RESUMEN
BACKGROUND AND OBJECTIVE: Naftifine, an allylamine, is highly effective against tinea pedis and exhibits relatively greater affinity to skin and nail beds, possibly due to its high lipophilicity. To study the efficacy and safety of naftifine 2% gel in an Indian population, a phase III multicentre double-blind, comparative, parallel-group study was conducted in comparison with miconazole 2% gel in patients with interdigital tinea pedis, with mild to moderate symptoms. PATIENTS AND METHODS: Patients presenting with mild to moderate signs and symptoms of interdigital tinea pedis and mycologically confirmed tinea infection were randomised to either naftifine hydrochloride 2% gel (n = 112) or miconazole 2% gel (n = 112) in 1:1 ratio. All patients were treated for 2 weeks with a follow-up of up to 12 weeks. Study evaluations were done at the end of 2, 6, and 12 weeks. The primary efficacy endpoint was the proportion of patients achieving clinical cure at week 6 (± 4 days) and secondary endpoints were the mycological cure at week 6 and week 12 and complete cure at week 12. RESULTS: At the end of week 6, clinical cure was 54.55% and 50.00% in the naftifine and miconazole groups (p = 0.4960), respectively, and it was increased to 78.18% and 76.36% in the naftifine and miconazole group (p = 0.7455) at the end of week 12. Mycological and clinical cure were similar in the naftifine and miconazole groups at week 6 and week 12. The safety and tolerability profiles of both treatments were similar. CONCLUSIONS: Naftifine 2% gel was efficacious and safe for the treatment of mild to moderate interdigital tinea pedis. Its clinical effectiveness was comparable to that of miconazole 2% gel. TRIAL REGISTRATION: Clinical Trials Registry of India: CTRI/2021/01/030753.
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Antifúngicos , Tiña del Pie , Humanos , Adulto , Tiña del Pie/diagnóstico , Tiña del Pie/tratamiento farmacológico , Tiña del Pie/inducido químicamente , Antifúngicos/efectos adversos , Miconazol/uso terapéutico , Administración Cutánea , Resultado del Tratamiento , Método Doble CiegoRESUMEN
Skin is the outer cover of our body, which protects vital organs from harm. This important body part is often affected by a series of infections caused by fungus, bacteria, viruses, allergies, and dust. Millions of people suffer from skin diseases. It is one of the common causes of infection in sub-Saharan Africa. Skin disease can also be the cause of stigma and discrimination. Early and accurate diagnosis of skin disease can be vital for effective treatment. Laser and photonics-based technologies are used for the diagnosis of skin disease. These technologies are expensive and not affordable, especially for resource-limited countries like Ethiopia. Hence, image-based methods can be effective in reducing cost and time. There are previous studies on image-based diagnosis for skin disease. However, there are few scientific studies on tinea pedis and tinea corporis. In this study, the convolution neural network (CNN) has been used to classify fungal skin disease. The classification was carried out on the four most common fungal skin diseases: tinea pedis, tinea capitis, tinea corporis, and tinea unguium. The dataset consisted of a total of 407 fungal skin lesions collected from Dr. Gerbi Medium Clinic, Jimma, Ethiopia. Normalization of image size, conversion of RGB to grayscale, and balancing the intensity of the image have been carried out. Images were normalized to three sizes: 120 × 120, 150 × 150, and 224 × 224. Then, augmentation was applied. The developed model classified the four common fungal skin diseases with 93.3% accuracy. Comparisons were made with similar CNN architectures: MobileNetV2 and ResNet 50, and the proposed model was superior to both. This study may be an important addition to the very limited work on the detection of fungal skin disease. It can be used to build an automated image-based screening system for dermatology at an initial stage.
