Dermatophytosis Research Articles

Essential Oils and their Components in Combating Fungal Pathogens of Human Skin-lipophilic Yeast Malassezia furfur

The most common problem of modern medicine is the development of increasing antifungal drug resistance nowadays including fungal infections of the skin and its appendages caused by dermatomycetes, yeast-like fungi, and molds so, there will be a need for alternative antifungal treatment. Natural substances with high antifungal properties like essential oils and their components show potential in this regard. Citrus lemon and Citrus sinensis essential oils were screened against Malassezia furfur by disc diffusion method and Minimum Inhibitory Concentration was determined by Modified Microdilution method. Citrus lemon (lemon) and Citrus sinensis (orange) show excellent inhibitory effects on the lipophilic, yeast-like fungus Malassezia furfur which causes Pityriasis versicolor, a chronic superficial fungal disease of the skin. The diameter of the inhibition zone was found to be 70 mm and 60 mm respectively. Malassezia furfur was found to be resistant against Clotrimazole & Ketoconazole. The minimum inhibitory concentration (MIC) of lemon and orange oil against Malassezia furfur was found to be 0.6 µl/ml and 0.8 µl/ml. These findings concluded that the use of Citrus lemon (lemon) and Citrus sinensis (orange) oil showed remarkable and excellent antifungal activity, and can be used as a traditional herbal medicine for the control of Pityriasis versicolor infection of the skin after undergoing clinical trials.

Pityriasis rosea: dermoscopic features in Uganda.

The study aimed to describe the dermoscopic features of pityriasis rosea among patients attending the skin clinic at Mbarara Regional Referral Hospital. A hospital-based cross-sectional descriptive study conducted for a 6-month period in the skin clinic of MRRH in Southwestern Uganda. Data were collected from consecutively recruited patients using structured questionnaires. Patients with a clinical diagnosis of pityriasis rosea were examined using a dermoscope and subsequently sent for KOH and TPHA tests to rule out fungal skin infection and secondary syphilis, respectively, and then received routine care at the skin clinic. There were 54 patients with pityriasis rosea seen. Dermoscopy was done on a total of 162 lesions of which 19 were herald patches, 51 were truncal lesions, 52 on the extremities while 40 were on the face and neck regions. Common dermoscopic features consisted of a violaceous background noted in 145 (89.51%), white scales in 161 (99.38%), diffuse scale distribution in 57 (35.19%), perifollicular scale type in 61 (37.65%), and brown-dotted pigmentary changes in 66 (40.74%). Other unique findings noted in a few lesions were cloudy structures, petechial spots, erosions, and punched out pits. Most prevalent dermoscopic features included: a violaceous background, white scales, diffuse scale distribution, perifollicular scale type, brown-dotted pigmentary changes with no visible blood vessels nor follicular changes. Other unique less frequently seen findings were cloudy structures, petechial spots, erosions, and punched out pits.

Antimicrobial properties of WCO-based composites enriched with hops and curly sorrel for green building solutions.

Modern production of vegetable oils has reached impressive levels, and the ever-growing quantities of waste cooking oil (WCO) provide a local source of raw materials for innovative materials. The WCO composite production process involves a series of reactions, including polymerisation, esterification, and transesterification, which lead to the hardening of composite materials. In light of the growing problem of bacterial and fungal diseases, materials with high strength properties and biocidal properties are being sought. Fungal infections of the skin are a widespread problem, and the number of cases is steadily increasing. This article presents a study of the antibacterial potential of WCO-based composites enriched with hops or sorrel root in the context of their application in the construction industry. The compressive and flexural strength of the oil composites, their absorbability and hydrophobicity, and their effects on Gram-positive (S. aureus and S. epidermidis) and Gram-negative (E. coli and P. aeruginosa) bacteria and fungi (A. niger, P. anomala) were investigated. Maximum split tensile strength (4.3 MPa) and flexural strength (5.1 MPa) were recorded for oil-hop composites. Oil composites enriched with curly sorrel and hops showed antibacterial activity against S. aureus at 27% and 25%. High biocidal activity (up to 70%) was recorded against E. coli and against S. epidermidis (up to 99%) due to the action of composites with curly sorrel. The antifungal activities of composites with hops was 15% and 19% for P. anomala and A. niger, respectively, while with curly sorrel they were 42% and 30%.

