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Background: Tinea pedis is one of the most prevalent superficial fungal infections. Initial antifungal treatment is often acquired over‐the‐counter (OTC) without previous consultation with a physician. Objective: Lately, increasing antifungal terbinafine resistance has been documented in Denmark and globally and it is therefore of interest to assess how Danish pharmacies advise customers with tinea pedis. Methods: One hundred Danish pharmacies were randomly selected and an employee interviewed from each. A structured question guide was followed, with the possibility to add further comments. Results: Interviews of 94 pharmacies were conducted. Six pharmacies never replied. Terbinafine as standard dose or cutaneous solution terbinafine one time application (Lamisil Once (R)) were recommended by 99% of the pharmacy employees as first‐line treatment. The customer was advised to seek medical attention when tinea pedis was recurring (93%), or when treatment duration was > 2 weeks (77%). The majority (88%) of the pharmacy employees had no knowledge about antifungal resistance. Conclusion: Only few pharmacy employees were aware of the current problem of antifungal resistance and the majority advised costumers to initiate treatment using OTC topical terbinafine. The problem of emerging antifungal resistance requires attention in order to provide customers with tinea pedis effective treatment and prevent further societal spread of resistance to antifungals. [ABSTRACT FROM AUTHOR]

Background. Сurrently, much attention is paid to the quality of patients, which is a promising direction of life, allowing to put a complete and objective picture of the disease, determine the most stable method of treatment, and evaluate its results. Aims. To evaluate the effectiveness of complex therapy in patients with onychomycosis and mycosis of the feet with concomitant non-alcoholic severe liver disease (NAFLD) using a modified questionnaire-questionnaire of the combined index of quality of life (QL-Index). Methods. The combined index of quality of life (QL-Index) was determined in patients with onychomycosis and mycosis of the feet with with concomitant NAFLD before and after complex therapy. Results. Analysis of the results of assessing the presence of a combined index of quality of life in 117 patients with onychomycosis and foot mycosis with concomitant NAFLD before treatment showed that the presence of onychomycosis and mycosis of the feet in the majority of respondents has a strong impact on the lives of the respondents (69.2%). After the complex treatment, according to the results of the combined questionnaire-questionnaire of the quality of life index, it was revealed that social activity in patients with onychomycosis and foot mycosis with concomitant NAFLD increased, and the psycho-emotional state improved. The quality of life of patients has improved, which significantly increased the effectiveness of this complex treatment. Conclusion. The high efficacy and safety of complex therapy, which included the use of the systemic antimycotic itraconazole in combination with external antifungal drugs, a hepatoprotector and a prebiotic in patients with onychomycosis and mycosis of the feet with concomitant NAFLD.

Background: Interdigital tinea pedis is the most common type of foot infection, which is often treated by topical or systemic antifungals. Due to the increase in antifungal resistance, antifungal socks are becoming potential alternatives for the daily management of tinea pedis. Methods: In this study, antifungal fibres were adopted to produce interdigital hygiene socks to split the third and fourth toe seams of the feet. In vitro antifungal activity was first examined to verify the effectiveness of the socks. Preventive efficacy against tinea pedis was then evaluated among healthy participants, followed by therapeutic effect detection in patients diagnosed with tinea pedis by analysing the improvement in total symptom scores (TTS). Results: The interdigital-type hygiene socks exhibited apparent antifungal activities in vitro. An in vivo study demonstrated significant preventive effects against tinea pedis for interdigital socks compared to plain socks (P = 0.011) and a lower TTS than noninterdigital (P = 0.04) or plain socks (P

The essential oils of aromatic and medicinal plants are an important resource used to control several health conditions; however, information about their composition and antimicrobial activity is scarce. This study used a gas chromatography-mass spectrometry (GC-MS) to analyze the composition of the essential oil (EO) of Tagetes lunulata Ort., a Mexican endemic plant, known as wild cempaxúchitl. The major components of the EO include: verbenone (47.17%), α-pinene (10.93%), 1,1,1-Trifluoro-2-hexanone (9.63%), β-caryophyllene (6.10%), germacrene-D (4.99%), L-verbenone (4.89%), and E-tagetone (4.44%). The disk agar diffusion method was used to evaluate the antimicrobial activity of T. lunulata against Trichophyton rubrum (athlete's foot). A significant antimicrobial activity was observed with a ≥60% EO concentration. The dilution method was used to determine the minimum inhibitory concentration (MIC): 200 µg ml-1. The T. lunulata EO recorded a strong antimicrobial activity against T. rubrum; therefore, it is a natural alternative for the control of natural antifungals. [ABSTRACT FROM AUTHOR]

