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Clinical Microbiology Reviews Dec 2023Invasive fusariosis is a serious invasive fungal disease, affecting immunocompetent and, more frequently, immunocompromised patients. Localized disease is the typical... (Review)
Review
Invasive fusariosis is a serious invasive fungal disease, affecting immunocompetent and, more frequently, immunocompromised patients. Localized disease is the typical clinical form in immunocompetent patients. Immunocompromised hosts at elevated risk of developing invasive fusariosis are patients with acute leukemia receiving chemotherapeutic regimens for remission induction, and those undergoing allogeneic hematopoietic cell transplant. In this setting, the infection is usually disseminated with positive blood cultures, multiple painful metastatic skin lesions, and lung involvement. Currently available antifungal agents have poor activity against species, but a clear-cut correlation between activity and clinical effectiveness does not exist. The outcome of invasive fusariosis is largely dependent on the resolution of immunosuppression, especially neutrophil recovery in neutropenic patients.
Topics: Humans; Fusariosis; Hematopoietic Stem Cell Transplantation; Antifungal Agents; Fusarium; Immunocompromised Host
PubMed: 37937988
DOI: 10.1128/cmr.00159-22 -
The New England Journal of Medicine Feb 2024
Review
Topics: Humans; Blastomycosis; Coccidioidomycosis; Histoplasmosis; Immunocompetence
PubMed: 38324487
DOI: 10.1056/NEJMra2306821 -
Hand Surgery & Rehabilitation Apr 2024Onychomycosis is a fungal infection of the nail, and the most common nail infection worldwide, causing discoloration and thickening of the nail plate. It is... (Review)
Review
Onychomycosis is a fungal infection of the nail, and the most common nail infection worldwide, causing discoloration and thickening of the nail plate. It is predominantly caused by dermatophytes. Clinical presentation is polymorphous. Diagnosis must be confirmed by mycological examination before initiating any therapy. Management is an ongoing challenge, often requiring several months' treatment, with a high risk of recurrence. Treatment must be adapted to clinical presentation and severity and to the patient's history and wishes. Debridement of all infected keratin is the first step, reducing fungal load. Systemic treatments are more effective than topical treatments, and combining the two increases the cure rate. Terbinafine is the drug of choice for dermatophyte onychomycosis, due to low drug interaction and good cost-effectiveness. Itraconazole and fluconazole are broad-spectrum antifungals that are effective against dermatophytes, yeasts, and some non-dermatophytic molds. Recurrence rates for onychomycosis are high. Prophylactic application of topicals and avoiding walking barefoot in public places may help prevent recurence.
Topics: Onychomycosis; Humans; Antifungal Agents; Debridement; Foot Dermatoses; Terbinafine; Naphthalenes; Administration, Topical
PubMed: 38218374
DOI: 10.1016/j.hansur.2024.101638 -
Dermatologic Clinics Jul 2023Tinea capitis, folliculitis, seborrheic dermatitis, and pediculosis capitis are four common scalp conditions. Although tinea capitis and seborrheic dermatitis are found... (Review)
Review
Tinea capitis, folliculitis, seborrheic dermatitis, and pediculosis capitis are four common scalp conditions. Although tinea capitis and seborrheic dermatitis are found more commonly in patients with skin of color and highly textured hair, all of these conditions have special diagnostic or management considerations in these populations. This article reviews the diagnosis and management of these common scalp conditions.
Topics: Humans; Dermatitis, Seborrheic; Scalp; Tinea Capitis; Skin; Inflammation
PubMed: 37236720
DOI: 10.1016/j.det.2023.02.008 -
CMAJ : Canadian Medical Association... Jul 2023
Topics: Humans; Blastomycosis
PubMed: 37524399
DOI: 10.1503/cmaj.230269 -
JAMA Dermatology Jun 2024
Topics: Onychomycosis; Humans; Antifungal Agents; Foot Dermatoses
PubMed: 38598197
DOI: 10.1001/jamadermatol.2023.5194 -
Transactions of the Royal Society of... May 2024Previous studies on the distribution of mycetoma globally have failed to identify Ecuador as an endemic country.
BACKGROUND
Previous studies on the distribution of mycetoma globally have failed to identify Ecuador as an endemic country.
