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Drugs in Context 2022Tinea versicolor is a common superficial fungal infection of the skin with various clinical manifestations. This review aims to familiarize physicians with the clinical... (Review)
Review
BACKGROUND
Tinea versicolor is a common superficial fungal infection of the skin with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea versicolor.
METHODS
A search was conducted in July 2022 in PubMed Clinical Queries using the key terms "tinea versicolor" OR "pityriasis versicolor". The search strategy included all clinical trials, observational studies and reviews published within the past 10 years.
RESULTS
Tinea versicolor is caused by species, notably , and . The condition is characterized by scaly hypopigmented or hyperpigmented macules/patches, primarily located on the upper trunk, neck and upper arms. The diagnosis is usually based on characteristic clinical features. If necessary, a potassium hydroxide preparation test can be performed to reveal numerous short, stubby hyphae intermixed with clusters of spores. Most patients with tinea versicolor respond to topical antifungal therapy, which has a better safety profile (fewer adverse events, fewer drug interactions) and lower cost compared to systemic treatment and is therefore the treatment of choice. Oral antifungal therapy is typically reserved for patients with extensive disease, frequent recurrences or disease that is refractory to topical therapy. Advantages of oral antifungal therapy include increased patient compliance, shorter duration of treatment, increased convenience, less time involved with therapy and reduced recurrence rates. On the other hand, oral antifungal therapy is associated with higher cost, greater adverse events and potential drug-drug interactions and is therefore not the first-line treatment for tinea versicolor. Long-term intermittent prophylactic therapy should be considered for patients with frequent recurrence of the disease.
CONCLUSION
Selection of antifungal agents depends on several factors, including efficacy, safety, local availability, ease of administration, likelihood of compliance and potential drug interactions of the antifungal agent.
PubMed: 36452877
DOI: 10.7573/dic.2022-9-2 -
Frontiers in Cellular and Infection... 2020Yeasts of the genus, , formerly known as , are lipophilic yeasts, which are a part of the normal skin flora (microbiome). colonize the human skin after birth and must... (Review)
Review
Yeasts of the genus, , formerly known as , are lipophilic yeasts, which are a part of the normal skin flora (microbiome). colonize the human skin after birth and must therefore, as commensals, be normally tolerated by the human immune system. The yeasts also have a pathogenic potential where they can, under appropriate conditions, invade the stratum corneum and interact with the host immune system, both directly but also through chemical mediators. The species distribution on the skin and the pathogenetic potential of the yeast varies between different related diseases such as head and neck dermatitis, seborrheic dermatitis, pityriasis versicolor, and folliculitis. The diagnostic methods used to confirm the presence of yeasts include direct microcopy, culture based methods (often a combination of morphological features of the isolate combined with biochemical test), molecular based methods such as Polymerase Chain Reaction techniques, and Matrix Assisted Laser Desorption/Ionization-Time Of Flight mass spectrometry and the chemical imprint method Raman spectroscopy. Skin diseases caused by are usually treated with antifungal therapy and if there are associated inflammatory skin mechanisms this is often supplemented by anti-inflammatory therapy. The aim of this paper is to provide an overview of related skin disease, diagnostic methods and treatment options.
Topics: Dermatitis, Seborrheic; Folliculitis; Humans; Malassezia; Skin; Tinea Versicolor
PubMed: 32266163
DOI: 10.3389/fcimb.2020.00112 -
Acta Dermatovenerologica Alpina,... Jun 2022Malassezia is a commensal fungus that constitutes normal skin microbiota. However, in certain conditions and individuals, it may transform into a pathogenic yeast with... (Review)
Review
Malassezia is a commensal fungus that constitutes normal skin microbiota. However, in certain conditions and individuals, it may transform into a pathogenic yeast with multiple associated dermatological disorders and various clinical manifestations. This phenomenon is influenced by a unique host-agent interaction that triggers the production of several virulence factors, such as indoles, reactive oxygen species, azelaic acid, hyphae formation, and biofilm formation. This review article discusses Malassezia virulence factors that contribute to the transformation of Malassezia from commensal to pathogenic as well as their role in dermatological disorders, including pityriasis versicolor, seborrheic dermatitis, Malassezia folliculitis, atopic dermatitis, and psoriasis.