Background: Tinea pedis is one of the most common superficial fungal infections of the skin, with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea pedis. Methods: A search was conducted in April 2023 in PubMed Clinical Queries using the key terms ‘tinea pedis’ OR ‘athlete’s foot’. The search strategy included all clinical trials, observational studies and reviews published in English within the past 10 years. Results: Tinea pedis is most often caused by Trichophyton rubrum and Trichophyton interdigitale. It is estimated that approximately 3% of the world population have tinea pedis. The prevalence is higher in adolescents and adults than in children. The peak age incidence is between 16 and 45 years of age. Tinea pedis is more common amongst males than females. Transmission amongst family members is the most common route, and transmission can also occur through indirect contact with contaminated belongings of the affected patient. Three main clinical forms of tinea pedis are recognized: interdigital, hyperkeratotic (moccasin-type) and vesiculobullous (inflammatory). The accuracy of clinical diagnosis of tinea pedis is low. A KOH wet-mount examination of skin scrapings of the active border of the lesion is recommended as a point-of-care testing. The diagnosis can be confirmed, if necessary, by fungal culture or culture-independent molecular tools of skin scrapings. Superficial or localized tinea pedis usually responds to topical antifungal therapy. Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis or in immunocompromised patients. Conclusion: Topical antifungal therapy (once to twice daily for 1–6 weeks) is the mainstay of treatment for superficial or localized tinea pedis. Examples of topical antifungal agents include allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate and amorolfine. Oral antifungal agents used for the treatment of tinea pedis include terbinafine, itraconazole and fluconazole. Combined therapy with topical and oral antifungals may increase the cure rate. The prognosis is good with appropriate antifungal treatment. Untreated, the lesions may persist and progress.

Allium cepa fractions have been shown to possess antifungal activity against Trichophyton rubrum. The antifungal effect of the plant is mainly attributed to the presence of Allicin. This study aims to formulate a topical antifungal gel and assess its physical stability and efficacy parameters against T. rubrum. The gel was formulated with various concentration of Allium cepa fractions FI (5%), F2 (7.5%), and F3 (12.5%). Each formulation was tested for physical stability and efficacy against T. rubrum. The agar well diffusion method was used to determine their antifungal activities using SDA plates. Furthermore, the antifungal activities were assessed by the presence or absence of inhibition zones after incubating the plates at 28°C for 7 days. The topical gel was a fawn-coloured homogenous semi-solid preparation that was readily spreadable upon skin contact with no tackiness sensation. The optimized gel showed no phase separation after the cycling test in six cycles (one cycle consists of temperatures of 4°C for 24 hours and 40°C for 24 hours). The efficacy test showed that the topical gel produced better inhibition zones against T. rubrum than the negative control. F3 (12.5%) showed the most inhibitory potentials of all the formulations (F1 and F2). These results demonstrate that Allium cepa fractions can be formulated into a stable semi-solid dosage form and with antifungal activity against T. rubrum. [ABSTRACT FROM AUTHOR]

Foot skin diseases are common problems encountered by dermatologists. They involve the skin and nails. In addition to the health aspect, there is also an aesthetic aspect, especially troublesome in the summer. It is recommended to visit a dermatologist with any disturbing skin lesion. The article presents an overview of the most common diseases in dermatology and podiatry offices.

Interdigital tinea pedis is the most common type of foot infection, which is often treated by topical or systemic antifungals. Due to the increase in antifungal resistance, antifungal socks are becoming potential alternatives for the daily management of tinea pedis. In this study, antifungal fibres were adopted to produce interdigital hygiene socks to split the third and fourth toe seams of the feet. In vitro antifungal activity was first examined to verify the effectiveness of the socks. Preventive efficacy against tinea pedis was then evaluated among healthy participants, followed by therapeutic effect detection in patients diagnosed with tinea pedis by analysing the improvement in total symptom scores (TTS). The interdigital-type hygiene socks exhibited apparent antifungal activities in vitro. An in vivo study demonstrated significant preventive effects against tinea pedis for interdigital socks compared to plain socks (P = 0.011) and a lower TTS than noninterdigital (P = 0.04) or plain socks (P < 0.0001). Moreover, interdigital socks showed a total effectiveness rate of 72.9% in patients with tinea pedis, with most of the symptoms alleviated. Interdigital-type hygiene socks not only exhibited in vitro antifungal activities but also showed significant prophylactic and therapeutic effects against interdigital tinea pedis in vivo. [ABSTRACT FROM AUTHOR]

Objective: To systematically review literature enabling the comparison of the efficacy of pharmaceutical treatments for tinea pedis in adults. Design: Systematic review of randomised controlled trials (RCTs) with mycological cure as the primary outcome. Secondary outcomes did include the clinical assessment of resolving infection or symptoms, duration of treatment, adverse events, adherence, and recurrence. Eligibility Criteria: Study participants suffering from only tinea pedis that were treated with a pharmaceutical treatment. The study must have been conducted using an RCT study design and recording age of the participant > 16 years of age. Results: A total of seven studies met the inclusion criteria, involving 1042 participants. The likelihood of resolution in study participants treated with terbinafine was RR 3.9 (95% CI: 2.0–7.8) times those with a placebo. Similarly, the allylamine butenafine was effective by RR 5.3 (95% CI: 1.4–19.6) compared to a placebo. Butenafine was similarly efficacious to terbinafine RR 1.3 (95% CI: 0.4–4.4). Terbinafine was marginally more efficacious than itraconazole, RR 1.3 (95% CI: 1.1–1.5). Summary/Conclusion: Topical terbinafine and butenafine treatments of tinea pedis were more efficacious than placebo. Tableted terbinafine and itraconazole administered orally were efficacious in the drug treatment of tinea pedis fungal infection. We are concerned about how few studies were available that reported the baseline characteristics for each treatment arm and that did not suffer greater than 20% loss to follow-up. We would like to see improved reporting of clinical trials in academic literature. Registration name: Treatment's for athlete's foot—systematic review with meta-analysis [CRD42020162078]. [ABSTRACT FROM AUTHOR]

