Twelve cases of tinea unguium in a pediatric clinic in 9 years

Tinea of the nails is not an exclusively adult pathology. The pediatrician should include this entity in the differential diagnosis.     

Phaeohyphomycosis of the ungual apparatus - Case report

Phaeohyphomycosis is a disease caused by dematiaceous fungi with a worldwide geographic distribution and broad spectrum. It is most commonly found in adult individuals of both genders and all races. We report the case of a 57-year-old woman with phaeohyphomycosis in the ungual apparatus.     

伊曲康唑对灰指甲的治疗效果临床观察

目的：观察在临床治疗灰指甲中伊曲康唑的治疗效果。方法：选取2012年6月-2013年6月在我院接受治疗的灰指甲病患24例，按照伊曲康唑服用剂量的不同，将其分成治疗组与对照组，每组12例，为照组中的病患每天提供lOOmg的伊曲康唑，为治疗组申的病患每周提供200mg的伊曲康唑，对比两组病患的治疗效果。结果：经过1到3个月的治疗后，对比两组病患的治疗效果，总治愈率均为100％，镜检真菌结果为阴性，治疗效果相同，P〉O．05，缺少统计学差异意义。对比两组病患的副反应发生率，治疗组副反应发生率为O％，明显低于对照组16．7％的副反应发生率，P〈O．05，具有统计学差异意义。结论：在临床治疗灰指甲病患时，小剂量使用伊曲康唑不仅治疗效果好，而且毒副作用小，经济负担轻，可以加强推广使用。     

Antiplasmodial activity of root extract and fractions of Croton zambesicus

The plant species Ageratina pichinchensis has been used, for many years, in Mexican traditional medicine for the treatment of superficial mycosis.

Aim of the study

This study compared the therapeutic effectiveness and tolerability of two concentrations of the standardized extract from Ageratina pichinchensis (12.6 and 16.8%) on patients with clinical and mycological diagnosis of mild and moderate onychomycosis.

Materials and methods

Two identical phytopharmaceuticals (containing the standardized extract from Ageratina pichinchensis) in nail lacquer solution for topical administration were evaluated in a double-blind clinical trial. Treatments were administered for 6 months to patients distributed in two groups.

Results and discussion

Of 122 patients who agreed to participate in the study, 103 (84.4%) concluded the treatment. The therapeutic effectiveness exhibited by the 12.6% Ageratina pichinchensis extract was 67.2%, while that of the 16.8% Ageratina pichinchensis extract was 79.1%. Regarding clinical evolution, analysis of results at the end of treatment evidenced that the 16.8% concentration possesses higher therapeutic effectiveness with a significant statistical difference (p = 0.010). No treatment produced side effects.

Conclusion

Both concentrations of phytopharmaceuticals possess high rates of effectiveness on patients with mild and moderate onychomycosis, and the formulation with a 16.8% concentration possesses higher effectiveness.     

少见真菌致海洋作业人员甲真菌病2例首报

患者均为男性,渔民和海洋航道工人,分别出现指甲和趾甲病变,时间不一。病甲屑真菌直接镜检阳性,真菌培养有棕黑色和灰白色绒毛样丝状真菌生长,经形态学和分子生物学鉴定分别为对半新柱顶孢和帚状曲霉。药敏试验显示对半新柱顶孢对伏立康唑MIC值最低(0.25μg/mL);帚状曲霉对伊曲康唑和泊沙康唑以及棘白菌素类抗真菌药MIC较低。提示这几类药物可以做为临床治疗的首选药物。     

Comparison of user‐friendliness and treatment cost of Loceryl® vs. Ciclopoli® – a patient's perspective

Topical monotherapy is a valid therapeutic approach in onychomycosis. Due to its lengthy course and its non‐reimbursed product status, cost and compliance are important issues and non‐pharmacological properties such as over‐the‐counter price and ease of use should be considered when deciding which product to recommend. We investigated surrogate parameters for patient‐friendliness and treatment cost in Germany in a questionnaire‐based prospective, comparative, intra‐individual, open‐label trial of the two common topical antifungal nail lacquers Loceryl^® (amorolfine 5%) and Ciclopoli^® (ciclopirox 8%) in eight patients with clinically diagnosed onychomycosis. The 2.5 ml bottle of Loceryl^® covered a treatment period of 308 days, resulting in treatment costs of €0.10 per day in comparison to the 3.3 ml bottle of Ciclopoli^®, covering 127 days at €0.21 per day, given once‐daily application for Ciclopoli^® and once‐weekly application for Loceryl^® in accordance with regulatory approval. Six out of eight patients favoured the Loceryl^® treatment regimen. Furthermore, four out of eight patients found Loceryl^® easier to apply, whereas three preferred Ciclopoli^®. In total, seven out of eight stated a clear preference for Loceryl^® over Ciclopoli^®. Loceryl^® therapy is less expensive and less time‐consuming. The therapeutic period that can be covered is longer and more patients stated a clear preference for Loceryl^® in comparison to Ciclopoli^®. The differences are statistically significant, underlining probable clinical relevance.     

Microsporum spp. onychomycosis: disease presentation,risk factors and treatment responses in an urban population

BackgroundDermatophytes are the main causative agent of all onychomycosis, but genus Microsporum is infrequent and the risk of acquiring the infection is often associated with exposure to risk factors.ObjectivesTo describe clinical characteristics of onychomycosis due to Microsporum onychomycosis in an urban population.MethodsThis was a retrospective analysis of the epidemiological and clinical features of 18 Microsporum onychomycosis cases of a total of 4220 of onychomycosis cases diagnosed between May 2008 and September 2011 at the tertiary referral center for mycology in Guatemala.ResultsEighteen cases of Microsporum onychomycosis (M. canis, n = 10; M. gypseum, n = 7; M. nanum, n = 1) were identified (prevalence = 0.43%). Infection was limited to nails only and disease duration ranged from 1 month to 20 years (mean = 6.55 years). The toenails were affected in all cases except for a single M. gypseum case of fingernail. The most common clinical presentation was distal lateral subungual onychomycosis (12/18) followed by total dystrophic onychomycosis (5/18), and superficial white onychomycosis (1/18). M. gypseum presented in 6 cases as distal lateral subungual onychomycosis and in 1 case like total dystrophic onychomycosis. Five cases (27.78%) were associated with hypertension, diabetes, and psoriasis. Treatment with terbinafine or itraconazole was effective. Two cases of M. canis distal lateral subungual onychomycosis responded to photodynamic therapy.ConclusionThis is the largest reported series of Microsporum onychomycosis and demonstrates such a disease in an urban population. In 27.78% of the cases risk factors for infection were associated to comorbid states. We also report the first 2 cases of successfully treated M. canis onychomycosis with photodynamic therapy and a rare case of M. canis associated dermatophytoma.     

广州市185株甲真菌病病原菌构成分析

目的：了解广州市甲真菌病病原菌的构成分布情况。方法：对2008年3月至2009年10月我科实验室185例甲屑培养阳性的病例及其病原菌构成比例进行回顾性分析。结果：185株菌中酵母菌占61.5%,其中光滑念珠菌最多见（19.0%）,次为近平滑念珠菌（15.1%）;皮肤癣菌占35.2%,主要以红色毛癣菌为主（17.8%）,须癣毛癣菌次之（16.2%）;非皮肤癣菌霉菌占4.8%,以黑曲霉为主（3.3%）。结论：本研究显示广州市甲真菌病病原菌中主要致病菌为酵母菌,其次为皮肤癣菌。