients in each group). Patients were followed up at 4th and 8th week for therapy response. Results At the end of 8th week KOH (Potassium hydroxide) mount was found to be negative in 86.67%, 73.33% and 63.33% among Itraconazole Fluconazole and Terbinafine groups respectively which was highly significant. Conclusion Dermatophytosis is comparatively more commonly seen in physically active age group. Clinical features waned off quicker and better with Itraconazole in comparison to Fluconazole and Terbinafine. Again fluconazole was found to be yielding better clinical outcome than Terbinafine. Overall outcome of patients with dermatophytosis was found to be more satisfactory with a 4 week oral dose of itraconazole. So from this study we conclude that Itraconazole is a better choice of drug for Dermatophytosis compared to Fluconazole and Terbinafine. Also fluconazole is comparatively a better choice than Terbinafine for the same. Disclosures All Authors: No reported disclosures

Tinea manuum: a 5 year retrospective study of demographic data, clinical characteristics, and treatment outcomes

Tinea manuum is a superficial fungal infection affecting the hands, particularly the palms and interdigital areas. This retrospective study investigated clinical features, laboratory findings, treatment, and outcomes in patients with fungal hand infections at Siriraj Hospital between 2016 and 2020. Among 107 patients, representing 1.3% of those with fungal skin infections, 64.5% were male, with a mean age of 54.3 ± 18.5 years. Diabetes mellitus was present in 26.2%, and 23.4% had prior topical steroid use. The most common symptom was itching (75.7%), while palm-scale (85.9%) was the most prevalent clinical finding. Concurrent fingernail onychomycosis was observed in 43%, and 59.8% had additional fungal skin infections. Among 50 positive cultures, dermatophytes accounted for 86% and nondermatophytes for 14%, with Trichophyton rubrum (54%) and Trichophyton mentagrophytes complex (24%) being the most frequent pathogens. Systemic antifungal treatment was administered to 57% of patients, with a mycological cure rate of 56.4%. A complete cure was achieved in 60.5% of dermatophyte infections but in none of the nondermatophyte cases (p = 0.003). These findings highlighted that tinea manuum could be caused by both dermatophytes and nondermatophytes, with significantly poorer outcomes observed in nondermatophyte infections. Concurrent fungal skin and nail infections should be evaluated for optimal management.

Epidemiological Analysis of Fungal Infection Disease in Pediatric Population: Focus on Hospitalization from 2007 to 2022 in Veneto Region in Italy.

Fungal infections (FIs) are widespread globally, affecting both immunocompromised and immunocompetent children, with varying clinical implications based on age and comorbidities. In immunocompromised children, particularly those with hematologic oncological conditions, FI leads to substantially longer hospital stays and increased in-hospital mortality, with reported rates ranging from 15% to 20%. Our study aims to analyze the epidemiological trends of fungal infections in the pediatric population within a specific region of Italy. We extracted ICD-9 codes related to fungal infections from hospital discharge records (HDRs) in the pediatric population of Veneto, located in the north-east of Italy, between 2007 and 2022. We included all children admitted to the hospital with a primary or secondary diagnosis during admission for other reasons. Data were stratified based on age, year, ward of admission, and type of diagnosis. Patients older than eighteen and HDRs related to a second admission within thirty days from the previous admission were excluded. A total of 1433 diagnoses were analyzed during the period, with 241 (16.8%) as main diagnoses and 1192 (83.2%) as secondary diagnoses. The overall hospitalization rate was 1084 cases/100,000 (1.69 cases/100,000 as primary diagnosis and 8.95 cases/100,000 as secondary). The hospitalization rate stratified for age was 11,055 cases/100,000 among infants younger than 1 year, 8.48 cases/100,000 among those aged 1-4 years, and 4.4 cases/100,000 among children older than 5. The more frequent infection was Candida spp. (62.8%), followed by Aspergillus spp. (14.6%) and skin mycosis (9.5%). Overall, the pediatric in-hospital case fatality rate due to FI was 2.09%. Our study elucidated the overall experience of fungal infections in the pediatric population of the Veneto region in Italy. Specifically, we underscored a relatively stable hospitalization rate for fungal diseases and a noteworthy mortality rate.

