The Experts below are selected from a list of 963 Experts worldwide ranked by ideXlab platform

Neil H. Shear - One of the best experts on this subject based on the ideXlab platform.

  • An Overview of Topical Antifungal Therapy in Dermatomycoses
    Drugs, 1998
    Co-Authors: Aditya K. Gupta, Thomas R. Einarson, Richard C. Summerbell, Neil H. Shear
    Abstract:

    Dermatophytes cause fungal infections of keratinised tissues, e.g. skin, hair and nails. The organisms belong to 3 genera, Trichophyton, Epidermophyton and Microsporum. Dermatophytes may be grouped into 3 categories based on host preference and natural habitat. Anthropophilic species predominantly infect humans, geophilic species are soil based and may infect both humans and animals, zoophilic species generally infect non-human mammals. It is important to confirm mycologically the clinical diagnosis of onychomycosis and other tinea infections prior to commencing therapy. The identity of the fungal organism may provide guidance about the appropriateness of a given Topical Antifungal Agent. Special techniques may be required to obtain the best yield of fungal organisms from a given site, especially the scalp and nails. It is also important to realise the limitations of certain diagnostic aids e.g., Wood’s light examination is positive in tinea capitis due to M. canis and M. audouinii (ectothrix organisms); however, Wood’s light examination is negative in T. tonsurans (endothrix organism). Similarly, it is important to be aware that cicloheximide in culture medium will inhibit growth of non-dermatophytes. Appropriate media are therefore required to evaluate the growth of some significant non-dermatophyte moulds. For tinea infections other than tinea capitis and tinea unguium, Topical Antifungals may be considered. For effective therapy of tinea capitis an oral Antifungal is generally necessary. Similarly, oral Antifungals are the therapy of choice, especially if onychomycosis is moderate to severe. Furthermore, where the tinea infection involves a large area, in an immunocompromised host or if infection is recurrent with poor response to Topical Agents, then oral Antifungal therapy may be necessary. Topical Antifungal Agents may be broadly divided into specific and nonspecific Agents. The former group includes the polyenes, azoles, allylamines, amorolfine, ciclopirox and butenafine. Generally the Topical Agent is available as a cream, sometimes for use intravaginally. Less commonly, the formulation may be in the form of a powder, lacquer, spray, gel or solution. Many of these Agents have a broad spectrum of activity, being effective against dermatophytes, yeasts and Malassezia furfur. For the treatment of tinea corporis, tinea cruris tinea versicolor and cutaneous candidosis, once or twice daily application may be required, the most common duration of therapy being 2 to 4 weeks. For tinea pedis the most common treatment duration is 4 to 6 weeks.

  • Terbinafine: an oral and Topical Antifungal Agent.
    Clinics in Dermatology, 1991
    Co-Authors: Neil H. Shear, Violette V. Villars, Christian Marsolais
    Abstract:

    Abstract Allylamines, named after a tertiary allylamine unit within their molecular structure, constitute a new class of Antifungal Agents. 1 A product, naftifme, with a novel chemical structure, identified during routine biologic screening proved to possess strong Antifungal activity. 2 Terbinafine, the newest in the family, resulted from research undertaken to optimize the Antifungal efficacy profile of the allylamines by manipulation of their chemical structure: addition of a triple bond and branching of the alkyl side chain adjacent to it. Terbinafine presents an advancement in Antifungal therapy in that it has a novel mode of action; it has fungicidal activity, it is active when given orally as well as Topically, and it has a better efficacy and safety profile than other currently used Antifungal Agents.

Aditya K. Gupta - One of the best experts on this subject based on the ideXlab platform.

