In vivo fungicidal effect of KP-103 in a guinea pig model of interdigital tinea pedis determined by using a new method for removing the antimycotic carryover effect

We developed a new technique for culture study that successfully recovers fungi from drug-treated skin tissues, in which tissue specimens were homogenized, dialyzed against water, digested with trypsin, and then washed with PBS, to eliminate the drug that remaining in the skin tissue specimens. With this modified culture method, we reevaluated the efficacy of KP-103, neticonazole, and lanoconazole in a guinea pig interdigital tinea pedis model. Guinea pigs with tinea pedis were topically treated with a 1% solution of KP-103 or a reference drug once a day for 10 consecutive days. Five days after the last treatment, left and right feet were subjected to culture study by the conventional and modified recovery culture methods, respectively. One hundred percent (20/20) of lanoconazole-treated feet were judged as culture-negative by the conventional culture method, but 85% (17/20) of the feet were shown to be culture-positive when the modified recovery culture method was used. On the other hand, KP-103 achieved high rates of culture-negative rates, 95% (19/20) and 85% (17/20), in both conventional and modified culture methods, respectively. Furthermore, on day-30 posttreatment, KP-103 sterilized 14 of the 20 infected feet, whereas neticonazole and lanoconazole were not effective even in reducing fungal burden. KP-103 proved to be highly effective in achieving mycological cure and preventing relapse against tinea pedis presumably because of its good bioavailability in the skin based on its low keratin-affinity, along with its potent antifungal activity.     

2%硝酸舍他康唑乳膏治疗体股癣和足癣疗效和安全性评价

目的 评价2％硝酸舍他康唑乳膏治疗足癣和体、股癣的疗效及安全性,并与2％硝酸咪康唑乳膏对照。方法 采用多中心随机双盲对照试验。试验组及对照组分别外用2％硝酸舍他康唑乳膏和2％硝酸咪康唑乳膏,每天2次,疗程4周。在治疗开始及治疗2周、4周、6周时进行观察。结果 足癣试验组61例,对照组58例;体、股癣试验组56例,对照组55例完成了观察。足癣在4周时,临床有效率试验组98．36％,对照组93．10％,在6周时分别为100％和98．28％;在4周和6周时真菌学清除率试验组均为95．1％,对照组均为100％;在4周时总有效率试验组98．36％,对照组93．10％,在6周时分别为100％和98．28％。体、股癣在4周时,临床有效率试验组98．21％,对照组92．73％,在6周时分别为100％和98．18％;在4周和6周时真菌学清除率试验组和对照组均为100％;在4周时总有效率试验组98．21％,对照组92．73％,在6周时分别为100％和98．18％。药物不良反应发生率试验组1．7％,对照组0．9％,表现为局部刺激。结果 显示2％硝酸舍他康唑乳膏治疗足癣和体、股癣的疗效及安全性与2％硝酸咪康唑乳膏相似（P〉0．05）。结论 2％硝酸舍他康唑乳膏治疗足癣和体、股癣有效、安全。     

Epidemiology of dermatophytoses: retrospective analysis from 2005 to 2010 and comparison with previous data from 1975

Dermatophyte infections are extremely frequent worldwide and their epidemiological features vary according to the geographical area and have changed in the last decades. We studied the spectrum of dermatophytoses by means of a retrospective analysis involving 6,133 patients referred to the Mycology Service of the Dermatology Clinic of Policlinico Hospital - University of Bari, Italy during the period 2005-2010. The most frequent clinical forms were tinea unguium (39.2% of the total dermatophytoses), tinea corporis (22.7%) and tinea pedis (20.4%). There was a predominance of women for tinea unguium and corporis and of men for tinea pedis and especially tinea cruris. T. rubrum was the prevalent causative agent, implicated in 64% of total cases, followed by M. canis (14%) and T. mentagrophytes (10%). The retrospective evaluation of epidemiological data collected at our Clinic since 1975 showed a gradual decrease in the frequency of tinea cruris, tinea corporis, and tinea capitis over time. On the contrary, during the past two decades, there has been a progressive increase in the frequency of tinea pedis and especially of tinea unguium. In parallel with this changing pattern, the frequency of isolation of T. rubrum has shown a continuous increase during the last 35 years, whereas a progressive decline of the etiological role of T. violaceum, M. canis and even more of E. floccosum has been noted.     