Decoding Fungal Skin Infections: Current and Emerging Trends in Diagnosis and Management

Decoding Fungal Skin Infections: Current and Emerging Trends in Diagnosis and Management

Examining Itraconazole Gel’s Effectiveness in Treating Fungal Dermatological Condition

Itraconazole is an antifungal medication commonly used to treat a variety of systemic and superficial fungal infections. While itraconazole is typically available in oral capsuleform, you can combine them to create a topical gel to treat fungal skin infections. This process involves extracting the active ingredientsfrom itraconazole capsules and incorporating them into a suitable gel base, such as a carbomer or hydroxyethyl cellulose -based formulation. The gel base is prepared by dissolving the active ingredient in an appropriate solvent, followed by careful mixing to ensure uniform distribution of itraconazole. Additional ingredients,such as preservatives and pH adjusters, may be added to enhance stability and self-life. The final gel formulation is packaged in airtight containers to protect it from degradation. Topical itraconazole gel provides a localized treatment for fungal infection on theskin, with the potential for improved drug delivery to affected areas. However, Healthcare practitioners should prescribe compounded itraconazole gels and assess their safety and effectiveness depending on patient-specific characteristics and the kind of infection.

Anti-Candida albicans effect and mechanism of Pachysandra axillaris Franch.

Pachysandra axillaris Franch., a traditional herbal medicine in Yunnan, has been used to treat traumatic injuries and stomach ailments, some of which were related to microbial infections in conventional applications, but, to the best of our knowledge, the antifungal bioactivity of this plant and its main antifungal components have not been previously reported. To identify the antifungal compounds of P. axillaris against fluconazole-resistant C. albicans in vitro and in vivo, and then elucidate the underlying mechanism of action. The antifungal compounds were obtained by bioguided isolation, and then they were investigated in vitro by MIC, growth curves, time-kill assay, and drug resistance induction. The antifungal mechanism was explored using combined network pharmacology and metabolomic analysis, and further supported by analyzing sterol composition using LC-MS/MS, scanning and transmission electron microscopy observation of fungal cell morphology, examining its effects on cell membranes using the fluorescent probes and RT-qPCR. Additionally, the antifungal effect in vivo was evaluated by a murine C. albicans skin infection model. Three bioactive compounds from P. axillaris efficiently inhibited fluconazole-resistant C. albicans (MIC=4μg/mL), in which the major compound, pachysamine M, affected the ergosterol biosynthesis pathway by inhibiting ERG genes (ERG1, ERG4, ERG7, ERG9, and ERG24), leading to the accumulation of squalene, lanosterol, and zymosterol. So, pachysamine M targeted cell membranes in vitro by reducing the ergosterol level, to avoid drug resistance. In addition, it promoted wound healing, reduced fungal load, and alleviated inflammation in vivo. Pachysamine M, an antifungal compound without reported before, inhibited fluconazole-resistant C. albicans efficiently in vitro and in vivo, and its mechanism targeted cell membranes, reducing the risk of drug resistance, which validated the traditional use of P. axillaris for the treatment of fungal skin infections.

Clinicomycological Correlation of Tinea Incognito

Background: Tinea incognito refers to the unusual clinical manifestation of dermatophytosis brought on by prior topical or systemic medication use. Given the widespread and easy diagnosis of dermatophytic infections, steroid usage has created a diagnostic conundrum, thus turning a straightforward infection that may be treated into a persistent, long-term skin disease. Objective: To examine the clinical characteristics of tinea incognito and correlate the clinical manifestations with the microbiological findings. Methods: An observational study was conducted with 100 cases in a department of microbiology, dermatology, venereology, and leprology, in India. The baseline data of the patients and clinical features of tinea incognito were recorded. To identify the causative agents, skin scrapes were collected and tested as per standard protocol. Results: In this study, 30% of the patients were between 31 and 40 years old. The male-to-female ratio was 2:1, 66% reported a history of application of the triple combination of steroids, and 34% used single steroids. Tinea corporis was seen in 30% of the patients, and the trunk/body (52%) was the most frequent site, followed by other sites (34%). Potassium hydroxide positivity was observed in 75% of the cases, cultural positivity in 77%, and both tests were positive in 75%. The most common organisms found were T. mentagrophytes (72.7 (56/77)%), T. rubrum (19.5 (15/77)%), and T. tonsurens 7.8 (6/77)%. Conclusion: Tinea incognito is a fungal skin infection that can present with various nonspecific clinical features. This steroid-modified dermatophytosis is largely under-reported because the underlying fungal infection is masked by the irrational use of topical steroids

