Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 513
Filter
1.
Bol. micol. (Valparaiso En linea) ; 36(2): 5-11, dic. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1352529

ABSTRACT

El síndrome de la uña verde o cloroniquia corresponde a la infección por Pseudomonas aeruginosa de una lámina ungueal dañada en pacientes con algún factor de riesgo identificable, siendo los más frecuentes la inmunosupresión, el ambiente húmedo constante y la patología ungueal preexistente. Su diagnóstico es relativamente sencillo si se logra observar la tríada característica de coloración verdosa de la lámina ungueal, paroniquia proximal crónica y onicolisis distal; en casos de duda diagnóstica se puede enviar una muestra de la uña afectada para cultivos o estudio histopatológico. El pilar de su tratamiento corresponde al uso de antibióticos tópicos o sistémicos en conjunto con medidas generales que protejan de la humedad. Es muy importante enfatizar la prevención de esta patología en el personal de salud, especialmente en el contexto del lavado de manos frecuente y riguroso implementado durante la pandemia COVID-19, ya que existen reportes de transmisión nosocomial de P. aeruginosa por profesionales de la salud con infección ungueal.(AU)


Green nail syndrome or chloronychia is the infection of a damaged nail plate by Pseudomonas aeruginosa in a patient with an identifiable risk factor; the most frequently described are immunosuppression, a persistent moist environment and preexisting nail disease. Its diagnosis is relatively simple if the characteristic triad of green discoloration of the nail plate, chronic proximal paronychia and distal onycholysis can be observed, in cases of doubt a sample of the affected nail can be sent for cultures or histopathology. The cornerstone of treatment is the use of topical or systemic antibiotics along with measures to protect the nail from moisture. Prevention of this disease must be emphasized in health care personnel, especially in the context of frequent and rigorous handwashing practices implemented during the COVID-19 pandemic, since there are reports of nosocomial transmission of P. aeruginosaby health care professionals with nail infection.(AU)


Subject(s)
Pseudomonas aeruginosa/pathogenicity , Pseudomonas Infections , Nails/microbiology , Pseudomonas Infections/diagnosis , Pseudomonas Infections/drug therapy , Syndrome , Health Personnel , Onychomycosis , Onycholysis , COVID-19
2.
Rev. méd. Urug ; 37(1): e37107, mar. 2021. tab, graf
Article in Spanish | LILACS, BNUY | ID: biblio-1289844

ABSTRACT

Resumen: Una proporción importante de infecciones en el pie diabético consisten en onicomicosis y tinea pedis, problema común en el pie, amenazante de la viabilidad del tejido que puede provocar infecciones bacterianas secundarias. Requieren períodos prolongados de tratamiento antimicótico con alta tasas de recaídas y reinfección. Diversos estudios han mostrado la seguridad y eficacia de las nanopartículas de plata (NP Ag) como agente antimicrobiano. Realizamos un estudio donde se evaluó el tratamiento con NP Ag en dermatomicosis del pie de pacientes diabéticos. Método: estudio piloto, abierto, prospectivo, randomizado y controlado en pacientes que asisten a una policlínica de pie diabético. Dieciocho pacientes cumplieron con los criterios de inclusión conformándose dos grupos homogéneos. Ambos grupos recibieron tratamiento estándar que consistió en antimicótico tópico y desbastado mecánico. El grupo intervención utilizó un textil (medias) confeccionadas con hilos con NP Ag. Se realizó control clínico y microbiológico hasta las 12 semanas. Se evaluó el porcentaje de remisión y el tiempo hasta alcanzar el mismo. Resultados: predominó la onicomicosis y el germen Trichophyton rubrum. En el grupo intervención se logró un mayor porcentaje de remisión de lesiones y en un tiempo menor que el grupo control. Conclusiones: el uso de medias confeccionadas con hilos de NP Ag se asoció con una mayor probabilidad de curación completa en un período de 12 semanas a pesar de que el número de pacientes no permitió llegar al nivel de significación estadística, pudiendo contribuir a la prevención de infecciones o úlceras suplementarias en el pie diabético.


Summary: Onychomycosis and tinea pedis represent a significant proportion of infections in the diabetic foot, a common foot problem, and they constitute a threat to the viability of tissues that may provoke secondary bacterial infections. To combat them, antifungal treatments are required for long periods of time, the rates of relapse and reinfection being high. Several studies have proved the safety and effectiveness of silver nano particles (NP Ag) as an antimicrobial agent. A study was conducted to assess nanoparticle agents for foot dermatomycosis in diabetic patients. Method: pilot, open, prospective randomized and controlled study in patients who are assisted in a diabetic foot policlinic. 18 patients complied with the inclusion criteria and two homogeneous groups were formed. Both groups received standard treatment consisting in topic antifungal and mechanical roughing. The intervention groups used a textile (stockings) made with silver nanoparticle threads. Clinical and microbiological control was made during 12 weeks, also assessing the remission percentage and the time it took to achieve it. Resultados: onychomycosis and trichophyton rubrum prevailed. The intervention group showed a greater percentage of remission of lesions in a period of time that was shorter than that of the control group. Conclusions: the use of stockings made with NP Ag threads was associated with a greater probability of complete healing, in a 12-week period, despite the fact that the number of patients was not statistically significant. This could contribute to the prevention of supplementary infections or ulcers in the diabetic foot.