METHODS
We present data on 35 cases of mycetoma in Ecuador between 1955 and 2021: 5 cases from our experience and 30 cases from the literature.
RESULTS
Eight cases of eumycetoma (23%) and 27 cases of actinomycetoma (77%) were diagnosed. Most cases originated from the coastal region of Ecuador.
CONCLUSIONS
For the first time in an English-language publication, this communication confirms the presence of mycetoma in Ecuador, securing Ecuador's position on the global mycetoma map.
Topics: Ecuador; Humans; Mycetoma; Male; Female; Adult; Middle Aged; Adolescent; Young Adult; Child
PubMed: 38214978
DOI: 10.1093/trstmh/trad098 -
PLoS Neglected Tropical Diseases Nov 2023Mycetoma is a chronic, incapacitating, destructive inflammatory disease with many serious damaging impacts. Currently, there is no control or prevention program as many... (Review)
Review
Mycetoma is a chronic, incapacitating, destructive inflammatory disease with many serious damaging impacts. Currently, there is no control or prevention program as many of its epidemiological characteristics, such as the causative organisms' ecological niche, natural habitat, primary reservoir, transmission mode, geographical distribution, incidence, and prevalence, remain unclear. This may be due to a lack of research interest, as mycetoma is still a neglected disease and the scarcity of accurate molecular diagnostic techniques in disease-endemic regions for accurate causative microorganisms identification and mapping. With this background, this study set out to address this knowledge gap by considering the mycetoma environmental occurrence predictors. The medical literature obtained data showed a close association between mycetoma occurrence and its environment. The causative microorganisms are available in the environment in active or dormant forms. Animal dung may be a natural niche and reservoir for these organisms, and thorns may facilitate the subcutaneous inoculation. Some environmental factors, such as the soil type and consistency, temperature, water sources, aridity index, and thorny trees, may be risk factors. The population in endemic areas socioeconomic, hygiene, and health education status are contributory factors for mycetoma. The individual's genetic and immunological backgrounds may determine the disease's susceptibility and resistance. Environmental conditions and personal hygiene improvement are mandatory to reduce disease occurrence. Mycetoma spatial mapping can detect disease cluster areas and then develop public health strategies for early case detection and management to reduce the disease burden. More research interests and facilities are needed to understand disease pathogenesis and appropriate patient management better.
Topics: Animals; Humans; Mycetoma; Soil; Ecosystem; Health Education; Neglected Diseases
PubMed: 37971968
DOI: 10.1371/journal.pntd.0011736 -
The Journal of Dermatological Treatment Dec 2023Onychomycosis is difficult to treat due to long treatment durations, poor efficacy rates of treatments, high relapse rates, and safety issues when using systemic... (Review)
Review
Onychomycosis is difficult to treat due to long treatment durations, poor efficacy rates of treatments, high relapse rates, and safety issues when using systemic antifungal agents. Device-based treatments are targeted to specific regions of the nail, have favorable safely profiles, and do not interfere with systemic agents. They may be an effective alternative therapy for onychomycosis especially with increasing reports of squalene epoxidase gene mutations and potential resistance to terbinafine therapy. In this review, we discuss four devices used as antifungal treatments and three devices used as penetration enhancers for topical agents. Lasers, photodynamic therapy, microwaves, and non-thermal plasma have the capacity to inactivate fungal pathogens demonstrated through studies. Efficacy rates for these devices, however, remain relatively low pointing toward the need to further optimize device or usage parameters. Ultrasound, nail drilling, and iontophoresis aid in improving the permeability of topical agents through the nail and have been investigated as adjunctive therapies. Due to the paucity in clinical data, their efficacy in treating onychomycosis has not yet been established. While the results of clinical studies point toward the potential utility of devices for onychomycosis, further large-scale randomized clinical trials following regulatory guidelines are required to confirm current results.
Topics: Humans; Onychomycosis; Antifungal Agents; Terbinafine; Nails; Photochemotherapy; Administration, Topical
PubMed: 37807661
DOI: 10.1080/09546634.2023.2265658 -
Cleveland Clinic Journal of Medicine Oct 2023
Topics: Humans; Tinea
PubMed: 37783500
DOI: 10.3949/ccjm.90a.23002