Treatment Of Tinea Pedis Research Articles

Interdigital-type antifungal socks for prevention and treatment of tinea pedis

BackgroundInterdigital tinea pedis is the most common type of foot infection, which is often treated by topical or systemic antifungals. Due to the increase in antifungal resistance, antifungal socks are becoming potential alternatives for the daily management of tinea pedis. MethodsIn this study, antifungal fibres were adopted to produce interdigital hygiene socks to split the third and fourth toe seams of the feet. In vitro antifungal activity was first examined to verify the effectiveness of the socks. Preventive efficacy against tinea pedis was then evaluated among healthy participants, followed by therapeutic effect detection in patients diagnosed with tinea pedis by analysing the improvement in total symptom scores (TTS). ResultsThe interdigital-type hygiene socks exhibited apparent antifungal activities in vitro. An in vivo study demonstrated significant preventive effects against tinea pedis for interdigital socks compared to plain socks (P = 0.011) and a lower TTS than noninterdigital (P = 0.04) or plain socks (P < 0.0001). Moreover, interdigital socks showed a total effectiveness rate of 72.9% in patients with tinea pedis, with most of the symptoms alleviated. ConclusionInterdigital-type hygiene socks not only exhibited in vitro antifungal activities but also showed significant prophylactic and therapeutic effects against interdigital tinea pedis in vivo.

PH- and Matrix Metalloproteinase-Responsive Multifunctional Bilayer Microneedles Platform for Treatment of Tinea Pedis.

Persistent foot odor and itchiness are common symptoms of tinea pedis, significantly disrupting the daily life of those affected. The cuticular barrier at the site of the tinea pedis is thickened, which impedes the effective penetration of antifungal agents. Additionally, fungi can migrate from the skin surface to deeper tissues, posing challenges in the current clinical treatment for tinea pedis. To effectively treat tinea pedis, we developed a platform of bilayer gelatin methacrylate (GelMA) microneedles (MNs) loaded with salicylic acid (SA) and FK13-a1 (SA/FK13-a1@GelMA MNs). SA/FK13-a1@GelMA MNs exhibit pH- and matrix metalloproteinase (MMP)-responsive properties for efficient drug delivery. The MNs are designed to deliver salicylic acid (SA) deep into the stratum corneum, softening the cuticle and creating microchannels. This process enables the antibacterial peptide FK13-a1 to penetrate through the stratum corneum barrier, facilitating intradermal diffusion and exerting antifungal and anti-inflammatory effects. In severe cases of tinea pedis, heightened local pH levels and MMP activity further accelerate drug release. Our research demonstrates that SA/FK13-a1@GelMA MNs are highly effective against Trichophyton mentagrophytes, Trichophyton rubrum, and Candida albicans. They also reduced stratum corneum thickness, fungal burden, and inflammation in a guinea pig model of tinea pedis induced by T. mentagrophytes. Furthermore, it was discovered that SA/FK13-a1@GelMA MNs exhibit excellent biocompatibility. These findings suggest that SA/FK13-a1@GelMA MNs have significant potential for the clinical treatment of tinea pedis as well as other fungal skin disorders.

Study on Efficacy and Safety of Terbinafine Vs. Itraconazole in the Treatment of Tinea Pedis

