RESUMO
Onychomycosis is a common progressive fungal infection of the nail bed, matrix, or plate leading to destruction and deformity of the toenails and fingernails. The prevalence of onychomycosis is increasing in the United States, particularly in the growing population of Latino patients. In this study, we evaluated the efficacy and safety of efinaconazole solution 10% in Latino patients with onychomycosis. Once-daily application of efinaconazole solution 10% may be an effective topical option for treatment of onychomycosis in this patient population.
Assuntos
Antifúngicos/uso terapêutico , Dermatoses do Pé/tratamento farmacológico , Onicomicose/tratamento farmacológico , Triazóis/uso terapêutico , Administração Tópica , Antifúngicos/administração & dosagem , Feminino , Dermatoses do Pé/etnologia , Dermatoses do Pé/patologia , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-Idade , Onicomicose/etnologia , Onicomicose/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Triazóis/administração & dosagem , Estados UnidosRESUMO
OBJECTIVE OF THE STUDY: Mycetomas are chronic sub-cutaneous tropical infections in which exogenous causative agents, fungal (eumycetes) or bacterial (actinomycetes), generate grains. The typical presentation is multi-fistulized pseudotumors. This disease, particularly eumycetoma, is difficult to treat. It is a major health problem in tropical and subtropical countries. In France, the disease is rare, but patients have access to a broader range of treatments. The authors had for objective to present the cases of mycetomas diagnosed in developed country and their management. PATIENTS AND METHODS: A retrospective study was made on the clinical presentation and management of mycetomas from 1995 to 2011, in the Bobigny Avicenne teaching hospital. RESULTS: Six patient files were studied. The patients were men with a median age of 31 years (16-70). Five patients were from Sub Saharan Africa, one from Sri Lanka. The etiologies were one actinomycetoma and five eumycetomas. There was bone involvement in five cases. There was one atypical presentation: a primary intra-osseous mycetoma. Three patients were cured including two by surgical management and one by medical treatment (actinomycetoma). Antifungal therapy failed (four patients) in every case (voriconazole, itraconazole, ketoconazole, terbinafine, caspofungin). CONCLUSION: The results of this study made in a non-epidemic zone revealed that despite a typical clinical presentation, the diagnosis and management were delayed because this imported disease is rare in France. The patients received new broad-spectrum triazole and caspofungin, but none were cured with antifungal therapy alone.
Assuntos
Emigrantes e Imigrantes , Micetoma/tratamento farmacológico , Adolescente , Adulto , África Subsaariana/etnologia , Idoso , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Países Desenvolvidos , Gerenciamento Clínico , Dermatoses do Pé/diagnóstico , Dermatoses do Pé/tratamento farmacológico , Dermatoses do Pé/etnologia , Dermatoses do Pé/cirurgia , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Micetoma/diagnóstico , Micetoma/etnologia , Micetoma/cirurgia , Nocardiose/diagnóstico , Nocardiose/tratamento farmacológico , Estudos Retrospectivos , Sri Lanka/etnologia , Resultado do Tratamento , Adulto JovemRESUMO
Onychomycosis is known to have predisposing factors and a high prevalence within families that cannot be explained by within-family transmission. We determined the frequency of HLA-B and HLA-DR haplotypes in 25 families of Mexican patients with onychomycosis in order to define the role of the class II major histocompatibility complex (MHC) in genetic susceptibility to this infection. Seventy-eight subjects participated in the study, 47 with onychomycosis and 31 healthy individuals. The frequencies of the HLA-B and HLA-DR haplotypes were compared with those found in first-degree relatives without onychomycosis and in a historic control group of healthy individuals. The frequencies in the controls were similar to those of the healthy relatives of the patients. However, on comparison of the patients with historic controls, we detected a higher frequency of the HLA-DR8 haplotype (P=.03; odds ratio, 1.89; 95% confidence interval, 0.98-36). These findings suggest that there are polymorphisms in genes of the MHC that increase susceptibility to onychomycosis, particularly haplotype HLA-DR8.
