DOCSLIB.ORG

Therapies for Common Cutaneous Fungal Infections

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Therapies for Common Cutaneous Fungal Infections MedicineToday 2014; 15(6): 35-47 PEER REVIEWED FEATURE 2 CPD POINTS Therapies for common cutaneous fungal infections KENG-EE THAI MB BS(Hons), BMedSci(Hons), FACD Key points A practical approach to the diagnosis and treatment of common fungal • Fungal infection should infections of the skin and hair is provided. Topical antifungal therapies always be in the differential are effective and usually used as first-line therapy, with oral antifungals diagnosis of any scaly rash. being saved for recalcitrant infections. Treatment should be for several • Topical antifungal agents are typically adequate treatment weeks at least. for simple tinea. • Oral antifungal therapy may inea and yeast infections are among the dermatophytoses (tinea) and yeast infections be required for extensive most common diagnoses found in general and their differential diagnoses and treatments disease, fungal folliculitis and practice and dermatology. Although are then discussed (Table). tinea involving the face, hair- antifungal therapies are effective in these bearing areas, palms and T infections, an accurate diagnosis is required to ANTIFUNGAL THERAPIES soles. avoid misuse of these or other topical agents. Topical antifungal preparations are the most • Tinea should be suspected if Furthermore, subsequent active prevention is commonly prescribed agents for dermatomy- there is unilateral hand just as important as the initial treatment of the coses, with systemic agents being used for dermatitis and rash on both fungal infection. complex, widespread tinea or when topical agents feet – ‘one hand and two feet’ This article provides a practical approach fail for tinea or yeast infections. The pharmacol- involvement. to antifungal therapy for common fungal infec- ogy of the systemic agents is discussed first here. • Oral antifungal treatments tions of the skin and hair. It is not intended to can often be pulsed inter mit- be an in-depth treatise on derma tomycoses, Systemic antifungal agents tently, reducing the overall and onychomycosis and cutaneous candidiasis Terbinafine dose required. are not covered in detail. The initial section Terbinafine is a highly effective antifungal agent, briefly reviews the practical pharma cology of by virtue of its fungicidal property. It is an ally- commonly used antifungal agents, in order to lamine and works by inhibiting squalene epoxi- guide their use. The defining features of various dase. It has greater affinity for fungal squalene Dr Thai is a Consultant Dermatologist and Visiting Medical Officer at the Epicutaneous Patch Testing Clinic and Hair Copyright _Layoutand 1 Nail17/01/12 Clinic, Prince 1:43 PM of Wales Page Hospital, 4 Randwick; a Visiting Medical Officer at the Macquarie University Hospital, © GETTY IMAGES/SPL CREATIVE Macquarie Park; and in private practice in Gordon, Sydney, NSW. MedicineToday x JUNE 2014, VOLUME 15, NUMBER 6 35 Downloaded for personal use only. No other uses permitted without permission. © MedicineToday 2014. TREATING COMMON FUNGAL INFECTIONS CONTINUED epoxidase than the human type. Inhibition interactions and there are no contraindi- may reduce absorption of griseofulvin; they results in a deficiency of ergosterol (an impor- cations to its use with other drugs. How- should be taken two hours after the anti- tant fungal cell wall constituent) and the ever, because it is an inhibitor of cytochrome fungal agent. Griseofulvin can increase the accumulation of squalene, both of which P450 2D6, care should be taken when metabolism of warfarin and the contra- disrupt fungal cell membranes. It is especially administering it to patients taking tricyclic ceptive pill. When co-administered with effective against infections caused by der- antidepressants and other drugs metabo- alcohol, patients should be warned about matophytes (Epidermophyton, Micro- lised by this isozyme. the disulfiram-like reaction that can occur. sporum and Trichophyton). About 80% of an oral dose of terbinafine Griseofulvin Itraconazole is absorbed, regardless of food intake, but Griseofulvin was the first important oral Itraconazole, a triazole, is useful in the first-pass metabolism