Background: Tinea pedis is a dermatophytosis of the feet usually occurs between the toes with the webspace between the fourth and fifth digits but, in many cases, may appear as an extensive pattern on the bottom and sides of the feet. Terbinafine and itraconazole were evaluated with the efficacy/effectiveness and toxicity in the systemic treatment of Tinea pedis and compared with each other. Objective: To compare the efficacy and safety of terbinafine vs. itraconazole in treating tinea pedis.&#x0D; Materials and Methods: A total of 50 patients were selected, and they were divided into groups (group-A and group B), each of which included 25 patients. Group A was given oral Terbinafine 250 mg daily for two weeks. Group B was given oral Itraconazole 200mg daily for the same duration. Patients were observed for the efficacy and side effects of the trial medicines. A baseline complete blood picture, liver and renal function test, and urine analysis were done and repeated frequently during therapy.&#x0D; Results: Most patients were in the fourth decade in both groups, and the male-to-female ratio was almost 4:1. Two groups of people were studied: group-A with terbinafine 250 mg daily and group B with itraconazole 200 mg daily for 14 days. Evaluated weekly during treatment and 02 weeks after cessation of therapy, and finally on 08th week to see the clinical improvement and adverse effects. The clinical response was found in chronic hyperkeratotic type: 08/08, 08/08; chronic interdigital type: 07/07, 07/06; vesico-bullous type: 06/05, 06/05; Mixed type: 04/03, 03/02 in group-A and group-B respectively. On average, 92% clinical improvement was found in group-A and 84% in group B. Most patients had nausea (20.0%) followed by 08% diarrhea in group A. On the other hand, in group B, most patients had nausea (28.0%), followed by 4.0% fatigue and 4.0% diarrhea, and only 01 patient found elevated liver enzyme but did not exceed the upper limit. 80% of patients in the terbinafine group had transient, mild to moderate nausea.&#x0D; Conclusion: No significant differences in efficacy and toxicity were found between terbinafine and itraconazole groups. Terbinafine may represent a good alternative for treating Tinea Pedis in patients who cannot take itraconazole or other available drugs due to contraindications.&#x0D; TAJ 2022; 36: No-1: 75-82

An Etiology Report for Burns Caused by Korean Folk Remedies.

Background In this modern era of science-based medicine, some people still accept folk remedies as an alternative form of medicine. However, misinformation and misuse of folk medicines can result in dangerous complications. Among the possible complications of folk remedy use, this study focused on the clinical characteristics of burns caused by folk remedies. Methods We retrospectively reviewed the clinical records of patients who had been treated for burns caused by folk remedies from May 2015 to April 2022. Data were collected on patients' age and gender, type of folk remedy, reason for using the folk remedy, the severity of the burn, the number of wounds, lesion type, and type of treatment. Results We found 59 patients with burns due to folk remedies. Most were female (76.3%) and ≥ 60 years old (72.9%). The most common type of folk remedy was moxibustion (74.6%), followed by the use of glacial acetic acid (20.3%). The reasons for using folk remedies were arthralgia relief (39%), health improvement (18.6%), and treatment of tinea pedis (11.9%). Most patients had multiple wound sites and had burns that were considered severe, requiring surgical treatment (72.9%). The majority of lesions were on the lower extremity, including the foot. Conclusion This study described the risk of burns caused by folk remedies and the clinical characteristics of the wounds. The results emphasize the need for greater public awareness of the risk of burn injuries when using folk remedies.

Disinfection trials with terbinafine-susceptible and terbinafine-resistant dermatophytes.

Treatment of tinea pedis and onychomycosis is complicated by high rates of reinfection and the emergence of terbinafine-resistant strains of Trichophyton spp. Effective disinfection of contaminated socks is an important measure. Appropriate washing reduces the risk of reinfection and is paramount in treating tinea pedis and onychomycosis. The aim of this study was to describe the effect of commonplace disinfection methods using socks pieces inoculated with terbinafine-resistant or terbinafine-susceptible isolates of Trichophyton spp. Sock pieces were inoculated with seven terbinafine-resistant isolates of Trichophyton spp. with known mutations in the SQLE-gene (T.rubrum (n=3), T.interdigitale (n=1) and T.indotineae (n=3)) and six terbinafine-susceptible isolates of Trichophyton spp. (T.rubrum (n=3) and T.interdigitale (n=3)). Methods of disinfection included soaking in a quaternary ammonium (QAC) detergent (0.5, 2 and 24h), freezing at -20°C (0.5, 12 and 24 h), domestic and steam washing (both at 40°C with detergent). Sock pieces were cultured for 4 weeks following disinfection. The primary end point was no growth at the end of week 4. Soaking in a QAC-detergent for 24h procured at disinfectant rate of 100% (13/13), whilst soaking in 0.5 and 2 h had a disinfectant rate of 46.2% (6/13) and 84.6% (11/13), respectively. Domestic washing (40°C with detergent) produced a disinfectant rate of 7.7% (1/13). Freezing at -20°C (0.5, 12 and 24h) and steam washing (40°C with detergent) had no disinfectant properties. Soaking in a QAC-detergent for 24 h effectively disinfected sock pieces contaminated with dermatophytes.