Athlete's foot (Tinea pedis) and toe nails infection (onychomycosis) are disease conditions caused by dermatophytes; both diseases are prevalent in adults, especially in farmers who often wear robber shoes during farming. Proper treatment of dermatophytes related skin diseases needs a proper understanding of susceptibility of the causative agents to the intended treatment option. This knowledge can only be derived from proper identification and characterization of the related fungi. In the present study, both traditional and molecular identification approaches were applied on cultured samples for detection and identification of Tinea pedis. From the PCR analysis, Microsporum canis and Trichophyton mentagrophytes were identified as the two commonest species implicated in Tinea pedis basing on their DNA banding patterns. From the fifty two identified dermatophyte isolates via the conventional identification methods, only 45 isolates were confirmed via molecular approach, with 25 isolated being confirmed as M. canis while 20 isolates were T. mentagrophytes. The same was confirmed with real time PCR quantification. [ABSTRACT FROM AUTHOR]

Objective: To systematically review literature enabling the comparison of the efficacy of pharmaceutical treatments for tinea pedis in adults. Design: Systematic review of randomised controlled trials (RCTs) with mycological cure as the primary outcome. Secondary outcomes did include the clinical assessment of resolving infection or symptoms, duration of treatment, adverse events, adherence, and recurrence. Eligibility Criteria: Study participants suffering from only tinea pedis that were treated with a pharmaceutical treatment. The study must have been conducted using an RCT study design and recording age of the participant > 16 years of age. Results: A total of seven studies met the inclusion criteria, involving 1042 participants. The likelihood of resolution in study participants treated with terbinafine was RR 3.9 (95% CI: 2.0–7.8) times those with a placebo. Similarly, the allylamine butenafine was effective by RR 5.3 (95% CI: 1.4–19.6) compared to a placebo. Butenafine was similarly efficacious to terbinafine RR 1.3 (95% CI: 0.4–4.4). Terbinafine was marginally more efficacious than itraconazole, RR 1.3 (95% CI: 1.1–1.5). Summary/Conclusion: Topical terbinafine and butenafine treatments of tinea pedis were more efficacious than placebo. Tableted terbinafine and itraconazole administered orally were efficacious in the drug treatment of tinea pedis fungal infection. We are concerned about how few studies were available that reported the baseline characteristics for each treatment arm and that did not suffer greater than 20% loss to follow-up. We would like to see improved reporting of clinical trials in academic literature. Registration name: Treatment’s for athlete’s foot—systematic review with meta-analysis [CRD42020162078].

Fungal infections are invasive infection that may be life threatening. Most of the infection caused in nail, skin, and hair. But common skin infections were caused by dermatophytes, including Trichophyton rubrum and T. tonsurans and canis of microsporum with various symptoms, risk factors were treated by using topical agents and oral agents. To overcome various limitations arises from the traditional dosage form nanotechnology methods were used by using the various nanocarriers mainly nano emulsion gel were focused to produce better effectiveness and safety to avoid some risk factors in the management of athlete's foot fungal infection. More number of nanotechnology methods were used in various fungal infection to provide better usage and reduce the side effects caused by the various fungal pathogen. This review mainly focuses on different nanotechnological approaches which include solid lipid nanoparticles, microspheres, liposome, niosomes, micro-emulsions, nano-emulsions. [ABSTRACT FROM AUTHOR]

This article is aimed at providing a succinct overview of the condition tinea pedis, commonly referred to as athlete’s foot. Tinea pedis is a very common fungal infection that affects a significantly large number of people globally. The presentation of tinea pedis can vary based on the different clinical forms of the condition. The symptoms of tinea pedis may range from asymptomatic, to mild-to-severe forms of pain, itchiness, difficulty walking and other debilitating symptoms. There is a range of precautionary measures available to prevent infection, and both oral and topical drugs can be used for treating tinea pedis. This article briefly highlights what athlete’s foot is, the different causes and how they present, the prevalence of the condition, the variety of diagnostic methods available, and the pharmacological and non-pharmacological management of the condition.

Les sportifs constituent une population particulièrement exposée aux infections fongiques. Ces mycoses, qui se localisent préférentiellement au niveau des pieds, sont dues à trois dermatophytes à transmission interhumaine retrouvés sur les sols des piscines, des vestiaires ou sur les tatamis. Ces infections deviennent souvent chroniques, ce qui explique le caractère récidivant des lésions. Des conseils et des mesures de prophylaxie individuelles et collectives s'imposent pour en venir à bout. Athletes are particularly susceptible to fungal infections. These mycoses, which are located most frequently on the feet, are due to three dermatophytes transmitted from person-to-person and found on swimming pool, changing room or dojo floors. These infections often become chronic, which explains the recurring nature of the lesions. Advice and individual and collective preventive measures are necessary to eradicate it. [ABSTRACT FROM AUTHOR]

Tinea pedis is a common condition seen in clinical practice and has a significant impact on quality of life. Recommendations of over-the-counter antifungal products based on consumer preferences may guide dermatologists in treating patients with tinea pedis and preventing onychomycosis recurrences. Our study aimed to determine consumer preferences of antifungal products for tinea pedis, focusing on features that may guide purchases and usage. A search was performed for antifungal products used to treat athlete's foot on Amazon.com as of 2018, and the top one percentile of over-the-counter products were sorted by rating and number of reviews. Functionality was the most cited positive feature (42% of comments) followed by cosmetic characteristics (14%). The median price of all products was $1.80 (range $0.33–$95.42), with solutions and balms associated with higher costs and soaks being the least expensive. Our study showed that the range of antifungal products available online for treatment and prevention of tinea pedis is large and variable in terms of type/vehicle, price, and ingredients. Physicians must counsel patients on the efficacy and Food and Drug Administration approval of listed ingredients, especially for those products associated with numerous supplementary claims. [ABSTRACT FROM AUTHOR]