Resumo: Uma proporção significativa de infecções do pé diabético consiste em onicomicose e Tinea pedis, um problema comum nos pés que ameaça a viabilidade do tecido e pode causar infecções bacterianas secundárias. Requerem períodos prolongados de tratamento antifúngico com altas taxas de recidiva e reinfecção. Vários estudos têm demonstrado a segurança e a eficácia das nanopartículas de prata (NP Ag) como agente antimicrobiano. Realizamos um estudo onde o tratamento com NP Ag foi avaliado na dermatomicose do pé de pacientes diabéticos. Método: estudo piloto, aberto, prospectivo, randomizado e controlado em pacientes atendidos em uma policlínica de pé diabético. Dezoito pacientes preencheram os critérios de inclusão, formando dois grupos homogêneos. Ambos os grupos receberam tratamento padrão que consiste em antifúngico tópico e moagem mecânica. O grupo intervenção utilizou um tecido (meias) confeccionado com fios NP Ag. O controle clínico e microbiológico foi realizado até 12 semanas. A porcentagem de remissão e o tempo para alcançá-la foram avaliados. Resultados: predominaram a onicomicose e o germe Trichophyton rubrum. No grupo intervenção, obteve-se maior percentual de remissão das lesões e em menor tempo que o grupo controle. Conclusões: o uso de meias confeccionadas com fios NP Ag esteve associado a uma maior probabilidade de cura completa, no período de 12 semanas, apesar do número de pacientes não permitir atingir o nível de significância estatística, podendo contribuir para a prevenção de infecções ou úlceras adicionais no pé diabético.


Subject(s)
Silver/therapeutic use , Onychomycosis/therapy , Diabetic Foot , Metal Nanoparticles/therapeutic use
3.
Artemisa; I Jornada Científica de Farmacología y Salud. Fármaco Salud Artemisa 2021; 2021. [1-13] p. tab.
Non-conventional in Spanish | MTYCI, LILACS, MTYCI | ID: biblio-1283644

ABSTRACT

Introducción: La onicomicosis constituye una afección muy frecuente de las uñas, que afecta gran parte de la población mundial, predominando en adultos y que repercute de manera negativa. Métodos: Se realizó una intervención terapéutica con 118 pacientes que asistieron a consulta de Dermatología del policlínico Turcios Lima, de Pinar del Río, entre enero y diciembre del 2019. Fueron incluidos aquellos pacientes entre 18 y 70 años de edad, con diagnóstico clínico de Onicomicosis y que no tuvieran enfermedades crónicas asociadas, previa autorización mediante consentimiento informado. Resultados: Predominó los pacientes comprendidos entre 41 y 60 años de edad, con 42.3%, con mayor número de masculinos, representados por el 55.0%; la mayoría de los pacientes tenían más de tres uñas afectadas, con un 37.2% en las mujeres predomino la onicomicosis en las uñas de las manos(24.5%) y en los hombres en las uñas de los pies, con 36.4%; el mayor porciento resultó curado ,de ellos un número importante los que tenían afectadas entre dos y tres uñas, para un 72.8% con relación a la curación de uñas afectadas, resultó mayor en los que tenían onicomicosis en las uñas de los pies con un 33.0%.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Onychomycosis/therapy , Antifungal Agents , Patients , Cuba , Dermatology
4.
Diagn. tratamento ; 25(2): 01-03, abr.-jun. 2020. fig, tab
Article in Portuguese | LILACS | ID: biblio-1116019

ABSTRACT

Contexto: Onicomicose (tinha ungueal) pode ser causada por fungos dermatófitos, não dermatófitos ou leveduras. Raramente, pode se manifestar como melanoquínia longitudinal (mancha acastanhada, longitudinalmente, na lâmina ungueal), sendo diagnóstico diferencial do melanoma acral ungueal (MAU), uma neoplasia maligna do aparelho ungueal. Descrição do caso: Paciente do sexo feminino, 63 anos de idade, com surgimento recente de melanoníquia longitudinal na unha do primeiro quirodáctilo direito. Tendo em vista a suspeita clínica de MAU, foi realizada biópsia da matriz ungueal. Laudo histopatológico evidenciou tratar-se de onicomicose. Paciente apresentou resolução completa do quadro após seis meses de tratamento com antifúngico oral. Discussão: Apesar da semelhança clínica entre a melanoníquia longitudinal do MAU e a de uma forma clínica incomum de onicomicose, tais doenças apresentam prognósticos díspares. Exames complementares, como o exame anatomopatológico da matriz ungueal, podem ser de fundamental importância na elucidação diagnóstica. Conclusões: O exame físico completo envolve a avaliação das unhas. A melanoníquia longitudinal não ocorre exclusivamente no MAU; doenças benignas, como a onicomicose, também podem ter a mesma manifestação clínica.