Topics: Dermatitis, Seborrheic; Dermatomycoses; Humans; Malassezia; Skin; Tinea Versicolor; Virulence Factors
PubMed: 35751534
DOI: No ID Found -
Journal of Clinical Medicine Mar 2022Oxidative stress represents the imbalance between oxidants and antioxidants and has been associated with a wide range of diseases. Thiols are the most important... (Review)
Review
Oxidative stress represents the imbalance between oxidants and antioxidants and has been associated with a wide range of diseases. Thiols are the most important compounds in antioxidant defense. There is an equilibrium between thiols and their oxidized forms, disulfides, known as dynamic thiol-disulfide homeostasis (TDH). In 2014, Erel and Neselioglu developed a novel automated assay to measure thiol and disulfide levels. Subsequently, many researchers have used this simple, inexpensive and fast method for evaluating TDH in various disorders. We have reviewed the literature on the role of TDH in skin diseases. We identified 26 studies that evaluated TDH in inflammatory diseases (psoriasis, seborrheic dermatitis, atopic dermatitis, vitiligo, acne vulgaris and rosacea), allergic diseases (acute and chronic urticaria) and infectious diseases (warts, pityriasis rosea and tinea versicolor). The results are heterogeneous, but in most cases indicate changes in TDH that shifted toward disulfides or toward thiols, depending on the extent of oxidative damage.
PubMed: 35329832
DOI: 10.3390/jcm11061507 -
Life (Basel, Switzerland) Oct 2023This narrative review presents a comprehensive overview of the diagnosis and management of pityriasis versicolor (PV), a common superficial fungal infection caused by... (Review)
Review
This narrative review presents a comprehensive overview of the diagnosis and management of pityriasis versicolor (PV), a common superficial fungal infection caused by the yeast Malassezia. PV is characterised by scaly hypopigmented or hyperpigmented patches, primarily affecting the upper trunk, neck, and upper arms. Regarding commensal interactions, Malassezia utilises nutrient sources without affecting the human host. In cases of pathogenicity, Malassezia can directly harm the host via virulence factors or toxins, or indirectly by triggering damaging host responses. The diagnosis typically relies on recognising characteristic clinical features. Due to the wide variability in its clinical presentation, recognising the differential diagnosis is critical. In this paper, we discuss the clinical differentials, with their dermatoscopic presentation, but also describe a range of helpful diagnostic techniques (microscopy, conventional and ultraviolet-induced fluorescence dermatoscopy, and confocal microscopy). Topical therapies are the primary treatment for PV, encompassing non-specific antifungal agents like sulphur with salicylic acid, selenium sulphide 2.5%, and zinc pyrithione. Additionally, specific topical antifungal medications with either fungicidal or fungistatic properties may also be incorporated into the topical treatment regimen, such as imidazoles, allylamines, and ciclopirox olamine. Systemic therapies might occasionally be used. Patient education and the promotion of good personal hygiene are pivotal to reduce the risk of recurrence. In recurrent cases, particularly during warmer and more humid periods, prolonged prophylaxis with topical agents should be considered.
PubMed: 37895478
DOI: 10.3390/life13102097 -
Frontiers in Cellular and Infection... 2020includes yeasts belong to the subphylum Ustilaginomycotina within the Basidiomycota. yeasts are commonly found as commensals on human and animal skin. Nevertheless,... (Review)
Review
includes yeasts belong to the subphylum Ustilaginomycotina within the Basidiomycota. yeasts are commonly found as commensals on human and animal skin. Nevertheless, species are also associated with several skin disorders, such as dandruff/seborrheic dermatitis, atopic eczema, pityriasis versicolor, and folliculitis. More recently, associations of with Crohn's disease, pancreatic ductal adenocarcinoma, and cystic fibrosis pulmonary exacerbation have been reported. The increasing availability of genomic and molecular tools have played a crucial role in understanding the genetic basis of commensalism and pathogenicity. In the present review we report genomics advances in highlighting unique features that potentially impacted biology and host adaptation. Furthermore, we describe the recently developed protocols for -mediated transformation in , and their applications for random insertional mutagenesis or targeted gene replacement strategies.
Topics: Animals; Dermatitis, Seborrheic; Humans; Malassezia; Skin; Symbiosis; Tinea Versicolor
PubMed: 32850491
DOI: 10.3389/fcimb.2020.00393 -
Gels (Basel, Switzerland) Nov 2023The purpose of this work was to develop a novel topical formulation of econazole nitrate based on gel that can be easily scaled up in one pot for the potential treatment...
