A comparative study between two antifungal agents, Luliconazole and Efinaconazole, of their preventive effects in a Trichophyton-infected guinea pig onychomycosis model.

An efficacious period of two topical antifungal drugs was compared in a Trichophyton mentagrophytes-infected onychomycosis model in guinea pigs treated with antifungal drugs prior to infection. Luliconazole 5% (LLCZ) and efinaconazole 10% (EFCZ) test solutions were applied to the animals' nails once daily for 2 weeks followed by a nontreatment period of 2, 4, and 8 weeks. After each nontreatment period, the nails were artificially infected by the fungus. Drug efficacy was quantitatively evaluated by qPCR and histopathological examination of the nails collected following a 4-week post-infection period. The fungal infection was confirmed in the untreated group. Both LLCZ and EFCZ prevented fungal infection in the treated groups with the nontreatment period of 2 weeks. After the nontreatment period of 4 weeks, no infection was observed in the LLCZ-treated group; however, infection into the nail surface and fungal invasion into the nail bed were observed in the EFCZ-treated group. After the nontreatment period of 8 weeks, fungi were found in the nail surface and nail bed in some nails treated with EFCZ; however, no infection was observed in the nail bed of the LLCZ-treated group. The results suggest that LLCZ possesses longer-lasting antifungal effect in nails of the guinea pigs than EFCZ, and that this animal model could be useful for translational research between preclinical and clinical studies to evaluate the pharmacological efficacy of antifungal drugs to treat onychomycosis. This experimentally shown longer-lasting preventive effects of LLCZ could also decrease the likelihoods of onychomycosis recurrence clinically.

Identification of emerging trends in the prevalence of dermatophytoses in alpacas (Vicugna pacos) farmed in Poland.

The increasing number of dermatophytoses among animals observed recently in developed countries may be connected with relocation of many exotic species outside their natural living environment. Moreover, an impact on this situation may also be exerted by relapses related to limited compliance with antifungal treatment regimes. Many exotic animals, including camelids, imported to European countries are connected with cases of tuberculosis or zoophilic dermatophytoses in humans. In the present study, we identified and comprehensively analysed dermatophyte infections in alpacas from breeding farms in Poland. As part of this study, we determined the prevalence of dermatophyte infections in alpacas. The conventional and molecular mycological diagnostic procedures applied led to unambiguous identification of the aetiological factors of symptomatic dermatophytoses and asymptomatic animals, that is Trichophyton benhamiae and T. verrucosum. Furthermore, the susceptibility tests allowed choosing the best therapeutic option and revealed superior activity of allylamine drugs against all strains. Finally, in the case of strains isolated from symptomatic dermatophytoses, our study revealed a significantly higher virulence level expressed by high activity of chosen enzymes, especially related to keratinolytic and haemolytic activity. In conclusion, this report indicates that farmed alpacas can be a reservoir or vector for contagious zoophilic dermatophyte infection. For this reason, imported animals should be subjected to meticulous monitoring to detect not only symptomatic infections but also asymptomatic animals.

Cold Atmospheric Pressure Plasma Jet Reduces Trichophyton rubrum Adherence and Infection Capacity.

This study aimed to evaluate the effects of cold atmospheric pressure plasma (CAPP) jet on Trichophyton rubrum growth, germination and adherence to nail. The effects of plasma jet on T. rubrum conidia germination and on mycelial growth were evaluated by in vitro assays. An ex vivo nail infection model was used to evaluate the effects on conidia adherence and infection. Biochemical analyses of nail fragments exposed or not to CAPP were performed by attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy. Plasma jet exposure for 10 and 15 min completely inhibited mycelial growth after only one exposure. Fifteen minutes of exposure could reduce conidia germination in suspension. Fungal suspensions exposed to plasma jet for 10 and 15 min were not able to infect nail specimens. These results were corroborated by ATR-FTIR analyses of nail fragments. In conclusion, single exposure to CAPP for 15 min was able to inhibit fungal growth, adherence and infection capacity. The results suggest that cold atmospheric plasma jet can be a promising alternative for the treatment of onychomycoses caused by T. rubrum.

