A clinical study of skin manifestations in diabetes at a tertiary hospital in Kerala

<p class="abstract"><strong>Background:</strong> Though extensive data is available on diabetes and its systemic manifestations, research about the skin lesions in those afflicted with diabetes is scarce. The aim of this study was to understand dermatological manifestations in diabetes.</p><p class="abstract"><strong>Methods:</strong> A hospital based cross sectional study was carried out among 100 randomly selected diabetic patients afflicted with skin lesions due to diabetes.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 73 patients having cutaneous infections, 71.2% were having fungal infections. Out of 18 having bacterial infections, 38.9% were having furuncles. Out of 52 having fungal infections, 63.5% were having dermatophytosis. Out of 14 cases of candidal infections, the most common was intertrigo in 35.7%. Out of 33 cases of dermatophytosis, <em>T. cruris</em> was the most common in 54.5%. Out of 82 patients in whom we suspected dermatoses strongly associated with diabetes, the most common condition was pruritus in 36.6% of the cases.</p><p class="abstract"><strong>Conclusions:</strong> Bacterial skin infections and dermatophytosis were the most common diabetic dermatological lesions in the present study.</p>

Formulation and Evaluation of Antimicrobial Herbal Soap

Bacterial skin infections are most common amongst people, requiring significant attention for treatment and also for maintaining healthy skin. Some herbal plant extracts and their oils were found to have antibacterial activity. The aim and objective of the present study are to formulate and evaluate anti-bacterial herbal soap using Azadirachta indica, Ocimum tenuiflorum oils. The antibacterial activity of the prepared formulations was tested using the agar well diffusion method against the organisms Pseudomonas aeruginosa, Staphylococcus aureus and, Escherichia coli and they exhibited a good anti-bacterial effect. The prepared formulations were evaluated for various physicochemical parameters for which good characteristics were observed. The easy availability of plants and their effectiveness helps manufacturers with cost-effective benefits and with less or no side effects.

Recent Advances in Mupirocin Delivery Strategies for the Treatment of Bacterial Skin and Soft Tissue Infection

Skin and soft tissue infections (SSTIs) have increased problematically in hospital and ambulatory settings due to the poor immunity of hosts and multidrug-resistant pathogens. Mupirocin (MUP), a global topical antibiotic, is used for the treatment of SSTIs caused by various pathogens due to its unique mechanism of action. However, the therapeutic efficiency of MUP is hampered due to the protein binding and drug resistance caused by frequent use. A combined report covering the various aspects of MUP, such as the synthesis of the novel formulation, loading of the drug, and application against various skin infections, is missing. This comprehensive review focuses on various novel drug delivery strategies such as composite biomaterials/scaffold, hydrogel dressings, liposomes, liposomal hydrogel, microparticles/microspheres, microsponges, nanocapsules, nanofibers, silicone-based adhesive patches, and topical sprays. The therapeutic effect of the MUP can be synergized by combining with other agents and using novel strategies. The objective is to enhance patient compliance, decrease the resistance, magnify the delivery of MUP, and overcome the limitations of conventional formulations. Moreover, the carriers/dressing materials are biocompatible, biodegradable, stimulate wound healing, protect the wound from external environmental contamination, adsorb the wound exudates, and are permeable to oxygen and moisture. This review will help researchers to explore further the treatment of various bacterial skin infections by using MUP-loaded novel formulations with better efficacy, utilizing the novel nanostructures or combinatorial methods.

Uji Efektivitas Antibakteri Sediaan Salep Ekstrak Daun Puring (Codiaeum variegatum (L.) Rumph. Ex A.Juss) Terhadap Bakteri Staphylococus aureus