Assuntos
Dermatoses do Pé/genética , Genes MHC da Classe II , Genes MHC Classe I , Antígenos HLA-B/genética , Antígenos HLA-DR/genética , Dermatoses da Mão/genética , Onicomicose/genética , Polimorfismo Genético , Tinha do Couro Cabeludo/genética , Alelos , Etnicidade/genética , Saúde da Família , Dermatoses do Pé/epidemiologia , Dermatoses do Pé/etnologia , Frequência do Gene , Predisposição Genética para Doença , Subtipos Sorológicos de HLA-DR/genética , Dermatoses da Mão/epidemiologia , Dermatoses da Mão/etnologia , Haplótipos , Humanos , México/epidemiologia , Onicomicose/epidemiologia , Onicomicose/etnologia , Tinha do Couro Cabeludo/epidemiologiaAssuntos
Antimetabólitos Antineoplásicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Negro ou Afro-Americano , Dermatoses do Pé/induzido quimicamente , Dermatoses da Mão/induzido quimicamente , Pirimidinas/efeitos adversos , População Branca , Antimetabólitos Antineoplásicos/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Inibidores Enzimáticos/efeitos adversos , Inibidores Enzimáticos/farmacologia , Pé/patologia , Dermatoses do Pé/etnologia , Mãos/patologia , Dermatoses da Mão/etnologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Parestesia , Pirimidinas/farmacologia , Fatores de Risco , Síndrome , Timidina Fosforilase , Timidilato Sintase , Estados UnidosAssuntos
Infecções por Actinomycetales/etnologia , Emigração e Imigração , Dermatoses do Pé/etnologia , Dermatopatias Bacterianas/etnologia , Pele/patologia , Infecções por Actinomycetales/patologia , Adulto , Biópsia , Doença Crônica , Diagnóstico Diferencial , Seguimentos , Dermatoses do Pé/patologia , Humanos , Masculino , México/etnologia , Pele/microbiologia , Dermatopatias Bacterianas/patologiaRESUMO
This study was conducted to evaluate the occurrence of mycoses affecting the feet of soccer players and to compare this results with those in non-athlete individuals of the same age and sex. Initial evaluation consisted of a dermatological examination of the foot in 22 Chinese athletes, 83 Brazilian athletes and 24 Brazilian non-athletes. Scales of plantar skin, interdigital and subungual areas of the foot were collected for mycological examination (direct and culture). Nail clippings were obtained for histopathologic analysis. Tinea pedis was diagnosed more frequently among the non-athlete individuals. None of the Chinese athletes had tinea pedis alone. However, in this group onychomycosis was frequently higher when compared to the other groups. The fungal microbiota comprised Trichophyton rubrum (40%), Trichophyton mentagrophytes (36.4%) and Candida spp (20%). Candida spp was isolated only from Brazilian athletes. Results obtained with KOH wet mounts agreed with the results obtained in culture and with histopathologic examinations (50.5% vs 40.9%). The frequency of tinea pedis among soccer players was lower than the other groups in this study, possibly due to health education and professional feet care.
Assuntos
Onicomicose/epidemiologia , Futebol , Tinha dos Pés/epidemiologia , Adulto , Brasil/epidemiologia , Candida/isolamento & purificação , Candidíase Cutânea/epidemiologia , Candidíase Cutânea/etnologia , Candidíase Cutânea/microbiologia , China/epidemiologia , China/etnologia , Comorbidade , Feminino , Dermatoses do Pé/epidemiologia , Dermatoses do Pé/etnologia , Dermatoses do Pé/microbiologia , Promoção da Saúde , Humanos , Masculino , Micologia/métodos , Onicomicose/etnologia , Onicomicose/microbiologia , Prevalência , Tinha dos Pés/etnologia , Tinha dos Pés/microbiologia , Trichophyton/isolamento & purificaçãoRESUMO
Scytalidium dimidiatum is a geophilic dematiaceous, non-dermatophyte mould that can become a pathogen for plants and humans particularly in tropical and subtropical regions. We report 4 cases of S. dimidiatum onychomycosis presenting clinically as thickened and dark toenails. The skin of the soles was scaly. The time and location of the contaminations were uncertain. Indeed, the patients were ancient immigrants from the Maghreb to Belgium. They were also regularly travelling to their countries of origin. They were also often barefoot in the same Belgian mosque. The disease was unresponsive to current oral antifungal treatments.
Assuntos
Dermatomicoses/diagnóstico , Dermatoses do Pé/diagnóstico , Onicomicose/diagnóstico , Adulto , África do Norte/etnologia , Bélgica/epidemiologia , Dermatomicoses/epidemiologia , Dermatomicoses/etnologia , Dermatomicoses/transmissão , Surtos de Doenças , Dermatoses do Pé/epidemiologia , Dermatoses do Pé/etnologia , Humanos , Islamismo , Masculino , Pessoa de Meia-Idade , Onicomicose/epidemiologia , Onicomicose/etnologia , Onicomicose/transmissãoRESUMO
Infantile acropustulosis is a recurrent, pruriginous, vesiculopustular eruption of the palms and soles first described in 1979. We report six cases of infantile acropustulosis in recently emigrated children treated for scabies. Clinical follow-up was obtained by questionnaire addressed to patients' families and general practitioners. Our study suggests infantile acropustulosis is frequent in immigrant infants and could be a non-specific hypersensitivity reaction to Sarcoptes scabiei.