Survey of the present health & nutritional status of Shompen tribe of Great Nicobar Island.

Shompens are one of the two mongoloid tribes of Nicobar district. There is little information about their recent health status since the last survey which was conducted in 1998. Hence, a comprehensive health and nutritional survey was conducted in March 2017 to assess the changes. The survey was carried out by a joint team of various organizations including the ICMR-Regional Medical Research Centre and Tribal Welfare and Health Department both located in Port Blair. A detailed health and nutrition survey of the Shompen community was planned by deputing a field research team. The survey included demographic data, anthropometric data, clinical examination, screening for the markers of infectious diseases, respiratory pathogens, tuberculosis and haemoglobinopathies. About half of the Shompen adults (both males and females) had a body mass index (BMI) of ≥23. However, Shompen children had a good nutritional status with no child suffering from undernutrition. As per BMI for age, none of the children <5 yr were under-nourished, while in the 5-17 yr group, 12 per cent of children were undernourished. Anaemia prevalence was about 48.3 per cent, with 54 per cent prevalence in females and 43.8 per cent in males. Fungal infection of the skin, acute respiratory infection and abdominal pain were the common morbidities observed. None had active pulmonary tuberculosis. Of 38 Shompens screened for IgG (immunoglobulin G) antibodies, 42.1 and 18.4 per cent were positive for measles and rubella, respectively. Seroprevalence of Leptospira was 35.5 per cent. The prevalence of hypertension was 13.2 per cent, whereas another 28.9 per cent were pre-hypertensive. The population structure of the Shompen is not skewed and under nutrition was not widely prevalent among the children of <5 yr. The other positive observations were the absence of malaria, filariasis and dengue. However, there was natural infection of measles and rubella. Fungal skin infection and intestinal parasitic infestations were widely prevalent. Although cardiovascular risk profile was low, there were signs of emerging risk of over-weight, hypertension and dyslipidaemia. These together with the high prevalence of smokeless tobacco use may have a serious effect on the cardiovascular disease susceptibility of the Shompen population in the future.

SKIN DISORDERS IN THE LIGHT OF UNANI SYSTEM OF MEDICINE

Skin disorders have been prevalent since the Greco-Arabic period. Unani physicians have described the structure and functions of skin interpreting the etiology, clinical features, and management of various skin disorders. These scholars have stated a comprehensive description of various skin ailments such as Hikka (Pruritis), Urticaria (Shara), Quba (Ring worm), Jarb (Scabies), Acne (Basoor-e-Labniya), Bars(Vitiligo), Namla(Herpes), Nar farsi (Eczema), Daus sadaf (Psoriasis) and Saleel (Wart) etc. Ancient Unani scholars have been treating these ailments successfully forages. They have compiled a single as well as composite herbal formulations and various methods of Ila-j bit- tadbeer such as Cupping-Hijamah, Leeching-Irsal-e-Alaq for the treatment of skin disorders. These herbal medicine and therapies have greater significance in the treatment and management of various skin disorders.

The Efficacy of Sample Storage Envelopes in Collecting Scales From the Skin and Nails for Mycology Laboratory Diagnosis of Superficial Fungal Infection.

Background: Fungal cultures are unavailable in many hospitals. The development of an effective sample storage solution for timely transportation would improve management of patients with superficial fungal skin and nail infections. Objectives: This study aimed to evaluate the efficacy of sample storage envelopes to preserve skin and nail samples for timely microscopic examination and culture for superficial fungal infections. Methods: Patients aged 18 years and above with suspected superficial fungal infections were enrolled. The samples were divided into four envelopes. The baseline 20% potassium hydroxide (KOH) examination and fungal culture served as reference points. The stored samples were reexamined on Days 3, 7, 14, and 28. Results: The study included 90 patients with suspected superficial fungal infections (45 skin and 45 nail lesions). Reference KOH examinations showed branching septate hyphae in 36 (80.0%) for skin and 35 (77.8%) for nail infections. Reference fungal cultures were positive for the growth of dermatophyte and nondermatophyte molds in 34 (75.6%) and 28 (62.2%) in skin and nail infections, respectively. Sample storage envelopes maintained 100% sensitivity and specificity for up to 28 days with KOH examination for both skin and nail samples. On Day 28, the fungal culture sensitivity was 70.6% for the skin and 64.3% for the nail samples, with specificities of 100.0% and 88.2%, respectively. Conclusions: Sample storage envelopes effectively maintained diagnostic accuracy for up to 28 days with KOH examination for both skin and nail samples. Given the high specificity even on Day 28 for fungal culture, transferring samples within 28 days remains a reliable practice.