This article is aimed at providing a succinct overview of the condition tinea pedis, commonly referred to as athlete's foot. Tinea pedis is a very common fungal infection that affects a significantly large number of people globally. The presentation of tinea pedis can vary based on the different clinical forms of the condition. The symptoms of tinea pedis may range from asymptomatic, to mild-to-severe forms of pain, itchiness, difficulty walking and other debilitating symptoms. There is a range of precautionary measures available to prevent infection, and both oral and topical drugs can be used for treating tinea pedis. This article briefly highlights what athlete's foot is, the different causes and how they present, the prevalence of the condition, the variety of diagnostic methods available, and the pharmacological and non-pharmacological management of the condition. [ABSTRACT FROM AUTHOR]

Background/Objectives Footwear dermatitis is a form of contact dermatitis resulting from exposure to shoes. There have been only small studies regarding foot contact dermatitis in children. The present study was undertaken to define the prevalence and epidemiologic and clinical features of shoe dermatitis in children. Methods A retrospective study was undertaken of all children referred for patch testing between 1996 and 2015. Children with dermatitis limited to the feet were selected. Results We collected data from 389 children younger than 16 years, 52 of whom (13.4%) were referred with dermatitis exclusively on the feet. Diagnosis after patch testing was allergic contact dermatitis in 23 children (44.2%), atopic eczema in 12 (23.1%), juvenile plantar dermatosis in 8 (15.4%), dyshidrotic eczema in 6 (11.5%), irritant contact dermatitis in 2 (3.8%), and tinea pedis in 1 (1.9%). The most frequent allergens were potassium dichromate, thimerosal, cobalt chloride, mercapto mix, colophonium, mercury, and nickel( II) sulfate. Conclusion Allergic contact dermatitis caused by footwear is a common cause of foot dermatitis in children. Children with foot dermatitis should be referred for patch testing when an allergic origin is suspected. [ABSTRACT FROM AUTHOR]

Background: The unique health care needs of the homeless population have been well-documented in the literature. However, fewer studies are available assessing the prevalent dermatologic conditions that impact this population. Objective: The purpose of our study was to assess the frequency of dermatologic conditions occurring in a shelter-based homeless population, to understand patient demographic characteristics, and determine the suspected skin malignancy rate. Methods: We completed a retrospective chart review of patients seen at the free dermatology clinic held at the South Park Inn (SPI) homeless shelter in Hartford. Two-hundred-seventy-three patient paper charts from August 2008 to February 2016 were reviewed. Results: The most common dermatologic conditions included acne vulgaris (18.7%), atopic dermatitis (10.6%), tinea pedis (9.2%), xerosis (8.1%), and folliculitis (5.1%). The rate of suspected skin malignancies in this population was 2.5%. Conclusions: Some of our findings mirror the frequency of dermatologic conditions identified in sheltered homeless populations in previous studies. Differences seen may be attributed to geographic and demographic variability. The suspected skin cancer rate, which has been rarely studied, is of particular interest due to this population's risk for chronic sun exposure, lack of consistent sunscreen use, and poor access to dermatologic screening, and should be more thoroughly investigated in future studies. [ABSTRACT FROM AUTHOR]

Introduction: Birth rates are not only declining worldwide but people are also living longer. Despite the growing elderly population, there are limited numbers of studies on this population residing in nursing homes. We aimed to determine the prevalence of skin diseases in elderly residing in nursing homes in Southwest Anatolia, and to contribute to the development of preventive healthcare for these diseases. Materials and Method: We conducted a cross-sectional trial in two nursing homes located in the central province of Mugla. A questionnaire, including questions on sociodemographic characteristics, diagnosis of any dermatological diseases, and clinical history, was administered to the elderly patients. Results: Of the 105 elderly patients, 64 (61.0%) were males and 41 (39.0%) were females. Lentigo was identified as the most common skin disease (90.5%). Xerosis (78.1%), senile angioma (61.0%), and tinea unguium (59.0%) was followed lentigo respectively. Five (4.8%) elderly patients had decubitus ulcers. A significant difference was detected in the occurrence of tinea pedis, and decubitus ulcers (p=0.032 and p=0.000, respectively) in these patients compared with ambulatory patients. Conclusion: This study is thought to be among the pioneer researches evaluating the prevalence of skin diseases in the elderly patients residing in nursing homes in Southwest Anatolia. The information obtained should contribute to epidemiological data to determine the prevalence of skin diseases observed in the elderly population in nursing homes in this area. This knowledge may lead to the improvement of measures for preventing skin diseases in these patients. [ABSTRACT FROM AUTHOR]

