Relationship Between Acanthosis Nigricans and Fungal Infection: Clinical and Histopathological findings

Background: Acanthosis nigricans (AN) is a skin condition that presents clinically with hyperpigmented, hyperkeratotic, and velvety skin changes, especially in the intertriginous areas. The intertriginous areas are also susceptible to superficial cutaneous fungal infections. The potential relationship between AN and cutaneous fungal infection has not been investigated. Objective: The aim of this study was to determine the relationship, if any, between AN and fungal infection, both clinically and pathologically. Methods: A retrospective review was performed using electronic medical records and histology of biopsy slides obtained from 29 patients who were diagnosed with AN by two dermatopathologists. Comparison was made between the clinical and pathological findings of AN with fungal infection (ANFI+) and AN without fungal infection (ANFI-). Results: Among the 29 patients with AN, fungal spores were detected on the biopsy slides of 18 patients (62.1%) and appeared in the epidermal furrow more often than in the epidermal ridge. No significant clinical difference was found between the ANFI+ and ANFI- groups; however, in the ANFI+ group, lesions were more prevalent in the neck area (p = 0.048). In addition, the ANFI+ biopsy slides revealed more papillomatosis than ANFI- biopsy slides (p = 0.006). Conclusion: Fungal infection tends to appear in combination with AN when more severe papillomatosis is also present.

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Triggers and markers of skin aging in women with menopausal syndrome

Medical Council ◽

10.21518/2079-701x-2021-21-2-86-92 ◽

2022 ◽

pp. 86-92

Author(s):

A. G. Mamontova ◽

E. N. Usoltseva ◽

T. P. Pisklakova ◽

E. M. Lepikhina ◽

K. V. Nikushkina

Keyword(s):

Skin Pigmentation ◽

Video Camera ◽

Skin Condition ◽

Skin Aging ◽

Menopausal Syndrome ◽

Skin Changes ◽

Second Stage ◽

Digital Video Camera ◽

Condition Of Women ◽

The Relationship

Introduction. External manifestations of aging, and especially skin aging are the most important for modern women.Aim. The aim of our study was to identify a set of adverse factors that effect on the skin of women in menopausal transition (MP) and in postmenopause (PM), and to identify markers of skin aging in this category of women.Materials and methods. The study included 36 women in MP and PM suffering from MS. At the first stage, anamnesis was collected, anthropometric data and severity of MS were evaluated, and the hormonal profile of patients was determined. At the second stage, computer mapping of the skin was performed using the digital video camera Aramo SG with the skin XPpro program. Statistic analysis was performed using the SPSS v13.0 program. Spearman’s analysis was used to determine the relationship between anthropometric, clinical and anamnestic data and the measurements of skin condition of women in MP and PM. Results. According to the obtained data, the main triggers of skin aging of women in MP and PM are: the presence of metabolic disorders (obesity, metabolic syndrome), decrease of estradiol and progesterone levels in blood serum as well as increase of prolactin level and rhythm disturbance of melatonin secretion. Markers of skin aging in women with menopausal syndrome are decreased moisture, increased oiliness in T-zone, increased of skin pigmentation and enlarged pore size.Conclusions. The obtained data are useful for management involuting skin changes of women in PM and MP suffering from MS. The data justifies the relevancy to normalization not only the estradiol level, but other sex steroids, melatonin, as well as correction of metabolic endocrine processes, and treatment of MS.

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The double trouble: COVID-19 associated mucormycosis a focused review and future perspectives

10.25259/gjmpbu_4_2021 ◽

2021 ◽

Vol 16 ◽

pp. 4

Author(s):

Arun Kumar Agnihotri ◽

Monika Vij ◽

Okezie I. Aruoma ◽

Vipul D Yagnik ◽

Theeshan Bahorun ◽

...