Skin innate immune response against fungal infections and the potential role of trained immunity.

Fungal skin infections are distributed worldwide and can be associated with economic and social traits. The immune response related to skin cells is complex and its understanding is essential to the comprehension of each cell's role and the discovery of treatment alternatives. The first studies of trained immunity (TI) described the ability of monocytes, macrophages and natural killer (NK) cells to develop a memory-like response. However, the duration of TI does not reflect the shorter lifespan of these cells. These conclusions supported later studies showing that TI can be observed in stem and haematopoietic cells and, more recently, also in non-immune skin cells such as fibroblasts, highlighting the importance of resident cells in response to skin disorders. Besides, the participation of less studied proinflammatory cytokines in the skin immune response, such as IL-36γ, shed light into a new possibility of inflammatory pathway blockade by drugs. In this review, we will discuss the skin immune response associated with fungal infections, the role of TI in skin and clinical evidence supporting opportunities and challenges of TI and other inflammatory responses in the pathogenesis of fungal skin infections.

A design of expert-based development and optimization of voriconazole-loaded aspasomal gel for topical delivery

The research aimed to develop a voriconazole (VRC)-loaded aspasomal gel for topical drug delivery, to minimize the dosing frequency and associated side effects. Aspasomal formulations were prepared using the thin film hydration method and their vesicle size (VS) and entrapment efficiency (%EE) were assessed. Optimization was carried out using a 32-factorial design by design expert software. The optimized batch underwent in vitro anti-fungal activity testing and morphological analysis using high-resolution transmission electron microscopy. This optimized batch was then incorporated into a gel, and various parameters such as drug content, pH, viscosity, spreadability, in vitro diffusion, ex vivo permeation, and in vivo skin irritancy were evaluated. The optimized aspasomal formulation displayed a VS of 171.36 ± 2.3 nm and an %EE of 80.77% ± 1.75%. In vitro drug diffusion and ex vivo permeation studies demonstrated significant release rates of 94.09% and 48.87% after 24 and 12 hours, respectively. The optimized formulation exhibited better in vitro anti-fungal activity against Candida albicans compared to a commercially available formulation. Skin irritancy tests on rat skin showed no signs of erythema or edema, confirming non-irritation. Long-term stability analysis confirmed the formulation’s stability under cold conditions. In conclusion, VRC-loaded aspasomes present a promising alternative for treating skin fungal infections, offering controlled drug release and minimizing adverse effects, ultimately enhancing patient outcomes.

ЧУВСТВИТЕЛЬНОСТЬ ВОЗБУДИТЕЛЕЙ ДЕРМАТОФИТИЙ К ПРОТИВОГРИБКОВЫМ СРЕДСТВАМ, АНТИСЕПТИКАМ И ДЕЗИНФЕКТАНТАМ

Dermatophytes form the group of fungal pathogens of humans, which includes 43 species, of which the most important representatives are the genera Trichophyton and Microsporum. In recent years, patients with the established diagnoses of “mycosis pedis“, "skin mycosis of the palms“ and "onychomycosis”, and associations of dermatophytes and moulds as well as dermatophytes as an aetiological factor in mixed infections and yeast-like fungi often play a role. The main objective of the current study was to determine the susceptibility of dermatophytosis pathogens (Trichophyton spp., Microsporum spp.) isolated from samples of biological from patients with mycoses to modern antifungals, antiseptics and disinfectants. Within the framework of this study, 142 clinical isolates of dermatophytes identified as Trichophyton spp. (n=68) and Microsporum spp. (n=74) were obtained from patients with diagnoses of "B35.3 Mycosis of the feet", "B35.0 Microsporia". It was found that the most active antifungal agents against clinical isolates of dermatophytes are itraconazole, terbinafine and amphotericin B. Among the studied clinical isolates of Trichophyton spp. in Microsporum spp. conditionally resistant strains to the studied antimycotics have been identified. Most of the studied clinical isolates of dermatophytes were high sensitive to antiseptics based on iodine, fucorcinol, undecylenic and boric acids. Disinfectants based on aldehydes, guanidine derivatives, triamines, and glycolic acid showed the greatest activity against clinical isolates of dermatophytes. Based on our data, preference should be given to amphotericin B, itraconazole and terbinafine-based drugs when prescribing ethiotropic therapy for patients with dermatomycosis. It is advisable to use antipseptics and disinfectants for dermatomycosis, taking into account the sensitivity of micromycetes to them.