limits bioavailability antifungal agent available for the treat- treatment of onychomycosis and dermato- to 40%. Terbinafine is lipophilic and thus ment of fungal skin infections. Histori- mycoses. It is also useful for infections widely distributed, with significant and cally its main use was in the treatment of caused by Candida, Malassezia and some rapid distribution in skin stratum cor- tinea capitis. Being only fungistatic, it nondermatophyte moulds. It acts by inhib- neum, sebum, hair and nails. is not as effective as the other agents iting 14α-demethylase, resulting in inhi- High concentrations of the medication described here. bition of ergosterol production from are reached in the stratum corneum within Treatment needs to be continuous until lanosterol. hours of commencement of therapy. After mycological and clinical cure when gri- Being a highly lipophilic drug, itracona- 12 days of terbinafine 250 mg per day, there seofulvin is used to treat dermatophyte zole is best taken with a meal. A low pH is enough drug in the skin to maintain a infections. This often leads to protracted gastric environment is also useful to aid minimum inhibitory concentration (MIC) courses (several weeks to months), espe- absorption. In patients who have relative for two to three weeks after cessation of cially with onychomycosis, for which up achlorhydria (i.e. those taking H2-antago- treatment. Terbinafine is found in the dis- to 18 months of treatment may be required. nists, proton pump inhibitors or antacids) tal nail after one week of therapy, and after It is important to note that griseofulvin or who are taking the drug on an empty six or more weeks of treatment it is detect- has no activity against the yeasts Candida stomach, absorption is aided by the able for at least another 30 weeks (indicat- and Malassezia (formerly known as co- administration of a cola soft drink. The ing the potential for continued action). It Pityrosporum). drug is often used in a pulsatile manner. is also found in the hair after one week of Typical doses in children are 10 to Itraconazole rapidly presents into the treatment, and may be detected for up to 15 mg/kg daily, with recalcitrant cases stratum corneum and persists for three to another 50 days after just two weeks of requiring up to 25 mg/kg daily, and in four weeks after cessation of therapy. In treatment. adults, 500 mg to 1 g daily. The medication the nail, a MIC is achieved after only one As terbinafine is metabolised in the liver is best taken with a fatty meal to increase week of 200 mg itraconazole twice a day. and the metabolites are excreted in the absorption. For children, the tablets can be After several one-week-per-month pulses urine, dose adjustment is required in crushed and administered with, for exam- of treatment, the drug can persist for patients with renal failure where the serum ple, chocolate, full-cream ice cream or months in the nail plate. Appreciable creatinine level exceeds 300 µmol/L. With peanut butter. The medication is presented amounts are present in hair after only one the exception of those with renal insuffi- to the skin via sweat, concentrating in the week of therapy, with higher concentrations ciency, dose adjustment is not required in stratum corneum. It is quickly cleared from found with longer pulses. Itraconazole can the elderly. skin and hair after cessation of therapy. persist for up to nine months after cessation Terbinafine is generally a very safe Although well tolerated, side effects are of therapy. agent. The most common adverse effects common with the use of griseofulvin and are headache, gastrointestinal symptoms include headaches, photosensitivity, drug Fluconazole and drug eruptions; hepatic and haema- rashes, gastrointestinal disturbance, uri- Fluconazole is a commonly used tological complications are quite uncom- nary and menstrual disturbances, liver broad-spectrum triazole that, like other mon. Blood counts and liver function tests dysfunction and neurological effects azoles, inhibits 14α-demethylase. However, should be performed if terbinafine is to be (fatigue, mood changes, dizziness, blurred it is much less lipophilic and much less used continuously for more than six weeks. vision). Changes to spermatogenesis occur, protein-bound than other azoles. It has One peculiar