Copper-impregnated socks: A novel therapeutic option for combating occupational dermatophytosis

BackgroundOperational and training requirements of soldiers necessitate prolonged use of occlusive footwear which makes them susceptible to Tinea pedis and affects their performance. This study assesses copper oxide–impregnated socks as a treatment modality in soldiers with Tinea pedis. MethodsThree hundred serving soldiers with Tinea pedis were randomly divided in two groups of 150 cases each. One group was supplied with 02 pairs of polyester copper oxide–impregnated socks and the second group was treated with oral terbinafine 250mg /day for two weeks and topical terbinafine twice a day for three weeks. Five end points viz. scaling, erythema, fissuring, vesicular eruptions and itching were monitored using the visual analogue score (VAS) weekly for 03 weeks. ResultsCopper oxide socks helped in reducing all the end points as assessed by VAS. The group treated with terbinafine showed better response; however test socks were as efficacious as oral and topical terbinafine in controlling fissuring and vesiculation. Safety profile of the copper impregnated socks was comparable with the conventional treatment. ConclusionCopper-impregnated socks are effective and safe in treating Tinea pedis. They may also have prophylactic role in tinea pedis in susceptible serving soldiers deployed at remote locations in different terrain and weather conditions.

Preparation, and Assessment of Antidermatophyte Activity of Miconazole-Urea Water-Soluble Film.

Cutaneous mycoses, particularly tinea pedis caused by Trichophyton rubrum, are commonly known infections in humans. They are still considered as a major public health problem worldwide affecting the quality of life due to prolonged period of treatment and development of drug resistance, which leads to recurrence of infections. The objective of our study was to assess the effectiveness of miconazole in the presence and absence of urea, as a penetration enhancer, against T. rubrum and to formulate both of them in a water-soluble film to be applied topically for the purpose of treating tinea pedis caused by this fungus. Drug combination revealed synergism where miconazole minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) (0.5 and 1 mg/L) were considerably declined to 0.001 and 0.004 mg/L, respectively, when combined with 20% urea. This enhanced drug interaction activity against the test strain was explained by the alterations raised on the morphology and ultrastructures observed microscopically. Minimal fungicidal dose of miconazole/urea combination displayed plasmolysis and shrink cytoplasm; however, necrotic cells with punctured walls and degraded cytoplasmic content were observed at high fungicidal dose. Water-soluble films, prepared using increasing values of miconazole MFC and urea, were transparent, smooth, uniform, and flexible. Their physicochemical characters showed homogeneity in weight, thickness, drug content, and folding endurances with normal surface pH values, indicating the reproducibility of the preparation method. The novel simulation model for the film mechanism of action supported the idea and the suggested application method of the new dosage form. Evaluation of these films was carried in vitro using disk diffusion assay as well as in vivo using guinea pig dermatophytosis model. The in vitro assessment revealed an increase in the inhibition zone diameters in a concentration-dependent manner upon using 10 or 20% of urea combined with miconazole. In vivo test showed that combination of 0.004 mg/L miconazole with 20% urea (M + U20) showed the highest efficacy percentage (95.83%), which was statistically superior to the infected untreated control (p < 0.001) in fungal burden reduction as well as improvement in clinical scores (p < 0.001). This work supports the hypothesis and suggests a new promising dosage form for the treatment of T. rubrum infections.

Managing athlete’s foot

This article is aimed at providing a succinct overview of the condition tinea pedis, commonly referred to as athlete’s foot. Tinea pedis is a very common fungal infection that affects a significantly large number of people globally. The presentation of tinea pedis can vary based on the different clinical forms of the condition. The symptoms of tinea pedis may range from asymptomatic, to mild-to-severe forms of pain, itchiness, difficulty walking and other debilitating symptoms. There is a range of precautionary measures available to prevent infection, and both oral and topical drugs can be used for treating tinea pedis. This article briefly highlights what athlete’s foot is, the different causes and how they present, the prevalence of the condition, the variety of diagnostic methods available, and the pharmacological and non-pharmacological management of the condition.