Structure of mycoses of the skin and its appendices in HIV-infected patients

The spread of HIV infection is one of the most pressing problems of modern health care. The purpose of the work is to analyze the structure of the disease on the surface of the skin and its appendages by the nosological forms in HIV-infected persons and to establish a possible correlation between the presence of fungal lesions. The data obtained from 801 patients who sought medical help at the «Chernivtsi Regional Medical Center for Socially Significant Diseases» for the period from 2018 to 2023 were analyzed. The diagnosis of HIV infection was established according to the International Classification of Diseases of the 10th revision (ICD-10) and verified by the detection of specific serological and molecular biological markers of HIV. Mycological examination included micro­scopy of pathological material and cultural diagnosis. Analysing the structure of the disease it was found that skin mycoses and its appendages were detected in 334 (41,7%) HIV-infected patients. The main part of such patients – 237 (71%) – did not receive antiretroviral therapy (ART). Accordingly, dermatomycosis was detected in only 97 people (29%) who were adherent to ART. The relative risk method confirms the assessment of the effect of ART on the frequency of combined forms of mycosis – RR=0.608, which indicates the obvious rarity of the event (mycosis of the skin and its appendages), compared to the group that did not receive ART. A statistically significant direct relationship was established between the presence of a fungal skin lesion and its applications and indicators of HIV load in the blood – r=0.421...0.460 at p<0.001, as well as the duration of HIV infection – r=0.573...0.611 at p<0.01 . In addition, there is a clear positive correlation of medium strength between the duration of HIV infection and the level of viremia – r=0.388...0.427 at p<0.01, as well as an inverse weak relationship with the number of CD4+-lymphocytes – r=-0.105. ..-0.204 at p<0.05. The number of CD4+-lymphocytes was expected to be in an inverse correlation of medium strength with the HIV load (r=-0.618...-0.682, p<0.01). The relative risk of the development of mycoses of the skin and its applications in HIV-infected patients under the condition of antiretroviral therapy is only 0.262 (0.225-0.298), which indicates an obvious rarity of the event, compared to the group that did not receive antiretroviral therapy. The majority of HIV-infected patients (62.3%) have a combination of several nosological forms of mycosis of the skin and its applications. A strong inverse relationship between the probability of developing combined forms of mycoses and receiving antiretroviral therapy was revealed – r=-0.719...-0.806 at p<0.001. In the absence of antiretroviral therapy, a statistically significant direct relationship was established between the presence of fungal lesions of the skin and its appendages and indicators of HIV load in the blood, as well as the duration of HIV infection.

Development and Evaluation of Antifungal Gel from Garlic Powder

Introduction: Garlic has long been recognized for its antifungal properties, but could not find strong place in formulation and development due to the unstable nature of allicin, a sulfur-rich compound present in garlic, referred to as di-allyl thiosulfinate, plays a key role in inhibiting fungal growth. Objectives: Purpose of the study was to use microwave-processed garlic powder in formulation and development of multipurpose antifungal gel using carbopol as a gelling polymer. Materials and Methods: Antifungal Susceptibility testing was performed as per CLSI guidelines using processed garlic powder against Candida albicans (MTCC 277) and Malassezia furfur (MTCC No-1374) as prominent species involved in fungal infections of hair, skin and vagina. Carbopol 934 was used to develop and optimize the gel formulations. A skin irritation assessment was conducted using the HET-CAM test method. Results and Discussion: The antifungal activity of gel was observed for 24, 48, 72 hours and further observations were continued for seven days’ period and effective concentration was identified, wherein formulation prepared with 1% concentration of garlic powder was found to be prominently effective. The results from the HET-CAM test confirmed the non-irritating properties of the formulated product. In the positive control, coagulation occurred within 0.5 seconds of application, while no such reaction was observed with the developed antifungal gel formulation, indicating its lack of irritancy. Conclusion: The developed antifungal gel formulation using microwave-processed garlic powder was found to be stable and effective for longer with no skin irritation observed.