Subject(s)
Biopsy , Onychomycosis , Dermatology , Nail Diseases
5.
Rev. chil. pediatr ; 91(1): 131-138, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092798

ABSTRACT

Resumen: La onicomicosis (OM) es una infección fúngica de las uñas, cuyo principal agente causal es el Tricophytum rubrum. Si bien es una patología infrecuente en niños, se ha observado un aumento en la prevalencia en el último tiempo. Hasta la fecha, existen diversos estudios y guías clínicas de OM en adultos. Sin embargo, la literatura en edad pediátrica es escasa, lo que dificulta el tratamiento en pediatría. En el presente articulo se revisa la literatura actual, los métodos diagnosticos de OM, datos epidemiológicos locales y globales, y se presentan las opciones de tratamiento disponibles conside rando su eficacia y perfil de seguridad en población pediátrica.


Abstract: Onychomycosis (OM) is a fungal infection of the nails, whose main etiologic agent is Trichophytum rubrum. Although, it is an unusual pathology in children, in the last years an increase in its preva lence has been observed. To date, there are several studies and clinical guidelines for OM in adults. However, literature in children is scarce, which makes pediatric treatment difficult. The objective of this publication was to review the current literature in order to establish diagnostic methods for OM, national and international epidemiological data, and to provide treatment options taking into account their efficiency and safety profile in the pediatric population.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Onychomycosis/diagnosis , Onychomycosis/microbiology , Onychomycosis/drug therapy , Onychomycosis/epidemiology , Pediatrics , Global Health , Antifungal Agents/therapeutic use
6.
Rev. Soc. Bras. Med. Trop ; 53: e20190214, 2020. tab, graf
Article in English | LILACS | ID: biblio-1057290

ABSTRACT

Abstract INTRODUCTION: The aim of this study was to evaluate some virulence factors in Candida albicans isolates from patients with onychomycosis and determine the correlation between these factors and the antifungal resistance profile. METHODS: Seventy species of C. albicans were confirmed using polymerase chain reaction amplification of the HWP1 gene. According to the Clinical & Laboratory Standards Institute guidelines, the susceptibility profile of four antifungal agents was investigated, and the production of aspartyl protease, phospholipase, haemolysin, and biofilm was determined. The correlation between these profiles was also investigated. RESULTS: The isolates indicated different levels of resistance and production of virulence factors. Significant correlations were observed between the minimum inhibitory concentration (MIC) of fluconazole/itraconazole and biofilm production, between phospholipase production and fluconazole/itraconazole MIC, and between fluconazole MIC and hemolytic activity in C. albicans isolates. The results also showed significant correlations between phospholipase activity and biofilm production. CONCLUSIONS: Our findings will contribute to a better understanding of the pathogenesis of C. albicans and characterize the relationship between virulence factors and antifungal resistance, which may suggest new therapeutic strategies considering the possible involvement of the virulence mechanism in the effectiveness of treatment.


Subject(s)
Humans , Candida albicans/pathogenicity , Onychomycosis/microbiology , Virulence Factors , Antifungal Agents/pharmacology , Nails/microbiology , Phospholipases/biosynthesis , Candida albicans/drug effects , Candida albicans/ultrastructure , Microscopy, Electron, Scanning , Microbial Sensitivity Tests , Polymerase Chain Reaction , Biofilms/growth & development , Drug Resistance, Fungal , Aspartic Acid Proteases/biosynthesis , Hemolysis
7.
Educ. med. super ; 33(4): e1962, oct.-dic. 2019. []
Article in Spanish | LILACS, CUMED | ID: biblio-1089936

ABSTRACT

Introducción: Para el correcto diagnóstico de la onicomicosis es fundamental realizar una adecuada toma de muestra. Objetivo: Evaluar la competencia de los alumnos del grado en Podología en la realización de la toma de muestra ungueal como experiencia preclínica y clínica. Métodos: Estudio observacional, descriptivo y transversal, realizado sobre una muestra de 75 alumnos, pertenecientes a segundo (n = 45) y cuarto curso (n = 30) del grado en Podología. Los alumnos de segundo curso no contaron con experiencia previa, mientras que los de cuarto ya habían realizado prácticas preclínicas y clínicas. Se evaluó el procedimiento de toma de muestras ungueales mediante el grado de seguimiento de cada alumno del protocolo preestablecido y explicado. Además, se obtuvo el porcentaje de cultivos contaminados tras el período de incubación de las muestras. Resultados: Los alumnos de cuarto curso siguieron más fielmente el protocolo de toma de muestras ungueales y las contaminaron significativamente menos que los alumnos de segundo curso (23,3 por ciento frente al 51,1 por ciento; p-valor = 0,017). La experiencia previa en toma de muestras ungueales (p-valor = 0,027) y en la realización de quiropodias (p-valor = 0,016) redujo significativamente el porcentaje de cultivos contaminados. Conclusiones: Una sola práctica preclínica no es suficiente para que la mayoría de los alumnos de segundo curso adquieran la competencia de toma de muestra. Las experiencias preclínica y clínica de los alumnos de cuarto curso constituyen un factor determinante para la correcta realización de la toma de muestra ungueal(AU)