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Dermatomicosis , Onicomicosis , Tiña , Humanos , Tiña del Pie/diagnóstico , Tiña del Pie/microbiología , Tiña del Pie/patología , Dermatomicosis/diagnóstico , Dermatomicosis/microbiología , Dermatomicosis/patología , Tiña/patología , Piel/diagnóstico por imagen , Piel/patología , Onicomicosis/diagnóstico , Onicomicosis/microbiología , Onicomicosis/patologíaRESUMEN
This study aimed to determine the prevalence of onychomycosis and interdigital tinea pedis in a cohort of Spanish patients with diabetes in whom onychomycosis was clinically suspected (n = 101). Samples from a first toenail scraping and the fourth toe clefts were subjected to potassium hydroxide direct vision and incubated in Sabouraud and dermatophyte test medium. Fifty-eight samples were also analyzed by a pathologist using periodic acid-Schiff staining and Calcofluor white direct fluorescence microscopy. Onychomycosis was only confirmed in 41 patients (40.6%). The most frequent aetiological agent was Trichophyton rubrum, isolated in 10 patients (36%), followed by Candida parapsilosis in 7 patients (25%). Tests on the fourth toe cleft samples were only positive in 11 patients (10.9%), and in all cases, onychomycosis was also diagnosed. Neuroischemic foot was the only significant variable associated with onychomycosis in the univariate analysis (P < .01). A positive result for mycosis in the fourth toe cleft was found in 11 cases (10.9%) and was associated with a history of myocardial infarction (P< .01; odds ratio [OR]: 84.2, confidence interval [CI]: 6.8-1036.4) and neuroischemic foot (P< .01; OR: 13.7, CI: 12.6-71.6) in the multivariate model. In conclusion, the prevalence of onychomycosis and tinea pedis in patients with diabetes in whom onychomycosis was clinically suspected was 40.6% and 10.9%, respectively. In addition, onychomycosis was not always associated with tinea pedis. These results show that clinical diagnosis has low accuracy in people with diabetes mellitus, and that diagnosis should not be based on clinical toenail characteristics alone.
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Diabetes Mellitus , Onicomicosis , Humanos , Tiña del Pie/diagnóstico , Tiña del Pie/epidemiología , Onicomicosis/diagnóstico , Onicomicosis/epidemiología , Dedos del Pie , PrevalenciaRESUMEN
BACKGROUND AND OBJECTIVES: Onychomycosis (OM) and tinea pedis (TP) are common fungal infections. Currently, diagnosis is based on direct microscopy and culture that have a low to moderate sensitivity and/or require up to 3-4 weeks until results are obtained. PCR techniques have emerged for the diagnosis of fungal infections, but little is known about their sensitivity and specificity in diagnosing. Here, we compared the diagnostic value of a DNA-chip technology, that detects 56 fungal pathogens, in a single-center prospective diagnostic study with microscopy and culture in suspected OM/TP. PATIENTS AND METHODS: Microscopy, culture and DNA microarray assays were performed on scraping material from patients with suspected OM (n = 67) or TP (n = 73). To test whether swabs can be used as an alternative for scraping, PCR yields were compared in a further 13 patients with OM and 11 patients with TP. RESULTS: DNA microarrays had the highest sensitivity. Combination of DNA-chip technology with microscopy further increased the sensitivity, and results from this combined laboratory diagnosis can be obtained within 24 hours. Comparison of sampling techniques (scraping, dry or wet swab) for DNA-chip assays showed similar results in suspected OM or TP. CONCLUSIONS: DNA-chip technology shows high sensitivity for OM and TP diagnosis, especially when combined with microscopy.
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Onicomicosis , Tiña del Pie , ADN , Humanos , Análisis de Secuencia por Matrices de Oligonucleótidos , Onicomicosis/diagnóstico , Prevalencia , Estudios Prospectivos , Tiña del Pie/diagnóstico , Tiña del Pie/microbiologíaRESUMEN
Plantar dermatoses (PD) are common, occurring either spontaneously on healthy skin or developing secondarily from previously established foot disease. PD share similar symptoms and morphology, making them challenging to differentiate. A few of the most frequently encountered PD include tinea pedis, psoriasis, contact dermatitis, dyshidrotic dermatitis (or recurrent vesicular palmoplantar dermatitis), and juvenile plantar dermatosis. This review offers practical advice for diagnosing and treating the most common PD in the primary care office.