Background Diabetes patients are particularly susceptible to fungal infections because their vascular and immunological systems are compromised. Objectives The present study aimed to determine prevalences of tinea pedis and onychomycosis, factors predisposing to their development, and antifungal susceptibilities of causative fungal species against fluconazole, itraconazole, and terbinafine in patients with type 2 diabetes mellitus ( DM). Methods Study groups were defined according to hemoglobin A1C rates of ≥6.5% for the diabetes group and ≤5.7% for control subjects. A total of 600 diabetes subjects and 152 control subjects were evaluated. Rates of onychomycosis and tinea pedis in diabetes patients, and associations with age, gender, blood glucose level, duration of diabetes and serum lipid profile were investigated, as were the distribution and antifungal susceptibility of agents isolated. Results Patients with onychomycosis and/or tinea pedis numbered 85 in the diabetes group and nine in the control group ( P = 0.006). The development of onychomycosis or tinea pedis was significantly related to increasing age and male gender. Although the most common agents were dermatophytes, non-dermatophyte fungal isolates were not uncommon. Terbinafine was the most effective drug against dermatophytes but was invalid for non-dermatophyte isolates by in vitro antifungal susceptibility testing. Conclusions The development of onychomycosis or tinea pedis was significantly related to type 2 DM, increasing age, and male gender. The most common isolate was Trichophyton rubrum. The isolation and identification of the fungus is important to the effective management of tinea pedis and onychomycosis in diabetes patients because non-dermatophyte fungi can cause these infections. [ABSTRACT FROM AUTHOR]

Background: Tinea pedis is one of the most common superficial fungal infections of the skin, with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea pedis., Methods: A search was conducted in April 2023 in PubMed Clinical Queries using the key terms 'tinea pedis' OR 'athlete's foot'. The search strategy included all clinical trials, observational studies and reviews published in English within the past 10 years., Results: Tinea pedis is most often caused by Trichophyton rubrum and Trichophyton interdigitale . It is estimated that approximately 3% of the world population have tinea pedis. The prevalence is higher in adolescents and adults than in children. The peak age incidence is between 16 and 45 years of age. Tinea pedis is more common amongst males than females. Transmission amongst family members is the most common route, and transmission can also occur through indirect contact with contaminated belongings of the affected patient. Three main clinical forms of tinea pedis are recognized: interdigital, hyperkeratotic (moccasin-type) and vesiculobullous (inflammatory). The accuracy of clinical diagnosis of tinea pedis is low. A KOH wet-mount examination of skin scrapings of the active border of the lesion is recommended as a point-of-care testing. The diagnosis can be confirmed, if necessary, by fungal culture or culture-independent molecular tools of skin scrapings. Superficial or localized tinea pedis usually responds to topical antifungal therapy. Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis or in immunocompromised patients., Conclusion: Topical antifungal therapy (once to twice daily for 1-6 weeks) is the mainstay of treatment for superficial or localized tinea pedis. Examples of topical antifungal agents include allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate and amorolfine. Oral antifungal agents used for the treatment of tinea pedis include terbinafine, itraconazole and fluconazole. Combined therapy with topical and oral antifungals may increase the cure rate. The prognosis is good with appropriate antifungal treatment. Untreated, the lesions may persist and progress., Competing Interests: Disclosure and potential conflicts of interest: AKCL and KLH are associate editors of Drugs in Context and confirm that this article has no other conflicts of interest otherwise. This manuscript was sent out for independent peer review. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2023/06/dic.2023-5-1-COI.pdf, (Copyright © 2023 Leung AKC, Barankin B, Lam JM, Leong KF, Hon KL.)

Tinea pedis and onychomycosis often co-occur in individuals. A relationship between swimming pools and tinea pedis exists; however, little research has investigated the relationship between onychomycosis, tinea pedis, and swimming pools. This study sought to examine the prevalence of tinea pedis and onychomycosis among swimming pool employees, a population that may be at risk of tinea infections. Samples were taken from 169 employees at 21 swimming pools in the Netanya area, Israel. KOH microscopy and culture was used to identify fungi. About 46 % of swimming pool employees had concurrent tinea pedis and onychomycosis, 30 % had tinea pedis only, and 6 % had onychomycosis only, compared to 10, 8, and 8 % of controls, respectively. After adjusting for age and gender, swimming pool employees were 20× more likely to have concurrent tinea pedis and onychomycosis, 15× more likely to have tinea pedis only, and 3× more likely to have onychomycosis only compared to controls. The present results are in agreement with previous research and support that swimming pools remain an important source of fungal contamination. More attention to hygienic guidelines and preventative measures may be needed in these settings. [ABSTRACT FROM AUTHOR]

Purpose: To study the effect of balm for oily skin and body «Aysida» in the treatment mikozovu elderly.Materials and Methods: We observed 60 patients with mycosis stop between the ages of 60 to 78 years (49 women and 11 men). Disease duration ranged from 1 year to 3.5 years. Patients observed by blind samples were classified into two groups of 30 people. All patients received conventional systemic therapy. Group 1 patients received systemic therapy and external specific therapy (terbinafine cream topically 2 p / day). As an added emollients officinal ointment dexpantenol 2 p / day. Patients 2 groups to the system and the external specific therapy added medical cosmetic series Aysida «- a balm for oily skin and body. Treatment efficacy was assessed clinically and by means of microscopic research method.Results: Group 1 patients expressed therapeutic effect was observed in 69% after 10 days of starting treatment. In group 2 the efficiency was 82%. In patients 2 groups, along with a more pronounced positive dynamics, showed a significant decrease feelings of tightness, dryness and discomfort, peeling termination from the first week of treatment. Clinical manifestations completely resolved by day 14 of therapy, microscopic fungi were not detected in all patients on day 21 of treatment.Summary: there was a high therapeutic efficacy and good cosmetic effect cosmetic balm «Aysida» for problem skin and body in the complex therapy of fungal infections on background xerosis in the elderly.