Epidemiological Study on Trichophyton Disseminating from the Feet of the Elderly.

OBJECTIVES: To grasp the colonization status of Trichophyton in terms of spreading rate, we investigated the intergenerational epidemiological difference in the spreading rate of Trichophyton from teenagers to the elderly aged over 65. In addition, the elderly people were divided into two groups: those living at nursing homes and those living at their homes. We compared the two groups in terms of the difference in the spreading rate of Trichophyton. METHODS: Spreading rate was investigated by identifying the fungi collected by the cotton swab sampling method. The correlation between the responses to the questionnaire survey, which was conducted after the sample collection, and the spreading rate of Trichophyton was analyzed. RESULTS: The spreading rate of Trichophyton was 23.3%. It was confirmed that the spreading rate in general adults was 9.1%, whereas that in elderly people was 40.8%, which is significantly high. Also, it was confirmed that T. mentagrophytes shows a higher spreading rate among general adults, whereas T. rubrum shows a higher spreading rate among the elderly. Between the elderly living at nursing homes and those living at their homes, although no statistically significant difference was confirmed, the former tended to show a higher spreading rate than the latter. Also, the results of this study showed that spreading rate of Trichophyton and the detachment of the skin of the toes were significantly related. CONCLUSIONS: We found that the risk of spreading of Trichophyton increases with age. Particularly among elderly people aged over 65, taking some actions that prevent the spread of tinea pedis is recommended.

The anti-dermatophyte activity of Zataria multiflora essential oils.

OBJECTIVE: Dermtophytes are a group of pathogenic fungi and the major cause of dermatophytosis in humans and animals. Fighting dermatophytes by natural essential oils is one important issue in new researches. MATERIALS AND METHODS: In this investigation, we evaluated the anti-dermatophyte activities of three samples of Z. multiflora essential oils against dermatophytes along with analysis of chemical compositions of the essential oils and their anti-elastase activities on elastase production in dermatophytes. RESULTS: Carvacrol (1.5-34.4%), thymol (25.8-41.2%), carvacrol methyl ether (1.9-28.3%) and p-cymene (2.3-8.3%) were the main components of Z. multiflora essential oils. Z. multiflora essential oils (100ppm) inhibited the mycelium growth of dermatophytes (6±1.7-47.0±1.4%) and had the minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) values of 0.03-0.25µl/ml against dermatophytes. Essential oils inhibited elastase produced in dermatophytes and pure porcine elastase. CONCLUSION: Z. multiflora essential oils can be used as natural anti-dermatophyte agent for fighting dermatophytes in further preclinical and clinical studies.

In vitro efficacy of shampoos containing miconazole, ketoconazole, climbazole or accelerated hydrogen peroxide against Microsporum canis and Trichophyton species.

Objectives The objective was to evaluate the antifungal efficacy of shampoo formulations of ketoconazole, miconazole or climbazole and accelerated hydrogen peroxide wash/rinse against Microsporum canis and Trichophyton species spores. Methods Lime sulfur (1:16)-treated control, enilconazole (1:100)-treated control, accelerated hydrogen peroxide (AHP 7%) 1:20 and a 1:10 dilution of shampoo formulations of miconazole 2%, miconazole 2%/chlorhexidine gluconate 2-2.3%, ketoconazole 1%/chlorhexidine 2%, climbazole 0.5%/chlorhexidine 3% and sterile water-untreated control were tested in three experiments. In the first, a suspension of infective spores and hair/scale fragments was incubated with a 1:10, 1:5 and 1:1 dilution of spores to test solutions for 10 mins. In the second, toothbrushes containing infected cat hair in the bristles were soaked and agitated in test solutions for 10 mins, rinsed, dried and then fungal cultured (n = 12×). In the third, a 3 min contact time combined with an AHP rinse was tested (n = 10×). Good efficacy was defined as no growth. Results Water controls grew >300 colony-forming units/plate and all toothbrushes were culture-positive prior to testing. For the suspension tests, all test products showed good efficacy. Miconazole 2%, ketoconazole 1% and AHP showed good efficacy after a 10 min contact time. Good efficacy was achieved with a shorter contact time (3 mins) only if combined with an AHP rinse. Conclusions and relevance Lime sulfur and enilconazole continued to show good efficacy. In countries or situations where these products cannot be used, shampoos containing ketoconazole, miconazole or climbazole are alternative haircoat disinfectants, with a 10 min contact time or 3 mins if combined with an AHP rinse.