Indonesia is one of the rich countries among the plant’s potential medicinal properties is the puring leaf (Codiaem variegatum (L.) Rumph. Ex A.Jus) as an antibacterial. The puring leaves contain flavonoid, steroids, alkaloids, tannins, saponins and fenols. which serve as antibacterial. The use of antibacterial ointments can treat bacterial skin infections. Balm is a half-denser is intended for topical wear on the skin or the mucous membranes. Among the causes of infection is the Staphylococus aureus bacteria. The study aims to test the effectiveness of a suppressive antibacterias, the leaf extract ointment against the Staphylococus aureus bacteria. Extraction methods maceration method use a 96% solution. The research method used was oriental. The extract of the puring leaves used is 2,5%, 5%, 7,5%, 10%, the negative cotrol of the ointment without the extract and the positive control with the gentamicin ointment. Zone research is inhibiting every single formula. Averag buffer zone on formula 1 6.25 mm, formula 2 7.55 mm, formula 3 9.23 mm and formula 4 11.68 mm. Data acquired by the formation of a clear buffer zone around the commonwealth for 24 hours after treatment. The data was analyzed with one way ANOVA continues the post hoc test (Tukey). The result is that partial extract of puring leave can be made into unguent and effective Staphylocous aureus ATCC 25923Keywords: Extract of puring leaves; antibacterial; ointment and staphylococus aureus AbstrakIndonesia merupakan salah satu negara yang kaya akan keaneragaman tanaman yang memiliki potensi sebagai bahan obat, salah satunya yaitu daun puring (Codiaeum variegatum (L.) Rumph. Ex A.Juss) sebagai antibakteri. Daun puring memiliki senyawa flavonoid, steroid, alkaloid, tannin, saponin dan fenol yang berfungsi sebagai antibakteri. Penggunaan salep antibakteri dapat mengobati infeksi kulit yang disebabkan oleh bakteri. Salep merupakan sediaan setengah padat yang ditujukan untuk pemakaian topikal pada kulit atau selaput lendir. Salah satu penyebab infeksi adalah bakteri Staphylococcus aureus. Penelitian ini bertujuan untuk menguji efektivitas antibakteri sediaan salep ekstrak daun puring terhadap bakteri Staphylococus aureus. Metode ekstraksi menggunakan metode maserasi dengan pelarut 96%. Metode penelitian yang digunakan yaitu sumuran. Konsentrasi ekstrak daun puring yang digunakan adalah 2,5%, 5%, 7,5%, 10%, kontrol negatif yaitu salep tanpa ekstrak dan kontrol positif dengan salep gentamicin. Hasil penelitian zona hambat setiap formula berbeda. Rata-rata zona hambat pada formula 1 6,25 mm, formula 2 7,55 mm, formula 3 9,23 mm dan formula 4 11,68 mm. Data yang diperoleh dengan terbentuknya zona hambat bening di sekeliling sumuran selama 24 jam setelah perlakuan. Data dianalisa dengan one way ANOVA dilanjutkan uji post Hoc (Tukey). Kesimpulannya Ekstrak daun puring bisa dibuat sediaan salep dan ekstrak daun puring efektif terhadap bakteri Staphylococus aureus ATCC 25923Kata Kunci: Ekstrak daun puring; antibakteri; salep dan staphylococus aureus

Laser therapy in the correction of pathogenetic disorders in pyoderma

Currently, one of the priority medico-social problems of medicine is the optimization of methods for treating bacterial skin infections, in particular pyoderma associated with S pyogenes - group A Streptococcus. The traditional treatment complex, which includes antibacterial drugs used systemically or locally, selected taking into account individual sensitivity and the presence of pathognomonic microflora, is not always effective due to an increase in antibiotic resistance. Currently implemented methods of immunocorrection, carried out taking into account changes in the immune status in this pathology and the corresponding clinical pictures of patients, are pathogenetically justified and can be effective. The use of local laser therapy requires laboratory approaches to diagnostics, clarifying the role of factors of innate and adaptive immunity, intercellular mediators and antioxidant defense systems, which allow optimizing laser therapy as a method of treating this pathology. The use of a 450nm low-intensity laser promotes clinical recovery in patients.

Case Report: Dupilumab Successfully Controls Severe Eczema in a Child With Elevated IgE Levels and Recurrent Skin Infections

The efficacy of dupilumab in pediatric patients with severe eczema presenting in the setting of elevated immunoglobulin E (IgE) levels and recurrent bacterial skin infections is not well-understood. Here we present the case of a child with elevated IgE levels in whom dupilumab treatment led to remarkable control of his eczema and recurrent skin infections. We also review the use of dupilumab in other patients with molecularly proven cases of hyper IgE (HIGE) syndrome. Our case supports the notion that dupilumab may have a seminal application in treating severe eczema that occurs in the setting of elevated IgE levels and recurrent bacterial skin infections.