Objective: Impaired cellular immunity and reduced phagocytic function of polymorphonuclear leukocytes facilitate the development of skin fungal and bacterial infections due to uncontrolled hyperglycemia in diabetic patients. In our study, we aimed to assess onychomycosis and/or tinea pedis frequency in diabetic patients, and effects on the development of chronic complications, particularly foot ulcer. Methods: We included 227 diabetic patients in the study. Forty-three patients had diabetic foot ulcer. We screened and recorded demographic characteristics, HbA1c levels of patients, and presence of complications We examined patients dermatologically, and collected samples by scalpel from skin between toes, and from sole, toe nail, and area surrounding nails from suspected to have fungal infection. Results: Native positivity between toes was higher in men compared to women (p<0.05). We obtained significant relation between HbA1c elevation and native positivity between toes (p<0.05). Fungal infection between toes, at sole and toe nail significantly increased in patients with diabetic foot ulcer compared to patients without diabetic foot ulcer (p<0.05). Moreover, native positivity in patients with diabetic foot ulcer correlated with presence of fungal infection examination findings (p<0.05). Conclusion: Fungal infections were more frequently observed in the presence of poor glycemic control and peripheral vascular disease in diabetic patients in compliance with the literature, and the presence of fungal infection may also responsible for the development of foot ulcers. [ABSTRACT FROM AUTHOR]

Topical treatment for toenail onychomycosis has been fraught with a long-standing reputation of poor efficaey, primarily due to physical properties of the nail unit that impede drug penetration. Newer topical agents have been formulated as Solution, which appear to provide better therapeutic response in properly selected patients. It is important to recognize the impact the effects that mitigating and concomitant factors can have on efficaey. These factors include disease severity, gender, presence of tinea pedis, and diabetes. This article reviews results achieved in Phase 3 pivotal studies with topical efinaconazole 10% Solution applied once daily for 48 weeks with a focus on how the aforementioned factors influenced therapeutic outcomes. It is important for clinicians treating patients for onychomycosis to evaluate severity, treat concomitant tinea pedis, address control of diabetes if present by encouraging involvement of the patient's primary care physician, and consider longer treatment courses when clinically relevant. [ABSTRACT FROM AUTHOR]

Athlete's foot is a fungal infection of the foot which causes dry, itchy, flaky condition of the skin caused by Trichophyton species. In this study, the potential of ultra-small nanostructured lipid carrier (usNLC)-based topical gel of miconazole nitrate for the treatment of athlete's foot was evaluated. Nanostructure lipid carriers (NLCs) prepared by melt emulsification and sonication technique were characterized for particle size, drug entrapment, zeta potential and drug release. The optimized usNLC revealed particle size 53.79 nm, entrapment efficiency 86.77 %, zeta potential −12.9 mV and polydispersity index (PDI) of 0.27. The drug release studies of usNLC showed initial fast release followed by sustained release with 91.99 % drug released in 24 h. Optimized usNLCs were incorporated into carbopol-934 gel and evaluated for pH (6.8), viscosity (36,400 mPa s) and texture analysis. Antifungal activity against Trichophyton mentagrophytes exhibited wider zone of inhibition, 6.6 ± 1.5 mm for optimized usNLC3 gel viz-à-viz marketed gel formulation (3.7 ± 1.2 mm). Hen's egg test-chorioallantoic membrane (HET-CAM) irritation test confirmed optimized usNLC gel to be non-irritant to chorioallantoic membrane. Improved dermal delivery of miconazole by usNLC gel could be achieved for treatment of athlete's foot. [ABSTRACT FROM AUTHOR]

Background: Tinea pedis (TP) is an infection of the feet caused by fungi. The infectious diseases caused by dermatophytes are mainly related to the enzymes produced by these fungi. Up to the now, the local 8-iso-prostaglandin F2α (8-iso-PGF2α), concentration as oxidative stress biomarker and trace elements status have not been published in patients with TP. The aim of this study is to evaluate the relationship between oxidative stress and trace elements (Cu, Zn, Se), and to evaluate the ratios of Cu/Zn and Cu/Se in this disorder. Methods: Forty-three consecutive patients with a diagnosis of unilateral interdigital TP were enrolled in this study. The samples were obtained by scraping the skin surface. 8-iso-PGF2α concentrations in scraping samples were determined by ELISA. In addition, the levels of Se, Zn and Cu in scraping samples were determined on flame and furnace atomic absorption spectrophotometer using Zeeman background correction. Results: Oxidative stress was confirmed by the significant elevation in 8-iso-PGF2α concentrations (p < 0.05). When compared to non-lesional area, Zn and Se levels were significantly lower on lesional area, whereas Cu levels was higher on the lesional area than the non-lesional area (p < 0.05). In addition, the correlation results of this study were firstly shown that there were significant and positive correlations between Cu and 8-iso-PGF2α parameters, but negative correlations between Se-Cu; Se-8-iso-PGF2α parameters in lesional area. Furthermore, the ratios of Cu/Zn and Cu/Se were significantly higher on the lesional area than the non-lesional area (p<0.05). According to sex and fungal subtypes, there was no significant difference in the concentrations of 8-iso-PGF2α and trace elements in patients with TP (p > 0.05). Conclusions: Our results showed that there is a possible link between oxidative stress (increased 8-iso-PGF2α concentrations) and imbalanced of trace elements status in lesional area of TP patients. The use of antifungal agents together with both Zn and Se drugs could be helpful in the both regression of disease and in shortening the duration of disease. [ABSTRACT FROM AUTHOR]

