Fungal Skin Diseases Research Articles

Comparison of three staining techniques for rapid diagnosis of feline dermatophytosis

Feline dermatophytosis is a commonly encountered fungal skin disease in cats. Skin scrapings from cats with varying degrees of clinical signs were collected and subjected to microscopic and cultural examination. The clinical samples were stained with three different stains, lactophenol cotton blue (LPCB), Chicago sky blue (CSB) and Calcofluor white (CW) and were subjected to microscopic examination for fungal spores. The results of this microscopic examination were analysed and compared with growth of dermatophytes in Dermatophyte test medium (DTM). Based on cultural isolation, dermatophytosis was confirmed in 36 out of 82 cases tested. Comparison of staining techniques revealed that CW staining had better sensitivity (97.22 per cent), specificity (65.22 per cent) and overall agreement with cultures in DTM. Occurrence was found to be higher in kittens less than six months of age and long-haired breeds.

Chemiluminescence in Combination with Organic Photosensitizers: Beyond the Light Penetration Depth Limit of Photodynamic Therapy.

Photodynamic therapy (PDT) is a promising noninvasive medical technology that has been approved for the treatment of a variety of diseases, including bacterial and fungal infections, skin diseases, and several types of cancer. In recent decades, many photosensitizers have been developed and applied in PDT. However, PDT is still limited by light penetration depth, although many near-infrared photosensitizers have emerged. The chemiluminescence-mediated PDT (CL-PDT) system has recently received attention because it does not require an external light source to achieve targeted PDT. This review focuses on the rational design of organic CL-PDT systems. Specifically, PDT types, light wavelength, the chemiluminescence concept and principle, and the design of CL-PDT systems are introduced. Furthermore, chemiluminescent fraction examples, strategies for combining chemiluminescence with PDT, and current cellular and animal applications are highlighted. Finally, the current challenges and possible solutions to CL-PDT systems are discussed.

Fungal Flora in Asymptomatic Pet Guinea Pigs and Rabbits.

Simple SummarySmall mammals hider a wide number of saprophytic fungi associated with dermatophytosis in young or immunocompromised humans. This raises the possibility of potential zoonotic transmission of dermatophytes in animals from pet shops. Therefore, it is recommended that routine fungal diagnostic testing in pet guinea pigs (Cavia porcellus) and rabbits (Oryctolagus cuniculus domesticus) be carried out, to detect potential zoonotic fungi. The almost complete lack of cutaneous lesions in many cases associated with the presence of such a dermatophyte on healthy mammals may increase the risk of zoonotic transmission. This study identifies the most common fungal species that occur on the skin in guinea pigs and rabbits and determines the rate of asymptomatic carriers in healthy pet animals.Fungal skin diseases are well-recognized diseases with public health implications. The study provides a comprehensive overview and aims to determine the rate of positive fungal cultures to identify the most common fungal species in guinea pigs and rabbits and to determine the rate of asymptomatic carriers in healthy pet animals. This knowledge is essential for understanding disease transmission dynamics and epidemiological situation problems. A total of 167 animals (64 rabbits and 103 guinea pigs) were investigated in this study. The fungi of the genus Penicillium, Rhizopus, Mucor, Cladosporium, and Aspergillus were the most common in the examined animals, and they were isolated from 162 (97%) of the animals enrolled. No fungal growth was observed in 5 animals. In 15 cases (8.98%), we found pathogenic zoonotic dermatophytes (Trichophyton mentagrophytes), which caused several health problems in two humans in contact with affected animals. This study presents the prevalence of fungal flora in pet guinea pigs and rabbits in Slovakia.

Clinico-laboratory findings of Malassezia folliculitis in Indonesia: A multicentre study.