Achievement of complete mycological cure by topical antifungal agent NND-502 in guinea pig model of tinea pedis

We examined the therapeutic effect of a 1% cream preparation of NND-502, a novel topical antifungal agent, in a guinea pig tinea pedis model produced by infecting the plantar skin of guinea pigs with Trichophyton mentagrophytes. Animals developing tinea pedis were divided into two groups: an untreated control group and a treated group. In the latter group, after confirming infection had been established, the infected animals were topically treated with the NND-502 cream once daily for one week. The animals were reared in a clean environment free from exposure to exogenous dermatophytes. At one week (5 weeks post-infection), 6 weeks (10 weeks post-infection) and 16 weeks (20 weeks post-infection) after completion of the treatment, plantar skin samples were taken from a certain number of both groups of animals. The results demonstrated that all of the animals in the untreated control group and none of those in the treated group were culture-positive in this animal model of tinea pedis. The topical treatment with NND-502 achieved a mycological cure. Thus NND-502 can be considered a promising candidate as a new anti-dermatophytic agent for topical use.     

A study of dermatophytoses in Bangkok (Thailand)

A total of 719 cases of dermatophytoses was studied in the Division of Dermatology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand, during January to December 1986. Infection caused by fungus comprises 12%, while the incidence of dermatophytoses was 5.5% of skin disorders. The age group commonly infected was 12–21 years old (mean age of 18 years); 40% was female and 47.5% was male. In the female patients the common prevalent infections were tinea corporis 29%, tinea cruris 23%, tinea pedis 16%, while in male patients it was 28%, 39% and 14% respectively. Only 4 species of dermatophytes were isolated. The prevailing ones were: Trichophyton rubrum 66%, T. mentagrophytes 15%, Epidermophyton floccorum 13% and Microsporum gypseum 6%.     

822例浅部真菌病及其致病菌种分析

目的分析新疆乌鲁木齐市浅部真菌病病原菌的流行趋势。方法对2006年1月～2013年12月就诊于我院皮肤科门诊、有典型临床表现、真菌镜检及培养均阳性的822例患者进行致病病种及菌种分析。使用SPSS17．0统计软件对于结果进行统计分析。结果822例患者包括8个病种：体癣214例（26．0％）,足癣131例（15．9％）,头癣128例（15．6％）,甲真菌病125例（15．2％）,股癣119例（14．5％）,手癣54例（6．6％）,皮肤念珠菌病38例（4．6％）,花斑糠疹13例（1．6％）。菌种分布以须癣毛癣菌为首位,336株（40．9％）,其次为红色毛癣菌共239株（29．1％）,犬小孢子菌68株（8．3％）,铁锈色小孢子菌48株（5．8％）,念珠菌38株（4．6％）,断发毛癣菌33株（4．0％）,许兰黄癣菌23株（2．8％）,马拉色菌13株（1．6％）,疣状毛癣菌9株（1．1％）,紫色毛癣菌7株（0．9％）,支顶孢霉菌4株（0．5％）,曲霉、絮状表皮癣菌各2株（各0．2％）。统计学分析显示：不同性别足癣、股癣、甲真菌病及花斑糠疹构成比有统计学意义（P〈0．05）,除体癣及花斑糠疹外,本组其他浅部真菌病的分布在年龄方面有着明显的差别（P〈O．05）。结论乌鲁木齐市浅部真菌病发病率排在前3位的依次为体癣、足癣、头癣,致病病原菌以毛癣菌为主,须癣毛癣菌为首位致病菌,其次为红色毛癣菌。足癣及甲真菌病好发于女性,而股癣及花斑糠疹好发于男性。除体癣及花斑糠疹外,不同年龄段浅部真菌病分布有明显差异,其中头癣主要好发于青少年。     