Introduction: For the correct diagnosis of onychomycosis, it is essential to take an adequate sample. Objective: To assess the competence of students of the degree in Podiatry in the realization of nail sampling as a preclinical and clinical experience. Methods: Observational, descriptive and cross-sectional study carried out on a sample of 75 students, belonging to the second (n=45) and fourth academic years (n=30) of the degree in Podiatry. The second-year students did not have previous experience, while the fourth-year students had already done preclinical and clinical practices. The nail sampling procedure was assessed by the degree of follow-up of each student of the pre-established and explained protocol. In addition, the percentage of contaminated cultures was obtained after the incubation period of the samples. Results: The fourth-year students followed the nail sampling protocol more faithfully and contaminated them significantly less than second-year students (23.3 percent versus 51.1 percent; p value=0.017). Previous experience in nail sampling (p value=0.027) and in performing podiatry (p value=0.016) significantly reduced the percentage of contaminated cultures. Conclusions: A single preclinical practice is not enough for most second-year students to acquire the competence of sampling. The preclinical and clinical experiences of fourth-year students constitute a determining factor for the correct realization of the nail sampling(AU)


Subject(s)
Humans , Podiatry , Specimen Handling , Cross-Sectional Studies , Onychomycosis
8.
An. bras. dermatol ; 94(3): 344-347, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1011119

ABSTRACT

Abstract: Background: Of all nail disorders seen in dermatology offices, half of them are due to onychomycosis. The main differential diagnosis is nail psoriasis. The objective of this study was to compare the microscopic findings, other than the presence of fungi, in the clipping of onychomycosis versus normal nails and nail psoriasis. Methods: Cross-sectional study of onychomycosis cases, analyzed by clipping and compared with data on normal nails and those with nail psoriasis. Results: Sixty-two onychomycosis samples were compared with 30 normal nails and 50 nails with psoriasis. In onychomycosis, measurement of subungual region, serous lakes, neutrophils and number of layers of parakeratosis are more intense than in psoriasis. Onychocariosis is less common in psoriasis, while bacteria are more frequent. The nail transition zone is more commonly blurred and irregular in onychomycosis. Conclusion: Clipping helps in the differential diagnosis of onychomycosis and nail psoriasis and may be useful even when fungi are not found.


Subject(s)
Humans , Onychomycosis/pathology , Nail Diseases/pathology , Nails/pathology , Parakeratosis , Psoriasis/microbiology , Psoriasis/pathology , Cross-Sectional Studies , Onychomycosis/microbiology , Diagnosis, Differential , Nail Diseases/microbiology , Nails/microbiology , Neutrophils
10.
Infectio ; 23(1): 39-44, Jan.-Mar. 2019. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-975561

ABSTRACT

Resumen Objetivo: Describir las características clínico-epidemiológicas de una población con diagnóstico de infección cutánea micótica en los pies confirmada por examen directo con KOH y cultivo en un centro de referencia de Bogotá, Colombia. Material y método: Estudio observacional descriptivo en el que se incluyeron todos los pacientes con lesiones en los pies que fueron atendidos en el servicio de micología entre el año 2011 y el 2016. Se analizaron las características sociodemográficas, clínicas, etiologías y el perfil de tratamiento por medio de un análisis bivariado. Resultados: Se incluyeron 305 pacientes, de los cuales el 82% residía en zona urbana de la ciudad de Bogotá. El hábito más frecuente fue bañarse descalzo, la forma clínica que predominó fue la interdigital y el 35% de los casos presentó de forma simultánea tiña del pie y onicomicosis. Los agentes etiológicos más comunes fueron los dermatofitos con el 95,2% de los casos. Discusión: La presentación clínica sugestiva de micosis, además del resultado positivo del examen directo y del cultivo, permiten hacer el diagnóstico de estas in fecciones. Las características sociodemográficas de quienes sufren este tipo de micosis en Colombia se relacionan con su contagiosidad y tendencia a la cronicidad. La intervención de tales aspectos debe hacer parte de las estrategias para su prevención.


Summary Objective: To describe the clinical and epidemiological characteristics of the population with cutaneous mycosis in the feet confirmed by positive mycological studies diagnosed in a reference center in Bogota, Colombia. Methods: Descriptive observational study in which all patients with lesions in the feet that were treated in the mycology service between 2011 and 2016 were included. In all cases KOH examination and fungal culture were performed. The sociodemographic and clinical characteristics, etiologies and the treatment profile were assessed using a bivariate analysis. Results: A total of 305 patients were included, of which 61% were men and 82% lived in an urban area of the city of Bogota. The most common behavior was to take a barefoot bath, the most important comorbidities were venous insufficiency and psoriasis, the main clinical form was interdigital and 35% of the cases presented simultaneously tinea pedis and onychomycosis. The group of dermatophytes was the most frequently isolated (95.2%). Discussion: Clinical examination corresponding with mycosis in the feet, direct examination, and positive culture, allow the physician accurate diagnosis and guide the most appropriate treatment of these infections according to their etiology. The sociodemographic characteristics of those who suffer from this mycosis in Co lombia are related to their contagiousness and tendency to chronicity, therefore, the intervention of such aspects must be part of the strategies for their prevention.


