Fungal infections dermatophyte

The most widespread are dermatophytic fungal infections, which include skin, hair, and nails. Most infections can be cured by using topical drugs, such as tolnaftate, undecylenic acid, haloprogin, clotrimazole, and miconazole. Griseofulvin is used orally for deep infections, in particular for infections of the nail bed. Currently, ketoconazole is widely used for treating chronic dermatophytes. 

Itraconazole (Sporanox), a triazole, is highly lipophilic and concentrates in skin. It is approved for both cutaneous deep fungal infections and dermatophyte nail disease, for which shorter courses of therapy are probably effective. Pulse therapy, whereby the drug is administered for 1 week and then the patient is off treatment for 3 weeks between pulses, may reduce toxicity without compromising antifungal efficacy. 

The treatment of superficial fungal infections caused by dermatophytic fungi may be accomplished (1) with topical... 

Miconazole is an alternative. Clotrimazole is an effective topical agent for dermatophyte, yeast, and other fungal infections (intertrigo, athlete s foot, ringworm, pityriasis versicolor, fungal nappy rash). 

Fungal infections superficial dermatophyte or Candida infections purely involving the skin can be treated with a topical imidazole (e.g. clotrimazole, miconazole). Pityriasis versicolor, a yeast infection, primarily involves the trunk m young adults it responds poorly to imidazoles but topical terbinafine or selenium sulphide preparations are effective severe infection may require systemic itraconazole. Invasion of hair or nails by a dermatophyte or a deep mycosis requires systemic therapy terbinafine is the most effective drug. Terbinafine and griseo-fulvin are ineffective against yeasts, for which itraconazole is an alternative. Itraconazole can be used in weekly pulses each month for 3-4 months it is less effective against dermatophytes than terbinafine. 

Dermatophyte is the term applied to a range of fungi capable of colonizing the skin, nails or hair. The principal dermatophytic fungi are Trichophyton, Microsporum and Epidermophyton species. The most commonly encountered dermatophytic infections are athlete s foot (infection of the foot) and ringworm (fungal infection of the scalp or skin). 

Athlete s foot is the commonest of a group of topical fungal infections (see Chapter 28) caused by dermatophytes, organisms that invade and proliferate on the outermost horny layer (stratum corneum) of the skin, hair and nails. They do not normally penetrate deeper into the skin or tissues. Dermatophytes tend to thrive in areas of the body that are occluded and moist. 

Topical fungal infections are mostly caused by dermatophytes, organisms that invade and proliferate on the outermost, horny layer (stratum corneum) of the... 

Organisms called dermatophytes cause the majority of superficial fungal infections of the skin, hair and nails. The most common dermatophytes that infect humans belong to... 

Onychomycosis Fungal infection of the nails is caused most frequently by dermatophytes and Candida. Mixed infections are common. The nail must be cultured or chpped for histological examination before initiating therapy because up to a third of dystrophic nails that appear clinically to be onychomycosis are actually due to psoriasis or other conditions. 

Tolnaftate, a much older drug, is chemically a thiocarbamate but has the same mechanism of action as the allyl amines. These drugs have a more limited spectrum of activity than the azoles and are effective only against dermatophytes. Therefore, they are employed in the treatment of fungal infections of the skin and nails (35). 

Amorolfine is the only drug in this class that is employed clinically in the treatment of human fungal infections. Amorolfine is not currently available in the United States, but it is marketed in Europe and Asia for the topical treatment of dermatophytic infections (44). 

The polycyclic antibiotic, griseofulvin, is derived from Penicillium griseofulvum and is perhaps the most important agent in the systemic treatment of dermatophyte infections (Fig. 2). It is used orally for the treatment of superficial fungal infections of nails, hair, and skin, increasing the resistance of keratin to infection. Side effects of therapy are usually mild most common are nausea, diarrhoea and headaches (Swartz 1962). 

Dermatophyte superficial fungal infections are the most common dermatological infections in the athlete (Bergfeld and Elston 1994). The most common dermatophytes implicated in tinea pedis are Trichophyton ruhrum, Epidermophyton floccosuniy and Trychophyton mentagrophytes (Elewski and Weil 1996). In a study of 150 swimmers, 15% presented with... 

The agents that induce superficial fungal infections include dermatophytes (responsible for tinea, or ringworm) and Candida species yeasts. 

Fungal skin infections are primarily caused by dermatophytes such as Trichophyton, Microsporum, and Epidermophyton. Trichophyton rubrum accounts for more than 75% of all cases in the United States.36 To a lesser extent, Candida and other fungal species cause skin infections. With tinea infections, the causative dermatophyte typically invades the stratum corneum without penetration into the living tissues, leading to a localized infection. 

Despite negligible cerebrospinal fluid concentrations, itraconazole shows promise in the treatment of cryptococcal and coccidioidal meningitis. Additional uses for itraconazole include treatment of vaginal candidiasis, tinea versicolor, dermatophyte infections, and onychomycosis. Fungal naU infections account for most use of this drug in the outpatient setting. 

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