side effect is a disturbance, and men taking griseofulvin should not very high bioavailability and its absorption or even loss, of taste in some patients, father children for at least six months after is not affected by food. which can be irreversible.Copyright _Layout 1 17/01/12ceasing 1:43 treatment.PM Page 4 When used as a once-a-week 150 mg Terbinafine has no serious drug The use of antacids and H2-antagonists pulse, fluconazole is present in the skin 36 MedicineToday x JUNE 2014, VOLUME 15, NUMBER 6 Downloaded for personal use only. No other uses permitted without permission. © MedicineToday 2014. TABLE. TREATMENT OPTIONS FOR COMMON CUTANEOUS FUNGAL INFECTIONS Fungal infection First-line therapy Second-line therapy General notes Tinea corporis, Topical terbinafine Oral terbinafine 250 mg for 2 to 4 Keep skin dry Tinea capitis, Topical imidazoles weeks Identify and eliminate Tinea cruris, Fluconazole 200 mg weekly for 2 to source Tinea faciei, 4 weeks (off-label use) Tinea manuum Itraconazole 200 mg twice daily for 1 week per month for several months Griseofulvin 500 mg daily for several
Load more

Recommended publications
  • Estimated Burden of Serious Fungal Infections in Ghana
    Journal of Fungi Article Estimated Burden of Serious Fungal Infections in Ghana Bright K. Ocansey 1, George A. Pesewu 2,*, Francis S. Codjoe 2, Samuel Osei-Djarbeng 3, Patrick K. Feglo 4 and David W. Denning 5 1 Laboratory Unit, New Hope Specialist Hospital, Aflao 00233, Ghana; [email protected] 2 Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box KB-143, Korle-Bu, Accra 00233, Ghana; [email protected] 3 Department of Pharmaceutical Sciences, Faculty of Health Sciences, Kumasi Technical University, P.O. Box 854, Kumasi 00233, Ghana; [email protected] 4 Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana; [email protected] 5 National Aspergillosis Centre, Wythenshawe Hospital and the University of Manchester, Manchester M23 9LT, UK; [email protected] * Correspondence: [email protected] or [email protected] or [email protected]; Tel.: +233-277-301-300; Fax: +233-240-190-737 Received: 5 March 2019; Accepted: 14 April 2019; Published: 11 May 2019 Abstract: Fungal infections are increasingly becoming common and yet often neglected in developing countries. Information on the burden of these infections is important for improved patient outcomes. The burden of serious fungal infections in Ghana is unknown. We aimed to estimate this burden. Using local, regional, or global data and estimates of population and at-risk groups, deterministic modelling was employed to estimate national incidence or prevalence. Our study revealed that about 4% of Ghanaians suffer from serious fungal infections yearly, with over 35,000 affected by life-threatening invasive fungal infections.
    [Show full text]
  • Tinea Infections: Athlete's Foot, Jock Itch and Ringworm
    Tinea Infections: Athlete’s Fo ot, Jock Itch and Ringworm What is tinea? Tinea is caused by a fungus that grows on your skin, hair or nails. As it grows, it spreads out in a circle, leaving normal-looking skin in the middle. This makes it look like a ring. At the edge of the ring, the skin is lifted up by the irritation and looks like a red and scaly rash. To some people, the infection looks like a worm is under the skin. Because of the way it looks, tinea infection is often called “ringworm.” However, there really is not a worm under the skin. How did I get a ringworm/tinea? You can get a fungal infection by contact with person or environment. Some fungi live on damp surfaces, like the floors of showers or locker rooms. You can even catch a fungal infection from your pets. Dogs and cats, as well as farm animals, can be infected with a fungus. Often this infection looks like a patch of skin where fur is missing (mange). What areas of the body are affected by tinea infections? Fungal infections are named for the part of the body they infect. Tinea corporis is a fungal infection of the skin on the body. If you have this infection, you may see small, red spots that grow into large rings almost anywhere on your arms, legs or chest. Tinea pedis is usually called “athlete’s foot.” The moist skin between your toes is a perfect place for a fungus to grow. The skin may become itchy and red, with a white, wet surface.