Conocimientos sobre epidermofitosis en trabajadores de hogar de ancianos / Knowledge about epidermofitosis in nursing home workers

Se realizó un estudio de intervención para determinar la necesidad de aprendizaje sobre epidermofitosis en trabajadores vinculados con la asistencia a pacientes del Hogar de Ancianos Provincial Caridad Jaca, de Guantánamo en abril del 2014. Se trabajó con una muestra de 57 trabajadores, que voluntariamente decidieron participar en el estudio, personal de enfermaría, técnicos en podología y asistentes en los servicios de enfermería. Inicialmente a los participantes se les aplicó una encuesta para determinar las necesidades de aprendizaje sobre el tema, y sobre la base de los resultados se diseñó la propuesta de intervención capacitante que se propone. Se analizaron variables como: medidas de prevención, forma de transmisión, síntomas y signos, concepto, agente causal. Se aplicó la técnica de análisis de distribución de frecuencia en escala cualitativa para todas las variables. Los datos se presentaron en tablas de porcentaje(AU)

An intervention study was carried out to determine the need for learning about epidermofitosis in workers associated with the assistance of patients at the Caridad Jaca Provincial Nursing Home in Guantanamo in April, 2014. A sample of 57 workers as volunteers decided to participate in the study, nursing staff, podiatry technicians and assistants in the nursing services. Initially the participants were given a survey to determine the learning needs on the subject, and on the basis of the results, the proposed intervention was designed. Variables were analyzed such as: prevention, measures, and form of transmission, symptoms and signs, concept, causal agent. The frequency distribution analysis technique was applied on a qualitative scale for all variables. The data were presented in percentage tables

Dermatofitoses: agentes etiológicos, formas clínicas, terapêutica e novas perspectivas de tratamento / Dermatophytoses: etiologic agents, clinical forms, therapy and new perspectives of treatment

As dermatofitoses têm ocorrência mundial, sendo mais prevalentes em países de clima tropical e subtropical. Dados epidemiológicos indicam que essas micoses estão entre as infecções fúngicas de maior ocorrência. O quadro clínico mais comum de dermatofitose inclui despigmentação, placas anulares, prurido e perda de cabelo, com lesões tipicamente conhecidas como tineas, ocasionadas por fungos filamentosos dermatofíticos de três gêneros anamórficos: Microsporum, Trichophyton e Epidermophyton. O tratamento das dermatofitoses, em geral, está relacionado ao uso de antifúngicos tópicos e/ou sistêmicos, apresentando como problemática o surgimento de espécies multirresistentes. Esta revisão aborda as dermatofitoses e seus agentes etiológicos de forma aprofundada em aspectos epidemiológicos, apresentando a importância clínica do tema, com ênfase na causa, prevenção, tratamento e prognóstico dessa micose cutânea (AU)

Dermatophytoses have worldwide occurrence with higher prevalence in tropical and subtropical countries. Epidemiological data show that these mycoses are among the most frequent fungal infections. The most common symptoms of dermatophytoses include depigmentation, annular plaques, itching and hair loss, with lesions such as tinea, caused by dermatophytic filamentous fungi of three anamorphic genera: Microsporum, Trichophyton and Epidermophyton. Topical and/or systemic antifungalmedications are used in the treatment of dermatophytoses in general, resulting in problems such as the emergence of multidrug-resistant species. This review discusses dermatophytoses and their etiological agents with a focus on epidemiological aspects, presenting the clinical importance of the issue, with emphasis on cause, prevention, treatment and prognosis of this skin mycosis (AU)

IL-1 signaling inhibits Trichophyton rubrum conidia development and modulates the IL-17 response in vivo.