Subject(s)
Humans , Male , Female , Adult , Tinea Pedis , Onychomycosis , Dermatomycoses , Foot , Mycoses , Psoriasis , Venous Insufficiency , Baths , Health Strategies , Colombia , Arthrodermataceae , Infections , Mycology
12.
Rev. bras. cancerol ; 65(4)20191216.
Article in Portuguese | LILACS | ID: biblio-1048663

ABSTRACT

Introdução: A síndrome mão-pé é uma reação adversa experimentada por vários pacientes em tratamento para o câncer e fator preditor de morbidade e mortalidade. Objetivo: Avaliar as evidências científicas relacionadas à identificação, prevenção e tratamento da síndrome mão-pé induzida por agentes quimioterápicos, identificar os principais sinais e sintomas que possibilitam o reconhecimento da síndrome e, ainda, discutir a ocorrência de onicomicoses no contexto da síndrome mão-pé. Método: Trata-se de uma revisão sistemática na MEDLINE/PubMed, Biblioteca Virtual da Saúde e Scopus, incluindo literatura cinzenta e busca manual. Os 29 estudos incluídos na revisão foram analisados e classificados segundo a hierarquia dos níveis de evidência Grading of Recommendations Assessment, Development and Evaluations (GRADE) e a confiabilidade entre os examinadores (coeficiente Kappa) foi calculada. Resultados: Foram identificados estudos que demonstraram eficácia na prevenção da síndrome mão-pé com o uso da crioterapia e hidroterapia. Evidenciaram-se resultados satisfatórios com o uso do creme de ureia na prevenção e tratamento, e o uso de piridoxina não apresentou resultados conclusivos. Foram encontrados mecanismos para identificação da síndrome e para classificação dos agentes indutores. O grupo dos taxanos predominou entre os medicamentos indutores da síndrome mão-pé. Conclusão: Existem evidências consistentes, porém não contemplam todos os fármacos indutores da síndrome e não exploram outras manifestações relacionadas às onicólises e onicomicoses. O estudo apresentou resultados que poderão auxiliar os prescritores na identificação da síndrome mão-pé, além de alternativas para prevenção e tratamento. Contudo, vale destacar a necessidade de pesquisas futuras para elucidar a etiologia e protocolos de tratamento.


Introduction: Hand-foot syndrome is an adverse reaction experienced by many cancer patients and a predictor of morbidity and mortality. Objective:To evaluate the scientific evidence related to the identification, prevention and treatment of chemotherapeutic-induced hand-foot syndrome, to identify the main signs and symptoms that enable the recognition of the syndrome, and to discuss the occurrence of onychomycosis in the context of the hand-foot syndrome. Method: This is a systematic review at MEDLINE/PubMed, Virtual Health Library and Scopus, including gray literature and manual search. The 29 studies included in the review were analyzed and graded according to the hierarchy of evidence levels Grading of Recommendations Assessment, Development and Evaluations (GRADE) and reliability among examiners (Kappa coefficient) was calculated. Results:It were identified studies that demonstrated efficacy in preventing hand-foot syndrome using cryotherapy and hydrotherapy. Satisfactory results were evidenced with the use of urea cream for prevention and treatment, and the use of pyridoxine showed inconclusive results. Mechanisms for identification of the syndrome and classification of inducing agents were found. The taxane group predominated among hand-foot syndrome inducing drugs. Conclusion: There are consistent evidences but do not include all drugs inducing the syndrome and do not explore other manifestations related to onycholysis and onychomycosis. The study presented results that may help prescribers to identify hand-foot syndrome, as well as alternatives for prevention and treatment. However, it is worth highlighting the need for future studies to elucidate the etiology and treatment protocols.


Introducción: El síndrome de pies y manos es una reacción adversa experimentada por muchos pacientes con cáncer y un predictor de morbilidad y mortalidad. Objetivo: Evaluar la evidencia científica relacionada con la identificación, prevención y tratamiento del síndrome de pies y manos inducido por quimioterapia, identificar los principales signos y síntomas que permiten el reconocimiento del síndrome y analizar la aparición de onicomicosis en el contexto del síndrome mano-pie. Método:Esta es una revisión sistemática en MEDLINE/PubMed, Virtual Health Library y Scopus, que incluye literatura gris y búsqueda manual. Los 29 estudios incluidos en la revisión se analizaron y clasificaron de acuerdo con la jerarquía de los niveles de evidencia Grading of Recommendations Assessment, Development and Evaluations (GRADE). Resultados: Identificamos estudios que demostraron eficacia en la prevención del síndrome mano-pie usando crioterapia e hidroterapia. También mostraron resultados satisfactorios con el uso de crema de urea en la prevención y el tratamiento, y el uso de piridoxina no mostró resultados concluyentes. Se encontraron mecanismos para la identificación del síndrome y la clasificación de los agentes inductores. El grupo de taxanos predominó entre los fármacos inductores del síndrome mano-pie. Conclusión: Existe evidencia consistente pero no incluye todas las drogas que inducen el síndrome y no explora otras manifestaciones relacionadas con la onicólisis y la onicomicosis. El estudio presentó resultados que pueden ayudar a los prescriptores a identificar el síndrome de manos y pies, así como alternativas para la prevención y el tratamiento. Sin embargo, vale la pena destacar la necesidad de futuras investigaciones para dilucidar la etiología y los protocolos de tratamiento.