MANAGEMENT OF DADRU KUSHTA BY SHODHANA AND SHAMANA CHIKITSA- A SINGLE CASE STUDY

In recent, there has been an increase in skin problems due to a fast lifestyle, less immunity, unhygienic living conditions, and poor nutrition. Skin is the most exposed and largest organ of the body. From a cosmetic point of view, a patient who suffers from any skin disease experiences physical, emotional and socio-economic embarrassment in their society because the mirror that reflects internal & external pathology in such diseases is the skin, which helps in diagnosis. Among various skin infections, tinea/ringworm is spreading rapidly and affecting all the age groups of the population. In Ayurveda, Skin infection is termed Twak Vikara or Kushtha roga. Dadru is termed as a Dadru Kushtha. In contemporary medicine, tinea/ringworm, a skin fungal infection, is correlated to Dadru Kushta due to similarities in their signs and symptoms. A prevalence study demonstrated that 20-30% of the population have skin problems requiring attention. The present study was conducted on a patient diagnosed with Dadru kushta for 1 year. Acharya Charaka mentioned Shodhana Chikitsa and Shamana Chikitsa for the purification of Kushtha Roga. Considering the signs and symptoms, the patient was treated with classical Vamana Karma (therapeutic emesis) and Virechana Karma (therapeutic purgation) and shamana chikitsa. Assessment was done before treatment and after treatment with PASI Score. The results were highly significant in various subjective and objective parameters like Raga, Kandu and the number of Pidika and Mandala after treatment. During the follow-up period of 15 days, the drug effect suggested a sustained impact on the Dadru kushta.

Fungal Infection of the Skin –In The Current Scenario

The incidence of fungal infections is increasing at an alarming rate, presenting an enormous challenge to healthcare professionals. COVID-19 associated Mucormycosis (CAM) was mostly isolated during the second wave with mortality rate of almost 31-50%. Superficial and subcutaneous fungal infections affect the skin, keratinous tissues and mucous membranes. Included in this class are some of the most frequently occurring skin diseases, affecting millions of people worldwide. Although rarely life threatening, they can have debilitating effects on a person‘s quality of life and may in some circumstances spread to other individuals or become invasive. Most superficial and subcutaneous fungal infections are easily diagnosed and readily amenable to treatment. The indications for the use of currently available diagnosis and test, antifungal agents, their adverse effects, drug interactions, drugs resistance and COVID-19–associated mucormycosis in India.

Machine Learning Techniques for Skin Fungal Infection Detection -A Review

Skin diseases are the most common than other diseases. Skin diseases may be caused by fungal infection, allergy, bacteria, viruses, etc. Fungal disease affects more than billions people worldwide. The accurately of diagnosing skin fungal infections can be challenging in their early stages or present with symptoms, which mimic other dermatological disorders. The identification and categorization of skin fungal infections could be improved by recent developments in deep learning and artificial intelligence (AI). It offers a more effective and dependable substitute for conventional diagnostic techniques. Here we tried to focus on various methods for identifying fungal skin that rely on deep learning (such as transformers, convolutional neural networks, and hybrid models), the difficulties related to data diversity and availability, going over the shortcomings of current datasets, how data augmentation and synthetic data creation which might help close these gaps. We also investigate how improving interpretability and usability can help clinical uptake of AI-based diagnostic systems. Finally, the study concludes with suggestions for further research, highlighting the revolutionary potential of deep learning in dermatology and stressing the necessity of sophisticated model architectures, a wide range of high-quality datasets, and thorough clinical validation.

