Predisposing factors, clinical features and treatment outcomes of Fusarium onychomycosis and comparison of its characteristics with Neoscytalidium onychomycosis.

BACKGROUND: Fusarium spp. are common organisms causing onychomycosis. Research on the clinical presentations and treatment of this condition is limited. OBJECTIVE: This study evaluated the demographic data, clinical characteristics, and treatment outcomes of Fusarium onychomycosis. METHODS: A retrospective study was conducted at Siriraj Hospital, Thailand. Patients with onychomycosis, at least 2 repeated positive mycological cultures for Fusarium spp., and a photo at diagnosis (January 2014-December 2019) were included. Demographic data and clinical characteristics of Fusarium onychomycosis were analyzed and compared with those of Neoscytalidium onychomycosis, the other common nondermatophytes onychomycosis in tropical countries. RESULTS: Seventeen patients with twenty-four nails were analyzed. Fusarium onychomycosis was significantly related to a history of pedicure (p = 0.04). Predominant lateral involvements of subungual hyperkeratosis onychomycosis, but without concurrent foot infections, were significantly found in Fusarium onychomycosis (p < 0.001 for each). Among the treatments, urea was 80% effective. Topical amphotericin B was 75% effective. Both amorolfine 5% nail lacquer and long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet laser were 66.7% effective. Lastly a combination of long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet laser and amorolfine 5% nail lacquer was 50% effective. CONCLUSIONS: Important predisposing factors and clinical manifestations of Fusarium onychomycosis were a history of pedicure and predominant lateral-nail involvement, but no concomitant fungal foot infections. Topical treatment (urea cream, amphotericin B, or amorolfine nail lacquer) showed excellent outcomes.

Efficacy of olive leaf extract-containing cream for facial rejuvenation: A pilot study.

BACKGROUND: Olive leaf extract (OLE), a naturally extracted product from olive leaves, contains oleuropein and other bioactive phenolic compounds. Oleuropein was identified to have various medical properties. It was also found to inhibit the effects of both acute and chronic UVB-induced skin damage as well as accelerate wound healing activity. AIMS: To evaluate the efficacy of olive leaf extract-containing cream on facial rejuvenation. METHODS: This is a prospective pilot study with a total of 36 participants, who presented with photoaging skin. All participants applied the olive leaf extract-containing cream (SUPERHEAL™ O-Live Cream, PhytoCeuticals, Inc, USA) to their whole face twice daily for 2 months. Primary outcomes measured in the study were the changes in the biophysical properties of the skin assessed with the following parameters: melanin and erythema index, transepidermal water loss (TEWL), skin hydration, skin pH, sebum level, texture, and wrinkles. RESULTS: After 2 months, TEWL decreased significantly (P = .007) and maintained the results 1 month after discontinuation of the treatment (P = .007). Skin hydration also increased significantly after 2 months (P = .004). Wrinkles improved significantly on all follow-ups (P < .001, P = .001, P = .001, respectively). An image of the skin captured using Visioscan® showed improvement of the skin texture 2 months after treatment. Majority of the participants (64%) noted improvement in their skin texture. CONCLUSION: Olive leaf extract-containing cream provided benefits on skin rejuvenation in human skin.

Assessment of the quality of life (QoL) of patients with dermatitis and the impact of patch testing on QoL: A study of 519 patients diagnosed with dermatitis.

BACKGROUND: Dermatitis can impair the quality of life (QoL) of patients. Knowledge of the QoL-associated factors and the impact of patch testing on QoL is limited. OBJECTIVES: To identify demographic and clinical factors affecting QoL, and to measure the impact of patch testing on QoL of dermatitis patients. METHODS: The data and Dermatology Life Quality Index (DLQI) questionnaires of 519 dermatitis patients were analyzed. Of these, 107 underwent patch testing and completed the questionnaires two times (once before testing and again 60 days afterward). RESULTS: The overall mean (±standard deviation) DLQI was 9.5 (±6.4). Patients aged 20 to 59 years and those who had more frequent disease exacerbations demonstrated significantly higher DLQIs. For each DLQI question, being female and aged 20 to 59 years were associated with impairments of various aspects of life, whereas the anatomical site of dermatitis impacted each question differently. The DLQI scores of the patients undergoing patch testing decreased significantly, irrespective of whether the test results were positive or negative. CONCLUSIONS: Being of a working age and having more frequent disease exacerbations had negative QoL impacts. In addition, patch testing improved almost every aspect of the DLQI.

Trichophyton erinacei Onychomycosis: The First to Evidence a Proximal Subungual Onychomycosis Pattern.

Trichophyton erinacei is an emerging cause of dermatophyte infections, which are frequently isolated from hedgehogs. Nail infections from T. erinacei are rarely reported. We describe the case of a 23-year-old Thai female who had a history of systemic lupus erythematosus with lupus nephritis type III and who developed widespread skin and nail infections caused by T. erinacei that were most likely transmitted from a hedgehog. Although the patient did not demonstrate a clinical improvement or mycological cure following systemic itraconazole and fluconazole treatment, she achieved clinical and mycological cures after terbinafine therapy. A drug susceptibility test should be performed in patients with T. erinacei infections to facilitate decision-making about antifungal therapy. Here, we are the first to report a case of proximal subungual onychomycosis from a T. erinacei infection.