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Skinmed 2023
Topics: Humans; Alopecia Areata; Tinea Capitis; Alopecia
PubMed: 37771022
DOI: No ID Found -
Expert Opinion on Therapeutic Patents 2023Onychomycosis, a multifactorial fungal infection of the nails, shows a global prevalence of about 5.5% and is responsible for 50% of all nail infections. To develop... (Review)
Review
INTRODUCTION
Onychomycosis, a multifactorial fungal infection of the nails, shows a global prevalence of about 5.5% and is responsible for 50% of all nail infections. To develop effective management strategies, it is necessary to understand the etiology, pathophysiology, and risk factors of onychomycosis. Oral route of drug delivery is one of the routes utilized to deliver anti-fungal agents, but, has its own limitations like longer duration of treatment, increased adverse effects, and potential for drug interaction. The ungual route has received greater attention due to its localized, non- invasive action and improved patient compliance.
AREAS COVERED
This review comprehensively discusses conventional onychomycosis therapies and patented novel drug delivery systems for the management of onychomycosis including chemical permeation enhancers, non-particulate drug delivery systems, penetration enhancing devices etc., Databases such as PubMed, ResearchGate, and Google Patents were searched by using the keywords onychomycosis and trans-ungual drug delivery.
EXPERT OPINION
Enormous research has been conducted and is still ongoing to find the best possible novel drug delivery system for onychomycosis management. Approaches like incorporation of herbal constituents in nano-formulations, inkjet printing, laser devices, iontophoretic techniques, etc. can be employed to make safe and effective drug delivery systems which are regulatory compliant.
Topics: Humans; Onychomycosis; Antifungal Agents; Administration, Topical; Patents as Topic; Nails; Drug Delivery Systems
PubMed: 37800854
DOI: 10.1080/13543776.2023.2268278 -
Dermatologie (Heidelberg, Germany) Sep 2023The horse is the most common reservoir of Trichophyton (T.) equinum. However, this zoophilic dermatophyte only rarely causes infections in humans. The following case...
The horse is the most common reservoir of Trichophyton (T.) equinum. However, this zoophilic dermatophyte only rarely causes infections in humans. The following case report describes such a case. In addition to epidemiology, treatment is described and the morphological and physiological characteristics of T. equinum are illustrated. Because of its formation of spiral hyphae and nodal organs, which has not been previously documented for this species, the isolated strain was deposited in the German Collection of Microorganisms and Cell Cultures (DSM No. 114196).
Topics: Humans; Animals; Horses; Arthrodermataceae; Tinea; Trichophyton; Cell Culture Techniques
PubMed: 37280370
DOI: 10.1007/s00105-023-05162-1 -
Tropical Doctor Jan 2024Mycetoma is a suppurative chronic bacterial or fungal disease inoculated into the body by minor trauma which may penetrate from subcutaneous tissue to bone. Although the...
Mycetoma is a suppurative chronic bacterial or fungal disease inoculated into the body by minor trauma which may penetrate from subcutaneous tissue to bone. Although the lower extremities are most commonly affected, rare forms can also be seen from time to time. The diagnostic triad of swelling in the affected area, multiple sinus formation, and purulent discharge with grains are typical. Definitive diagnosis is made by isolation of the causative pathogen, radiologic imaging, and histopathologic examination. Antifungal and antibacterial options are applied together with surgery. Our aim in this case series is to report and analyze 10 rare cases of mycetoma.
Topics: Humans; Mycetoma; Somalia; Antifungal Agents; Anti-Bacterial Agents
PubMed: 37715653
DOI: 10.1177/00494755231201664 -
Medical Mycology Dec 2023Fusarium species represent an opportunistic fungal pathogen. The data in Mexico about Fusarium infections in humans are scarce. Here, we present a retrospective series...