Luliconazole is a novel imidazole derivative, which has demonstrated in vitro efficacy against dermatophytes and Candida. The results from Phase III trials show that luliconazole 1% cream applied once daily for 2 weeks successfully resolved the clinical signs and symptoms as well as eradicated the pathologic fungi, which cause tinea pedis. A 1-week treatment with luliconazole 1% cream also produced favorable clinical and mycological results in clinical trials for tinea corporis and tinea cruris. Across trials, adverse events consisted mainly of localized reactions following application. The development of a new antifungal agent is timely due to mounting resistance among existing treatments. Because luliconazole requires a short duration of treatment, it may assist in reducing disease recurrence as a result of patient nonadherence. [ABSTRACT FROM AUTHOR]

The prevalence of onychomycosis differs according to geographic area and over time and is influenced by several factors. The epidemiology of onychomycosis in Italy is still unclear. To evaluate the prevalence of onychomycosis in a representative sample of the Italian population a group of Dermatologists and General Practitioners carried out an observational survey on the patients coming to their office during a 1-month period. Any patient with skin or systemic disease giving their consent was enrolled. Demographic characteristics, comorbidities, lifestyles, history of previous mycosis, clinical aspects of onychomycosis and mycological evaluation were studied. A total of 8331 patients (56.7% female and 43.3% male) were evaluated. More than half of them were aged ≥46 years. Onychomycosis was diagnosed in 14.2% of patients. Big toe and thumb were the most frequently affected nails. Onychomycosis was moderate-severe in 74.1% of the cases. Mycological tests were positive in 81.3% of the cases. Dermatophytes were found in 76.6% of the cases, yeasts in 17.2% and moulds in 6.3%. Risk factors and/or comorbidities were present in 68.2% of the cases. This survey showed a 14% prevalence of onychomycosis in the evaluated population. The main risk factors were previous onychomycosis, diabetes, hallux valgus and use of occlusive footwear. [ABSTRACT FROM AUTHOR]

Background. Dermatophytosis is common worldwide and continues to increase. Objective. This study was undertaken to determine the prevalence of dermatophytosis and the spectrum of ringworm fungi in patients attending a tertiary hospital. Methods. Samples were collected from 305 patients. A portion of each sample was examined microscopically and the remaining portion of each sample was cultured onto plates of Sabouraud’s dextrose agar containing chloramphenicol with and without cycloheximide. Dermatophyte isolates were identified by studying macroscopic and microscopic characteristics of their colonies. Result. Of 305 samples, fungi were detected in 166 (54.4%) by KOH of which 95 were dermatophytes while 242 (79.4%) samples were culture positive of which 130 isolates were dermatophytes. Among dermatophyte isolates T. violaceum was the most common (37.7%) cause of infection. Tinea unguium was the predominant clinical manifestation accounting for 51.1% of the cases. Patients with age group 25–44 and 45–64 years were more affected. T. violaceum was the most common pathogen in tinea unguium and tinea capitis, whereas T. mentagrophytes was the most common pathogen in tinea pedis. Conclusion. Further intensive epidemiological studies of ring worm fungus induced dermatophytosis which have public health significance are needed. [ABSTRACT FROM AUTHOR]

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Tinea pedis, which is a dermatophytic infection of the feet, can involve the interdigital web spaces or the sides of the feet and may be a chronic or recurring condition. The most common etiological agents are anthropophiles, including Trichophyton rubrum sensu stricto, which is the most common, followed by Trichophyton interdigitale and Epidermophyton floccosum. There has been a change in this research arena, necessitating a re-evaluation of our knowledge on the topic from a multidisciplinary perspective. Thus, this review aimed to provide a solid overview of the current status and changing patterns of tinea pedis. The second half of the twentieth century witnessed a global increase in tinea pedis and a clonal spread of one major etiologic agent, T. rubrum. This phenomenon is likely due to increases in urbanization and the use of sports and fitness facilities, the growing prevalence of obesity and the aging population. For optimal patient care and management, the diagnosis of tinea pedis should be verified by microbiological analysis. In this review, we discuss the epidemiology, clinical forms, complications and mycological characteristics of tinea pedis and we highlight the pathogenesis, prevention and control parameters of this infection. [ABSTRACT FROM AUTHOR]

To derive a form of treatment forTinea pedis(also known as athlete’s foot), an attempt has been made to synthesize chitosan microcapsules that contain an antifungal agent using a coacervation technique. The antifungal agent, namely, clotrimazole, is encapsulated in different amounts: 25, 50, 75, and 100?mg. Optical and scanning electron microscopies demonstrate that the newly developed microcapsules have spherical core–shell forms with smooth surfaces and the particle sizes range from 2 to 10??m. It is observed that chitosan microcapsules with a drug input of 25?mg clotrimazole show the highest encapsulation efficiency when compared with microcapsules that have 50, 75, and 100?mg of drug input. An analysis of thein vitroantifungal activity confirms that the chitosan/clotrimazole microcapsules show obvious inhibition ofTrichophyton rubrumgrowth. The cytotoxicity results show that the newly developed microcapsules are non-cytotoxic to skin cell lines. The prepared drug-loaded microcapsules could be applied onto bandages or socks, and will continuously release antifungal drugs in a controlled manner under pressure. [ABSTRACT FROM AUTHOR]