The purpose of this work was to develop a novel topical formulation of econazole nitrate based on gel that can be easily scaled up in one pot for the potential treatment of fungal and yeast infections. Econazole nitrate, a topical antifungal, is used to treat tinea versicolor, tinea pedis, and tinea cruris. Compared to applying cream or ointment, topical gels offer numerous advantages, one of which is that the drug is released more quickly to the intended site of action. A viscous mixture of propylene glycol, Capmul MCM C8, methyl and propyl paraben, and econazole nitrate were mixed together before being formulated into the optimized Carbopol gel bases. The gel's color, appearance, and homogeneity were assessed visually. For every formulation, the drug content, pH, viscosity, spreadability, and gel strength were characterized. The cup plate diffusion method was used to evaluate the anti-fungal activity of the prepared formulations. To assess the behavior of the developed system, studies on in vitro release and mechanism were conducted. The manufactured formulations were transparent, pale yellow, and exhibited excellent homogeneity. The pH of each formulation was roughly 6.0, making them suitable for topical use. The concentration of Carbopol 940 resulted in a significant increase in viscosity and gel strength but a significant decrease in spreadability. It was demonstrated that the prepared formulations inhibited the growth of and . In contrast, the standard blank gel showed no signs of antifungal action. By increasing the concentration of Carbopol 940, the in vitro release profile of econazole nitrate significantly decreased. Following the Korsmeyer-Peppas model fitting, all formulations exhibited n values greater than 0.5 and less than 1, indicating that diffusion and gel swelling control econazole nitrate release.
PubMed: 38131915
DOI: 10.3390/gels9120929 -
Agri : Agri (Algoloji) Dernegi'nin... Jan 2021Dermoscopic examination is a very effective and practical method that significantly reduces the need for invasive diagnostic procedures in many skin diseases....
Dermoscopic examination is a very effective and practical method that significantly reduces the need for invasive diagnostic procedures in many skin diseases. Dermoscopic features of many cutaneous conditions have been well described, however, only one single case report has defined dermoscopic features of notalgia paresthetica so far. The clinical presentation of this entity can mimic many dermatological conditions including lichen simplex chronicus, cutaneous amyloidosis, and tinea versicolor. We tried to identify dermoscopic findings of the notalgia paresthetica, aiming to facilitate the diagnosis.
Topics: Amyloidosis, Familial; Humans; Paresthesia; Peripheral Nervous System Diseases; Pruritus; Skin Diseases, Genetic
PubMed: 34254657
DOI: 10.14744/agri.2020.80106 -
Mycoses Jul 2022Lipophilic basidiomycetous yeasts of the Malassezia genus can cause various skin diseases, such as seborrheic dermatitis, pityriasis versicolor, folliculitis and atopic...
BACKGROUND
Lipophilic basidiomycetous yeasts of the Malassezia genus can cause various skin diseases, such as seborrheic dermatitis, pityriasis versicolor, folliculitis and atopic dermatitis, and even life-threatening fungemia in newborns and immunocompromised individuals. Routine mycological media used in clinical practice do not contain sufficient lipid ingredients required for the growth of Malassezia species. A recently developed medium, FastFung agar, is promising for culturing fastidious fungal species.
METHODS
In this study, we compared FastFung agar and mDixon agar for culturing Malassezia species from nasolabial fold and retroauricular specimens of 83 healthy individuals and 187 and 57 patients with acne vulgaris and seborrheic dermatitis, respectively.
RESULTS
Malassezia species were identified using conventional tests and matrix-assisted laser desorption/ionisation mass spectrometry. In total, 96 of 654 samples (14.6%) contained Malassezia species. The total isolation rate was significantly higher in patients with seborrheic dermatitis (40.4%) than in healthy volunteers (21.7%; p < .05), and the rate of M. furfur isolation was significantly higher for patients with acne vulgaris (13.9%) and seborrheic dermatitis (24.6%) than for healthy individuals (1.5%; p < .05). FastFung agar was superior to mDixon agar in M. furfur isolation (p = .004) but showed similar performance in the case of non-M. furfur species (p > .05). Among cultured Malassezia species, perfect agreement between mDixon agar and FastFung agar was found only for M. globosa (κ = 0.90).
CONCLUSION
Our results indicate that FastFung agar favours the growth of Malassezia species and should be useful in clinical mycology laboratories.
Topics: Acne Vulgaris; Agar; Dermatitis, Seborrheic; Humans; Infant, Newborn; Malassezia; Skin; Tinea Versicolor
PubMed: 35506984
DOI: 10.1111/myc.13450