Dermatophytes: Fungal infections of the skin, nails and hair

Dermatophytes: Fungal infections of the skin, nails and hair

Ethno-Medicinal Uses of Dongoria Kandha of Niyamgiri Hill, Odisha, India

Background: In the current study, the Ethnomedicinal data have been collected from tribal people of Niyamgiri hill region of Kalahandi district, Odisha, India. The tribals of this region have been using the medicinal plants to treat various diseases since the time immemorial. Objective: The main objective is to find out the mostly used plant parts and their Ethnomedicinal values used to cure different diseases by tribal people of Niyamgiri hill region of Kalahandi district, Odisha, India. Methods: It includes to record the information on medicinal uses of plant by leading healers by taking interviews and recording the comprehensive knowledge about the medicinal properties of different plants with the snow ball technique and sampling method. Plants are recognized by the local practitioner also known as Kabiraja or Vaidya in forest floor and were classified botanically. Results: The present study records the use of different parts of 50 plant species which belongs to 47 genera of 35 families, against 48 human diseases, with special reference to diarrhoea, dysentery, cold, cough, piles and fever. The practitioners use these plants to treat kinds of ailments like asthma, skin diseases, constipation, diabetes, toothache, wound healing, headache, infertility in women, mouth ulcer, insect bites, ring worms, thirst and eczema. All these medicinal plants are used as healing sources as there is not modern medical facilities available nearby. The collected data are analysed through use value (UV). Bacopa monnieri (UV of 1.50), Bryonia laciniosa (UV of 1.33), Andrographis paniculata (UV of 1.0), Bryophyllum pinnatum (UV of 0.83) and Celastrus paniculalus (UV of 0.83) are the most frequently and popularly used medicinal plant species in the study area. Conclusion: 50 plant species that were collected from Niyamgiri hill region. It is found that still a large number of tribal people use their traditional knowledge and culture and have adopted herbal therapy for most of the diseases because of the strong belief of the local practitioners.

TECHNICAL AND PATENT PERSPECTIVE ON FILM FORMING TOPICAL SPRAYS

Film-forming systems were a viable option for topical and transdermal medication administration in the present study. Medication administered via the skin serves two purposes: topical treatment of skin disorders and transdermal drug absorption into the circulation. Apart from the ease of self-administration, the topical route provides a broad and diverse surface and functions as a substitute for oral and hypodermic injection drug delivery routes. Existing dosage forms, such as creams, patches, and ointments, have several drawbacks. In addition to being unsightly, patches can be painful to put on curved surfaces, create discomfort while peeling off, and most often cause skin irritation because of their occlusive qualities, which block sweat ducts and prevent perspiration from evaporating from the skin surface. This review encompasses the mechanism of polymers, such as ethyl cellulose and Eudragit types, plasticizers, and penetration enhancers utilized in film formation. Overall, polymeric film-forming sprays exhibit substantial potential for the convenient administration of antibiotics and antiseptics to treat bacterial, fungal, and viral skin infections. The application of topical medication is thought to result in both local and systemic effects. The physicochemical characteristics of the medication and patient adherence determine how well the topical treatment works. Poor permeability and poor adherence to the skin are some of the disadvantages of conventional pharmaceutical formulations for topical and dermatological administration. The development of medication delivery technologies intended for topical administration to the skin includes the use of topical film-forming systems.

Cutaneous Innate Lymphoid Populations Drive IL-17A-Mediated Immunity in Nannizzia gypsea Dermatophytosis.

Fungal skin infections significantly contribute to the global human disease burden, yet our understanding of cutaneous immunity against dermatophytes remains limited. Previously, we developed a model of epicutaneous infection with Microsporum canis in C57BL/6 mice, which highlighted the critical role of IL-17RA signaling in antidermatophyte defenses. In this study, we expanded our investigation to the human pathogen Nannizzia gypsea and demonstrated that skin γδTCRint and CD8/CD4 double-negative βTCR+ T cells are the principal producers of IL-17A during dermatophytosis. These IL-17A+ T cells exhibited an activated/memory phenotype, including a subset of proliferating tissue-resident cells. Notably, restriction of lymphocyte trafficking after fingolimod administration in infected mice did not lead to increased susceptibility, indicating that local antifungal defenses are independent of T-cell priming in lymph nodes. In addition, Rag1-/- mice lacking T and B lymphocytes effectively controlled infection and exhibited increased IL-17A production by innate lymphoid cells. Furthermore, Rag2-/-Il2rg-/- mice, devoid of T, B, and innate lymphoid cells, were highly susceptible to dermatophytosis compared with Rag2-/-or wild-type mice, demonstrating that innate lymphoid cells are sufficient to antifungal defenses in T-cell-deficient mice. In conclusion, our study underscores the coordinated interplay between skin γδT, αβT, and innate lymphoid cell subsets in controlling primary N gypsea dermatophytosis.