    [Show full text]
  • Introduction
    Notes Introduction 1. In the book, we use the terms ‘fungal infections’ and ‘mycoses’ (or singular fungal infection and mycosis) interchangeably, mostly following the usage of our historical actors in time and place. 2. The term ‘ringworm’ is very old and came from the circular patches of peeled, inflamed skin that characterised the infection. In medicine at least, no one understood it to be associated with worms of any description. 3. Porter, R., ‘The patient’s view: Doing medical history from below’, Theory and Society, 1985, 14: 175–198; Condrau, F., ‘The patient’s view meets the clinical gaze’, Social History of Medicine, 2007, 20: 525–540. 4. Burnham, J. C., ‘American medicine’s golden age: What happened to it?’, Sci- ence, 1982, 215: 1474–1479; Brandt, A. M. and Gardner, M., ‘The golden age of medicine’, in Cooter, R. and Pickstone, J. V., eds, Medicine in the Twentieth Century, Amsterdam, Harwood, 2000, 21–38. 5. The Oxford English Dictionary states that the first use of ‘side-effect’ was in 1939, in H. N. G. Wright and M. L. Montag’s textbook: Materia Med Pharma- col & Therapeutics, 112, when it referred to ‘The effects which are not desired in any particular case are referred to as “side effects” or “side actions” and, in some instances, these may be so powerful as to limit seriously the therapeutic usefulness of the drug.’ 6. Illich, I., Medical Nemesis: The Expropriation of Health, London, Calder & Boyars, 1975. 7. Beck, U., Risk Society: Towards a New Society, New Delhi, Sage, 1992, 56 and 63; Greene, J., Prescribing by Numbers: Drugs and the Definition of Dis- ease, Baltimore, Johns Hopkins University Press, 2007; Timmermann, C., ‘To treat or not to treat: Drug research and the changing nature of essential hypertension’, Schlich, T.
    [Show full text]
  • Fungal Infections from Human and Animal Contact
    Journal of Patient-Centered Research and Reviews Volume 4 Issue 2 Article 4 4-25-2017 Fungal Infections From Human and Animal Contact Dennis J. Baumgardner Follow this and additional works at: https://aurora.org/jpcrr Part of the Bacterial Infections and Mycoses Commons, Infectious Disease Commons, and the Skin and Connective Tissue Diseases Commons Recommended Citation Baumgardner DJ. Fungal infections from human and animal contact. J Patient Cent Res Rev. 2017;4:78-89. doi: 10.17294/2330-0698.1418 Published quarterly by Midwest-based health system Advocate Aurora Health and indexed in PubMed Central, the Journal of Patient-Centered Research and Reviews (JPCRR) is an open access, peer-reviewed medical journal focused on disseminating scholarly works devoted to improving patient-centered care practices, health outcomes, and the patient experience. REVIEW Fungal Infections From Human and Animal Contact Dennis J. Baumgardner, MD Aurora University of Wisconsin Medical Group, Aurora Health Care, Milwaukee, WI; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI; Center for Urban Population Health, Milwaukee, WI Abstract Fungal infections in humans resulting from human or animal contact are relatively uncommon, but they include a significant proportion of dermatophyte infections. Some of the most commonly encountered diseases of the integument are dermatomycoses. Human or animal contact may be the source of all types of tinea infections, occasional candidal infections, and some other types of superficial or deep fungal infections. This narrative review focuses on the epidemiology, clinical features, diagnosis and treatment of anthropophilic dermatophyte infections primarily found in North America.