Comparison of Efficacy and Safety of Topical 1% Butenafine and Topical 1% Ciclopirox Olamine in the Treatment of Tinea Pedis and Evaluation of the Effects on the Quality of Life of These Treatmens: A Randomized Single-Blind Trial

Comparison of Efficacy and Safety of Topical 1% Butenafine and Topical 1% Ciclopirox Olamine in the Treatment of Tinea Pedis and Evaluation of the Effects on the Quality of Life of These Treatmens: A Randomized Single-Blind Trial

Treatment of Tinea Pedis in Elderly Patients Using External Preparations.

Infection rate of tinea pedis is high in the elderly, wherein treatment by a dermatologist should be considered to prevent infecting their family members. About 90 percent of cases with tinea pedis is treated only using external preparations. In treating the elderly with tinea pedis using external preparation, we should take into consideration that the elderly have thinner and weaker skin compared to younger people. There are many kinds of dosage form (cream, ointments, lotion, spray, and so on) for external preparations to treat tinea pedis. Generally, liquid forms such as lotions and sprays cause stronger irritation compared to ointments and creams, thus, caution should be taken for side effects when applying them to the elderly. Contact dermatitis is the most frequent side effect of external preparations. Caution should also be taken for the type of additives used. The composition of the preparation should be checked when changing dosage forms, or when switching brand-name drugs to generic drugs. Since the adherence rate of external preparations is low, it is preferable to use those with strong antibacterial activity and only have to be applied once a day.

Once-daily luliconazole cream 1% for the treatment of interdigital tinea pedis

Luliconazole is an imidazole antifungal agent with a unique chemical structure. In this article, we summarize the in vitro data, animal studies and clinical trial data relating to the use of topical luliconazole cream 1% in the treatment of tinea pedis. Preclinical studies have demonstrated potent activity against dermatophytes. Luliconazole has strong fungicidal activity against Trichophyton spp., similar to that seen with terbinafine. Evidence from clinical trials in tinea pedis have shown once-daily application of luliconazole cream 1% for 14 days to be effective and well tolerated.

Diagnosis and Management of Onychomycosis: Perspectives from a Joint Podiatry-Dermatology Roundtable.

Onychomycosis is a fungal infection, and, as such, one of the goals of treatment should be eradication of the infective agent. Despite this, in contrast to dermatologists, many podiatric physicians do not include antifungals in their onychomycosis treatment plans. Before initiating treatment, confirmation of mycologic status via laboratory testing (eg, microscopy with potassium hydroxide preparation, histopathology with periodic acid-Schiff staining, fungal culture, and polymerase chain reaction) is important; however, more podiatric physicians rely solely on clinical signs than do dermatologists. These dissimilarities may be due, in part, to differences between specialties in training, reimbursement patterns, or practice orientation, and to explore these differences further, a joint podiatric medicine-dermatology roundtable was convened. In addition, treatment options have been limited owing to safety concerns with available oral antifungals and relatively low efficacy with previously available topical treatments. Recently approved topical treatments-efinaconzole and tavaborole-offer additional options for patients with mild-to-moderate disease. Debridement alone has no effect on mycologic status, and it is recommended that it be used in combination with an oral or topical antifungal. There is little to no clinical evidence to support the use of lasers or over-the-counter treatments for onychomycosis. After a patient has achieved cure (absence of clinical signs or absence of fungus with minimal clinical signs), lifestyle and hygiene measures, prophylactic/maintenance treatment, and proactive treatment for tinea pedis, including in family members, may help maintain this status.

Two Feet-One Hand Syndrome: A Case Report / Sindrom dva stopala i jedne šake – prikaz slučaja

Abstract Two feet-one hand syndrome is a superficial fungal infections of the skin which involves both feet and one hand. Trichophyton rubrum and occasionally Trichophyton mentagrophytes are the usual causative organisms. We present a 32-year-old healthy man with sharply demarcated papular erythematous and squamous lesions on dorsal aspect of the feet and diffuse dry scaling lesions of the right palm. In this syndrome, the development of tinea pedis generally precedes the development of tinea manus, which usually occurs on the hand that excoriated the pruritic feet or picked the toenails with onychomycosis. Our patient often used his dominant right hand to scratch the feet. On mycological examination, fungal spores and mycelia were present and Trichophyton mentagrophytes was isolated. The patient was treated with itraconazole 200 mg daily for two weeks and topical terbinafine cream for four weeks. After the treatment all lesions resolved and fungal culture was negative. Early diagnoses and treatment of tinea pedis and education about prophylaxis, constant care and regular medical assistance would minimize this problem in predisposed individuals.