Epidemiology of Dermatophytoses in an Area South of Tehran,Iran

Dermatophyte infections have been considered to be a major public health problem in many parts of the world. The aim of this study was to identify the etiological and epidemiological factors of dermatophyte infections in an area south of Tehran. A total of 1254 patients suspected to have dermatophytic lesions were examined over a period of three years (1999-2001). Material collected from skin, hair, and nails was submitted to direct microscopic examination using KOH, cultured in Sabouraud dextrose agar and microscopically examined for colony morphology, in order to the identify the 169 dermatophytes isolated. The prevalence of dermatophytoses was 13.5% (95% CI: 11.7-15.5%). Their incidence was 10.6 per 100,000 person-years (95% CI: 8.5-13.2). Epiderophyton floccosum was the most frequent dermatophyte isolated (31.4%) followed by Trichophyton rubrum (18.3%), T. mentegrophytes (17.2%), T. violaceum (16.6%), Microsporum canis (6.5%), T. verrucosum (4.7%) and M. gypseum (4.1%). Epidermophytes floccosum was found to be the most common isolated dermatophyte in age groups 20-29 (30.2%). Tinea corporis (31.4%) was the most common type of infection, followed by tinea cruris (20.7%), tinea manuum (15.4%), tinea capitis (12.4%), tinea pedis (10.6%), tinea faciei (7.1%), and tinea unguium (2.4%). The frequency rate of all of the types of tinea was higher in males than in females. The anthrophilic species E. floccosum was the most common dermatophyte as a causative agent of tinea. The most prevalent fungal infection was tinea corporis caused by E. floccosum.     

Etiologic and epidemiologic study of dermatomycoses in Navarra (Spain)

We review the etiology of the dermatophytosis in Navarra (Spain) over a 5-year period and it is compared with previous studies. We have isolated 312 strains of dermatophyte fungi in 285 patients (188 men and 97 women). Trichophyton rubrum was the most frequently isolated species (58.6%) followed by Trichophyton mentagrophytes (26.2%) and Microsporum canis (10.5%). Concerning the location of the lesions, tinea pedis was the clinical pattern found in the greatest number of patients, followed by tinea corporis, tinea unguium and tinea capitis. Twenty eight percent of the isolations were accomplished in October and November. More than half of those patients questioned had had epidemiological contact with animals or practiced sports. The rise of tinea pedis in our region is emphasised. The possible causes of this increment are analyzed and some recommendations for its control are made.     

Analysis of Dermatomycoses in Lanzhou District of Northwestern China

The skin mycoses, perticularly dermatophytoses, in Lanzhou district, Northwestern China, was investigated during July 2002–June 2003. The specimens from patients suspected of having dermatomycoses were examined microscopically in KOH preparations and cultured on Sabouraud dextrose agar (SDA). Among 1443 suspected cases, 594 were KOH positive and 221 cultures of fungi were isolated. The most frequently isolated fungi were Trichophyton rubrum (43.9%) Trichophyton mentagrophytes (29.4%) and Candida species (14.0%). The frequency of tinea pedis, onychomycosis and tinea manuum were 38.7, 27.8 and 13.5%, respectively. In Lanzhou district, tinea pedis is the most commonly seen dermatophytoses, and T. rubrum is the most frequent etiologic agent.     