    [Show full text]
  • Seborrheic Dermatitis: an Overview ROBERT A
    Seborrheic Dermatitis: An Overview ROBERT A. SCHWARTZ, M.D., M.P.H., CHRISTOPHER A. JANUSZ, M.D., and CAMILA K. JANNIGER, M.D. University of Medicine and Dentistry at New Jersey-New Jersey Medical School, Newark, New Jersey Seborrheic dermatitis affects the scalp, central face, and anterior chest. In adolescents and adults, it often presents as scalp scaling (dandruff). Seborrheic dermatitis also may cause mild to marked erythema of the nasolabial fold, often with scaling. Stress can cause flare-ups. The scales are greasy, not dry, as commonly thought. An uncommon generalized form in infants may be linked to immunodeficiencies. Topical therapy primarily consists of antifungal agents and low-potency steroids. New topical calcineurin inhibitors (immunomodulators) sometimes are administered. (Am Fam Physician 2006;74:125-30. Copyright © 2006 American Academy of Family Physicians.) eborrheic dermatitis can affect patients levels, fungal infections, nutritional deficits, from infancy to old age.1-3 The con- neurogenic factors) are associated with the dition most commonly occurs in condition. The possible hormonal link may infants within the first three months explain why the condition appears in infancy, S of life and in adults at 30 to 60 years of age. In disappears spontaneously, then reappears adolescents and adults, it usually presents as more prominently after puberty. A more scalp scaling (dandruff) or as mild to marked causal link seems to exist between seborrheic erythema of the nasolabial fold during times dermatitis and the proliferation of Malassezia of stress or sleep deprivation. The latter type species (e.g., Malassezia furfur, Malassezia tends to affect men more often than women ovalis) found in normal dimorphic human and often is precipitated by emotional stress.
    [Show full text]
  • Hyperhidrosis: Sweating out the Details
    Focus on CME at the Université de Montréal Hyperhidrosis: Sweating Out the Details Antranik Benohanian, MD, FRCPC; and Nowell Solish, MD, FRCPC Presented at the 250th meeting of the Montreal Dermatological Society, April 2003 yperhidrosis (HH) remains a relatively Table 1 Hunknown disorder to the general public Most commonly affected sites and health-care professionals. According to the literature, 0.5% to 1% of the population is Site Prevalence affected by HH. However, a recent survey held Facial 68.9% in the U.S. places that figure at 2.8%; thus, Axillary 50.8% revealing that the prevalence is underrated. Plantar 28.7% Among those affected, only 38% had discussed Palmar 24.8% the problem with a health professional.1 HH may be classified as primary or sec- ondary; either type can be localized or gen- Besides affecting quality of life, HH predis- eralized. Table 1 lists the most commonly poses its victims to a host of dermatologic dis- affected sites. orders (Table 2).3 The control of HH would also control the associated disease condition, as has Impact on quality of life been recently reported with the treatment of dyshidrotic hand dermatitis with intradermal HH is known to be a socially embarrassing and botulinum toxin.4 occupationally disabling disorder. Many patients suffer in silence. Figure 1 illustrates the How is HH treated? impact HH has on quality of life.2 Those with axillary HH often have to change Systemic approach clothing several times a day and throw out Minor sedatives, such as amitriptyline and clothing because of the damage caused to fabric hydroxyzine, produce an anticholinergic, as and leather.
    [Show full text]
  • Estimated Burden of Fungal Infections in Oman
    Journal of Fungi Article Estimated Burden of Fungal Infections in Oman Abdullah M. S. Al-Hatmi 1,2,3,* , Mohammed A. Al-Shuhoumi 4 and David W. Denning 5 1 Department of microbiology, Natural & Medical Sciences Research Center, University of Nizwa, Nizwa 616, Oman 2 Department of microbiology, Centre of Expertise in Mycology Radboudumc/CWZ, 6500 Nijmegen, The Netherlands 3 Foundation of Atlas of Clinical Fungi, 1214GP Hilversum, The Netherlands 4 Ibri Hospital, Ministry of Health, Ibri 115, Oman; [email protected] 5 Manchester Fungal Infection Group, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, UK; [email protected] * Correspondence: [email protected]; Tel.: +968-25446328; Fax: +968-25446612 Abstract: For many years, fungi have emerged as significant and frequent opportunistic pathogens and nosocomial infections in many different populations at risk. Fungal infections include disease that varies from superficial to disseminated infections which are often fatal. No fungal disease is reportable in Oman. Many cases are admitted with underlying pathology, and fungal infection is often not documented. The burden of fungal infections in Oman is still unknown. Using disease frequencies from heterogeneous and robust data sources, we provide an estimation of the incidence and prevalence of Oman’s fungal diseases. An estimated 79,520 people in Oman are affected by a serious fungal infection each year, 1.7% of the population, not including fungal skin infections, chronic fungal rhinosinusitis or otitis externa. These figures are dominated by vaginal candidiasis, followed by allergic respiratory disease (fungal asthma). An estimated 244 patients develop invasive aspergillosis and at least 230 candidemia annually (5.4 and 5.0 per 100,000).