Dermatophytosis are one of the most common fungal infections in the world. They compromise keratinized tissues and the main etiological agent is Trichophyton rubrum. Macrophages are key cells in innate immunity and prominent sources of IL-1ß, a potent inflammatory cytokine whose main production pathway is by the activation of inflammasomes and caspase-1. However, the role of inflammasomes and IL-1 signaling against T.rubrum has not been reported. In this work, we observed that bone marrow-derived macrophages produce IL-1ß in response to T.rubrum conidia in a NLRP3-, ASC- and caspase-1-dependent fashion. Curiously, lack of IL-1 signaling promoted hyphae development, uncovering a protective role for IL-1ß in macrophages. In addition, mice lacking IL-1R showed reduced IL-17 production, a key cytokine in the antifungal defense, in response to T.rubrum. Our findings point to a prominent role of IL-1 signaling in the immune response to T.rubrum, opening the venue for the study of this pathway in other fungal infections.

ANTIFUNGAL ACTIVITY OF Cymbopogon nardus (L.) Rendle (CITRONELLA) AGAINST Microsporum canis FROM ANIMALS AND HOME ENVIRONMENT.

Dermatophytosis is a common zoonosis in urban centers. Dogs and cats have played an important role as its disseminators. Environmental decontamination is essential for the prevention of its propagation to humans and animals. However, sanitizers or disinfectants with antifungal activity, currently available, have high toxicity. The present study evaluated the in vitro effects of an extract of citronella (Cymbopogon nardus) on 31 Microsporum canis isolates from animals and home environments. Susceptibility tests were performed based on document M38-A2 (2008) of the Clinical and Laboratory Standards Institute with modifications for natural products. Although susceptibility variation was observed between the fungus tested, the concentrations that inhibited the growth of 50 and 90% of the microorganisms were low (19.5 and 78 µg/mL, respectively). Thus, this citronella extract showed potent fungistatic and fungicide activities against M. canis isolated from animals and home environments. Therefore, it could be an alternative for dermatophytosis prophylaxis in the home environment.

Mating type gene for isolates of Trichophyton mentagrophytes from guinea pigs.

Trichophyton mentagrophytes were isolated from 19 of 20 guinea pigs in a children's corner of a zoo. The nucleotide sequence identity of the internal transcribed spacer region among 19 guinea pig isolates was 99%, including the reference strain of animal type 3 of T. mentagrophytes. The genomic DNA of all isolates were investigated for the mating (MAT) gene by specific polymerase chain reaction. The alpha-box gene was detected in all 19 isolates, while the high-mobility-group (HMG) gene was detected in only one of 19 isolates. Therefore, the guinea pig population harbored at least 2 MAT types of Arthroderma vanbreuseghemii. The T. mentagrophytes that was prevalent in this population may constitute a constant source of infection for persons coming into contact with guinea pigs.

Feline dermatophytosis: steps for investigation of a suspected shelter outbreak.

PRACTICAL RELEVANCE: Dermatophytosis (ringworm) is the most important infectious and contagious skin disease of cats in shelters. Its importance relates to the fact that it can affect all cats, but tends to affect those which would otherwise have good chances for adoption. Although many diseases in shelters fit this description, dermatophytosis is of particular significance because of associated public health concerns. CLINICAL CHALLENGES: Disease management in animal shelters is challenging because new animals are frequently entering the population, numerous animals are often housed together, and resources are almost always limited. GLOBAL RELEVANCE: Outbreaks of dermatophytosis occur worldwide and no animal shelter is completely shielded from possible introduction of the disease into the population. AUDIENCE: This article offers a flexible stepwise approach to dealing with a known or suspected outbreak of dermatophytosis in an animal shelter. It is based on the authors' experiences spanning more than a decade of responses and/or consultations. While primarily aimed at veterinarians involved in shelter medicine, the principles largely apply to other group-housing situations, such as catteries and breeding establishments. AIMS: The goals in dealing with a potential dermatophytosis outbreak are to ascertain if the 'outbreak' is actually an outbreak, to develop a shelter-specific outbreak management plan and to implement a long-term plan to prevent recurrences.