Subject(s)
Humans , Hand-Foot Syndrome/therapy , Antineoplastic Agents/adverse effects , Onychomycosis/diagnosis , Onychomycosis/therapy , Taxoids/adverse effects , Onycholysis/diagnosis , Onycholysis/therapy , Hand-Foot Syndrome/diagnosis
13.
Article in Korean | WPRIM | ID: wpr-766600

ABSTRACT

Onychomycosis is a fungal nail infection caused by various fungal species, including dermatophytes, non-dermatophytes, and yeast. It is one of most bothersome nail problems, because it may cause permanent deformity of the nail, local pain, paresthesia, and difficulties performing activities of daily living and engaging in social interactions. Additionally, the treatment of onychomycosis is considered to be challenging because of the long duration of treatment, high recurrence and treatment failure rates, and drug interactions. In this article, we review the prognostic factors for onychomycosis treatment, the treatment options that have been approved, and off-label therapies and devices. Furthermore, we describe preventive therapy for recurrence and emerging methods to achieve a high cure rate. For successful treatment of onychomycosis, the risk factors should be clarified according to the patient's status and the clinical characteristics of onychomycosis. Recently, combinations of various treatment options, such as systemic therapy with simultaneous topical antifungal agents and boost therapy, have been reported as effective treatments of onychomycosis. In addition, laser therapy, photodynamic therapy, and plasma therapy have been proposed as emerging curative options. Providing patient-specific treatment based on an understanding of these treatments plays a pivotal role in achieving better treatment results. This article suggested the updated treatment options for onychomycosis to help clinicians make proper plans and achieve better results.


Subject(s)
Activities of Daily Living , Antifungal Agents , Arthrodermataceae , Congenital Abnormalities , Drug Interactions , Interpersonal Relations , Laser Therapy , Onychomycosis , Paresthesia , Photochemotherapy , Plasma , Recurrence , Risk Factors , Treatment Failure , Yeasts
14.
Article in Korean | WPRIM | ID: wpr-759790

ABSTRACT

BACKGROUND: Onychomycosis is a chronic fungal nail disease that may have a profound effect on quality of life (QOL). OBJECTIVE: The purpose of this study was to evaluate the QOL in patients with toenail onychomycosis using the onychomycosis quality of life questionnaire (ONYCHO) and to determine the factors influencing the QOL of toenail onychomycosis patients. METHODS: A total of 102 adults (mean age, 59.54 years) with toenail onychomycosis who visited our department between July 2017 and June 2018 completed the ONYCHO, which consists of statements pertaining to social, emotional, and symptom problems. All patients with toenail onychomycosis had been diagnosed by positive direct microscopic examination. RESULTS: Most of the patients demonstrated significantly reduced QOL. The degree of QOL impairment differed between subgroups. Both social (p<0.01) and emotional (p<0.05) impairments were more conspicuous in the female than in the male patients, although there were no differences according to symptoms. Patients with more extent of toenail involvement were more affected by onychomycosis in all three ONYCHO scales (p for trend<0.05). In terms of the type of toenail onychomycosis, the degrees of social (p for trend<0.05), emotional (p for trend<0.05), and symptom (p for trend<0.01) impairment were more prominent in patients with total dystrophic onychomycosis than in those with superficial white onychomycosis and distal and lateral subungual onychomycosis. A tendency toward better QOL in terms of social problems, but not emotional or symptom problems, was associated with a longer duration of the disease (B, 8.95, 95%CI, 0.99–16.91). CONCLUSION: Although toenail onychomycosis is not a life-threatening disease, it has a significantly negative impact on the overall QOL of patients, which should be a focus of concern.


Subject(s)
Adult , Female , Humans , Male , Nail Diseases , Nails , Onychomycosis , Quality of Life , Social Problems , Weights and Measures
16.
Rev. cuba. pediatr ; 90(3): 1-8, jul.-set. 2018. ilus, tab
Article in Spanish | LILACS, CUMED | ID: biblio-978455

ABSTRACT

Introducción: la onicomadesis es el desprendimiento completo y espontáneo de la uña desde su extremo proximal, sin dolor o inflamación, consecutivo a la detención mitótica de la matriz ungular que conlleva a un cambio de su función. Objetivo: describir una serie de casos de onicomadesis atendidos en la consulta de Dermatología del Hospital Pediátrico Docente del Cerro, entre noviembre y diciembre del año 2017, después de presentar un cuadro clínico compatible con enfermedad boca, mano, pie, con la finalidad de contribuir al conocimiento de esta patema. Presentación de los casos: las edades estuvieron comprendidas en un rango entre 1 y 12 años, con solo 3 pacientes correspondientes al sexo masculino y solo uno con el color de la piel negra. Los días previos al padecimiento de la enfermedad boca, mano, pie se enmarcan entre 15 y 47 días de haber tenido los síntomas que indujeron al diagnóstico del citado morbo. El estudio virológico se efectuó en dos pacientes con presencia del Coxsackie A6. La evolución resultó satisfactoria en todos los casos. Conclusiones: los hallazgos, en general, coinciden con los mencionados en la literatura. Todos los pacientes presentaron semanas anteriores signos y síntomas compatibles con enfermedad boca, mano, pie. Es necesario orientar a los padres de los enfermos con este morbo, la posibilidad de la ocurrencia de onicomadesis como complicación, cuyo tratamiento es sintomático, seguido de buen pronóstico, para evitar la ansiedad familiar y los gastos de recursos innecesarios(AU)