Viscoplastic Medicine Theory (VMT #195): A Dermatology Investigation of the Relationship between the Intensity of 4 Diabetic Skin Fungal Infections Versus 3 Selected Influential Factors of Estimated Daily Average Glucose, Hyperglycemic Tar Score, and Body Weight Using Collected Data of 4 Clinical Cases of A Type 2 Diabetes Patient Based on Gh-Metho

Viscoplastic Medicine Theory (VMT #195): A Dermatology Investigation of the Relationship between the Intensity of 4 Diabetic Skin Fungal Infections Versus 3 Selected Influential Factors of Estimated Daily Average Glucose, Hyperglycemic Tar Score, and Body Weight Using Collected Data of 4 Clinical Cases of A Type 2 Diabetes Patient Based on Gh-Metho

Comprative Study of two Different Microscopic Techniqes and Fungal Culture for Isolation of Dermatophytes

Introduction: Fungal infections are very common in man. They are assuming greater significance both in developed &amp; developing countries due to advent of immunosuppressive drugs &amp; disease hot &amp; humid climate in tropical &amp; subtropical countries like India makes dermatophytosis or ringworm a very common superficial fungal skin infection. Dermatophytosis is caused by dermatophytes, a group of keratinophilic fungi that require long incubation period to grow. The clinical presentation, though very typical of ringworm infection, is very often confused with other skin disorder particularly due to rampant application of broad – spectrum steroid containing skin ointments and cream leading to further misdiagnosis and mismanagement. Materials and Methods: Cross sectional lab based investigational study was conducted and skin, hair, nail sample from 110 clinically suspected cases of dermatophytosis were taken from OPD of district hospital of central India and were screened by direct microscopicexamination using 10% potassium hydroxide (KOH) with and without 40% dimethyl sulphoxide (DMSO) mount. 10% potassium hydroxide (KOH) with 40% Dimethyl sulphoxide mount (DMSO) mixed in equal proportion. Results: Direct microscopy using KOH mount is simple, rapid and easy method to visualize fungal elements. Many modification have been evolved to increase the specificity &amp; sensitivity of KOH microscopy results like use of 5% glycerol, addition of 36% DMSO, and addition of parker’s blue(4) in this study we compered the results of conventional KOH mount and a modified technique (40%KOH with DMSO)(5). When doing direct microscopic. Conclusion: The modified KOH with DMSO mount had allowed fastest and better visualization of fungal elements at 10 minutes instead of routine 30 minutes.

A CASE OF ACUTE CORONARY SYNDROME UNDER IMMUNSUPRESSION WHO IS THE CRIMINAL NEUTROPHILS OR T CELLS?

Chronic granulomatous disease (CGD) is a primary immunodeficiency characterized by recurrent, life-threatening bacterial and fungal infections of the skin, airways, lymph nodes, liver, brain, and bones. These infections most commonly occur in organs in contact with the outside world (lungs, gastrointestinal tract, and skin), as well as in lymph nodes that drain these structures. While involvement can be seen in many organs, there is no known cardiovascular involvement. Our case is an ACS case that has a different place in the literature because acute coronary syndrome (ACS) was seen in a 20-year-old male patient with a diagnosis of chronic granulomatous disease.

