Quantification of iodiconazole by LC-MS/MS, a new topical transdermal cream, in dermatophytosis patients' plasma.

BACKGROUND: A rapid and sensitive LC-MS/MS method was established to measure iodiconazole (ADKZ) in dermatophytosis patients treated topically with 2% ADKZ cream. METHODOLOGY: ADKZ was extracted by liquid-liquid extraction (LLE) and separated by an Agilent Zorbax SB-C18 column (2.1 × 150 mm, 3.5 µm) using methanol - 0.01% formic acid (70:30, v/v) as the mobile phase. All the validation assays met the acceptable criteria and the linearity ranged from 10 to 1000 pg/ml. CONCLUSION: The method has been validated to be simple, sensitive and successfully applied to the study. The average amount of ADKZ absorbed into blood was approximately 0.51 µg daily, and ADKZ blood concentrations were consistent during the four-week treatment course. The cumulation of ADKZ in vivo was almost negligible.

New insights into genes, immunity, and the occurrence of dermatophytosis.

Fungal infections in humans are among the most prevalent diseases globally. Superficial invasion by dermatophytes leads to skin, hair, and nail infection. Even though they have usually been associated with extrinsic conditions such as immunosuppression, environmental factors, and contaminated individuals, objects, or surfaces; people are not equally susceptible to dermatophyte infection, even when they have the same risk factors. This commentary summarizes findings that provide evidence of familial or genetic predisposition to fungal infection, mediated by innate and/or adaptive immunity.

Low DEFB4 copy number and high systemic hBD-2 and IL-22 levels are associated with dermatophytosis.

Dermatophytes initiate dermatophytosis, but susceptibility to infection is dictated by host genetic factors, although the role of some of these-such as human beta-defensin 2 (hBD-2) genomic (DEFB4) copy number (CN) variation and its induction by IL-22-remains unclear. This was investigated in this cross-sectional study in 442 unrelated Caucasian subjects, including 195 healthy controls and 247 dermatophytosis patients who were divided into five subgroups according to clinical presentation. DNA samples were evaluated for DEFB4 CN variation by relative quantification using the comparative CT method, and serum hBD-2 and IL-22 levels were determined by ELISA. DEFB4 CN in patients was significantly lower and, except in the tinea cruris subgroup, serum hBD-2 levels were higher than in controls. The positive correlation between hBD-2 levels and DEFB4 CN observed in controls was not detected in patients, who also had higher serum IL-22 levels that were positively correlated with hBD-2 levels. Moreover, unlike in control subjects, the serum IL-22 level was negatively correlated with DEFB4 CN in patients. Taken together, these findings suggest an association between decreased DEFB4 CN, elevated serum hBD-2 and IL-22 levels, and dermatophytosis, underscoring a gene/cytokine interaction in the occurrence of this infection.

Trace minerals status and antioxidant enzymes activities in calves with dermatophytosis.

The aim of this study was to determine the levels of trace minerals Zn, Cu, and Se, the effect of dermatophytosis on the level of thiobarbituric acid reactive substances (TBARS) as an indicator of lipid peroxidation, the status of enzymatic and nonenzymatic antioxidants, and the relationship between the mentioned trace minerals and antioxidant defense system in calves with dermatophytosis. A total of 21 Holstein calves with clinically established diagnosis of dermatophytosis and an equal number of healthy ones were included in this study. Results showed that 81% of mycotic isolates were Trichophyton verrucosum, while 19% were Trichophyton mentagrophytes. The level of Zn, Cu, Se, and glutathione (GSH) and the activity of the antioxidant enzymes, glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) were significantly (P

[Multicentric and localized tineas in immunocompromised patients]. / Tiñas multifocales y localizadas en pacientes inmunosuprimidos.

From the dermatological point of view, multifocal or multicentric tineas are widespread dermatophytic infections affecting two or more anatomical areas. In the immunosuppressed patient, these lesions are frequently atypical and the risk factors are not well established. The aims of this study were: to determine the risk factors associated to multicentric tinea in immunocompromised patients; to evaluate the immune response by trichophytin and candidin skin test, to determine the etiological agent and to quantify some serum interleukines. Thirty-six multicentric tinea and 37 localized tinea patients, both with immunocompromised factors, were included. By means of a questionnaire several risk factors were identified; the trichophytin and candidin skin test was evaluated after 48 hours. Mycological direct examination and culture were performed. The interleukins IL-2, IL-4, IL-10 and interferon gamma were quantified by ELISA. Statistical analysis was made by Chi-square, U Mann Whitney and logistic regression. In disseminated tinea patients a predominance of females (69%) versus localized tinea patients (30%) was observed. Prednisone, azathioprine and cyclophosphamide treatment was associated to multicentric tinea. Trichophytin was negative in all disseminated tinea patients and positive in only three localized tinea cases, candidin was positive in six and eight cases of multicentric and localized tinea respectively. Trichophyton rubrum was the most frequent etiological agent. No differences in interleukin concentrations were found. Female gender and some immunosuppressor treatments were associated with a high probability to develop multicentric tinea. In this study a defect in the cellular immune response was the possible explanation for the extensive reactions.