新型酮康唑喷膜对豚鼠体癣模型疗效的观察

目的 观察新型酮康唑喷膜对豚鼠体癣模型的疗效。方法 选择健康豚鼠20只,用穿刺法制备豚鼠体癣模型。将体癣模型随机分A组（新型酮康唑喷膜治疗组）,B组（喷膜基质治疗组）,C组（复方酮康唑霜治疗组）和D组（对照组）。根据豚鼠皮疹和真菌学检查进行疗效评估。结果 A组和C组的豚鼠治疗后局部红斑和水肿明显减轻,与治疗前比较有显著意义（P〈0．05）;停药2周时,A组和C组真菌镜检、培养阴性率均为100％,明显高于B和D组（P〈0．05）。结论 新型酮康唑喷膜对豚鼠体癣模型有良好的抗真菌活性。     

A study of 3891 cases of mycoses in the tropics.

4103 cases suspected of mycoses were analysed as to sex, age and site of disease and 3891 were proved cases. This group formed 50% of total mycoses or 13-93% of all dermatoses recorded in the Government General Hospital, Madras, during the period of study. There were 66-26% adult female, 27-6% adult male and 6-14% were below 13 years. Dermatophytoses were found in 73-5%; the other common diseases were tinea versicolor (17-68%) and candidiasis (12-43%). Multiple sites of involvement or more than 1 disease in the same individual were mostly observed. The incidence of piedra (0-1%) and deep mycoses (0-156%) was very low. Mycetoma was the common disease (5/6) in deep mycoses. In dermatophytoses, tinea corporis (49-71%) and tinea cruris (47-85%) commonest; tinea axillaris (3-42%), tinea capitis (1-72%) and tinea barbae (1-29%) were less common. The incidence of tinea manuum, tinea pedis and tinea unguium was similar (4-97%-6-38%). High temperature and humidity were related to the higher incidence of tinea corporis, tinea cruris and tinea versicolor. Mainly children suffered from tinea capitis. All other mycoses were commonly found in adults between 2nd and 3rd decades. In all mycoses but candidiasis, female predominated. Cutaneous candidiasis was mainly a problem of housewives. Among the dermatophytes Trichophyton violaceum was predominant (33-7%) followed by T. rubrum (32-6%). Trichophyton schoenleinii and M. gypseum were rarely isolated. From mycetoma, Madurella mycetomii, Nocardia braziliensis, N. asteroides and Actinomadura spp. were isolated. Demonstration of Cryptococcus laurentii in 1 case is reported in this area for the first time.     

足癣患者治疗现状调查

目的了解中国足癣患者的治疗现状,加强临床医生对相关诊治指南推荐方案的认知和理解。方法中国医师协会皮肤科医师分会组织全国9家医院进行中国足癣患者治疗现状问卷调查。结果共收集到问卷690份,结果显示我国足癣患者大多数选择自行购买外用抗真菌药物治疗,最常选用的外用药物为咪唑类药物,往往以瘙痒和／或皮疹消失作为停止治疗的依据,治疗最长时间中位数为2周,在治疗足癣的疗程上显示出明显不足。足癣患者常合并甲真菌病等其他皮肤癣菌病,同时其家庭成员患病率也较高,在治疗足癣患者的同时,应积极治疗其合并的其他皮肤癣菌病,也应同时对患者家庭成员进行治疗。结论本研究对更加有针对性地制定合理足癣预防和治疗方案并加强患者宣教具有重要作用。     

特比萘芬治疗顽固性手、足癣的临床疗效及安全性评价

目的评价特比萘芬治疗顽固性手、足癣的临床疗效及安全性。方法将120例患者随机分为实验组和对照组,实验组口服特比萘芬250mg,1次/d,联合外用特比萘芬乳膏,2次/d,连续3周;对照组患者仅外用特比萘芬乳膏2次/d,连续3周。停药2周后评价最终疗效和不良反应,停药4周后观察复发率。结果停药2周后,实验组患者的临床有效率为95%,真菌学清除率为95%,不良反应发生率为5%（主要为胃肠道反应）;对照组患者的临床有效率为40%,真菌学清除率为75%。停药4周后,实验组患者未见复发,对照组患者复发率为20%。结论口服特比萘芬联合外用特比萘芬乳膏治疗顽固性手、足癣是安全、有效的。     