Introduction: onychomadesis is the total and spontaneous detachment of the nail from its proximal end, without pain or inflammation, and following the mitotic halting of the nail matrix that leads to a change in its function. Objective: to describe a series of cases of onychomadesis attended in the Dermatology clinic of the Pediatric Teaching Hospital of Cerro, in the period of November to December of 2017, after presenting clinical manifestations compatible with mouth, hand, and foot disease, and in order to contribute to the knowledge of this pathology. Presentation of cases: ages were among 1 and 12 years old, with only 3 patients corresponding to the male sex and only one with black skin. The days before presenting symptoms of mouth, hand, and foot disease were between 15 and 47 days after having the symptoms that led to the diagnosis of the aforementioned disease. The virological study was carried out in two patients with the presence of Coxsackie A6. The evolution was satisfactory in all cases. Conclusions: in general the findings coincide with those mentioned in the literature. All patients presented previous signs and symptoms compatible with mouth, hand, and foot disease in the previous weeks. It is necessary to guide the parents of patients with this disease on the possibility of the onychomadesis occurrence as a complication, whose treatment is symptomatic, followed by a good prognosis to avoid family anxiety and the expense of unnecessary resources(AU)


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Hand, Foot and Mouth Disease/complications , Hand, Foot and Mouth Disease/prevention & control , Nail Diseases/complications , Nail Diseases/etiology , Onychomycosis/complications
17.
Dermatol. pediátr. latinoam. (En línea) ; 13(2): 90-105, abr.-jun. 2018. ilus
Article in Spanish | LILACS | ID: biblio-982663

ABSTRACT

La paquioniquia congenital (PC) es una genodermatosis poco frecuente, caracterizada por presentar queratodermia palmoplantar dolorosa y debilitante, uñas hipertróficas, hiperqueratosis folicular, quistes epidérmicos, leucoqueratosis oral y ocasionalmente hiperhidrosis, ronquera y dientes natales. Está asociada a mutaciones heterocigotas en los genes que codifican queratinas 6a, 6b, 6c, 16 y 17. Se presenta una familia con dos miembros en dos generaciones afectados por PC: un niño de 2 años de edad con alteración de la coloración, hiperqueratosis de las 20 uñas, con dolor periungueal, múltiples pápulas foliculares color piel en tronco y dientes natales y su madre, con alteración del esmalte dentario, distrofia hipertrófica de las 20 uñas, cromoniquia, queratodermia plantar dolorosa y múltiples esteatocistomas de distribución generalizada.En ambos, se realizó el diagnóstico molecular por secuenciación masiva de exoma clínico, el cual confirmó el diagnóstico clínico y permitió determinar inequívocamente el tipo de PC en el niño, motivo de ésta presentación.


Pachyonychia congenital (PC) is a rare genodermatosis characterized by painful palmoplantar keratoderma, hypertrophic nail dystrophy, follicular hyperkeratosis, epidermal cysts, oral leukokeratosis and, less commonly, palmoplantar hyperhidrosis, hoarseness and natal teeth. PC is caused by mutations in keratin 6a, 6b, 6c, 16 and 17 genes. We report a family with two members in two generations affected by PC: a two-year old boy, presenting abnormal pigmentation and hyperkeratosis of the 20 nails, perionychium pain, multiple skin-colored follicular papules on the trunk and natal teeth. His mother has dental enamel defects, hypertrophic dystrophy of the fingernails and toenails, chromonychia, painful plantar keratoderma and generalized steatocystoma multiplex. We performed the molecular diagnosis by clinical exome massive sequencing which allowed us to confirm the clinical diagnosis and to determine the specific type of PC in our patient.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Adult , Keratosis , Pachyonychia Congenita , Steatocystoma Multiplex , Onychomycosis
18.
Infectio ; 22(2): 105-109, abr.-jun. 2018. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-892761

ABSTRACT

Abstract Introduction: Onychomycosis are fungal nail infections that can be caused by dermatophytes, non-dermatophytic molds and yeasts, which are capable of breaking down keratin. Mixed onychomycosis are a controversial subject and they are the outcome of the combination of two dermatophytes, dermatophytes/nondermatophytic molds or dermatophytes/yeast. Objetives: To determine the frequency of total dystrophic onychomycosis caused by more than one etiological agent (mixed onychomycosis) in outpatients from a Dermatologic Center in Guatemala and to establish the characteristics associated with this fungal infection. Methods: Prospective observational study from August to December of 2012. Nail samples were obtained from patients with total dystrophic onychomycosis to identify the causal agents by culture in Sabouraud dextrose and Mycosel® agar. Results: 32 of 130 patients had mixed onychomycosis. 68.5% were associated to tinea pedis. The most common association was between T. rubrum + Candida, T. rubrum + M. canis and T. rubrum + opportunist fungi. Conclusions: Mixed onychomycosis represent 25% of the total dystrophic onychomycosis in Guatemala. We observed an important relationship between diabetes and the main association was T. rubrum with Candida spp.