Development of a topical formulation of a thiadiazole derivative

Introduction. Development of broad-spectrum antibacterial medicines for treatment of bacterial and fungal infections of animal skin is an urgent task of pharmaceutical industry, medicine and agricultural industry. The most promising dosage form for the treatment of superficial infectious diseases is gel. The most important advantages are the absence of side effects associated with ingestion, as well as the formation of a protective film that prevents re-infection of the animal.Aim. To develop the composition of topical form in the form of gel on the basis of active pharmaceutical substance with a wide spectrum of antimicrobial action for therapy of infectious diseases of animal skin.Materials and methods. The object of the study was an original substance – thiadiazole derivative, obtained by the organic synthesis department of the Department of Organic Chemistry of the Federal State Budgetary Educational Institution of Higher Professional Education SPHFU of the Ministry of Health of Russia. Gel formers (sodium alginate and carbomer), propylene glycol, surfactants (surfactants), etc. were used in the work. The obtained thiadiazole gels were studied in terms of pH, appearance, thermostability, colloidal stability, film formation, in addition, the rheological properties of the gels were determined.Results and discussion. It was found that gels in which sodium alginate and carbomer acted simultaneously as gel formers had thixotropic properties providing the best stability of the structure. The gels in which glycerin was added formed an elastic film preventing damage and drying of the animal skin.Conclusion. As a result of this study, a topical formulation in the form of a gel containing a new thiadiazole derivative was developed for the treatment of infectious diseases of animal skin.

Fungal Skin Diseases and Associated Factors in Outpatients of Bangabandhu Memorial Hospital, Chattogram

Background: Fungi are ubiquitous in nature and exist as free living saprobes that derive no obvious benefits from parasitizing human. Fungal infection or mycosis is a disease caused by fungi. The prime objective was to determine the prevalence of the fungal skin diseases and explore the associate factors including socio-economic status, demographical and personal hygiene of the patients. Materials and methods: This cross sectional research study was performed in the Outpatients Department of Dermatology and Venereology, Bangabandhu Memorial Hospital, Chattogram during the period from January 2023 to April 2023 (120 days). A total number of 200 patients were randomly selected. Results : Among 200 patients, 75 patients had fungal infection with highest prevalence (37.50%) where ringworm 58(77.33%) and oral candidiasis 3(4.00%) where highest and lowest. In case of associate factors, summer season (60.00%) married (77.67%) secondary education (36.00%) Tk 15000/- Tk-20,000/- monthly (37.33%) and upper middle class status (37.33%) Muslims (86.67%) Traders (32.00%) Urban areas (70.66%) tap water (69.33%) recurrent infections (62.66%) and Overcrowding family (66.66%) had higher prevalence of fungal infections of skin. Conclusion: This study provides a fair picture of fungal skin diseases, better health education, properly maintain personal hygiene, improvement of standard of living, proper case diagnosis and proper treatment and management may remain of importance in managing fungal skin diseases. Chatt Maa Shi Hosp Med Coll J; Vol.22 (2); July 2023; Page 51-55

De novo design of Na+-activated lipopeptides with selective antifungal activity: A promising strategy for antifungal drug discovery

In recent years, invasive fungal infections have posed a significant threat to human health, particularly due to the limited availability of effective antifungal medications. This study responds to the urgent need for powerful and selective antifungal agents by designing and synthesizing a series of lipopeptides with lipoylation at the N-terminus of the antimicrobial peptide I6. Compared to the parent peptide I6, lipopeptides exhibited selective antifungal efficacy in the presence of Na+. Among the variants tested, C8-I6 emerged as the most effective, with an average effective concentration of 5.3μM against 12 different fungal species. C8-I6 combated fungal infections by disrupting both cytoplasmic and mitochondrial membranes, impairing the proton motive force, generating reactive oxygen species, and triggering apoptosis in fungal cells. Importantly, C8-I6 exhibited minimal hemolysis and cytotoxicity while effectively inhibiting fungal biofilm formation. In vivo experiments further validated the safety and therapeutic potential of C8-I6 in treating fungal skin infections. These findings underscore the significance of lipoylation in enhancing the efficacy of antimicrobial peptides, positioning C8-I6 as a promising candidate in fighting against drug-resistant fungal infections.