Malassezia folliculitis (MF) is a humid-favoured fungal skin disease caused by Malassezia species. Inaccurate treatments, changes in skin flora and disease exacerbation are often occurred due to oversights in the diagnosis. Several diagnostic methods are established for MF. To identify clinico-laboratory findings of Malassezia folliculitis in Indonesia. The study was conducted from January 2014 to December 2018 in seven referral teaching hospitals. Medical records of MF-diagnosed patients were obtained and analysed using the binomial test, chi-square test and Cohen's Kappa coefficient in SPSS 26.0. A total of 353 cases of MF were identified in seven referral teaching hospitals in Indonesia, 66.3% of which were males and 33.7% were females, dominated by the 17-25 years old group (44.5%). Itchy sensation (83.9%) was a major subjective complaint. Lesions were majorly found on the trunk-chest, back and shoulder (68.3%), while the clinical manifestation are mostly follicular papule-pustular lesions (62.1%). Patients were 87.4% positive by KOH examination (modified Jacinto Jamora's criteria) and 69.1% positive by Wood's lamp. Generally, sex, age, subjective complaint, lesion location, clinical manifestation and both examinations were statistically significant (p < .001). A significant relationship between all the clinical criteria of the patients in the KOH especially the clinical manifestation was significantly related to Wood's lamp. The Cohen's Kappa assessment suggested that there was an agreement between KOH and Wood's lamp (κ=-0.272, p < .001). The clinical symptoms of Malassezia folliculitis are dominated by pruritus, papulopustular follicular lesions on the trunk and the presence of spore load.

The Epidemiologic and Sociodemographic Features of Superficial Fungal Infection Among Children in East Java Suburban Public Hospital

Background: Superficial fungal infection is a common skin disease among children, causing morbidity and reducing quality of life. The disease's prevalence and etiological agents change with geographic area, age, humidity, and sex. The data on this matter is still limited in Indonesia. Purpose: To determine the current epidemiologic and sociodemographic features of superficial fungal infection among children. Methods: This descriptive study examined all the pediatric inpatients and outpatients at the Department of Dermatology and Venerology of East Java suburban Public Hospital in Indonesia from 2016 to 2020 who met the inclusion criteria. Result: From 2016 to 2020, the number of fungal infection patients was 12.3% (n = 175) among 1,427 dermatology patients. Pityriasis versicolor (PVC) is the most common fungal skin disease (4.1%), followed by tinea capitis (2.2%), tinea cruris (1.6%), and tinea corporis (1.4%). Subjects aged 6 to 12 years old were the most likely to be infected with a fungus. Boys were more likely to develop this infection. Conclusion: From 2017 to 2020, there was a downward trend in children's superficial fungal infections. Pityriasis versicolor (PVC) is a fungal skin ailment that cause the most cases compared to other fungal infections. Boys and children between the ages of 6 to 12 years old were the most susceptible to fungal infection.

Factors Influencing Bacterial and Fungal Skin Communities of Montane Salamanders of Central Mexico.

Host microbial communities are increasingly seen as an important component of host health. In amphibians, the first land vertebrates that are threatened by a fungal skin disease globally, our understanding of the factors influencing the microbiome of amphibian skin remains incomplete because recent studies have focused almost exclusively on bacteria, and little information exists on fungal communities associated with wild amphibian species. In this study, we describe the effects of host phylogeny, climate, geographic distance, and infection with a fungal pathogen on the composition and structure of bacterial and fungal communities in seven tropical salamander species that occur in the Trans-Mexican Volcanic Belt of Central Mexico. We find that host phylogenetic relatedness is correlated with bacterial community composition while a composite climatic variable of temperature seasonality and precipitation is significantly associated with fungal community composition. We also estimated co-occurrence networks for bacterial and fungal taxa and found differences in the degree of connectivity and the distribution of negative associations between the two networks. Our results suggest that different factors may be responsible for structuring the bacterial and fungal communities of amphibian skin and that the inclusion of fungi in future studies could shed light on important functional interactions within the microbiome.

Prevalence and burden of skin diseases among the elderly in Singapore: a 15-year clinical cohort study.