    [Show full text]
  • Scalp Eczema Factsheet the Scalp Is an Area of the Body That Can Be Affected by Several Types of Eczema
    12 Scalp eczema factsheet The scalp is an area of the body that can be affected by several types of eczema. The scalp may be dry, itchy and scaly in a chronic phase and inflamed (red), weepy and painful in an acute (eczema flare) phase. Aside from eczema, there are a number of reasons why the scalp can become dry and itchy (e.g. psoriasis, fungal infection, ringworm, head lice etc.), so it is wise to get a firm diagnosis if there is uncertainty. Types of eczema • Hair clips and headgear – especially those containing that affect the scalp rubber or nickel. Seborrhoeic eczema (dermatitis) is one of the most See the NES booklet on Contact Dermatitis for more common types of eczema seen on the scalp and hairline. details. It can affect babies (cradle cap), children and adults. The Irritant contact dermatitis is a type of eczema that skin appears red and scaly and there is often dandruff as occurs when the skin’s surface is irritated by a substance well, which can vary in severity. There may also be a rash that causes the skin to become dry, red and itchy. on other parts of the face, such as around the eyebrows, For example, shampoos, mousses, hair gels, hair spray, eyelids and sides of the nose. Seborrhoeic eczema can perm solution and fragrance can all cause irritant contact become infected. See the NES factsheets on Adult dermatitis. See the NES booklet on Contact Dermatitis for Seborrhoeic Dermatitis and Infantile Seborrhoeic more details. Dermatitis and Cradle Cap for more details.
    [Show full text]
  • Molecular Analysis of Dermatophytes Suggests Spread of Infection Among Household Members
    Molecular Analysis of Dermatophytes Suggests Spread of Infection Among Household Members Mahmoud A. Ghannoum, PhD; Pranab K. Mukherjee, PhD; Erin M. Warshaw, MD; Scott Evans, PhD; Neil J. Korman, MD, PhD; Amir Tavakkol, PhD, DipBact Practice Points When a patient presents with tinea pedis or onychomycosis, inquire if other household members also have the infection, investigate if they have a history of concomitant tinea pedis and onychomycosis, and examine for plantar scaling and/or nail discoloration. If the variables above areCUTIS observed, think about spread of infection and treatment options. Dermatophyte infection from the same strains may Drs. Ghannoum, Mukherjee, and Korman are from University be an important route for transmission of derma- Hospitals Case Medical Center, Cleveland, Ohio. Dr. Warshaw is from the University of Minnesota, Minneapolis, and Minneapolis Veterans tophytoses within a household. In this study, we AffairsDo Medical Center. Dr. Evans is from Notthe Harvard School of Public used molecularCopy methods to identify dermatophytes Health, Boston, Massachusetts. Dr. Tavakkol was from Novartis in members of dermatophyte-infected households Pharmaceuticals Corporation, East Hanover, New Jersey, and and evaluated variables associated with the currently is from Topica Pharmaceuticals, Inc, Los Altos, California. spread of infection. Fungal species were identi- This article was supported by a grant from Novartis Pharmaceuticals Corporation. Dr. Ghannoum has served as a consultant and/or fied by polymerase chain reaction (PCR) using speaker for and has received grants and contracts from Merck & Co, primers targeting the internal transcribed spacer Inc; Novartis Pharmaceuticals Corporation; Pfizer Inc; and Stiefel, (ITS) regions (ITS1 and ITS4). For strain differen- a GSK company.