Resumen Introducción: Las onicomicosis son infecciones fúngicas de las uñas que pueden ser causadas por dermatofitos, mohos no dermatofitos y levaduras, que son capaces de degradar la queratina. Las onicomicosis mixtas son un tema polémico y es el resultado de la combinación de dos dermatofitos, dermatofitos / mohos no dermatofitos o dermatofitos / levadura. Objetivos: Determinar la frecuencia de la onicomicosis distrófica total causada por más de un agente etiológico (onicomicosis mixta) en pacientes ambulatorios de un Centro Dermatológico en Guatemala y establecer las características asociadas a esta infección fúngica. Métodos: Estudio observacional prospectivo de agosto a diciembre de 2012. Se obtuvieron muestras de uñas de pacientes con onicomicosis distrófica total para identificar los agentes causales en cultivo de agar dextrosa Sabouraud y Mycosel®. Resultados: 32 de 130 pacientes tenían onicomicosis mixta. 68.5% se asociaron a tinea pedis. La asociación más común fue entre T. rubrum + Candida, T. rubrum + M. canis y T. rubrum + hongos oportunistas. Conclusiones: La onicomicosis mixta representa el 25% de la onicomicosis distrófica total en Guatemala. Observamos una relación importante entre la diabetes y la asociación principal fue T. rubrum con Candida spp.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Onychomycosis , Dermatology , Tinea Pedis , Candida , Agar , Arthrodermataceae , Fungi , Guatemala , Infections , Nails
19.
São Paulo; s.n; 2018. 90 p. graf, ilus, tab.
Thesis in Portuguese | SES-SP, LILACS, SES-SP, SESSP-CTDPROD, SES-SP, SESSP-ACVSES | ID: biblio-972113

ABSTRACT

A onicomicose é uma infecção micótica das unhas, com interesse emSaúde Pública pela alta morbidade e ocorrência de surtos, em especial, ematletas e militares. Algumas condições mórbidas estão associadas a essaforma de micose o que pode acentuar seu caráter recidivante e crônico. Aidentificação correta dos agentes etiológicos das onicomicoses, sejamleveduras ou fungos filamentosos, pode ser subsídio para tratamentoadequado da infecção, além de fornecer indicação sobre possíveis fontes deinfecção. Este estudo teve como objetivo caracterizar e determinar asuscetibilidade a antifúngicos de fungos filamentosos agentes deonicomicoses em população militar da aeronáutica. Amostras ungueais delesões de 50 pacientes, com suspeita de onicomicose em pés ou mãos,foram coletadas para exame micológico direto, cultura, isolamento,identificação fenotípica e molecular dos agentes etiológicos. O perfil desuscetibilidade dos agentes etiológicos, frente a 3 fármacos antifúngicosusados no tratamento das onicomicoses, foi determinado pelo método dereferência americano (CLSI ). Fungos filamentosos foram implicados em 50(62,5%) casos, prevalecendo dermatófitos (43; 86%), como T. rubrum (22;44%), T. mentagrophytes var. interdigitale (19; 38%) e M. gypseum (3; 6%) enão dermatófitos (6; 12%), incluindo feo-hifomicetos como Chaetomiumglobosum (4; 8%) e hialo-hifomicetos como Fusarium solani e Scytalidiumspp. (1; 2% cada um). Em relação à suscetibilidade a antifúngicos, foiverificado que menores concentrações de terbinafina foram suficientes parainibir o crescimento fúngico do total de isolados, se comparadas às deitraconazol e fluconazol (MIC 50%/MIC 90%, respectivamente, de 0,015/0,06mg/L, 0,06/0,12 mg/L e 32/32 mg/L)...


Onychomycosis is a fungal infection of the nails, with interest in Public Healthdue to the high morbidity and occurrence of outbreaks, especially in athletesand soldiers. Some morbid conditions are associated with this form ofmycosis, which may accentuate its recurrent and chronic character. Thecorrect identification of the etiological agents of onychomycosis, whetheryeasts or filamentous fungi, can be a subsidy for adequate treatment of theinfection, as well as providing indication about possible sources of infection.This study aimed to characterize and determine de antifungal drugsusceptibility of filamentous fungi agents of onychomycosis in theaeronautical military population. Ungual samples of lesions of 80 patientswith suspicion of onychomycosis in feet or hands were collected for directmycological examination, culture, isolation, phenotypic and molecularidentification of the etiological agents. The susceptibility profile of theetiological agents to 3 antifungal drugs used in the treatment ofonychomycosis, was determined using the American reference method(CLSI). Filamentous fungi were implicated in 50 (62.5%) cases, withdermatophytes prevailing (43; 86%), such as T. rubrum (22; 44%), T.mentagrophytes var. interdigitale (19; 38%), and M. gypseum (3; 6%) ornon-dermatophytes (6; 12%), including feo-hyphomicetes such asChaetomium globosum (4; 8%), and hialo-hyphomycetes like Fusariumsolani and Scytalidium spp. (1; 2% each). Regarding susceptibility toantifungals, it was found that lower concentrations of terbinafine weresufficient to inhibit fungal growth in the total of isolates, compared toitraconazole and fluconazole (MIC 50%/90%, respectively: 0.015/0.06 mg/L,0.06/0.12 mg/L and 32/32 mg/L)...


Subject(s)
Humans , Arthrodermataceae , Fungi , Onychomycosis
SELECTION OF CITATIONS
SEARCH DETAIL