Pityriasis Rosea: Prevalence and Clinical variants in Uganda

Purpose : The study aimed to determine the prevalence and describe the clinical variants, of Pityriasis rosea among patients attending the Skin clinic at MRRH Patients and methods : A hospital-based cross-sectional descriptive study conducted for a 6-month period in the Skin clinic of MRRH in Southwestern Uganda. Data were collected from 1,802 consecutively recruited patients using structured questionnaires. Patients with a clinical diagnosis of Pityriasis rosea were examined and subsequently sent for KOH and TPHA tests to rule out fungal skin infection and secondary syphilis respectively then received routine care at the skin clinic Results : 54 patients with pityriasis rosea were seen giving a prevalence of 3.0%(95% CI: 2.3-3.9) with a median age of 20.5 and a peak incidence of 21-30 years with female predominance. Nineteen (35.19%) had a herald patch. Papules and plaques were the predominant morphologies noted in 47 (87.04%) and 34 (62.96%) respectively while most patients had lesions on the trunk and upper extremities, 51 (94.44%) of the patients each. Majority, 52 (96.30%) had a symmetrical pattern and 26 (48.15%) had a “ Christmas-tree” pattern. None of them had oral nor nail involvement. Conclusion : Pityriasis rosea is seen often among patients attending the skin clinic at MRRH with a prevalence of 3.0%, median age of 20.5, peak incidence of 21-30 years with female predominance. A few had a herald patch, presented with a polymorphic eruption predominated with papules and plaques, lesions mostly occurred on the trunk and upper extremities with a symmetrical pattern.

Preparation and characterization of a curcumin nanoemulsion gel for the effective treatment of mycoses

Fungal infections of skin including mycoses are one of the most common infections in skin or skins. Mycosis is caused by dermatophytes, non-dermatophyte moulds and yeasts. Various studies show different drugs to treat mycoses, yet there is need to treat it with applied drugs delivery. This study was designed to prepare a bio curcumin (CMN) nanoemulsion (CMN-NEs) for transdermal administration to treat mycoses. The self-nanoemulsification approach was used to prepare a nanoemulsion (NE), utilizing an oil phase consisting of Cremophor EL 100 (Cre EL), glyceryl monooleate (GMO), and polyethylene glycol 5000 (PEG 5000). Particle size (PS), polydispersity index (PDI), zeta potential (ZP), Fourier transform infrared (FTIR) spectrophotometric analysis, and morphological analyses were performed to evaluate the nanoemulsion (NE). The in vitro permeation of CMN was investigated using a modified vertical diffusion cell with an activated dialysis membrane bag. Among all the formulations, a stable, spontaneously produced nanoemulsion was determined with 250 mg of CMN loaded with 10 g of the oil phase. The average droplet size, ZP, and PDI of CMN-NEs were 90.0 ± 2.1 nm, − 7.4 ± 0.4, and 0.171 ± 0.03 mV, respectively. The release kinetics of CMN differed from zero order with a Higuchi release profile as a result of nanoemulsification, which also significantly increased the flux of CMN permeating from the hydrophilic matrix gel. Overall, the prepared nanoemulsion system not only increased the permeability of CMN but also protected it against chemical deterioration. Both CMN-ME (24.0 ± 0.31 mm) and CMN-NE gel (29.6 ± 0.25 mm) had zones of inhibition against Candida albicans that were significantly larger than those of marketed Itrostred gel (21.5 ± 0.34 mm). The prepared CMN-NE improved the bioavailability, better skin penetration, and the CMN-NE gel enhanced the release of CMN from the gel matrix on mycotic patients.

Subcentimeter Corticotroph Adenoma: an Evaluation of Diagnostic Elements

Cushing’s disease (CD) is an uncommon yet serious disorder, linked to increased morbidity and mortality. Diagnosis of these patients are complex, and emphasis should be placed on early detection for better management of these patients. The objective of this case report is to evaluate the diagnostic elements in the identification of a subcentimeter adrenocorticotrophic hormone (ACTH)-dependent pituitary adenoma. We report a case of a 26-year-old man who presented with extensive superficial fungal infection of the skin, unintentional weight gain, hypertension, dyslipidaemia as well as cushingoid appearance suspicious of hypercortisolism. Raised midnight plasma cortisol and 24-hour urinary cortisol levels warranted further investigation. Overnight and 48-hour low-dose dexamethasone suppression test (LDDST) were non-suppressed. Subsequent bilateral inferior petrosal sinus sampling (BIPSS) was not only efficient in differentiating pituitary from ectopic Cushing’s syndrome (CS) but was shown to be superior to magnetic resonance imaging (MRI) in lateralisation of the pituitary adenoma.