  • Onychomycosis: review of recurrence rates, poor prognostic factors, and strategies to prevent disease recurrence.
    Cutis, 2004
    Co-Authors: Aditya K. Gupta, Lindsay E. Lynch
    Abstract:

    Treatment of onychomycosis is associated with substantial disease reappearance rates. Identification of factors associated with therapeutic failure may help develop strategies to prevent recurrence of onychomycosis. Aspects of a patient's health and lifestyle, local factors involving the nail, therapeutic options, and environmental conditions are associated with poor therapeutic response. Strategies to reduce recurrence of disease involve the reduction of both relapse (delayed failure) and reinfection. The Topical Antifungal Agent ciclopirox nail lacquer, may be a consideration for prophylaxis of this chronic disease.

  • An Overview of Topical Antifungal Therapy in Dermatomycoses
    Drugs, 1998
    Co-Authors: Aditya K. Gupta, Thomas R. Einarson, Richard C. Summerbell, Neil H. Shear
    Abstract:

    Dermatophytes cause fungal infections of keratinised tissues, e.g. skin, hair and nails. The organisms belong to 3 genera, Trichophyton, Epidermophyton and Microsporum. Dermatophytes may be grouped into 3 categories based on host preference and natural habitat. Anthropophilic species predominantly infect humans, geophilic species are soil based and may infect both humans and animals, zoophilic species generally infect non-human mammals. It is important to confirm mycologically the clinical diagnosis of onychomycosis and other tinea infections prior to commencing therapy. The identity of the fungal organism may provide guidance about the appropriateness of a given Topical Antifungal Agent. Special techniques may be required to obtain the best yield of fungal organisms from a given site, especially the scalp and nails. It is also important to realise the limitations of certain diagnostic aids e.g., Wood’s light examination is positive in tinea capitis due to M. canis and M. audouinii (ectothrix organisms); however, Wood’s light examination is negative in T. tonsurans (endothrix organism). Similarly, it is important to be aware that cicloheximide in culture medium will inhibit growth of non-dermatophytes. Appropriate media are therefore required to evaluate the growth of some significant non-dermatophyte moulds. For tinea infections other than tinea capitis and tinea unguium, Topical Antifungals may be considered. For effective therapy of tinea capitis an oral Antifungal is generally necessary. Similarly, oral Antifungals are the therapy of choice, especially if onychomycosis is moderate to severe. Furthermore, where the tinea infection involves a large area, in an immunocompromised host or if infection is recurrent with poor response to Topical Agents, then oral Antifungal therapy may be necessary. Topical Antifungal Agents may be broadly divided into specific and nonspecific Agents. The former group includes the polyenes, azoles, allylamines, amorolfine, ciclopirox and butenafine. Generally the Topical Agent is available as a cream, sometimes for use intravaginally. Less commonly, the formulation may be in the form of a powder, lacquer, spray, gel or solution. Many of these Agents have a broad spectrum of activity, being effective against dermatophytes, yeasts and Malassezia furfur. For the treatment of tinea corporis, tinea cruris tinea versicolor and cutaneous candidosis, once or twice daily application may be required, the most common duration of therapy being 2 to 4 weeks. For tinea pedis the most common treatment duration is 4 to 6 weeks.

G Ruoff - One of the best experts on this subject based on the ideXlab platform.

  • Double-blind comparison of itraconazole and placebo in the treatment of tinea corporis and tinea cruris
    Journal of The American Academy of Dermatology, 1994
    Co-Authors: David M. Panser, Robert J. Pariser, G Ruoff
    Abstract:

    Background: Tinea corporis and tinea cruris are usually treated with a Topical Antifungal Agent unless the infection is unresponsive, involves an extensive area, is chronic, or is in a dif-ficult-to-access area. In these cases oral Antifungals are frequently used. Objective: This double-blind study was undertaken to determine whether a 2-week course of oral itraconazole would produce statistically significant clinical and mycologic improvement in the treatment of tinea corporis, tinea cruris, or both, over the results obtained with placebo. Asecond objective was to determine the safety of itraconazole, through routine measurements of serum chemistry profiles. Methods: Sixty-seven patients were entered into a double-blind, multicenter study to compare the clinical and mycologic effects of itraconazole, 100 mg daily (45 patients), and placebo (22 patients) on tinea corporis and/or tinea cruris. The duration of treatment was 2 weeks. The investigators assessed signs and symptoms and performed a potassium hydroxide examination and culture at baseline, at termination of therapy, and 2 weeks after completion of treatment. Results: Twenty-two (96%) of 23 evaluable patients in the itraconazole group had healed or markedly improved lesions, as compared with 5 of 13 (39%) in the placebo group ( p ≤ 0.01). Similarly, the condition in 13 of 23 patients (57%) in the itraconazole group was mycolog-ically cleared at the end of treatment whereas this result occurred in only 2 (17%) of 12 patients in the placebo group ( p = 0.02). The prevalence of adverse side effects was lower for the itraconazole-treated group (20%) than for the placebo-treated group (36%). Conclusion: Itraconazole 100 mg once daily is an effective Agent for the treatment of tinea cruris and tinea corporis.