Keyword(s):

Fungal Infection ◽

Paranasal Sinuses ◽

Fungal Infections ◽

Fungal Spores ◽

Diabetic Patients ◽

Corticosteroid Administration ◽

Uncontrolled Diabetes ◽

The Family ◽

Need To Evaluate ◽

The Many

Mucormycosis, a deadly fungal infection, has affected thousands of COVID-19 patients in India. Mucormycosis, formerly known as zygomycosis, is caused by the many fungi that belong to the family “Mucorales.” These molds are commonly found in soil, air, and damp walls and frequently colonize oral mucosa, nose, paranasal sinuses, and throat. The pathophysiological consequences of diabetes combined with the acute inflammatory surge in COVID-19 and steroid treatment weakens person’s immunity and renders susceptibility to fungal infections. Patients treated for severe COVID-19 have damaged lungs and suppressed immune system, an environment that supports fungal infection. Fungal spores can grow in airways or sinuses, and invade bodies’ tissues, explaining why the nasal cavity and paranasal sinuses are the most common site of mucormycosis infection, the consequential spread to the eyes can cause blindness, or causing headaches or seizures if the infection spreads to the brain. Poorly controlled diabetes often results in acidosis in tissues a suitable environment for Mucorales fungi to grow, exacerbating the risk for mucormycosis. This becomes clinically important, especially in India that has an increased prevalence of undiagnosed and uncontrolled diabetes. Given that a significant increase in the cases of mucormycosis in the diabetic patients treated for COVID-19 is strongly associated with corticosteroid administration, there is a need to evaluate use of dietary nutraceuticals with immune boosting potentials that modulate metabolic abnormalities in the management of COVID-19 associated mucormycosis.

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A pharmacoepidemiology study of local fungal infections in skin and venereal diseases outpatient department of a rural tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20201187 ◽

2020 ◽

Vol 9 (4) ◽

pp. 616

Author(s):

Preety Bansal ◽

Seema Baishnab

Keyword(s):

Fungal Infection ◽

Fungal Infections ◽

Tertiary Care ◽

Antifungal Drugs ◽

Care Hospital ◽

Dermatology Department ◽

Number Of Patients ◽

Common Skin ◽

Cutaneous Fungal Infection ◽

Number Of Males

Background: Fungal infections of the skin were the 4th most common skin disease in 2010 affecting 984 million people. An estimated 20-25% of the world’s population has some form of fungal infection. Dermatophytes are fungi that cause superficial infections of the skin, commonly referred to as tinea infections.Methods: This was a prospective and an observational study conducted from February 2018 to January 2019 in Dermatology Department. Prescriptions included all newly diagnosed patients with cutaneous fungal infection of both sex who attended dermatology OPD. Factors considered were sociodemographic parameters, the disease encountered and number of patients in each group and number of patients who received antifungal therapy (oral and topical) etc.Results: 1000 prescriptions were analysed of patients between 18 to 65 years of age with cutaneous fungal infections. There were a greater number of males (57.4%) than females (42.6%). The average number of antifungal drugs prescribed per prescription was 2.33. Majority of the patients were prescribed itraconazole (82.30%) followed by terbinafine (9.70%) and fluconazole (8.0%).Conclusions: The most common oral antifungal drug used was itraconazole. Ketoconazole and Terbinafine were the most commonly used topical agents respectively.

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Association between Hospital Visits for Superficial Fungal Infections and Climatological Factor

Journal of Mycology and Infection ◽

10.17966/jmi.2020.25.2.35 ◽

2020 ◽

pp. 35-41

Author(s):

Hyun-Min Seo ◽

Se Kwang Park ◽

Se Uk Oh ◽

Ju Wang Jang ◽

Joung Soo Kim

Keyword(s):

Relative Humidity ◽

Fungal Infection ◽

Fungal Infections ◽

National Sample ◽

Effect Of Temperature ◽

Tinea Unguium ◽

Average Temperature ◽

Hospital Visits ◽

Epidemiological Characteristics ◽

The Relationship

Background: No cohort studies exist on the effect of temperature and humidity on the number of visits to hospitals by patients with superficial fungal infections. Objective: The aim of our study was to investigate the relationship between climatological factors and superficial fungal infection-related hospital visits. Methods: This study was a retrospective cohort study based on the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database of patients with superficial fungal infection, from 2003 to 2012. We analyzed epidemiological characteristics and types of superficial fungal infection using descriptive statistics. We extracted climatological variables including temperature, relative humidity, precipitation, wind speed, possible duration of sunshine, and duration of sunshine from the Korea Meteorological Administration. Results: 116,903 patients presented with superficial fungal infections in the NHIS-NSC database. The most common type of superficial fungal infection-related hospital visits was tinea unguium (46.72%), followed by tinea pedis (28.38%), tinea corporis (9.19%), and tinea cruris (7.52%). Significant positive linear associations were found between mean daily superficial fungal infection-related hospital visits and daily average temperature (p < 0.001) and relative humidity (p < 0.001). Conclusion: The data from this study indicated that high temperature and high relative humidity may exacerbate superficial fungal infections.