Prevalence of Dermatophytoses in the Zarqa District of Jordan

A total of 350 clinically suspected cases of dermatomycoses were examined for causative fungi during July 1997 to September 1998. Mycotic infection was demonstrable by microscopy and culture in 199 (56.8%) cases. The most common superficial mycotic infections were tinea pedis (35.2%) followed by tinea capitis (23.1%), tinea unguium (21.6%) and tinea corporis (10.6%). Most of the infected patients were 1–9, 20–29 and 30–39 years old. Men were mainly infected with tinea cruris and tinea pedis, while women were infected with tinea pedis, tinea unguium and tinea capitis. The frequencies of etiological agents isolated from patients were as follows: Trichophyton mentagrophytes var. interdigitale (32.7%), T. rubrum (28.6%), Epidermophyton floccosum (20.1%), Microsporum canis (11.1%), T.schoenleinii (4%), T.verrucosum (2%), T.violaceum (1%), and M. gypseum (0.5%). The number of infections varied with the seasons. The highest number of cases of tinea pedis and tinea cruris occurred in the summer months, while tinea capitis, tinea corporis and tinea unguium occurred in the spring and winter months. This revised version was published online in June 2006 with corrections to the Cover Date.     

Dermatophytoses in Mexico

The dermatophytic infections are superficial mycoses common in Mexico, they have an estimated frequency of 5% in dermatological outpatients. In this review we present a global view of these mycoses as well as their etiological agents in tinea capitis, tinea pedis, tinea corporis, tinea cruris and onychomycosis and also uncommon infections such as tinea imbricata and epidermophytosis of the diaper area. We also analyze these infections in diabetic patients, healthy carriers and dermatophytic infections in pets and laboratory animals. The most important publications about dermatophytosis in Mexico in the dermatological, epidemiological or mycological area are reviewed, specially those published in the last ten years.     

中国基层医疗机构手癣和足癣诊治现状调查

目的了解基层医生有关手癣、足癣的诊治现状,分析影响因素,制定有针对性的措施。方法通过网络平台对全国19个省市的基层医生进行问卷调查。结果共回收完整问卷729份。结果显示:①约20%的基层医生对手、足癣的发病因素方面存在认识不足,约50%的基层医生对受侵犯皮肤的组织定位存在误区。②基层医生对手、足癣鉴别诊断的重要性重视不够,真菌镜检设备使用率不足一半。③基层医生能正确选用外用抗真菌药,硝酸咪康唑乳膏使用率超过80%。④仍有10.70%的基层医生推荐使用外用糖皮质激素治疗手、足癣。结论基层医生在手、足癣的规范诊疗方面仍有待提高。     

A study of dermatophytoses in Hamadan,the governmentship of West Iran

In order to determine the extent and causative agents of dermatophytoses in the Hamadan region of West Iran; a study was made during a 9-month period from October 1991 to June 1992. A total of 7495 individuals were studied of whom 681 (9%) were suspect of having cutaneous mycoses. Among them dermatophytoses were the commonest infections (259/681=38%). Of 259 individuals infected with dermatophytes, tinea capitis were observed in 163 (62.9%); t. corporis in 27 (10.4%); t. manuum and t. cruris in 19 (7.3%) each; t. barbae and faciei in 14 (5.4%); t. pedis in 13 (5%) and t. unguium in 4 (1.5%). A total of 144 patients yielded dermatophyte cultures. The frequency of the isolated species in decreasing order was as follows: Trichophyton verrucosum, 78 (54.1%); T. schoenleinii, 48 (33.3%); Microsporum canis, 8 (5.5%); Epidermophyton floccosum, 5 (3.5%); T. mentagrophytes and M. gypseum, 2 (1.4%) each; T. tonsurans, 1 (0.7%). In conclusion, the most prevalent dermatophytosis in this region was t. capitis with the infecting agent of T. schoenleinii.     