Comparison of Oral Terbinafine with Itraconazole in the Treatment of Tinea Pedis

Comparison of Oral Terbinafine with Itraconazole in the Treatment of Tinea Pedis

Comparison of 2 weeks versus 4 weeks of luliconazole 1％ cream for the treatment of tinea pedis: a randomized, double-blind, multicenter, controlled trial

Objective To evaluate the efficacy and safety of different courses of luliconazole 1％ cream in the treatment of tinea pedis.Methods A randomized,double-blind,multicenter controlled trial was conducted.According to a stratified randomization protocol,420 patients positive for fungal elements on direct microscopy were equally and randomly divided into 3 groups:short-term group applying luliconazole 1％ cream once daily for 2 weeks followed by placebo once daily for the next 2 weeks,long-term group applying luliconazole 1％ cream once daily for 4 weeks,bifonazole group applying bifonazole 1％ cream once daily for 4 weeks.Efficacy was assessed in terms of mycological clearance and clinical response rates on week 2,3,4 and 6 after initiation of treatment.Statistical analysis was carried out by paired t test,analysis of variance,chi-square test and a nonparametric test.Results Finally,398 patients were eligible for the efficacy analysis.The clinical response rate in the bifonazole group,shortterm group and long-term group was 29.29％,31.43％ and 35.00％ respectively on week 2 after initiation of treatment (P ＞ 0.05),73.57％,78.57％ and 70.00％ respectively on week 3 (P ＞ 0.05),89.29％,91.43％ and 89.29％ respectively on week 4 (P ＞ 0.05),with the mycological clearance rate being 49.29％,58.57％ and 57.86％ respectively on week 2 (P ＞ 0.05),80.00％,87.86％ and 85.00％ respectively on week 4 (P ＞ 0.05).Significant differences were observed on week 2 after the end of treatment in mycological clearance rate (80.71％ in the bifonazole group vs.90.00％ in the short-term group vs.89.29％ in the long-term group,P ＜ 0.05),but not in clinical response rate (92.14％ in the bifonazole group vs.92.86％ in the short-term group vs.92.14％ in the longterm group,P ＞ 0.05).The incidence rate of local adverse reactions was 0.71％ in the bifonazole group,0 in the short-term group and 2.14％ in the long-term group.Conclusion Luliconazole 1％ cream is effective and well tolerated in the treatment of tinea pedis,with the efficacy of 2-week once-daily regimen equivalent to that of 4-week once-daily regimen. Key words: Luliconazole; Bifonazole; Tinea, pedis; Clinical protocols; Randomized controlled trials

Chitosan/Clotrimazole microcapsules for Tinea pedis treatment: in-vitro antifungal and cytotoxicity study

To derive a form of treatment for Tinea pedis (also known as athlete’s foot), an attempt has been made to synthesize chitosan microcapsules that contain an antifungal agent using a coacervation technique. The antifungal agent, namely, clotrimazole, is encapsulated in different amounts: 25, 50, 75, and 100 mg. Optical and scanning electron microscopies demonstrate that the newly developed microcapsules have spherical core–shell forms with smooth surfaces and the particle sizes range from 2 to 10 μm. It is observed that chitosan microcapsules with a drug input of 25 mg clotrimazole show the highest encapsulation efficiency when compared with microcapsules that have 50, 75, and 100 mg of drug input. An analysis of the in vitro antifungal activity confirms that the chitosan/clotrimazole microcapsules show obvious inhibition of Trichophyton rubrum growth. The cytotoxicity results show that the newly developed microcapsules are non-cytotoxic to skin cell lines. The prepared drug-loaded microcapsules could be applied onto bandages or socks, and will continuously release antifungal drugs in a controlled manner under pressure.