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Karakteristik penyakit kulit pada anak di poliklinik kulit dan kelamin RSUP. Dr. M. Djamil Padang periode 2016-2018

Jurnal Kedokteran Syiah Kuala ◽

10.24815/jks.v20i3.18277 ◽

2020 ◽

Vol 20 (3) ◽

Author(s):

Rina Gustia ◽

Satya Wydya Yenny ◽

Sigya Octari

Keyword(s):

Fungal Infection ◽

Skin Disease ◽

Medical Records ◽

Skin Diseases ◽

Fungal Infections ◽

Common Disease ◽

High Morbidity ◽

Common Skin ◽

The Impact

Abstrak. Latar belakang : Penyakit kulit menyebabkan morbiditas yang tinggi, termasuk pada anak. Prevalensi dermatosis pada anak berkisar 34-87,7% dengan pola yang sangat bervariasi dan dipengaruhi oleh banyak faktor. Dampak penyakit kulit ini dapat mempengaruhi kualitas hidup anak.Metode : Penelitian retrospektif deskriptif dengan mengambil data dari rekam medis pasien anak dengan umur 1-18 tahun yang berobat ke Poliklinik Kulit dan Kelamin RSUP.Dr. M. Djamil Padang pada periode Januari 2016– Desember 2018. Hasil : Selama 3 tahun didapatkan 277 pasien baru, perempuan 123 (44,4%) dan laki - laki 154 (55,6%). Berdasarkan kelompok penyakit yang terbanyak adalah dermatitis (29, 9%), diikuti oleh infeksi jamur (16,9%), infestasi parasit (13, 4%), infeksi virus (13, 3%), dan infeksi bakteri (6,9%).Kesimpulan: Penyakit kulit terbanyak terjadi pada anak laki – laki. Infeksi jamur merupakan penyakit kulit paling sering, diikuti oleh infestasi parasit. Infeksi jamur yang sering terjadi adalah pitiriasis versikolor, sedangkan infestasi parasit yang paling sering adalah skabies. Kata kunci: karakteristik penyakit kulit, anak, penelitian retrospektif Abstrack. Background: Skin disease causes high morbidity, including in children. The prevalence of dermatosis in children ranges from 34 to 87.7% with a pattern that is varied and influenced by many factors. The impact of this skin disease can affect the quality of life of childrenMethod : A descriptive retrospective, which is taking data from the medical records of patients aged 1 - 18 years who seek treatment at Dermatology and Venereology outpatient clinic at RSUP. M. Djamil Padang in the period January 2016 - December 2018.Result : During 3 years,there were 277 new patient which consist of 123 boy (44.4%) and 154 girl (55.6%). Based on the group of diseases, dermatitis were the most common disease (29,9%), followed by fungal infection (16.9%), parasit infestations (13,4%), viral infection (13,3%) and bacterial infection (6,9%). Conclusion : Most skin diseases occur in boys. Fungal infections were the most common skin diseases, followed by parasit infestations. The most common fungal infection is pityriasis versicolor, while the most frequent parasit infestation is scabies.Keywords:characterization of skin diseases, children, retrospective study

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Clinical experience with SUBA-itraconazole at a tertiary paediatric hospital

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkaa382 ◽

2020 ◽

Vol 76 (1) ◽

pp. 249-252

Author(s):

Joanne Abbotsford ◽

David A Foley ◽

Zoy Goff ◽

Asha C Bowen ◽

Christopher C Blyth ◽

...