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Tiña del Pie , Humanos , Tiña del Pie/diagnóstico , Tiña del Pie/terapiaAsunto(s)
Tiña del Pie , Tiña , Adulto , Arthrodermataceae , Femenino , Humanos , Tiña/diagnóstico , Tiña del Pie/diagnóstico , TrichophytonRESUMEN
Fungal infections present with a broad spectrum of diseases in humans (from relatively mild superficial infections of the skin and mucous membranes to the invasive or chronic infections of internal organs, which have a high mortality rate). Globally, up to 1.6 million people die each year as a result of various types of mycoses. Currently, many scientific studies focus on the best possible understanding of the aspects of the epidemiology and pathogenesis of invasive mycoses and effective methods to combat them. However, mycoses of the skin and its appendages remain a relatively less explored area. In some communities, superficial mycoses are a frequent problem as they affect nearly 70% of the population, an example of which is the athlete's foot. It involves the nails (onychomycosis) and skin (tinea pedis). It is mainly caused by keratin-decomposing dermatophyte fungi. Less often, infections are caused by non-dermatophyte moulds (Fusarium, Aspergillus, Scopulariopsis) or yeasts. Several factors have been listed as having substantial influence on the development of dermatophytosis, including those related to climate, season, geographical region, as well as to demography, socioeconomic and cultural customs, professions or contact with animals. In this review, we summarise the current knowledge about aetiology, epidemiology, diagnostics and therapy of tinea pedis with a special focus to the role of podologic management in spreading, prevention and therapy of mycoses. The article presents up-to-date knowledge on the management of the patient from the diagnosis, treatment and skincare, to counselling on how to prevent fungal skin infections in the long term.
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Dermatomicosis , Onicomicosis , Tiña del Pie , Belleza , Dermatomicosis/diagnóstico , Dermatomicosis/prevención & control , Dermatomicosis/terapia , Hongos , Humanos , Onicomicosis/diagnóstico , Onicomicosis/prevención & control , Onicomicosis/terapia , Infección Persistente , Tiña del Pie/diagnóstico , Tiña del Pie/prevención & controlAsunto(s)
Dermatomicosis , Tiña del Pie , Humanos , Tiña del Pie/complicaciones , Tiña del Pie/diagnóstico , TrichophytonRESUMEN
A 7-year-old girl presented with a hyperkeratotic scale on the plantar surface of her left foot. A microscopic potassium hydroxide examination was performed and negative. Reflectance confocal microscopy was performed showing fungal hyphae and an inflammatory infiltrate confirming a diagnosis of tinea pedis.
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Tiña del Pie , Trichophyton , Niño , Femenino , Humanos , Microscopía Confocal , Tiña del Pie/diagnósticoRESUMEN
Tinea pedis affects the life quality distinctly and patients those with a prolonged disease often resort to non-medical methods. We sought to evaluate patients' knowledge about tinea pedis and approaches to the non-pharmacological agents. A cross-sectional study was conducted on 152 patients with tinea pedis who answered the survey between July and November 2019. Demographic and clinical features, patients' attitudes, behaviors, and opinions about non-pharmacological treatments related to tinea pedis were evaluated. Of 152 patients, 65 (42.8%) were female and 87 (57.2%) were male. The frequency of at least one non-pharmacological agent use for tinea pedis was 55.9%. The most common non-pharmacological agent was cologne (27.0%), followed by saltwater, vinegar, and henna. The rate of non-pharmacological agent use was not significantly different between genders and patients with different education levels. Information sources for tinea pedis were dermatologists in only 42 patients (27.8%). The opinion that the disease will improve spontaneously was not significantly different between the groups according to the education level (P = .154). Tinea pedis needs awareness as a health problem particularly in Muslim populations. Patients should be prevented from applying wrong practices and informed about the risk factors, contagiousness, and treatment options by physicians.
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Actitud , Tiña del Pie , Estudios Transversales , Femenino , Humanos , Masculino , Factores de Riesgo , Encuestas y Cuestionarios , Tiña del Pie/diagnóstico , Tiña del Pie/terapiaRESUMEN
An otherwise healthy 3-year-old girl presented with a several-month history of scaly lesions on her palms and soles. The lesions on the palms and right sole had been successfully treated with a steroid for pompholyx by a nearby dermatology clinic, but the lesion on the left sole persisted and spread to the back of the foot. On the initial visit, the patient exhibited an itchy and scaly erythematous left foot lesion. Direct microscopic examination of the scales revealed a considerable amount of fungal elements. A diagnosis of tinea pedis was made, and antifungal treatment with a neticonazole ointment was initiated. Complete cure was achieved after 4 weeks of treatment. The primary mycological cultures from the scales simultaneously revealed two types of colonies: a white powdery flat colony and a white downy elevated colony with a reddish-yellow bottom. Although the powdery colony was identified as Trichophyton mentagrophytes complex on slide culture, the downy colonies could not be identified based on cultural and morphological characteristics. The nucleotide sequences of the internal transcribed spacer region from both colonies showed an exact match, which eventually led to their identification as Trichophyton interdigitale. Further genotyping at three points in the non-transcribed spacer region in both colonies also showed the same NTS type of D2II. It is very rare for two morphologically different colonies to be isolated from the primary culture under the same conditions in tinea cases. Genetic tests are of extreme value to identify the strain in such cases.