Populations around the world are rapidly ageing. The profile of skin diseases in the elderly is likely to present unique demands on the healthcare system. To provide current data on the burden of skin diseases in Singaporean patients and identify differences in the pattern of skin diseases between elderly patients and the rest of the population. This was a retrospective cohort study of 858 117 patients who attended the National Skin Centre between 2004 and 2018. Prevalence was calculated by grouping International Classification of Diseases codes into different categories of skin conditions based on Global Burden of Disease and American Academy of Dermatology classifications. Years lost to disability (YLDs) and disability-adjusted life years (DALYs) were calculated to report the morbidity and mortality of skin diseases. Differences of each skin condition between age groups were compared. The three most prevalent dermatoses across all age groups were dermatitis (33.3%), acne vulgaris (8.3%) and viral skin diseases (7.5%). The top three most common skin conditions among the elderly were dermatitis (37.7%), viral skin diseases (6.2%) and fungal skin diseases (4.3%). Decubitus ulcers, keratinocyte carcinomas and scabies represented a significant proportion of YLD per 100 000 in the elderly (P < 0.001). Malignant melanomas, keratinocyte carcinomas, cellulitis, pyoderma and decubitus ulcers contributed to high DALYs in patients aged 70-80 years. Aligning health systems with specific healthcare needs will reduce the disproportionately high burden of skin disease observed in the elderly.

Tinea capitis in China

British Journal of DermatologyVolume 186, Issue 4 p. e185-e185 Plain Language Summary Tinea capitis in China First published: 04 April 2022 https://doi.org/10.1111/bjd.21079AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Linked article: Chen et al. Br J Dermatol 2022; 186:705–712 Tinea capitis is an infection of the scalp and hair caused by dermatophytes (fungi that can obtain nutrients from keratin-rich tissues such as skin, hairs and nails, and cause tinea capitis). It is an important fungal skin disease in children and is still common in developing countries such as China. The pathogens (the type of fungi) that cause tinea capitis varies across regions and changes over time. This study aimed to find out more about tinea capitis in China. It involved 29 hospitals and from August 2019 to July 2020 patients who visited one of these hospitals and were diagnosed with tinea capitis were included in the study. Information about age and sex, risk factors and fungal tests were collected. The pathogens were identified by morphology (appearance seen by the naked eye or under the microscope) or, more complicated, molecular sequencing (characteristics of the DNA sequences). Of 611 patients in the study, about three-quarters were between 2 and 8 years old. The children with tinea capitis were mainly boys (56%) and the adults were mainly females (83%). Ten types of dermatophytes were found. The most common type was zoophilic Microsporum canis (65%, a dermatophyte which is often associated with cats and dogs) followed by anthropophilic Trichophyton violaceum (14%, a dermatophyte that is mainly transmitted between humans). The most common pathogen differed by region, for example, in the central region compared with eastern, western and northeastern regions. Doctors are advised to pay more attention to the different transmission routes and type of dermatophytes in different age groups from different regions. Volume186, Issue4April 2022Pages e185-e185 RelatedInformation

Tinea Imbricata among the Indigenous Communities: Current Global Epidemiology and Research Gaps Associated with Host Genetics and Skin Microbiota.

Tinea imbricata is a unique fungal skin disease that mostly affects indigenous populations in Southeast Asia, Oceania, and Central and South America. The control and management of this disease among these communities are challenging given their remote locations, certain traditional practices, and severe malnutrition status. To date, there are only a handful of reports published globally, which highlights the need for a more holistic approach in addressing this skin disease. Several bodies of evidence and reports have shown that host genetic factors have a profound influence on the pathogenesis of tinea imbricata, while skin microbiota is touted to have a role in the pathogenesis of the disease. However, there are limited studies of how host genetics and skin microbiota impact disease susceptibility in the host. To improve the understanding of this disease and to find possible long-term effective treatment among the affected indigenous communities, a comprehensive literature review is needed. Hence, this review paper aims to present the current status of tinea imbricata among the indigenous communities, together with published findings on the possible underlying reasons for its specific distribution among these communities, particularly on the ways in which host skin microbiota and host genetics affect occurrence and disease patterns. This information provides valuable insights for future research by highlighting the current knowledge gaps in these areas.

An ancient haplotype containing antimicrobial peptide gene variants is associated with severe fungal skin disease in Persian cats.