Keyword(s):

Fungal Infection ◽

Dose Adjustment ◽

Fungal Infections ◽

Allergic Bronchopulmonary Aspergillosis ◽

Serum Levels ◽

Therapeutic Drug ◽

Drug Levels ◽

Paediatric Hospital ◽

Oral Formulations ◽

Cutaneous Fungal Infection

Abstract Background Itraconazole remains a first-line antifungal agent for certain fungal infections in children, including allergic bronchopulmonary aspergillosis (ABPA) and sporotrichosis, but poor attainment of therapeutic drug levels is frequently observed with available oral formulations. A formulation of ‘SUper BioAvailability itraconazole’ (SUBA-itraconazole; Lozanoc®) has been developed, with adult studies demonstrating rapid and reliable attainment of therapeutic levels, yet paediatric data are lacking. Objectives To assess the safety, efficacy and attainment of therapeutic drug levels of the SUBA-itraconazole formulation in children. Methods A single-centre retrospective cohort study was conducted, including all patients prescribed SUBA-itraconazole from May 2018 to February 2020. The recommended initial treatment dose was 5 mg/kg twice daily (to a maximum of 400 mg/day) rounded to the nearest capsule size and 2.5 mg/kg/day for prophylaxis. Results Nineteen patients received SUBA-itraconazole and the median age was 12 years. The median dose was 8.5 mg/kg/day and the median duration was 6 weeks. Indications included ABPA (16 patients), sporotrichosis (1), cutaneous fungal infection (1) and prophylaxis (1). Of patients with serum levels measured, almost 60% (10/17) achieved a therapeutic level, 3 with one dose adjustment and 7 following the initial dose. Adherence to dose-adjustment recommendations amongst the seven patients not achieving therapeutic levels was poor. Of patients with ABPA, 13/16 (81%) demonstrated a therapeutic response in IgE level. SUBA-itraconazole was well tolerated with no cessations related to adverse effects. Conclusions SUBA-itraconazole is well tolerated in children, with rapid attainment of therapeutic levels in the majority of patients, and may represent a superior formulation for children in whom itraconazole is indicated for treatment or prevention of fungal infection.

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The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea

Journal of Fungi ◽

10.3390/jof7080639 ◽

2021 ◽

Vol 7 (8) ◽

pp. 639

Author(s):

Yae-Jee Baek ◽

Yun-Suk Cho ◽

Moo-Hyun Kim ◽

Jong-Hoon Hyun ◽

Yu-Jin Sohn ◽

...

Keyword(s):

Cohort Study ◽

South Korea ◽

Fungal Infection ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Lung Transplant ◽

Fungal Infections ◽

Transplant Recipients ◽

Tertiary Center ◽

Lung Transplant Recipients

(1) Background: Lung transplant recipients (LTRs) are at substantial risk of invasive fungal disease (IFD), although no consensus has been reached on the use of antifungal agents (AFAs) after lung transplantation (LTx). This study aimed to assess the risk factors and prognosis of fungal infection after LTx in a single tertiary center in South Korea. (2) Methods: The study population included all patients who underwent LTx between January 2012 and July 2019 at a tertiary hospital. It was a retrospective cohort study. Culture, bronchoscopy, and laboratory findings were reviewed during episodes of infection. (3) Results: Fungus-positive respiratory samples were predominant in the first 90 days and the overall cumulative incidence of Candida spp. was approximately three times higher than that of Aspergillus spp. In the setting of itraconazole administration for 6 months post-LTx, C. glabrata accounted for 36.5% of all Candida-positive respiratory samples. Underlying connective tissue disease-associated interstitial lung disease, use of AFAs before LTx, a longer length of hospital stay after LTx, and old age were associated with developing a fungal infection after LTx. IFD and fungal infection treatment failure significantly increased overall mortality. Host factors, antifungal drug resistance, and misdiagnosis of non-Aspergillus molds could attribute to the breakthrough fungal infections. (4) Conclusions: Careful bronchoscopy, prompt fungus culture, and appropriate use of antifungal therapies are recommended during the first year after LTx.

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Estimated Burden of Fungal Infections in Oman

Journal of Fungi ◽

10.3390/jof7010005 ◽

2020 ◽

Vol 7 (1) ◽

pp. 5

Author(s):

Abdullah M. S. Al-Hatmi ◽

Mohammed A. Al-Shuhoumi ◽

David W. Denning

Keyword(s):