Tinea pedis (TP) may lead to the development of foot ulcers in diabetic patients; thus, its prevention in diabetic patients is important. TP occurs after dermatophytes on the skin scales of TP patients attach to the feet. Therefore, it is necessary to remove the scales and dermatophytes, and this can be performed using various methods, including foot washing. This study aimed to objectively examine the association between the presence of TP and foot-washing habits. We included 33 diabetic patients, and, of these, 17 had TP. The presence of washing residue on the feet was determined by applying a fluorescent cream to the participants’ feet, and images of the feet were captured under ultraviolet light before and after foot washing. Our results showed that diabetic patients with TP had higher levels of washing residue on their feet than those without TP. The importance of washing feet to prevent TP needs to be emphasized through educational programs for diabetic patients. Furthermore, the development of an effective foot-washing technique is essential. [ABSTRACT FROM AUTHOR]

The article focuses on a study on the efficiency of a sanitizing technique to decrease bacterial and fungal population from athletes' footwear. It reports that the procedure of sanitizing athletes footwear was successful as it reduced the microbial load in the footwear. It further states that there were reductions in the colony forming units of Staphylococcus spp, Enterococcus spp, E.coli and yeast. It also mentions that the Cyberclean used for disinfection was effective.

Background Tinea pedis is a commonly encountered dermatophytic infection with a clinical prevalence of 15-25%. Limited studies have evaluated the prevalence of occult tinea pedis. Objectives The aims of this study were to evaluate the prevalence of occult tinea pedis in asymptomatic subjects with feet that appeared healthy and to identify possible related risk factors. Methods A prospective study of 221 asymptomatic subjects with apparently normal feet was conducted. All subjects completed a questionnaire covering anamnestic details (personal and family histories of tinea pedis, preferred footwear) and were examined for foot odor and the clinical presence of tinea pedis and onychomycosis. Samples were taken from the foot for direct microscopic examination and culture. Results Among the 221 patients, 31 (14.0%) were positive for occult tinea pedis. Positive cultures from both the anterior and posterior aspects of the foot were obtained in 22 patients. The most common pathogen isolated was Trichophyton rubrum. Strong correlations emerged between occult tinea pedis and characteristics such as male gender, foot odor, previous personal and family histories of tinea pedis, and clinical and mycological evidence of onychomycosis. No significant associations were found between occult tinea pedis and age or preferred footwear. Conclusions The prevalence of occult tinea pedis is similar to that of clinical tinea pedis. This may imply that patients with subclinical infection carry a risk for transmitting disease similar to that of clinical carriers. This is of great importance in the prevention and management of the disease as high-risk asymptomatic carriers can be identified. [ABSTRACT FROM AUTHOR]

The study aims to statistically develop a microemulsion system of an antifungal agent, itraconazole for overcoming the shortcomings and adverse effects of currently used therapies. Following preformulation studies like solubility determination, component selection and pseudoternary phase diagram construction, a 3-factor D-optimal mixture design was used for optimizing a microemulsion having desirable formulation characteristics. The factors studied for sixteen experimental trials were percent contents (w/w) of water, oil and surfactant, whereas the responses investigated were globule size, transmittance, drug skin retention and drug skin permeation in 6 h. Optimized microemulsion (OPT-ME) was incorporated in Carbopol based hydrogel to improve topical applicability. Physical characterization of the formulations was performed using particle size analysis, transmission electron microscopy, texture analysis and rheology behavior. Ex vivo studies carried out in Wistar rat skin depicted that the optimized formulation enhanced drug skin retention and permeation in 6 h in comparison to conventional cream and Capmul 908P oil solution of itraconazole. The in vivo evaluation of optimized formulation was performed using a standardized Tinea pedis model in Wistar rats and the results of the pharmacodynamic study, obtained in terms of physical manifestations, fungal-burden score, histopathological profiles and oxidative stress. Rapid remission of Tinea pedis from rats treated with OPT-ME formulation was observed in comparison to commercially available therapies (ketoconazole cream and oral itraconazole solution), thereby indicating the superiority of microemulsion hydrogel formulation over conventional approaches for treating superficial fungal infections. The formulation was stable for a period of twelve months under refrigeration and ambient temperature conditions. All results, therefore, suggest that the OPT-ME can prove to be a promising and rapid alternative to conventional antifungal therapies against superficial fungal infections. [ABSTRACT FROM AUTHOR]

Purpose: To isolate and identify the chemical components of Paraoncidium reevesii. Methods: Silica gel column chromatography was used to isolate the components from petroleum ether and ethyl acetate fractions of the acetone extract, and the structures of the compounds were derived from ¹H-nuclear magnetic resonance (¹H-NMR), 13C-nuclear magnetic resonance (13C-NMR) and mass spectrometry (MS) analyses and also with the aid of literature data for authenticated samples. Results: Cholesterol (1), baconipyrone D (2), chimyl alcohol (3), batyl alcohol (4), a-monpalmitin (5), stearic acid (6), 3-indolecarboxylic acid (7), uracil (8), thymine (9), uridine (10), thymidine (11) were isolated from the marine slug (Paraoncidium reevesii). Conclusion: All the isolated compounds are being reported here for Paraoncidium reevesii for the first time. The results provide base data for further study of the Onchidiidae as a Chinese traditional remedy for asthma and athlete's foot. [ABSTRACT FROM AUTHOR]