Dermatophytosis, also known as ringworm, is a contagious fungal skin disease affecting humans and animals worldwide. Persian cats exhibit severe forms of the disease more commonly than other breeds of cat, including other long-haired breeds. Certain types of severe dermatophytosis in humans are reportedly caused by monogenic inborn errors of immunity. The goal of this study was to identify genetic variants in Persian cats contributing to the phenotype of severe dermatophytosis. Whole-genome sequencing of case and control Persian cats followed by a genome-wide association study identified a highly divergent, disease-associated haplotype on chromosome F1 containing the S100 family of genes. S100 calcium binding protein A9 (S100A9), which encodes a subunit of the antimicrobial heterodimer known as calprotectin, contained 13 nonsynonymous variants between cases and controls. Evolutionary analysis of S100A9 haplotypes comparing cases, controls, and wild felids suggested the divergent disease-associated haplotype was likely introgressed into the domestic cat lineage and maintained via balancing selection. We demonstrated marked upregulation of calprotectin expression in the feline epidermis during dermatophytosis, suggesting involvement in disease pathogenesis. Given this divergent allele has been maintained in domestic cat and wildcat populations, this haplotype may have beneficial effects against other pathogens. The pathogen specificity of this altered protein should be investigated before attempting to reduce the allele frequency in the Persian cat breed. Further work is needed to clarify if severe Persian dermatophytosis is a monogenic disease or if hidden disease-susceptibility loci remain to be discovered. Consideration should be given to engineering antimicrobial peptides such as calprotectin for topical treatment of dermatophytosis in humans and animals.

Economic efficiency of different treatment schemes of cats microsporia

The most common fungal skin disease in animals is microsporia; the principal causative agent is the fungus Microsporum canis. The disease is of fungal etiology and highly contagious. The pathogen can stay in the environment for a long time and pose a risk of human infection. Cats, especially those walking on the street, are a significant factor in transmitting the infection. Spores of Microsporum canis can persist on the surface of the cat's body for a long time and, under favorable conditions, can provoke clinical manifestations of the disease. Under these circumstances, they are intensively distributed in the environment. Therefore, choosing the optimal therapeutic approach to solving this problem is essential. Treatment of sick animals should be practical and aimed at preventing the spread of the pathogen and cost-effective and beneficial to both veterinary specialists and owners of sick cats, as the duration of treatment is on average 14–21 days in order to determine the cost-effectiveness of treatment of microsporia in cats with the antifungal agent “Micromar” and immunostimulant “Biogluk” in comparison with other schemes, the calculation of the cost-effectiveness ratio CER. This made it possible to obtain accurate and complete data, as it took into account the cost of treatment and the number of animals that recovered during the complex therapy. Sick animals were divided into three groups. Each sick animal received treatment for 21 days. The first group was treated with the systemic antifungal itraconazole and treated with a 1 % solution of clotrimazole. The second group was vaccinated twice with Vakderm antifungal vaccine and treated daily with a topical antifungal agent (1 % clotrimazole solution). The third group used the antifungal agent “Micromar” and immunostimulant “Biogluk”. To control the quality of therapy, culture was performed on the nutrient medium for dermatophytes from the affected areas of the animal's body. The calculation of cost-effectiveness indicators showed that the treatment of cats with microsporia is effective in all groups of studied animals, as recovery occurred in each patient. However, the costs of therapy are different. In particular, in the first group, the CER coefficient is – 48.00 hryvnias, in the second – 42.00 hryvnias, in the third – 13.00 hryvnias.

Standardization of resazurin use in susceptibility testing of natural products against yeasts in planktonic cells and in biofilms formation

Natural products, such as the ethanolic propolis extract (PE), have been shown to be a safe and effective therapeutic alternative for the treatment of fungal skin and nail diseases. However, the presence of the resin and the physicochemical characteristics of the extract sometimes difficult the reading and determination of breakpoints of the in vitro tests, evidencing the need for alternatives that facilitate the reading. The present study aimed to standardize the use of resazurin in tests of susceptibility of PE with planktonic yeast cells and biofilm forms. The antifungal activity of PE was determined by minimum inhibitory concentration (MIC) and we observed that, for all Candida spp. tested, the most reproducible MIC results were obtained when resazurin was placed after 24 hours of incubation and remained more 24 hours with yeasts plus PE. For encapsulated yeasts, there was no dye reduction and color transition. Resazurin was also used for the evaluation of minimal biofilm inhibitory concentration and minimal biofilm eradication concentration and it was metabolized and reproduced the action of PE on Candida biofilms. In addition, microdilution checkerboard plates were made with the dye, which assisted reading the result of the interaction between PE and nystatin. We observed that the resin, the color and the turbidity of the PE slightly changed the color of the resazurin in high concentrations of the extract and did not impair the reading. Therefore, the resazurin standardization tests were proven to be efficient and grounds that it should be used as an auxiliary methodology for reading and interpretation of the susceptibility tests for non-encapsulated yeasts with natural products, which form turbidity or precipitation, such as propolis.

