REVIEW ARTICLE: Toenail onychomycosis: an important global disease burden

Thomas, Jackson; Jacobson, GA; Narkowicz, CK; Peterson, Gregory M.; Burnet, H; Sharpe, C. T.

doi:10.1111/j.1365-2710.2009.01107.x

Cited by 287 publications

(295 citation statements)

References 156 publications

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“…14 Some authors have postulated that this gender difference may be due to differences in hormone levels that result in a different capacity to inhibit the growth of dermatophytes. [14][15][16][17] We observed that fingernails (69.84%) were most commonly affected site followed by toenails (19.84%). In 65 (10.32%) patients both the finger and toenails were affected.…”

Section: Discussionmentioning

confidence: 99%

Onychomycosis: dermatophytes to yeasts: an experience in and around Mumbai, Maharashtra, India

et al. 2017

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Background: Onychomycosis is a fungal nail infection having wide range of prevalence in different geographical regions. It becomes imperative to know prevalent causative agent in local area to improve quality of life of patients. Present study was aimed to study epidemiological, clinical and laboratory aspects of onychomycosisMethods: Study was carried out prospectively at a tertiary care teaching hospital Nail scrapings of 630 clinically suspected cases of onychomycosis over a period of 5 years (January 2012 to December 2016) were subjected to KOH examination and culture.Results: Young adults in age group of 21-40 years (67.61%) were predominantly affected with male to female ratio of 1.8:1. Overall prevalence of onychomycosis of the present study is 58.41%. Yeasts were isolated in 47.86%, dermatophytes in 30.71% and non dermatophytic filamentous fungi in 21.43%Conclusions: Present study demonstrates a shift in causative agents from dermatophytes to yeasts.

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Section: Discussionmentioning

confidence: 99%

Onychomycosis: dermatophytes to yeasts: an experience in and around Mumbai, Maharashtra, India

et al. 2017

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“…1,2 Dermatomycosis usually manifests as itchy, sore skin rashes and tinea on the toes, the inner thighs or groin; leading to flaking and blistering of the affected area. Fungi may spread to the scalp or nails causing hair loss and thickened or deformed fingernails.…”

Section: Introductionmentioning

confidence: 99%

Biosynthesized silver and gold nanoparticles are potent antimycotics against opportunistic pathogenic yeasts and dermatophytes

Rónavári¹,

Igaz²,

Gopisetty³

et al. 2018

IJN

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Background Epidemiologic observations indicate that the number of systemic fungal infections has increased significantly during the past decades, however in human mycosis, mainly cutaneous infections predominate, generating major public health concerns and providing much of the impetus for current attempts to develop novel and efficient agents against cutaneous mycosis causing species. Innovative, environmentally benign and economic nanotechnology-based approaches have recently emerged utilizing principally biological sources to produce nano-sized structures with unique antimicrobial properties. In line with this, our aim was to generate silver nanoparticles (AgNPs) and gold nanoparticles (AuNPs) by biological synthesis and to study the effect of the obtained nanoparticles on cutaneous mycosis causing fungi and on human keratinocytes. Methods Cell-free extract of the red yeast Phaffia rhodozyma proved to be suitable for nanoparticle preparation and the generated AgNPs and AuNPs were characterized by transmission electron microscopy, dynamic light scattering and X-ray powder diffraction. Results Antifungal studies demonstrated that the biosynthesized silver particles were able to inhibit the growth of several opportunistic Candida or Cryptococcus species and were highly potent against filamentous Microsporum and Trichophyton dermatophytes. Among the tested species only Cryptococcus neoformans was susceptible to both AgNPs and AuNPs. Neither AgNPs nor AuNPs exerted toxicity on human keratinocytes. Conclusion Our results emphasize the therapeutic potential of such biosynthesized nanoparticles, since their biocompatibility to skin cells and their outstanding antifungal performance can be exploited for topical treatment and prophylaxis of superficial cutaneous mycosis.