The prevalence of skin diseases in Greece, impact on quality of life and stigmatization: A population‐based survey study

AbstractBackgroundThere is no population‐based evidence on the prevalence and impact of skin diseases in Greece.ObjectivesTo describe the prevalence of 12 main skin diseases and their impact on quality of life (QoL) and feelings of stigmatization in the Greek population.MethodsA population‐based survey in an adult Greek representative sample was carried out as part of the multinational ‘EADV burden of skin diseases study’. Quality of life (QOL) was measured using the Dermatology Life Quality Index (DLQI) and the Visual Analogue Scale (VAS) from the EuroQol‐5D (EQ. 5D) questionnaires.ResultsIn 1010 participants, 47.8% (n = 483) declared at least one skin disease or condition or skin‐related unpleasant sensation in the last 12 months. Fungal skin infection was reported with the higher prevalence (7.5%), followed by alopecia (5.7%), atopic dermatitis (5%), acne (3.6%), sexually transmitted diseases (2.7%), psoriasis (2.2%) chronic urticaria (1.5%), rosacea (1.3%), nonmelanoma skin cancer (1.5%), vitiligo (0.6%), cutaneous melanoma (0.6%) and hidradenitis suppurativa (0.3%). Mean VAS‐EQ. 5D and DLQI scores were 77.8 and 2.2, respectively. Among those reporting at least one skin problem, 68.1% reported an impact of the skin condition on their personal life and 51% reported an impact on time to take care of themselves. Regarding the impact on work‐life decisions, 22.2% reoriented their professional activity, 13% were refused a professional offer, 22.2% did not get the job they hoped to and 16.7% chose their work with their skin problem in mind. Regarding feelings of stigmatization, 12% felt left out/rejected by others, 6.6% were refused access to leisure facilities and 9.8% reported the impression to be looked at with disgust.ConclusionsOur population‐based study provides new information on the prevalence of skin diseases in the Southern European country of Greece and highlights the impact of prevalent skin disease on life‐altering decisions and stigmatization.

Bacillus subtilis engineered for topical delivery of an antifungal agent.

Fungal skin infections are a common condition affecting 20-25 percent of the world population. While these conditions are treatable with regular application of an antifungal medication, we sought to develop a more convenient, longer-lasting topical antifungal platform that could increase patient adherence to treatment regimens by using Bacillus subtilis, a naturally antifungal bacteria found on the skin, for drug production and delivery. In this study, we engineered B. subtilis for increased production of the antifungal lipopeptide iturin A by overexpression of the pleiotropic regulator DegQ. The engineered strain had an over 200% increase in iturin A production as detected by HPLC, accompanied by slower growth but the same terminal cell density as determined by absorbance measurements of liquid culture. In an in vitro antifungal assay, we found that despite its higher iturin A production, the engineered strain was less effective at reducing the growth of a plug of the pathogenic fungus Trichophyton mentagrophytes on an agar plate compared to the parent strain. The reduced efficacy of the engineered strain may be explained by its reduced growth rate, which highlights the need to address trade-offs between titers (e.g. measured drug production) and other figures of merit (e.g. growth rate) during metabolic engineering.

Exploiting response surface D-optimal design study for preparation and optimization of spanlastics loaded with miconazole nitrate as a model antifungal drug for topical application

PurposeSkin fungal infections are widely spreading worldwide and are considered a main cause of skin, mucous membranes, and systemic diseases. In an approach to enhance the topical delivery of miconazole nitrate (MZN) as a poorly permeable antifungal agent, spanlastics nanocarriers as a type of elastic vesicles were adopted in the current work.MethodsMZN spanlastics were prepared and optimized according to a D-optimal response surface design to investigate the influence of formulation variables, edge activator (EA) percentage, EA type on particle size (PS), and drug entrapment efficiency percentage (% EE) as dependent variables. The spanlastics optimized formula (F7) was further assessed for its elasticity and physico-pharmaceutical properties before being incorporated into a gel. The F7 gel formula was also examined for its physical properties, in vitro release, in vitro antifungal activity against Candida albicans (ATCC® 10231), and ex vivo skin deposition studies. The results of the F7 gel formula were compared to the F7 aqueous dispersion.ResultsThe D-optimal design revealed that F7, developed using Tween 60 as EA and Span 60 at a weight ratio 2:8, is the optimized formula. F7 was an elastic, spherical, non-aggregated vesicle with an average PS of 210 nm and a drug entrapment efficiency of 90%. The drug was present in an amorphous form within the vesicles. The gel form of F7 showed a prolonged drug release behavior relative to the solution form, where 75% of the drug was released over 10 h for the former and 5 h for the latter. The antifungal study revealed a significant (p < 0.05) increase in the zone of inhibition of Candida albicans (ATCC® 10231) demonstrated by spanlastics compared to MZN suspension at the same concentration level. MZN suspension showed cytotoxic activity at a concentration of 20 μg/mL and above; the incorporation of the drug in spanlastics dispersion or gel form increased the cell viability percentage. The skin deposition studies showed that F7 deposition in the dermal layer, where deep skin infections occur, is 164-folds that of the plain drug.ConclusionsThe results confirm the potential application of MZN-spanlastics to treat deeply seated skin fungal infections.