The burden of skin diseases in India: Global Burden of Disease Study 2017.

Background The prevalence of skin diseases has increased over the last few decades, and they contribute to a significant burden on health-care systems across the world. Aims/Objective This report looks at the burden of skin and subcutaneous diseases in terms of years lived with disability and agestandardised years lived with disability in India using the Global Burden of Disease Study results from 2017. Methods Data were obtained from the Global Burden of Disease online interactive tool. Updated estimates of the world's health for 359 diseases and injuries and 84 risk factors from 1990 to 2017 are available in this interactive tool. Results Years lived with disability due to skin and subcutaneous diseases accounted for 4.02% of the total years lived with disability in India in 2017. There was an increase of 53.7% in all age standardised years lived with disability for all the skin and subcutaneous diseases from 1990 to 2017. Among skin and subcutaneous diseases, dermatitis contributed maximum years lived with disability (1.40 million; 95% uncertainty interval, 0.82-2.21) in 2017, followed by urticaria (1.02 million; 95% uncertainty interval, 0.06-1.44) with percentage increases of 48.9% and 45.7% respectively. Conclusion The burden due to infectious skin diseases (e.g., scabies, fungal skin disease and bacterial skin disease) and non-infectious diseases (e.g., dermatitis, urticaria and psoriasis) has increased over the past three decades, however the age-standardised years lived with disability for leprosy, scabies, fungal infections, sexually transmitted infections and non-melanoma skin cancer (basal cell carcinoma) has decreased. The high burden of skin and subcutaneous diseases demand that they be given due importance in the national programmes and health policy of India.

Seasonal and gender variation in skin disease: A cross-sectional study of 3120 patients at Razi hospital

Objective: We aimed to determine the prevalence of different skin diseases and their seasonal variations at the Razi dermatology hospital from 2019 to 2020.Methods: In this cross-sectional study, we obtained data from the medical records of 3120 patients visiting the dermatology clinic of Razi hospital. The prevalence of skin diseases was evaluated using meteorologically defined seasons. We looked for significant equally distributed results during each season.Results: During all seasons, women were referred to our clinic more frequently than men. Some diseases demonstrated significant seasonality with a peak during the winter, including acne, eczema, wart, seborrheic dermatitis, nevus, vitiligo, lentigo, and dermatophytosis. Atopic dermatitis was more frequent during the spring and winter compared with other seasons (p < .05). Actinic keratosis and lichen planus showed a significant seasonal trend with a peak during the summer (p < .05). Infections, including viral, bacterial, and fungal skin diseases, were more frequent during the winter than the summer (p = .001).Conclusion: This study provides an overview of the seasonal distribution of dermatology visits at our referral hospital, which will aid in developing better policies to prevent and manage skin disorders in outpatient visits.

"Fungal Skin Diseases and Related Factors in Outpatients of Three Tertiary Care Hospitals of Dhaka, an Urban City of Bangladesh: Cross-Sectional Study"

"Fungal Skin Diseases and Related Factors in Outpatients of Three Tertiary Care Hospitals of Dhaka, an Urban City of Bangladesh: Cross-Sectional Study"

Performance results of the improved working classification of superficial mycoses of the skin in carrying out their clinical and epidemiological monitoring