Efficacies and safety of traditional Chinese medicine plus bifonazole cream for tinea pedis patients

To evaluate the efficacy and safety of traditional Chinese medicine plus bifonazole 1% cream in the treatment of tinea pedis. A total of 375 patients with tinea pedis were randomly assigned to receive traditional Chinese medicine plus bifonazole 1% cream (treatment group, n=196) or bifonazole 1% cream alone (control group, n=179). Efficacy was estimated in terms of mycological care, total clinical sign and symptom scores. And adverse reactions were also recorded. The results showed that, at Week 2 post-treatment, the cure rate was 45.41% (89/196) and effective rate 77.04% (151/196) in combination group versus 34.08% (61/179) and 61.45% (110/179) in control group. There was significant inter-group difference (P 0.05). Key words: Tinea, foot; Treatment outcome

Can we Prevent Onychomycosis?

Onychomycosis is a fungal infection involving the nail unit. Distal lateral subungal onychomycosis (DLSO) is the most common subtype and usually results from untreated tinea pedis. Once fungus has invaded the nail unit, it can be a challenge to treat. Though onychomycosis has been historically viewed as a cosmetic concern, treating this disease is important due to potential complications, especially in elderly and immunocompromised individuals. As the incidence continues to increase, it is vital for health professionals to understand that onychomycosis may be prevented by treating tinea pedis.

Naftifine HCl 2 % Cream for the Treatment of Tinea Pedis: A Review

Tinea pedis is a common skin disease that is usually managed with topical antifungal medications. Allylamines, including terbinafine and naftifine 1 % cream, have been proven efficacious and safe in the treatment of tinea pedis. The treatment duration for the majority of topical antifungal is 4 weeks, which results in poor patient compliance and frequent relapses. Recently, naftifine 2 % cream has been approved to treat tinea pedis with 2 weeks of application. We discuss the mechanism of action, adverse events, and clinical efficacy of naftifine 2 % cream.

Efficacy, Tolerability and Consumer Acceptability of Terbinafine Topical Spray versus Terbinafine Topical Solution: A Phase IIa, Randomised, Observer-Blind, Comparative Study

Tinea pedis is one of the world's most prevalent dermatophyte infections. MedSpray™ tinea pedis 1% w/w (topical spray) is a novel, easy-to-use propellant-based spray formulation containing 1% w/w terbinafine, requiring no manipulation at the site of infection. This is in contrast to the only formulation currently approved in Europe for single application (none are approved in the USA for single use), which is Lamisil(®) Once 1% w/w (topical solution), containing 1% w/w terbinafine hydrochloride, which requires manipulation on the affected area. The aim of this study was to evaluate the efficacy, tolerability and consumer acceptability of a topical spray versus a topical solution in the treatment of tinea pedis. This study is a phase IIa, randomised, observer-blind, non-inferiority comparative study of the topical spray compared with the topical solution over a 12-week study period. The study was conducted at Bioskin GmbH, Hamburg and Berlin. Patients (n = 120) who presented with the presence of interdigital tinea pedis caused by dermatophytes on one or both feet were enrolled in the study. Patients were randomly assigned between the two treatment groups. Either the topical spray or the topical solution was administered by the study nurse and consisted of a single application (equivalent to 20mg of terbinafine per foot) on day 1 of the study. No further applications were made for the duration of the study. The hypothesis formulated before commencement of the study was that the topical spray would prove to be non-inferior to the topical solution. Efficacy assessments, including clinical signs and symptoms, mycology and microscopy were performed at baseline and 1, 6 and 12weeks after treatment. The rate of mycological cure at week 1 was statistically equivalent for both treatments. There was a significant reduction in the overall clinical score as assessed by the Physician's Global Assessment of signs and symptoms for both treatment groups. The topical spray and the topical solution showed comparable anti-fungal activity. Furthermore, the non-inferiority of topical spray to the topical solution was confirmed as determined by the proportion of patients categorised as successfully treated at week 1. This confirms that a topical spray product, which can be applied once without touching the affected skin, is equally as effective in the treatment of tinea pedis and removes the risk of organism transfer associated with touching infected areas. EudraCT-No. 2008-002399-92.