Azorean Black Tea (Camellia sinensis) Antidermatophytic and Fungicidal Properties

The treatment of dermatophytoses, the most common human fungal infections, requires new alternatives. The aim of this study was to determine the antidermatophytic activity of the aqueous Azorean Black Tea extract (ABT), together with an approach to the mechanisms of action. The phytochemical analysis of ABT extract was performed by HPLC. The dermatophytes susceptibility was assessed using a broth microdilution assay; potential synergies with terbinafine and griseofulvin were evaluated by the checkerboard assay. The mechanism of action was appraised by the quantification of the fungal cell wall chitin and β-1,3-glucan, and by membrane ergosterol. The presence of ultrastructural modifications was studied by Transmission Electron Microscopy (TEM). The ABT extract contained organic and phenolic acids, flavonoids, theaflavins and alkaloids. It showed an antidermatophytic effect, with MIC values of 250 µg/mL for Trichophyton mentagrophytes, 125 µg/mL for Trichophyton rubrum and 500 µg/mL for Microsporum canis; at these concentrations, the extract was fungicidal. An additive effect of ABT in association to terbinafine on these three dermatophytes was observed. The ABT extract caused a significant reduction in β-1,3-glucan content, indicating the synthesis of this cell wall component as a possible target. The present study identifies the antidermatophytic activity of the ABT and highlights its potential to improve the effectiveness of conventional topical treatment currently used for the management of skin or mucosal fungal infections.

Comparative descriptive analysis of socio-demographic status in immunocompetent and immunocompromised patients with mycoses of the skin, hair and nails

BACKGROUND: Despite the achievements of modern medicine, people's susceptibility to fungal infections is only increasing. In this regard, it is extremely important to understand which social factors are most characteristic of people suffering from mycoses of the skin, hair and nails.&#x0D; AIM: to study the socio-demographic status of immunocompetent and immunocompromised patients with mycoses of skin, hair and nails.&#x0D; MATERIALS AND METHODS: A multicenter prospective cohort observational study of the social and demographic characteristics of immunocompetent and immunocompromised individuals with mycoses of the skin of hair and nails was conducted. Four groups of patients were formed: immunocompetent persons, persons with diabetes mellitus, patients with autoimmune diseases while taking immunosuppressants, patients with infection human immunodeficiency virus (HIV). A total of 646 people were examined. To ensure the quality of research and information processing, questionnaires were developed to be filled in for each examined patient. At the time of inclusion in the study, data concerning the place of residence and living conditions of patients, their lifestyle, marital status, bad habits and profession were entered into the questionnaires.&#x0D; RESULTS: Significant differences (p 0.0001) were revealed between the studied socio- demographic characteristics in the study groups. The age of immunocompetent patients with mycoses of skin, hair and nails was 914 years lower than the age of immunocompromised. Female persons prevailed in the case of autoimmune diseases ― 71.1%. Harmful habits were registered in 60% of patients with superficial mycoses and HIV. 83.33% of autoimmune patients were married. Urban residents prevailed over rural residents in the case of diabetes mellitus and autoimmune pathology. Persons of manual work professions in 48.48% of cases were identified among patients with HIV infection, which was more than in other study groups.&#x0D; CONCLUSION: When studying the socio- demographic characteristics of patients with mycoses of skin, hair and nails, significant differences were revealed in all the factors studied. The obtained results indicate the need to develop a personalized approach to the diagnosis, prevention and treatment of these infections.