The results of testing of the improved working classification of superficial mycoses of the skin and its appendages (SMS) in the Republic of Azerbaijan for the period of 2012-2016 are presented. Given the variety of classifications of fungal skin diseases, many years of clinical experience have shown that none of them fully meets the requirements of a practicing physician. The author has developed and improved the classification of mycoses of the skin and its appendages, which will facilitate the diagnosis and the appointment of therapy, since this classification takes into account the tissue and topographic localization of the mycotic process, which greatly facilitates the diagnosis by dermatovenerologists, and will also reveal the true prevalence of mycotic pathology. Based on the traditional form No. 9, among 246 cases of superficial mycoses of the skin and its appendages identified in the city of Baku for the period of 2012-2016, the largest number of patients (79.44±2.6%) were diagnosed with mycoses of the scalp – 32, 52±1.21%, smooth skin mycoses – 30.08%±1.28 multi-colored lichen – 14.80%±1.01, which corresponds to the frequency of occurrence of these forms of SMS at the age of 11-20 years (44.01±3,1%) and 0-10 years (39.08±3.1%), leaders in the age line of groups with SMS in Baku. A reliable statistical difference was revealed in the detection of superficial mycoses of the skin and its appendages in the city of Baku during the study period. Based on the developed working classification, the nosological structure of the incidence of SMS in the city of Baku for the period 2012-2016 is represented by the following – 1919 episodes: mycoses of the scalp – 675 patients (35.17±1.1%); mycoses of smooth skin – 638 patients (33.25±1.1%); multi-colored lichen – 264 patients (13.76±0.8%); combined mycoses of smooth skin and scalp – 134 patients (6.98±0.6%); onychomycoses – 97 patients (5.05±0.5%); purulent-infiltrative form of mycoses – 66 patients (3.44±0.4%); skin candidiasis – 19 patients (0.99±0.2%); feet of the mycoses – 19 patients (0.99±0.2%); inguinal epidermophytosis – 7 patients (0.36±0.1%). The prevalence of nosologies preserved in the largest number of patients (1578 patients – 82.23±0.9%), mycoses of the scalp – 35.17±1.1% (675 patients), smooth skin mycoses – 33.25±1.1% (638 patients), multicolored lichen – 13.76%±0.8 (264 patients). The greatest number of patients with SMS was also detected in the age group of 11-20 years (42.12±3.1%) and 0-10 years (40.32±3.1%). The data of a comparative analysis of the results of the developed and improved classification of superficial mycoses of the skin and its appendages with the data of the traditional reporting form, made it possible to expand the scope of the analyzed nosologies and increase the objectivity of statistical data for assessing the epidemiological situation in the study region.

Antifungal activities of quince seed mucilage hydrogel decorated with essential oils of Nigella sativa, Citrus sinensis and Cinnamon verum.

Background and Objectives:Candidiasis and pityriasis versicolor are opportunistic fungal infections that are caused by Candida spp. and Malassezia spp. yeasts. Conventional drugs like azole and amino derivatives are known to treat fungal skin diseases. However, drawbacks like long-term side effects and drug resistance lead to investigate on antifungal properties of phytochemicals as an alternative to available synthetic drugs.Materials and Methods:The herbal nano hydrogel was successfully synthesized from Quince Seed extract followed by ultrasonic treatment and it has been formulated using a mixture of essential oils. We evaluated the antifungal in vitro assay for a mixture of essential oils in combination with herbal nano hydrogel against Candida albicans and Malasezia furfur strains by micro dilution method.Results:The results indicated that essential oils possess antifungal activity with the MIC value of 12.5 and 6.24 mg/ml against C. albicans and M. furfur, respectively. No fungicidal effect was reported for the herbal hydrogel before nanofabrication while it shown some antifungal activity after ultrasonic treatment for 5 and 10 minutes. As anticipated; the antifungal property of essential oil mixture was appreciably improved when it combined with herbal nano hydrogel where the highest level of inhibition was observed at concentration of 3.125 mg/ml for both strains. The loss in biological activity observed when the ultrasonic treatment on herbal nano hydrogel performed for longer time.Conclusion:The proposed plant-based nano formulation shown promising in vitro antifungal activities against C. albicans and M. furfur strains and its antifungal properties were comparable with commercially available agents like clotrimazole. The new formulation expected to be safe with minimum long-term side effects. Further investigations are underway to confirm the safety and the mechanism of the action of this new herbal formulation.

Terbinafine Hydrochloride Combined With Itraconazole for Fungal Skin Diseases: A Randomized Controlled Trial.