Fusarium species represent an opportunistic fungal pathogen. The data in Mexico about Fusarium infections in humans are scarce. Here, we present a retrospective series of patients with a confirmed diagnosis of fusariosis in eight different hospitals in Mexico from January 2010 to December 2019. The diagnosis of proven fusariosis was made according to the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium (EORT/MSG) criteria. A total of 49 cases were identified in our series. Most patients had burn injuries (49%), and 37% had hematological malignancies. Most patients had fire injuries (40%), followed by electric injuries (8%), febrile neutropenia (10%), and pancytopenia (6%). Patients had skin and soft tissue involvement in 49%, followed by blood culture isolation and biopsies from different sites of the body (lung, sinuses, bone tissue, and eyes). Febrile neutropenia (10%) and fungemia (8%) were the most common clinical syndromes in immunosuppressed patients. Most patients received monotherapy (67%), where voriconazole was used in 30% of the cases, followed by conventional amphotericin B (16%), and lipidic formulations of amphotericin B in 10% (either liposomal amphotericin B or amphotericin B lipid complex). Combination therapy was used in 20% of the cases, and the most common combination therapy was triazole plus any lipidic formulation of amphotericin B (10%). Mortality related to Fusarium infection occurred in 22% of patients. Fusariosis is a serious threat. Burn injuries and hematologic malignancies represent the most common causes of infection in this small series from Mexico.
Topics: Humans; Fusariosis; Amphotericin B; Antifungal Agents; Retrospective Studies; Mexico; Fusarium; Voriconazole; Hematologic Neoplasms; Burns; Febrile Neutropenia
PubMed: 37944000
DOI: 10.1093/mmy/myad112 -
MMW Fortschritte Der Medizin Aug 2023
Topics: Humans; Dermatomycoses; Antifungal Agents
PubMed: 37537465
DOI: 10.1007/s15006-023-2800-8 -
Expert Review of Anti-infective Therapy 2023spp. are a group of lipid-dependent basidiomycetes yeasts acting as commensal organisms of the human and animal skin. However, under some not well-defined... (Review)
Review
INTRODUCTION
spp. are a group of lipid-dependent basidiomycetes yeasts acting as commensal organisms of the human and animal skin. However, under some not well-defined circumstances, these yeasts may switch to opportunistic pathogens triggering a number of skin disorders with different clinical presentations. The genus comprises of 18 lipid-dependent species with a variable distribution in the hosts and pathologies thus suggesting a host- and microbe-specific interactions.
AREA COVERED
This review highlighted and discussed the most recent literature regarding the genus as a commensal or pathogenic organisms highlighting a-associated skin disorders in humans and animals and their antifungal susceptibility profile. A literature search of associated skin disorders was performed via PubMed and Google scholar (up to May 2023), using the different keywords mainly associated with skin disorders and Malassezia antifungal resistance.
EXPERT OPINION
yeasts are part of the skin mycobiota and their life cycle is strictly associated with the environment in which they live. The biochemical, physiological, or immunological condition of the host skin selects spp. or genotypes able to survive in a specific environment by changing their metabolisms, thus producing virulence factors or metabolites which can cause skin disorders with different clinical presentations.
Topics: Humans; Animals; Malassezia; Tinea Versicolor; Dermatomycoses; Antifungal Agents; Dermatitis, Seborrheic; Skin; Lipids
PubMed: 37883074
DOI: 10.1080/14787210.2023.2276367 -
Journal of Clinical Immunology Dec 2023Inborn errors of the IL-17A/F-responsive pathway lead to chronic mucocutaneous candidiasis (CMC) as a predominant clinical phenotype, without other significant clinical...
PURPOSE
Inborn errors of the IL-17A/F-responsive pathway lead to chronic mucocutaneous candidiasis (CMC) as a predominant clinical phenotype, without other significant clinical manifestations apart from mucocutaneous staphylococcal diseases. Among inborn errors affecting IL-17-dependent immunity, autosomal recessive (AR) IL-17RC deficiency is a rare disease with only three kindreds described to date. The lack of an in vitro functional evaluation system of IL17RC variants renders its diagnosis difficult. We sought to characterize a 7-year-old Japanese girl with CMC carrying a novel homozygous duplication variant of IL17RC and establish a simple in vitro system to evaluate the impact of this variant.
METHODS
Flow cytometry, qPCR, RNA-sequencing, and immunoblotting were conducted, and an IL17RC-knockout cell line was established for functional evaluation.