Disseminated sporotrichosis in a person with human immunodeficiency virus disease

Introduction. Disseminated sporotrichosis is an incapacitating infection caused by the dimorphic fungus Sporothrix schenckii. Because this condition may mimic the presentation of tuberculosis, syphilis and other bacterial infections, the diagnosis may be missed or delayed. Case Presentation. We describe a case of disseminated sporotrichosis in a patient with poorly controlled human immunodeficiency virus infection. The patient was initially treated for bacterial skin infections. The differential diagnosis also included tuberculosis and syphilis. Only after appropriate specimens had been sent for microbiological and histopathological investigations was the diagnosis of disseminated sporotrichosis made and appropriate treatment started. The patient showed a good clinical response to itraconazole. Conclusion. This report highlights the importance of having a high index of suspicion of endemic mycoses when managing immunocompromised patients. The report also demonstrates that a delay in the diagnosis of sporotrichosis increases morbidity and results in unnecessary and inappropriate treatment with associated costs and adverse effects.

Bacterial Skin Infections in Livestock and Plant-Based Alternatives to Their Antibiotic Treatment

Due to its large surface area, the skin is susceptible to various injuries, possibly accompanied by the entrance of infective agents into the body. Commensal organisms that constitute the skin microbiota play important roles in the orchestration of cutaneous homeostasis and immune competence. The opportunistic pathogen Staphylococcus aureus is present as part of the normal biota of the skin and mucous membranes in both humans and animals, but can cause disease when it invades the body either due to trauma or because of the impaired immune response of the host. Colonization of livestock skin by S. aureus is a precursor for majority of bacterial skin infections, which range from boils to sepsis, with the best-characterized being bovine mastitis. Antibiotic treatment of these infections can contribute to the promotion of resistant bacterial strains and even to multidrug resistance. The development of antibiotic resistance to currently available antibiotics is a worldwide problem. Considering the increasing ability of bacteria to effectively resist antibacterial agents, it is important to reduce the livestock consumption of antibiotics to preserve antibiotic effectiveness in the future. Plants are recognized as sources of various bioactive substances, including antibacterial activity towards clinically important microorganisms. This review provides an overview of the current knowledge on the major groups of phytochemicals with antibacterial activity and their modes of action. It also provides a list of currently known and used plant species aimed at treating or preventing bacterial skin infections in livestock.

Pan-caspase inhibition as a potential host-directed immunotherapy against MRSA and other bacterial skin infections

Staphylococcus aureus causes most skin infections in humans, and the emergence of methicillin-resistant S. aureus (MRSA) strains is a serious public health threat. There is an urgent clinical need for nonantibiotic immunotherapies to treat MRSA infections and prevent the spread of antibiotic resistance. Here, we investigated the pan-caspase inhibitor quinoline–valine–aspartic acid–difluorophenoxymethyl ketone (Q-VD-OPH) for efficacy against MRSA skin infection in mice. A single systemic dose of Q-VD-OPH decreased skin lesion sizes and reduced bacterial burden compared with vehicle-treated or untreated mice. Although Q-VD-OPH inhibited inflammasome-dependent apoptosis-associated speck-like protein containing caspase activation and recruitment domain (ASC) speck formation and caspase-1–mediated interleukin-1β (IL-1β) production, Q-VD-OPH maintained efficacy in mice deficient in IL-1β, ASC, caspase-1, caspase-11, or gasdermin D. Thus, Q-VD-OPH efficacy was independent of inflammasome-mediated pyroptosis. Rather, Q-VD-OPH reduced apoptosis of monocytes and neutrophils. Moreover, Q-VD-OPH enhanced necroptosis of macrophages with concomitant increases in serum TNF and TNF-producing neutrophils, monocytes/macrophages, and neutrophils in the infected skin. Consistent with this, Q-VD-OPH lacked efficacy in mice deficient in TNF (with associated reduced neutrophil influx and necroptosis), in mice deficient in TNF/IL-1R and anti-TNF antibody-treated WT mice. In vitro studies revealed that combined caspase-3, caspase-8, and caspase-9 inhibition reduced apoptosis, and combined caspase-1, caspase-8, and caspase-11 inhibition increased TNF, suggesting a mechanism for Q-VD-OPH efficacy in vivo. Last, Q-VD-OPH also had a therapeutic effect against Streptococcus pyogenes and Pseudomonas aeruginosa skin infections in mice. Collectively, pan-caspase inhibition represents a potential host-directed immunotherapy against MRSA and other bacterial skin infections.