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“…Trichophyton rubrum is the main culprit of superficial mycosis of the nail (onychomycosis), which is often long lasting and has a high incidence of recurrence. Onychomycosis affects 10% of the general population, 20% of the population older than 60 years, 50% of people older than 70 years, and 30% of diabetic patients, and it can often result in pain, disability, and psychosocial stress, therefore significantly reducing quality of life (1)(2)(3). The conventional treatments involve excruciating surgical nail avulsion and toxic systemic antifungal drugs.…”

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confidence: 99%

Silicon Phthalocyanine 4 Phototoxicity in Trichophyton rubrum

Lam

Dimaano

Oyetakin-White

et al. 2014

Antimicrob Agents Chemother

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dTrichophyton rubrum is the leading pathogen that causes long-lasting skin and nail dermatophyte infections. Currently, topical treatment consists of terbinafine for the skin and ciclopirox for the nails, whereas systemic agents, such as oral terbinafine and itraconazole, are also prescribed. These systemic drugs have severe side effects, including liver toxicity. Topical therapies, however, are sometimes ineffective. This led us to investigate alternative treatment options, such as photodynamic therapy (PDT). Although PDT is traditionally recognized as a therapeutic option for treating a wide range of medical conditions, including agerelated macular degeneration and malignant cancers, its antimicrobial properties have also received considerable attention. However, the mechanism(s) underlying the susceptibility of dermatophytic fungi to PDT is relatively unknown. As a noninvasive treatment, PDT uses a photosensitizing drug and light, which, in the presence of oxygen, results in cellular destruction. In this study, we investigated the mechanism of cytotoxicity of PDT in vitro using the silicon phthalocyanine (Pc) 4 [SiPc(OSi(CH 3 ) 2 (CH 2 ) 3 N(CH 3 ) 2 )(OH)] in T. rubrum. Confocal microscopy revealed that Pc 4 binds to cytoplasmic organelles, and upon irradiation, reactive oxygen species (ROS) are generated. The impairment of fungal metabolic activities as measured by an XTT (2,3-bis[2-methoxy-4-nitro-5-sulfophenyl]-2H-tetrazolium-5-carboxyanilide inner salt) assay indicated that 1.0 M Pc 4 followed by 670 to 675 nm light at 2.0 J/cm 2 reduced the overall cell survival rate, which was substantiated by a dry weight assay. In addition, we found that this therapeutic approach is effective against terbinafine-sensitive (24602) and terbinafine-resistant (MRL666) strains. These data suggest that Pc 4-PDT may have utility as a treatment for dermatophytosis. Utilizing mainly keratin for their source of energy, dermatophytes can cause dermatophytosis or tinea of the skin, hair, and nails that impact the quality of life of infected patients, especially in immunocompromised individuals. Trichophyton rubrum is the main culprit of superficial mycosis of the nail (onychomycosis), which is often long lasting and has a high incidence of recurrence. Onychomycosis affects 10% of the general population, 20% of the population older than 60 years, 50% of people older than 70 years, and 30% of diabetic patients, and it can often result in pain, disability, and psychosocial stress, therefore significantly reducing quality of life (1-3). The conventional treatments involve excruciating surgical nail avulsion and toxic systemic antifungal drugs. Topical therapy is a less invasive and hence more attractive treatment for the eradication of fungal infection. However, dismal patient compliance often contributes to the high rate of unsuccessful treatment (4). It is for these reasons that alternative therapeutic agents need to be developed that can effectively target T. rubrum without significantly harming the host.In vitro studies have dem...

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REVIEW ARTICLE: Toenail onychomycosis: an important global disease burden

Cited by 287 publications

References 156 publications

Onychomycosis: dermatophytes to yeasts: an experience in and around Mumbai, Maharashtra, India

Onychomycosis: dermatophytes to yeasts: an experience in and around Mumbai, Maharashtra, India

Biosynthesized silver and gold nanoparticles are potent antimycotics against opportunistic pathogenic yeasts and dermatophytes

Silicon Phthalocyanine 4 Phototoxicity in Trichophyton rubrum

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