Griseofulvin in the treatment of dermatomycoses and onychomycoses produced by dermatophytes of the Trichophyton group

Summary Based on observations on the therapy of 128 patients affected with tinea unguium, tinea manus et pedis, tinea granulomatosa nodularis (Granuloma Majocchi), tinea cruris, tinea corporis, tinea barbae and tinea capitis due to infection with dermatophytes of theTrichophyton group, determinations were made for the absolute and relative indication of griseofulvin in the treatment of these mycoses. For each affection, comparisons were made between the therapeutic results obtained by combined therapy with oral griseofulvin (uniform daily dose 1 g for each case) and local therapy with 1 % water solution organic dyes, coal tar on the one hand, and mere local therapy as described above, on the other. For treatment, griseofulvin of different production was available: British Grisovin, Likuden and Likuden M from West-Germany, and Griseofulvin produced in the German Democratic Republic. No essential differences were found in the therapeutic effect of the individual preparations, the tolerance, however, was found to be best with Likuden. On the basis of comparisons made for the results of the individual methods of treatment, griseofulvin therapy was found to be an absolute indication of the mycotic diseases as follows: tinea capitis, tinea cruris follicularis trichophytica and tinea unguium. A relative indication was found to be tinea corporis, tinea barbae, tinea cruris, and tinea manus et pedis.All patients were subjected to microscopic and culture examination. The frequency of the individual dermatophytes was as follows:Trichophyton rubrum in 56 cases,Trichophyton verrucosum in 19 cases,Trichophyton mentagrophytes in 16 cases, andTrichophyton violaceum in 1 case. Thirty six cases showed negative cultures.In conclusion, the author recommends individual selection of patients for the griseofulvin therapy.     

Study of dermatophytoses in Lanzarote (1995-199)

We report on the incidence of dermatophytes isolated in Lanzarote island from June-95 to December-99. We gathered 76 samples. Tinea corporis was the most frequent (40.79%) condition, and after this, tinea pedis (26.31%). Trichophyton rubrum was the commonest agent isolated involving 52.63% of patients. We compare our results with other canarian studies, and with clinical patterns described in other spanish studies published in the 1990's. From these comparations we can deduce: a) The distribution of clinical pictures is not homogeneous among the papers, b) tinea corporis etiology is heterogeneous among the series and c) tinea pedis etiology is homogeneous in most of studies. We believe that the comparison by clinical forms avoids any bias due to distribution of clinical forms.     

Epidemiology of superficial mycosis (tinea pedis, onychomycosis) in elementary school children in Istanbul, Turkey

The purpose of this study is to determine the prevalence of tinea pedis and onychomycosis in children of elementary school age and to examine the socio-demographic attributes that may be effective in correlation of both mycoses. 3,390 female and 3,768 male children between ages 6-14 have been examined in seven schools. Skin scrapings and nail samples were taken from 13 students who were suspected to have tinea pedis and from 49 students who were suspected to have onychomycosis. According to direct microscopy (10-15% KOH+calcofluor white) and culturel examination (Sabouraud dextrose agar and dermatophyte test medium) 11 students were diagnosed as tinea pedis and 24 were diagnosed as onychomycosis. Trichophyton rubrum was isolated in 3 students with tinea pedis whose culture was positive and five Candida albicans, five Candida glabrata and one Candida tropicalis cases were isolated from 11 samples with onychomycosis. Tinea pedis prevalence has been found to be 3.3%0. Differences between onychomycosis prevalence based on age have been found to be significant (p < 0.001). In conclusion, it has been determined that the prevalence of tinea pedis and onychomycosis among children is low. Candida spp. was isolated from all of the 14 samples diagnosed as onychomycosis. Our study shows similar results with previous studies done in Turkey and that Trichophyton rubrum continues to be the most isolated agent.