    [Show full text]
  • WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/05 (2006.01) A61P 31/02 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, (21) International Application Number: BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, PCT/CA20 14/000 174 DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, 4 March 2014 (04.03.2014) KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, (25) Filing Language: English OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, (26) Publication Language: English SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, (30) Priority Data: ZW. 13/790,91 1 8 March 2013 (08.03.2013) US (84) Designated States (unless otherwise indicated, for every (71) Applicant: LABORATOIRE M2 [CA/CA]; 4005-A, rue kind of regional protection available): ARIPO (BW, GH, de la Garlock, Sherbrooke, Quebec J1L 1W9 (CA). GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, (72) Inventors: LEMIRE, Gaetan; 6505, rue de la fougere, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, Sherbrooke, Quebec JIN 3W3 (CA).
    [Show full text]
  • Dermatophyte and Non-Dermatophyte Onychomycosis in Singapore
    Australas J. Dermatol 1992; 33: 159-163 DERMATOPHYTE AND NON-DERMATOPHYTE ONYCHOMYCOSIS IN SINGAPORE JOYCE TENG-EE LIM, HOCK CHENG CHUA AND CHEE LEOK GOH Singapore SUMMARY Onychomycosis is caused by dermatophytes, moulds and yeasts. It is important to identify the non-dermatophyte moulds as they are resistant to the usual anti-fungals. A prospective study was undertaken in the National Skin Centre, Singapore to study the pattern of dermatophyte and non-dermatophyte onychomycosis. 53 male and 47 female patients seen between June 1990 and June 1991 were entered into the study. Direct microscopy was done and the nail clippings were cultured. Toe and finger nails were equally infected. Dermatophytes were isolated from 21 patients namely, T. rubrum (12/21), T. interdigitale (5/21), T. mentagrophytes (3/21) and T. violaceum (1/21). Candida onychomycosis occurred in 39 patients and was caused by C. albicans (38/39) and C. parapsilosis (1/39). 37/39 patients had associated paronychia. 5 types of moulds were isolated from 12 patients, namely Fusarium species (6/12), Aspergillus species (3/12), S. brevicaulis (1/12), Aureobasilium species (1/12) and Penicillium species (1/12). Although the clinical pattern and microscopy may predict the type of organisms, in practice this is difficult. Only cultures were confirmatory. 28% (28/100) had negative cultures despite a positive microscopy, and moulds (12/100) grown might be contaminants rather than pathogens. Key words: Moulds, yeasts, fungi, tinea, onychomycosis, dermatophyte, non-dermatophyte INTRODUCTION METHODS AND MATERIALS Onychomycosis, a common nail disorder, is 100 consecutive patients, seen in our centre caused by dermatophytes, non-dermatophyte between June 1990 and June 1991, with a new moulds, or yeasts.
    [Show full text]
  • Introduction to Bacteriology and Bacterial Structure/Function
    INTRODUCTION TO BACTERIOLOGY AND BACTERIAL STRUCTURE/FUNCTION LEARNING OBJECTIVES To describe historical landmarks of medical microbiology To describe Koch’s Postulates To describe the characteristic structures and chemical nature of cellular constituents that distinguish eukaryotic and prokaryotic cells To describe chemical, structural, and functional components of the bacterial cytoplasmic and outer membranes, cell wall and surface appendages To name the general structures, and polymers that make up bacterial cell walls To explain the differences between gram negative and gram positive cells To describe the chemical composition, function and serological classification as H antigen of bacterial flagella and how they differ from flagella of eucaryotic cells To describe the chemical composition and function of pili To explain the unique chemical composition of bacterial spores To list medically relevant bacteria that form spores To explain the function of spores in terms of chemical and heat resistance To describe characteristics of different types of membrane transport To describe the exact cellular location and serological classification as O antigen of Lipopolysaccharide (LPS) To explain how the structure of LPS confers antigenic specificity and toxicity To describe the exact cellular location of Lipid A To explain the term endotoxin in terms of its chemical composition and location in bacterial cells INTRODUCTION TO BACTERIOLOGY 1. Two main threads in the history of bacteriology: 1) the natural history of bacteria and 2) the contagious nature of infectious diseases, were united in the latter half of the 19th century. During that period many of the bacteria that cause human disease were identified and characterized. 2. Individual bacteria were first observed microscopically by Antony van Leeuwenhoek at the end of the 17th century.
    [Show full text]