RESULTS
The patient presented with oral and mucocutaneous candidiasis without staphylococcal diseases since the age of 3 months. Genetic analysis showed that the novel duplication variant (Chr3: 9,971,476-9,971,606 dup (+131bp)) involving exon 13 of IL17RC results in a premature stop codon (p.D457Afs*16 or p.D457Afs*17). Our functional evaluation system revealed this duplication to be loss-of-function and enabled discrimination between loss-of-function and neutral IL17RC variants. The lack of response to IL-17A by the patient's SV40-immortalized fibroblasts was restored by introducing WT-IL17RC, suggesting that the genotype identified is responsible for her clinical phenotype.
CONCLUSIONS
The clinical and cellular phenotype of the current case of AR IL-17RC deficiency supports a previous report on this rare disorder. Our newly established evaluation system will be useful for the diagnosis of AR IL-17RC deficiency, providing accurate validation of unknown IL17RC variants.
Topics: Female; Humans; Infant; Child; Candidiasis, Chronic Mucocutaneous; Interleukin-17; Candidiasis; Fibroblasts; Base Sequence
PubMed: 38129603
DOI: 10.1007/s10875-023-01601-9 -
PLoS Neglected Tropical Diseases Aug 2023Deep learning, which is a part of a broader concept of artificial intelligence (AI) and/or machine learning has achieved remarkable success in vision tasks. While there...
BACKGROUND
Deep learning, which is a part of a broader concept of artificial intelligence (AI) and/or machine learning has achieved remarkable success in vision tasks. While there is growing interest in the use of this technology in diagnostic support for skin-related neglected tropical diseases (skin NTDs), there have been limited studies in this area and fewer focused on dark skin. In this study, we aimed to develop deep learning based AI models with clinical images we collected for five skin NTDs, namely, Buruli ulcer, leprosy, mycetoma, scabies, and yaws, to understand how diagnostic accuracy can or cannot be improved using different models and training patterns.
METHODOLOGY
This study used photographs collected prospectively in Côte d'Ivoire and Ghana through our ongoing studies with use of digital health tools for clinical data documentation and for teledermatology. Our dataset included a total of 1,709 images from 506 patients. Two convolutional neural networks, ResNet-50 and VGG-16 models were adopted to examine the performance of different deep learning architectures and validate their feasibility in diagnosis of the targeted skin NTDs.
PRINCIPAL FINDINGS
The two models were able to correctly predict over 70% of the diagnoses, and there was a consistent performance improvement with more training samples. The ResNet-50 model performed better than the VGG-16 model. A model trained with PCR confirmed cases of Buruli ulcer yielded 1-3% increase in prediction accuracy across all diseases, except, for mycetoma, over a model which training sets included unconfirmed cases.
CONCLUSIONS
Our approach was to have the deep learning model distinguish between multiple pathologies simultaneously-which is close to real-world practice. The more images used for training, the more accurate the diagnosis became. The percentages of correct diagnosis increased with PCR-positive cases of Buruli ulcer. This demonstrated that it may be better to input images from the more accurately diagnosed cases in the training models also for achieving better accuracy in the generated AI models. However, the increase was marginal which may be an indication that the accuracy of clinical diagnosis alone is reliable to an extent for Buruli ulcer. Diagnostic tests also have their flaws, and they are not always reliable. One hope for AI is that it will objectively resolve this gap between diagnostic tests and clinical diagnoses with the addition of another tool. While there are still challenges to be overcome, there is a potential for AI to address the unmet needs where access to medical care is limited, like for those affected by skin NTDs.
Topics: Humans; Artificial Intelligence; Buruli Ulcer; Pilot Projects; Deep Learning; Mycetoma; Skin Diseases; Neglected Diseases
PubMed: 37578966
DOI: 10.1371/journal.pntd.0011230 -
The Journal of Allergy and Clinical... Sep 2023
Topics: Humans; Gain of Function Mutation; Hematopoietic Stem Cell Transplantation; Antibodies, Monoclonal; Antibodies, Neutralizing; STAT1 Transcription Factor; Candidiasis, Chronic Mucocutaneous
PubMed: 37367708
DOI: 10.1016/j.jaci.2023.05.016