Fungal Infection ◽

Fungal Infections ◽

Epidemiological Studies ◽

Vaginal Candidiasis ◽

Skin Infections ◽

Opportunistic Pathogens ◽

Fungal Rhinosinusitis ◽

Populations At Risk ◽

Different Populations ◽

Underlying Pathology

For many years, fungi have emerged as significant and frequent opportunistic pathogens and nosocomial infections in many different populations at risk. Fungal infections include disease that varies from superficial to disseminated infections which are often fatal. No fungal disease is reportable in Oman. Many cases are admitted with underlying pathology, and fungal infection is often not documented. The burden of fungal infections in Oman is still unknown. Using disease frequencies from heterogeneous and robust data sources, we provide an estimation of the incidence and prevalence of Oman’s fungal diseases. An estimated 79,520 people in Oman are affected by a serious fungal infection each year, 1.7% of the population, not including fungal skin infections, chronic fungal rhinosinusitis or otitis externa. These figures are dominated by vaginal candidiasis, followed by allergic respiratory disease (fungal asthma). An estimated 244 patients develop invasive aspergillosis and at least 230 candidemia annually (5.4 and 5.0 per 100,000). Only culture and microscopy are currently available for diagnosis, so case detection is suboptimal. Uncertainty surrounds these figures that trigger the need for urgent local epidemiological studies with more sensitive diagnostics.

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Rapidly dissolving microneedle patch of amphotericin B for intracorneal fungal infections

Drug Delivery and Translational Research ◽

10.1007/s13346-021-01032-2 ◽

2021 ◽

Author(s):

Alyaa A. Albadr ◽

Ismaiel A. Tekko ◽

Lalitkumar K. Vora ◽

Ahlam A. Ali ◽

Garry Laverty ◽

...

Keyword(s):

Fungal Infection ◽

Amphotericin B ◽

Fungal Infections ◽

Fungal Growth ◽

Significant Inhibition ◽

Corneal Tissue ◽

Biodegradable Poly ◽

Invasive Method ◽

Poorly Soluble ◽

Microneedle Patch

AbstractChronic fungal infection of the cornea could lead to blindness if not treated properly. Topical amphotericin B (AMP-B) is considered the first treatment of choice for ocular fungal infection. However, factors related to its poor solubility and penetration through intact cornea lead to poor bioavailability. Microneedles (MNs) are emerging as a minimally invasive method to enhance ocular drug delivery. This study aims to investigate the potential use of biodegradable poly(vinylpyrrolidone) (PVP) and hyaluronic acid (HA)–based rapidly dissolving MNs for delivery of AMP-B to treat fungal infection. The data obtained illustrates PVP/HA MN arrays’ reproducibility, good mechanical strength, and faster dissolution with 100% drug recovery. Multiphoton microscopic results revealed that MNs successfully penetrate the corneal tissue and enhance AMP-B permeation through corneal layers. Furthermore, PVP/HA MN arrays showed high solubility. Both PVP and HA successfully decreased AMP-B cytotoxicity when compared to free drug. More interestingly, the biocompatible MN formulations preserved the antifungal activity of AMP-B, as demonstrated by significant inhibition of fungal growth. Therefore, this study shows the feasibility of ocular delivery of the poorly soluble AMP-B using a fast-dissolving MN patch. Graphical abstract

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Differential Diagnosis of Seborrheic Dermatitis

Pediatrics in Review ◽

10.1542/pir.7.7.204 ◽

1986 ◽

Vol 7 (7) ◽

pp. 204-211

Author(s):

Mary L. Williams

Keyword(s):

Atopic Dermatitis ◽

Differential Diagnosis ◽

Metabolic Diseases ◽

Fungal Infections ◽

Seborrheic Dermatitis ◽

Local Therapy ◽

Skin Condition ◽

Unknown Etiology ◽

Common Skin ◽

Nutritional And Metabolic Diseases

Seborrheic dermatitis is a common skin condition of infancy of unknown etiology. The disorder is usually mild and responsive to therapy. In severe or atypical cases, a variety of other entities should be considered in the differential diagnosis. Atopic dermatitis, psoriasis, psoriasiform-id reaction, fungal infections, and irritant contact dermatitis can be differentiated on clinical grounds. Less common but more serious disorders, such as histiocytosis X, immunodeficiency disorders, and nutritional and metabolic diseases, may be considered in the child whose disease does not spontaneously resolve or respond satisfactorily to local therapy. Laboratory studies including skin biopsy may be helfpul in these cases. Seborrheic dermatitis is uncommon in children after infancy and before puberty. In this age group, scalp scaling is likely to be due to other causes, such as tinea capitis, atopic dermatitis, or psoriasis.

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