agar and Onychomycosis

Despite promising pharmacodynamic and pharmacokinetic profiles, modern antifungals exhibit limited efficacy in the treatment of onychomycoses. The clinical and mycological data are far from reaching a complete cure even after long-course treatments extending over many months. After reviewing the histological presentation of onychomycoses, one of the main reasons for treatment failure and disease recurrence appears to be the presence of dormant chlamydospores and arthroconidia inside the infected nail plate. Accordingly, we present a novel concept in onychomycosis treatment. It consists of the combination of an antifungal with a device boosting germination of fungal propagules in order to render these cells more responsive to treatment. Preliminary results of a pilot study support such a concept.

Topics: Administration, Topical; Adult; Agar; Antifungal Agents; Combined Modality Therapy; Culture Media; Humans; Middle Aged; Morpholines; Nails; Onychomycosis; Pilot Projects; Spores, Fungal; Trichophyton

Luliconazole, recently launched in Japan, is a novel topical imidazole antifungal agent for the treatment of onychomycosis. Using in vitro onychomycosis model, the effect of luliconazole on the morphology of the growing hyphae of Trichophyton mentagrophytes was investigated by scanning electron microscopy (SEM). The model was produced by placing human nail pieces on an agar medium seeded with conidia of T. mentagrophytes. After incubating the agar medium for 3 days, luliconazole was applied to the surface of the nail in which hyphal growth was recognized, then cultured for up to 24 h. The initial change after treatment with the drug was the formation of fine wrinkles on the surface of the hyphae, eventually, the hyphae were flattened, and after that, no hyphal growth was observed. On the other hand, when the nails were pretreated with luliconazole for 1 h, no hyphal growth was observed even after culturing for 24 h. This study suggests that luliconazole has a strong antifungal activity by inhibiting the ability of fungi to grow and the drug has both excellent nail permeation and retention properties.

Topics: Agar; Antifungal Agents; Culture Media; Humans; Hyphae; Imidazoles; Onychomycosis

Nail thickening is a poor prognostic factor in onychomycosis. Mechanical reduction by micromotor nail grinding is an alternative treatment for onychomycosis. However, this treatment introduces a large amount of infected nail dust particles into the air and can adversely affect other patients and health-care providers. The innovative recirculating airflow safety cabinet (ASC) was developed to prevent the spread of these generated infected nail dust particles. The aim of this study was to determine the efficacy of the ASC in patients with onychomycosis or traumatic onychodystrophy.. The ASC was used during the nail-grinding process in 50 patients, including 36 onychomycosis patients and 14 traumatic onychodystrophy patients. For each patient, five Sabouraud dextrose agar plates with chloramphenicol were positioned within the working space of the ASC, and the other five plates were positioned near the area of air exit after the carbon filters within the cabinet. A total of 500 plates were incubated at 25°C and evaluated every 7 days. The results of fungal cultures were analyzed.. In the traumatic onychodystrophy group, all fungal cultures of nail dust particles from both before and after filtration from the ASC were negative in all 14 patients. In the onychomycosis group, 52 fungal cultures (28.9%) from nail particles within the ASC working area tested positive; however, the results of fungal cultures of nail dust particles after filtration were all negative.. The newly developed ASC was found to be effective for preventing the spread of infected nail dust particles generated by micromotor nail grinding to mechanically reduce nail thickness in patients with onychomycosis.

Topics: Agar; Dust; Glucose; Humans; Nail Diseases; Nails; Nails, Malformed; Onychomycosis

Many topical commercial products are currently available for the treatment of onychomycosis. However, limited data are available concerning their antifungal activity. Using an in vitro onychomycosis model, the daily application of seven nail formulations was compared to the antifungal reference drug amorolfine (Loceryl(®) ) and evaluated for inhibitory activity against Trichophyton mentagrophytes using an agar diffusion test. Of all commercial nail formulations, only Excilor(®) and Nailner(®) demonstrated inhibitory activity, which was much lower compared to the daily application of Loceryl(®) . However, Excilor(®) showed similar efficacy compared to the conventional weekly application of Loceryl(®) . These results suggest a role for organic acids in the antifungal effect of Excilor(®) (acetic acid, ethyl lactate) and Nailner(®) (lactic acid, citric acid, ethyl lactate) as all tested formulations without organic acids were inactive.

Topics: Administration, Topical; Agar; Animals; Antifungal Agents; Cattle; Cosmetics; Disease Models, Animal; Hoof and Claw; Immunodiffusion; Morpholines; Onychomycosis; Trichophyton

Topics: Adult; Agar; Candidiasis, Cutaneous; Female; Glucose; Humans; Microsporum; Nails; Onychomycosis; Tinea Pedis; Trichophyton

Topics: Agar; Diagnosis, Differential; Edible Grain; Epidermophyton; Fingers; Griseofulvin; Humans; Hydroxides; Methods; Microscopy; Nails; Onychomycosis; Potassium; Tellurium; Time Factors; Toes; Trichophyton

Topics: Adult; Agar; Animals; Birds; Feathers; Glucose; Guinea Pigs; Hair; Humans; Male; Onychomycosis; Peptones; Plants; Spores; Textiles; Trichophyton

Topics: Agar; Antibiosis; Candida; Cryptococcus; Fingers; Humans; Nails; Onychomycosis; Rhodopseudomonas; Toes; Trichophyton

Topics: Adolescent; Adult; Agar; Child; Child, Preschool; Europe; Female; Humans; Male; Onychomycosis; Tinea; Tinea Pedis; Trichophyton