Effects of trichophytosis on serum zinc levels in calves.

The purpose of this study was to determine the zinc levels in calves with trichophytosis and to research the importance of zinc for fungi. The sera of 20 calves with trichophytosis and 10 healthy calves were used in this study. Zinc levels of the sera were measured by the atomic absorption spectrophotometer method. Serum zinc levels of diseased and healthy animals were found to be 42.0+/-16.6 microg/dL and 75.8+/-5.9 microg/dL, respectively. Serum zinc levels of diseased calves were lower than healthy ones and this difference were found to be important statistically (p<0.001), whereas there is no statistical difference on the levels of lymphocyte, monocyte, granulocyte, erythrocyte, hemoglobin, hematocrit, and mean corpuscular volume between groups. These parameters were not influenced by low zinc levels.

A comparative survey of serum androgenic hormones levels between male patients with dermatophytosis and normal subjects.

Fungal growth can be influenced by human physiological mediators such as androgenic hormones. The aim of this study was to investigate a possible relationship between androgenic hormones and susceptibility to dermatophytosis. To this purpose we measured the levels of testosterone, androstendione, and dehydroepianderosterone sulfate (DHEA-S) in 60 male patients with dermatophytosis due to Epidermophyton floccosum and Trichophyton rubrum by enzyme link immunoassay. Serum testosterone concentration was found to be significantly lower in patients with E. floccosum than in healthy subjects. No significant differences in androstendione and DHEA-S levels were noted between the patients and the healthy individuals. The results showed that testosterone concentration can be considered a predisposing factor for tinea cruris infection.

Dermatophytosis: association between ABO blood groups and reactivity to the trichophytin.

The authors investigated the relationship between dermatophytosis and ABO blood groups through blood typing, identification of isolated dermatophytes and specific cellular immune response of 40 individuals carriers of this mycosis. They verified that the fungus Trichophyton rubrum, isolated from 54.5% of the patients, was more frequent in individuals belonging to blood group A. The cellular immune response, evaluated through the trichophytin antigen, was positive in 25% of the studied patients; the presence of immediate reactions (30 minutes) was verified in 35%. The blood group distribution among patients with dermatophytosis and control groups was, respectively: 47.5% X 36% in group A, 40% X 50% in group O, 12. 5% X 11% in group B. Even though the authors have found a higher number of patients belonging to blood group A infected by T. rubrum, these results suggest that there is no statistical evidence that these individuals are more susceptible to dermatophytosis.

Dermatophytosis: association between ABO blood groups and reactivity to the trichophytin

The authors investigated the relationship between dermatophytosis and ABO blood groups through blood typing, identification of isolated dermatophytes and specific cellular immune response of 40 individuals carriers of this mycosis. They verified that the fungus Trichophyton rubrum, isolated from 54.5 percent of the patients, was more frequent in individuals belonging to blood group A. The cellular immune response, evaluated through the trichophytin antigen, was positive in 25 percent of the studied patients; the presence of immediate reactions (30 minutes) was verified in 35 percent. The blood group distribution among patients with dermatophytosis and control groups was, respectively: 47.5 percent X 36 percent in group A, 40 percent X 50 percent in group O, 12.5 percent X 11 percent in group B. Even though the authors have found a higher number of patients belonging to blood group A infected by T. rubrum, these results suggest that there is no statistical evidence that these individuals are more susceptible to dermatophytosis

Dermatophytosis: association between ABO blood groups and reactivity to the trichophytin / Dermatofitose: associação entre grupos sanguíneos ABO e reatividade à tricofitina