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Fenotipo , Tiña del Pie/diagnóstico , Tiña del Pie/microbiología , Trichophyton/genética , Preescolar , Femenino , Pruebas Genéticas , Humanos , Trichophyton/aislamiento & purificación , Trichophyton/patogenicidadAsunto(s)
Variación Anatómica , Extremidad Inferior/anatomía & histología , Síndrome del Músculo Piriforme/etiología , Tiña del Pie/etiología , Arterias/anatomía & histología , Arterias/diagnóstico por imagen , Humanos , Extremidad Inferior/diagnóstico por imagen , Imagen por Resonancia Magnética , Tomografía Computarizada Multidetector , Síndrome del Músculo Piriforme/diagnóstico , Tiña del Pie/diagnóstico , Venas/anatomía & histología , Venas/diagnóstico por imagenAsunto(s)
Antifúngicos/administración & dosificación , Cumplimiento de la Medicación , Terbinafina/administración & dosificación , Humanos , Cumplimiento de la Medicación/psicología , Onicomicosis/diagnóstico , Onicomicosis/tratamiento farmacológico , Estudios Prospectivos , Tiña del Pie/diagnóstico , Tiña del Pie/tratamiento farmacológicoRESUMEN
BACKGROUND: Tinea pedis is the most common dermatophyte infection. Treatment is critical to alleviate pruritic symptoms, to reduce the risk for secondary bacterial infection, and to limit the spread of infection to other body sites or other individuals. The objective of this study was to compare the abilities of econazole nitrate topical foam, 1% and ketoconazole cream (2%) to reduce pruritus, thus improving quality of life, and to determine patient preference for the foam product versus the cream product in patients with interdigital tinea pedis. STUDY DESIGN: A single-center, investigator-blinded, observational pilot study was conducted to compare econazole nitrate topical foam (1%) to ketoconazole cream (2%). In this split-body study, 20 subjects received both econazole nitrate topical foam and ketoconazole cream and applied the medications daily to either the right or left foot for 14 days. Improvements in patient quality of life (pruritus) and patient preference were measured using the pruritus visual analog scale (VAS), Skindex-16, and patient preference questionnaires. RESULTS: Nineteen subjects completed the study and one subject was lost to follow-up. Reductions in VAS scores of econazole nitrate topical foam were significantly greater than those of ketoconazole cream, indicating the superiority of the econazole nitrate foam in reducing pruritus. Skindex-16 data showed significant reductions in total scores and individual domains, including patient symptom, emotional, and functional domains, by the final visit. Since each subject received both medications the questionnaire was not medication-specific. Responses to patient preference questionnaires showed that econazole nitrate topical foam,1% was rated as "good" or "excellent" in all measures assessed. One adverse event was noted. CONCLUSION: In patients with interdigital tinea pedis, application of econazole nitrate topical foam 1% twice daily for two weeks was clinically effective and significantly superior to ketoconazole cream 2% in reducing pruritus. J Drugs Dermatol. 2018;17(2):229-232.
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Antifúngicos/administración & dosificación , Econazol/administración & dosificación , Tiña del Pie/diagnóstico , Tiña del Pie/tratamiento farmacológico , Administración Tópica , Adolescente , Adulto , Anciano , Composición de Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Método Simple Ciego , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Interdigital melanoma, as a subtype of acral lentiginous melanoma, is relatively uncommon in the Caucasian population. It frequently goes unrecognized for a prolonged period of time prior to diagnosis, due to its asymptomatic nature and variable clinical appearance. METHODS: We report the case of a 67-year-old Caucasian woman who presented with interdigital malignant melanoma affecting two neighboring interdigital spaces. It had evolved over a period of more than 15 years and had been initially misdiagnosed as tinea pedis due to the macerated appearance of the lesion and a positive mycologic examination. RESULTS: We highlight the striking involvement of two adjacent interdigital spaces and the neighboring area of the sole of the foot by the tumor. The melanoma was staged as IIIC, with pathologic grading T4bN2bM CONCLUSIONS: The involvement of two adjacent interdigital spaces is unusual and, to our knowledge, has not been previously highlighted in the medical literature. It may be explained, in part, by the longstanding nature of the lesion in our patient.