  • Double-blind comparison of itraconazole and placebo in the treatment of tinea corporis and tinea cruris.
    Journal of the American Academy of Dermatology, 1994
    Co-Authors: David M. Pariser, Robert J. Pariser, G Ruoff
    Abstract:

    Tinea corporis and tinea cruris are usually treated with a Topical Antifungal Agent unless the infection is unresponsive, involves an extensive area, is chronic, or is in a difficult-to-access area. In these cases oral Antifungals are frequently used. This double-blind study was undertaken to determine whether a 2-week course of oral itraconazole would produce statistically significant clinical and mycologic improvement in the treatment of tinea corporis, tinea cruris, or both, over the results obtained with placebo. A second objective was to determine the safety of itraconazole, through routine measurements of serum chemistry profiles. Sixty-seven patients were entered into a double-blind, multicenter study to compare the clinical and mycologic effects of itraconazole, 100 mg daily (45 patients), and placebo (22 patients) on tinea corporis and/or tinea cruris. The duration of treatment was 2 weeks. The investigators assessed signs and symptoms and performed a potassium hydroxide examination and culture at baseline, at termination of therapy, and 2 weeks after completion of treatment. Twenty-two (96%) of 23 evaluable patients in the itraconazole group had healed or markedly improved lesions, as compared with 5 of 13 (39%) in the placebo group (p < or = 0.01). Similarly, the condition in 13 of 23 patients (57%) in the itraconazole group was mycologically cleared at the end of treatment whereas this result occurred in only 2 (17%) of 12 patients in the placebo group (p = 0.02). The prevalence of adverse side effects was lower for the itraconazole-treated group (20%) than for the placebo-treated group (36%). Itraconazole 100 mg once daily is an effective Agent for the treatment of tinea cruris and tinea corporis.

Zhaohui Liu - One of the best experts on this subject based on the ideXlab platform.

Valentino Garau - One of the best experts on this subject based on the ideXlab platform.

  • application of the novel method in the diagnosis and treatment of median rhomboid glossitis candida associated
    European Journal of Dentistry, 2014
    Co-Authors: Francesca Maria Giovanna Pili, Matteo Erriu, Alessandra Piras, Valentino Garau
    Abstract:

    The aim of this work is to demonstrate how current molecular techniques should be integrated in the diagnostic process and can have a crucial role in the management of oral fungal infections. A case of median rhomboid glossitis Candida -associated and its resolution will be described step by step. At the time of the first observation, the lesion on the surface of the tongue did not respond to the previous administration of Topical Antifungal Agent, such a nystatin. Firstly, in order to identify the causative Agent and confirm Candida albicans infection, a brushing of the lesion was performed and polymerase chain reaction analysis was carried out. In addition, deoxyribonucleic acid sequencing method, known as Pyrosequencing ; , was used in the detection of point mutations commonly associated with fluconazole resistance and consequently, in the prediction of susceptibility to azole Agents. According to molecular findings, the administration of fluconazole has therefore led to resolution of the case in 2 weeks. This case highlights how the use of molecular techniques, now-a-days, can assist the clinicians to quickly obtain the report with highly accurate and precise results and appropriately support them in the diagnosis and therapeutic process.