The authors investigated the relationship between dermatophytosis and ABO blood groups through blood typing, identification of isolated dermatophytes and specific cellular immune response of 40 individuals carriers of this mycosis. They verified that the fungus Trichophyton rubrum, isolated from 54.5 percent of the patients, was more frequent in individuals belonging to blood group A. The cellular immune response, evaluated through the trichophytin antigen, was positive in 25 percent of the studied patients; the presence of immediate reactions (30 minutes) was verified in 35 percent. The blood group distribution among patients with dermatophytosis and control groups was, respectively: 47.5 percent X 36 percent in group A, 40 percent X 50 percent in group O, 12.5 percent X 11 percent in group B. Even though the authors have found a higher number of patients belonging to blood group A infected by T. rubrum, these results suggest that there is no statistical evidence that these individuals are more susceptible to dermatophytosis

Os autores investigaram a relação entre dermatofitose e grupos sanguíneos ABO por meio da tipagem sanguínea, identificação de dermatófitos isolados e resposta imune celular específica de 40 indivíduos portadores dessa micose. Verificaram que o fungo Trichophyton rubrum, isolado de 54,5 por cento dos pacientes, era mais frequente em indivíduos pertencentes ao grupo sanguíneo A. A resposta imune celular, avaliada pelo antígeno tricofitina, foi positiva em 25 por cento dos pacientes estudados; a presença de reações imediatas (30 minutos) foi verificada em 35 por cento. A distribuição do grupo sanguíneo entre os pacientes com dermatofitose e grupos controle foi, respectivamente: 47,5 por cento X 36 por cento no grupo A, 40 por cento X 50 por cento no grupo O, 12,5 por cento X 11 por cento no grupo B. Mesmo que os autores encontraram um maior número de pacientes pertencentes ao grupo sanguíneo A infectado por T. rubrum, estes resultados sugerem que não há evidências estatísticas de que esses indivíduos sejam mais suscetíveis à dermatofitose

ABO blood groups in relation to the infection rate of dermatophytosis.

The role of ABO blood groups in the carriage rate of dermatophytosis was studied. Blood grouping was done for 108 culture-proven dermatophytosis patients. Forty-nine patients belonged to blood group A, 54 to blood group O, three to blood group B and two to blood group AB. The incidence of dermatophytosis was found to be high in patients of blood group O and A. However, chronicity of the disease was more frequent in those in blood group A. The control group consisted of 100 healthy subjects. Sixteen out of 29 control subjects belonging to blood group A had a history of skin infections. None of the O blood group control subjects had a history of skin infections. Our study suggests that A blood group subjects may be prone to chronic dermatophytosis.

Defective phagocytosis in chronic trichophytosis.

Chronic trichophytosis as a primary clinical entity (primary chronic trichophytosis, PCT) is increasingly encountered in the literature. Its prevalent cause in Croatia is the anthropophilic form of Trichophyton interdigitale. Chronicity of the disease may result from immunological defects of the patients. Thus, in 62 patients with PCT: skin testing, enumeration of T- and B-lymphocytes in the peripheral blood, quantitation of immunoglobulin classes, and phagocytosis (random mobility, ingestion, digestion and extracellular killing) by peripheral blood leukocytes was tested. The findings were compared to those in healthy persons. Defective phagocytosis (random mobility, ingestion and digestion) was found in patients with PCT (P < 0.001). All the other results were within the control range. Therefore, PCT seems to be associated with defective phagocytosis of peripheral blood leukocytes in affected persons.

Itraconazole therapy for recalcitrant dermatophyte infections.

Five patients with recurrent Trichophyton rubrum infections had become unresponsive to topical and oral antifungal therapy. These patients were treated in an open trial of itraconazole, a new oral antifungal medication. Each patient responded promptly to therapy within 1 month and showed marked improvement at the end of 3 to 6 months of therapy. Complete clearing of toenail infections was not achieved in this limited trial and recurrences occurred in the four patients who had toenail infections. The drug was well tolerated and no adverse effects were observed. Itraconazole appears to be an effective drug for relief of clinical aspects of recalcitrant dermatophyte infections. Long-term safety and prevention of recurrence remain to be established.

Topically applied griseofulvin in prevention and treatment of Trichophyton mentagrophytes.

Griseofulvin is not considered effective in treatment of superficial fungal infections. However, when applied topically in organic solvents, the drug appeared in very high concentration in all levels of stratum corneum, and it generally persisted there in measurable amounts for four or more days after a single application. Based on this observation, double-blind experimental prophylactic and therapeutic studies were conducted. Topically applied griseofulvin in alcohol solution was highly effective in preventing experimentally induced Trichophyton mentagraphytes infection, but it had no therapeutic effect once the infection was initiated. Topically administered griseofulvin may prove useful in prevention of recurrences or as an adjunct to therapy in selected cases of superficial fungal infection.