Terbinafine and itraconazole are the common antifungal drugs in clinic. In vitro experiments proved that terbinafine combined with itraconazole achieves better antifungal effects. However, clinical study addressing this issue was still scarce. Terbinafine combined with itraconazole achieves better therapeutic effects in fungal skin diseases. Approximately 178 patients with fungal skin diseases from Meizhou People's Hospital, China, between October 2016 and October 2017 were admitted to this study. Patients were randomly distributed to 3 groups by randomly selecting random numbers and were treated with terbinafine, itraconazole, monotherapy, or combined therapy. Both patients and study investigators were unaware of grouping situations during experiments. Fifteen patients were excluded due to poor compliance, and 11 patients were excluded due to incomplete data. Finally, 152 patients were analyzed for this study. The therapeutic effects were evaluated by clinic symptom scores, mycology examination, the cure rate, and the cure time. Adverse events, relapse of disease, and patient's satisfaction level were recorded during follow-up. In the terbinafine + itraconazole group, at 14 days after treatment, the symptom scores were significantly decreased, compared with the terbinafine or itraconazole group (P1 < 0.05, P2 < 0.05). At 28 days after treatment, the fungal infection of 37 patients was eradicated, which were significantly more than 26 patients in the terbinafine group and 19 patients in the itraconazole group (P1 < 0.05, P2 < 0.05). The terbinafine + itraconazole group also exhibited 100% cure rate of patients with fungal skin diseases, shorter cure time, and increased number of cured patients during the same treatment period, which was better than terbinafine or itraconazole monotherapy (P1 < 0.05, P2 < 0.05). In addition, no adverse events and no relapse of fungal disease were reported in the terbinafine + itraconazole group during follow-up. Ninety-eight percent patients were satisfied with the therapeutic effects of combined treatment. Compared with terbinafine or itraconazole monotherapy, terbinafine + itraconazole combined treatment achieves better therapeutic effects in fungal skin diseases.

An environmentally friendly fluorine-free sandwich coating based on a nonwoven fabric for efficient unidirectional water transport.

Medical research reveals that keeping the skin surface dry can effectively prevent a variety of fungal skin diseases. Therefore, it is of great practical significance to develop a light, thin, comfortable and breathable functional garment fabric with efficient one-way water transmission for people's requirements. Here, we successfully prepared a three-layer stacking sandwich coating to construct a Janus nonwoven material with efficient unidirectional water transport function, viz. PDMS-ormosil-PDMS@nonwoven fabric (PDMS-ormosil-PDMS@NF). Theoretical analysis showed that the loading of ormosil particles could enhance the surface roughness, while PDMS could strengthen the hydrophobic properties and bondability between the ormosil particles and fabric, thus acting as an environmentally friendly fluorine-free treating agent. The results revealed that the hydrophilic-hydrophobic PDMS-ormosil-PDMS@nonwoven fabric maintained excellent hydrophobic stability and good air permeability even after abrasion, which solved the existing problems of aerogel poor deposition and PDMS poor permeability, benefiting the application of textiles with unidirectional water transport performance.

The use of essential oils in the treatment of malasseziasis in dogs and cats: Review

Malasseziasis is a common fungal skin disease of humans and animals, caused by the lipophilic yeast Malassezia pachydermatis. Treatment is based on the association between systemic and topical antifungal; however, recurrences are frequent and complicated by intercurrent dermatoses that complicate the clinical case. This recurrence is usually due to errors in dosage of the drugs, administration of the same by owners and resistance of the yeast. The mechanisms of antifungal resistance are associated with the specific or acquired characteristics of the pathogen to the drugs. As an alternative to traditional treatments, the use of herbal products, such as essential oils, in the veterinary clinic has become popular. Although the possible action of essential oils has been reported in human medicine for about 17 years, the specialized literature on its use in canine and feline malasseziasis is still scarce and studies are needed to investigate the mechanisms of action of essential oils in the metabolism of the yeast Malassezia pachydermatis. Thus, the objective of this work is to present a bibliographic review on the use of four essential oils for the treatment of primary or secondary malasseziasis in dogs and cats.