tretinoin and Dermatomycoses

The use of biological drugs in psoriasis is replacing traditional therapies due to their specific mechanism and limited side effects. However, the use of Interleukin 17 inhibitors and the modification of its cytokine pathway could favor the risk of fungal infections. All-trans retinoic acid is an active metabolite of vitamin A with anti-inflammatory and immunoregulatory properties through its capacity to stimulate both innate and adaptive immunity and to its effects on proliferation, differentiation and apoptosis in a variety of immune cells. Furthermore, it has been recently discovered that All-trans retinoic acid has a direct fungistatic effect against Candida and Aspergillus Fumigatus. On the basis of these new insights, in the current review, we suggest that the evaluation of serum level of All-trans retinoic acid or vitamin A should be considered as a predictive marker for the development of fungal infections among psoriatic patients treated with Interleukin 17 inhibitors. In clinical practice, vitamin A test could be added in the routine hospital diagnostic management for a better selection of psoriatic patients eligible to Interleukin 17 inhibitors.

Topics: Antibodies, Monoclonal, Humanized; Biomarkers; Candidiasis; Cytokines; Dermatomycoses; Humans; Interleukin-17; Mycoses; Patient Selection; Predictive Value of Tests; Psoriasis; Risk; Signal Transduction; Tretinoin; Vitamin A

Thirty-four patients with hereditary palmo-plantar keratoderma (HPPK) were examined with regard to dermatophyte infections. Twenty-two of the patients (65%) had dermatophytosis, a figure indicating a predisposition of this type of infection. E. floccosum was found in %0% of the HPPK patients as compared with 17% of the dermatophytoses of palms and soles in non-HPPK patients (p less than 0.01). Topical treatment of HPPK with 0.05% retinoic acid without occlusion had no observable effect.

Topics: Administration, Topical; Adolescent; Adult; Aged; Candida albicans; Child; Child, Preschool; Clinical Trials as Topic; Dermatomycoses; Epidermophyton; Female; Humans; Infant; Keratoderma, Palmoplantar; Male; Middle Aged; Tretinoin; Trichophyton

The drugs used in the treatment of superficial mycoses include substances with an indirect affect on the organisms such as the keratolytics as well as antifungal compounds. The antifungals include specific inhibitory compounds such as the polyene or imidazole antibiotics and substances with a wider spectrum of antiseptic activity. High cure rates (80-90%) can be achieved by most specific antifungals although this can be affected by the host response and the location of the infection. The orally active antifungals used in superficial disease, ketoconazole and griseofulvin, can be used in conditions unresponsive or inaccessible to topical therapy, such as chronic superficial candidosis and tinea capitis. However, the treatment of onychomycosis, particularly affecting toe nails, is highly unsatisfactory. There is therefore an important place for new drugs and new methods of applying them in the treatment of superficial (local) mycoses.

Topics: Administration, Oral; Administration, Topical; Amphotericin B; Antifungal Agents; Benzoates; Dermatomycoses; Drug Combinations; Etretinate; Female; Griseofulvin; Humans; Imidazoles; Ketoconazole; Nystatin; Potassium Permanganate; Resorcinols; Salicylates; Salicylic Acid; Suppositories; Tretinoin; Vagina