Feline dermatophytosis: aspects pertinent to disease management in single and multiple cat situations.

PRACTICAL RELEVANCE: Dermatophytosis (ringworm) is a superficial fungal skin disease of cats that, depending on the geographic region and practice caseload, may be encountered uncommonly through to commonly. This is a self-curing disease in an immunocompetent cat. GLOBAL IMPORTANCE: Dermatophytosis is prevalent worldwide and is one of a number of zoonotic skin diseases that cat owners are at risk of contracting. CLINICAL CHALLENGES: Dermatophytosis causes non-specific signs of hair loss, erythema and scaling, making it a differential diagnosis for many skin diseases of cats. The fact that this disease is infectious and contagious, and does not have any one classic clinical presentation, makes knowledge of diagnostic tools important in detection. The veterinarian's role is in early disease recognition and institution of appropriate therapy to hasten resolution of the disease. AIM: The focus of this article is to provide an update and review of the most pertinent aspects that may be helpful in the management of dermatophytosis in any single or multiple cat situation. EVIDENCE BASE: Where appropriate, evidence from the literature is used to supplement a summary of the author's clinical experience and research in feline dermatophytosis.

Control of bovine ringworm by vaccination in Norway.

Bovine ringworm caused by Trichophyton verrucosum is a notifiable disease in Norway. New infected herds are reported to the Norwegian Food Safety Authority. To limit spread of the disease, restrictions are imposed on holdings including access to common pastures and sale of live animals. Bovine ringworm has been endemic in the Norwegian dairy population for decades. Since 1980 a vaccine (Bovilis Ringvac LTF-130, Merck Animal Health) has been available. The vaccine contains an attenuated strain of T. verrucosum and stimulates humoral and cellular immune responses conferring protection. Efficacy and safety of the vaccine have been evaluated in experimental and field studies. Vaccination campaigns in densely populated counties have contributed to a substantial decrease in number of ringworm outbreaks. The annual incidence of new infected herds decreased from 1.7% in 1980 to 0.043% in 2004. Few herds remained with restrictions and a "mopping up" project was established to offer assistance specifically to these holdings. A milestone was achieved in 2009; no new herds with cases of clinical ringworm caused by T. verrucosum were reported to the authorities. By end of 2012, there are only two herds with restrictions. Vaccination during the last 30 years has been a key control measure in the effort to prevent disease outbreaks and eradicate bovine ringworm in Norway.

Inactivation of pathogenic dermatophytes by ultraviolet irradiation in swimming pool thermal water.

The effect of ultraviolet (UV) radiation from low-pressure mercury lamp against some pathogenic dermatophytes species such as Epidermophyton floccosum, Trichophyton mentagrophytes, Trichophyton rubrum, Trichophyton schoenleinii, Trichophyton tonsurans and Trichophyton violaceum suspended in thermal water was evaluated in laboratory-scale condition at various times. The main results showed that within 120 s of exposure, all species of dermatophytes are completely inactivated, which was evidenced by the absence of fungal regrowth, while after 60 s only T. tonsurans was recovered, with a reduction of 3.28 log. Shorter exposure times were not enough to completely inactivate all dermatophytes species. The samples treated with UV radiation for 120 s did not give evidence of fungal regrowth indicating that this disinfectant action is persistent over time. In conclusion, UV radiation can be proposed to reduce the risk of infection by dermatophytes eventually present in swimming pools that use thermal water.

[Tinea corporis]. / Tinea corporis.

Between February 2011 and April 2012, an outbreak caused 55 episodes of Tinea corporis in a Berlin kindergarten. According to the case definition Tinea corporis was confirmed in 2 cases, 16 cases were dermatologically probable, 24 cases were suspicious, whereas 13 cases were viewed as improbable. 48% (n=32/67) of all children had at least one episode of disease. Of those aged 4-6 years 76% (n=29/38) were affected, compared with 10% (n=3/29) of those younger than 4 years. Despite comprehensive hygienic measures being taken, the outbreak could not be quickly controlled. To stop the outbreak the immediate cooperation of public health service and medical staff, kindergarten employees, parents and children was necessary. The timely involvement of dermatologists along with a uniform treatment approach turned out to be of major importance. The recommended long treatment duration over several weeks affected adherence to treatment. Overall, the extended treatment in the kindergarten of affected skin areas of children proved to be the most effective measure for the control of the outbreak.