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Melanoma , Neoplasias Cutáneas , Anciano , Amputación Quirúrgica , Biopsia , Errores Diagnósticos , Femenino , Humanos , Melanoma/diagnóstico , Neoplasias Cutáneas/diagnóstico , Tiña del Pie/diagnósticoRESUMEN
Cutaneous infections and infestations are common among children and adolescents. Ectoparasitic infestations affect individuals across the globe. Head lice, body lice, scabies, and infestations with bed bugs are seen in individuals who reside in both resource poor areas and in developed countries. Superficial cutaneous and mucosal candida infections occur throughout the life cycle. Dermatophyte infections of keratin-containing skin and skin structures result in tinea capitis (scalp), tinea corporis (body), tinea pedis (foot), and tinea unguium (nails). Less frequent endemic fungal infections such as blastomycosis, coccidiodomycosis, and histoplasmosis may present with skin findings. This article will describe the epidemiology and transmission of these conditions as well as their clinical manifestations. The approach to diagnosis will be addressed as well as primary prevention and current therapies.
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Dermatomicosis/diagnóstico , Enfermedades Cutáneas Parasitarias/diagnóstico , Adolescente , Animales , Chinches , Candidiasis/diagnóstico , Candidiasis/epidemiología , Candidiasis/terapia , Candidiasis Cutánea/diagnóstico , Candidiasis Cutánea/epidemiología , Candidiasis Cutánea/terapia , Niño , Dermatomicosis/epidemiología , Dermatomicosis/terapia , Humanos , Infestaciones por Piojos/diagnóstico , Infestaciones por Piojos/epidemiología , Infestaciones por Piojos/terapia , Onicomicosis/diagnóstico , Onicomicosis/epidemiología , Onicomicosis/terapia , Pediculus , Escabiosis/diagnóstico , Escabiosis/epidemiología , Escabiosis/terapia , Dermatosis del Cuero Cabelludo/diagnóstico , Dermatosis del Cuero Cabelludo/epidemiología , Dermatosis del Cuero Cabelludo/parasitología , Dermatosis del Cuero Cabelludo/terapia , Piel/microbiología , Piel/parasitología , Piel/patología , Enfermedades Cutáneas Parasitarias/epidemiología , Enfermedades Cutáneas Parasitarias/terapia , Tiña/diagnóstico , Tiña/epidemiología , Tiña/terapia , Tiña del Cuero Cabelludo/diagnóstico , Tiña del Cuero Cabelludo/epidemiología , Tiña del Cuero Cabelludo/terapia , Tiña del Pie/diagnóstico , Tiña del Pie/epidemiología , Tiña del Pie/terapiaRESUMEN
OBJECTIVES: To examine the correlations between elements of feet-washing behavior, presence of tinea pedis (TP), and patients' background characteristics in order to identify a concrete intervention method to prevent TP. DESIGN AND PARTICIPANTS: A cross-sectional study of 30 patients with diabetes (16 with TP) who were admitted to or visited the university hospital. MAIN OUTCOME MEASURES: The presence of TP was confirmed by the detection of dermatophytes by direct microscopy. Data on elements of feet-washing behavior, such as scrubbing between the toes, were collected by observing recorded videos of participants normally washing their feet as they do at home. The patients' background characteristics included demographic data; diabetes-related factors; patient knowledge regarding diabetes, foot problems, and TP prevention; purpose for feet washing; and any difficulties in feet washing. MAIN RESULTS: The number of times patients scrubbed between their toes while washing with soap was significantly lower in patients with TP (odds ratio, 0.95; P = .036; with a cutoff value of 35 times) and those who had difficulty in reaching their feet with their hands (B = -14.42, P = .041). CONCLUSIONS: An effective foot-washing protocol should include specific instructions for patients to scrub between their toes at least 35 times in all 8 spaces while washing with soap. Appropriate advice is also needed for individuals who have difficulty reaching their feet with their hands. Education about appropriate foot-washing behavior may potentially prevent TP.