Formulation, characterization and evaluation of an optimized microemulsion formulation of griseofulvin for topical application.

The main objective of the study was to develop a microemulsion (ME) formulation of griseofulvin for the treatment of dermatophytosis (Indian Patent Application 208/DEL/2009). The oil phase was selected on the basis of drug solubility whereas the surfactant and cosurfactant were screened on the basis of their oil solubilizing capacity as well as their efficiency to form ME from pseudo-ternary phase diagrams. The influence of surfactant and cosurfactant mass ratio (Smix) on the ME formation and its permeation through male Laca mice skin was studied. The optimized formulation (ME V) consisting of 0.2% (w/w) griseofulvin, 5% (w/w) oleic acid, 40% (w/w) Smix (1:1, Tween 80 and ethanol) possessed globule size of 12.21 nm, polydispersity index of 0.109 and zeta potential value of -0.139 mV. ME V exhibited 7, 5 and almost 3-fold higher drug permeation as compared to aqueous suspension, oily solution and conventional cream respectively. Besides this the formulation was also evaluated for drug content, pH, stability, dermatopharmacokinetics and antifungal activity against Microsporum canis using guinea pig model for dermatophytosis. Treatment of guinea pigs with ME V resulted in a complete clinical and mycological cure in 7 days. The formulation was observed to be non-sensitizing, histopathologically safe, and stable at 5±3°C, 25±2°C and 40±2°C for a period of six months.

The results of Trichophyton tonsurans screening examinations and infection management in University Judo Federation of Tokyo athletes over a 4-year period.

BACKGROUND: T. tonsurans infection is spreading among combat sport athletes in Japan, and preventive measures are necessary. METHODS: A questionnaire survey and hairbrush-culture tests were conducted over a 4-year period on university judo athletes from about 50 university teams affiliated with the University Judo Federation of Tokyo. Culture-positive individuals were given specific treatment recommendations based on culture results and were advised to seek treatment at a medical clinic. Culture-positive individuals were re-tested at 3 months post-treatment. RESULTS: Approximately 65% of participants reported a history of T. tonsurans infection. The incidence of hairbrush culture-positive individuals overall gradually decreased from 11.3% (academic year 2008) to 5.4% (2011). Each year the incoming freshmen had the highest infection rate of the four academic classes. Beginning in 2009 the infection rates decreased sharply among those who had participated in the survey the previous year, and the decreases continued the following year (s) until graduation. Among culture-positive individuals, the incidence of asymptomatic carriers increased each year, from 86% in 2008 to 98% in 2011. The culture-negative conversion rate was 86% overall for those undergoing treatment. CONCLUSION: Preventive measures against T. tonsurans infection in the University Judo Federation of Tokyo were successful in increasing awareness of the disease, lowering the incidence of infection, and detecting asymptomatic carriers who require treatment.

Actualización en el tratamiento de las micosis cutáneas / Update on the Treatment of Superficial Mycoses

Se revisa la terapéutica disponible actualmente para el tratamiento de las micosis superficiales, las novedades existentes en el campo de la quimioterapia y los tratamientos coadyuvantes más útiles en este terreno. Se hace especial hincapié en el adecuado uso de los tratamientos convencionales y en algunos aspectos farmacoeconómicos relacionados con el tema. Se actualizan los procedimientos terapéuticos más adecuados en circunstancias especiales. Finalmente, se discuten algunas aportaciones novedosas encontradas en la literatura revisada (AU)

We review the current treatments available for superficial mycoses and discuss recent developments in pharmacotherapy and the most useful adjuvant treatments. Special emphasis is placed on the proper use of conventional therapies and a number of pharmacoeconomic issues. The review also offers an update on the best treatment choices in particular circumstances. Finally, we discuss some novel contributions found in the literature (AU)