Ketoconazole-p Aminobenzoic Cocrystal Exhibits a Potent Anti-inflammatory Effect on the Skin of BALBc Mice

Fungal infections are a growing global health problem. Therefore, our group has designed and characterized a novel cocrystal formulation starting from ketoconazole and para-amino benzoic acid, named KET-PABA aiming to improve the bioavailability, biocompatibility, and efficiency of the parent drug. The cocrystal showed improved physical properties, such as stability in suspension, solubility, as well as antimycotic efficiency as compared to ketoconazole. The current study investigated the local possible side effects induced on BALBc mice skin by the application of KET-PABA cocrystal. KET-PABA proved to be safe, without signs of skin sensitization as shown by the mouse ear sensitization test (MEST), or histopathology. KET-PABA induced a potent anti-inflammatory effect through the inhibition of proinflammatory cytokines such as IL1α, IL1β, IL6 and TNFα, and other inflammation promoters such as NRF2, compared to the vehicle. KET-PABA had no effect on the levels of the anti-inflammatory cytokine IL10, or proinflammatory enzyme COX2 and had minimal effects on the activation of the NFκB pathway. Overall, KET-PABA application induced no sensitization, moreover, it induced an anti-inflammatory response. Based on the improved antimycotic effect versus ketoconazole and the anti-inflammatory action, KET-PABA cocrystal has the potential to be an efficient drug in the treatment of cutaneous mycosis.

The prevalence of dermatophytoses in Brazil: a systematic review

Dermatophytosis is a common cutaneous mycosis worldwide whose prevalence in Brazil is still unknown. This systematic review has estimated the burden of dermatophytoses from updated literature data reported in the general Brazilian population. We used the following databases: Web of Science, Medline/PubMed, Embase, The Cochrane Library and Scopus for studies published between 2011 and 2020. Original articles with an emphasis on prevalence data for dermatophytosis in the Brazilian population, and diagnosed by culture exam or molecular biology were eligible. We also assessed the methodological quality of the studies. A total of 24 articles met the inclusion criteria and were reviewed. The occurrence of dermatophytoses found in the studies ranged from 4–88.50 %. The pooled prevalence of dermatophytosis for the population studies was 25 % (95 % CI: 24.7–25.3 %). The size of the samples used in the studies ranged from 45 to 36 446 participants, and ages ranged up to 98 years old. The populations studied involved mostly women. The presence of tinea unguium (toenail and fingernail) and tinea pedis were the most frequent dermatophytosis, and we observed a predominance of Trichophyton rubrum, T. interdigitale and T. mentagrophytes. The studies were primarily conducted in patient groups with suspected mycoses and were not entirely representative of the general population. Yet we believe that in the future, more collaborative strategies would improve both diagnostic capacity and epidemiological methodologies, associating the prevalence of dermatophytosis with social and environmental risk factors. This review helps to better understand future epidemiological trends in Brazil and the world.

Surveillance of Zoonotic Parasites in Animals Involved in Animal-Assisted Interventions (AAIs)

Animal-assisted interventions (AAIs) are based on the establishment of a therapeutic relationship between animals and beneficiaries that is certain to provide positive effects, while currently, it reads as if AAIs aim at exposing stakeholders to potential risk of infection. The surveillance of zoonotic pathogens is necessary for guaranteeing common health. This study investigated the presence of potentially zoonotic parasites, including dermatophytes, in animals involved in AAIs. Between 2015 and 2017, 190 animals (equids, dogs, cats, birds, rabbits, rodents, and goats) were investigated. Anamnestic and management data were recorded. Individual faecal samples were analysed using a copromicroscopic procedure. Fur and skin were examined for ectoparasites during clinical examinations, and samples for mycological investigation were collected by brushing. Parasites were described in 60 (31.6%) investigated animals. Thirteen out of the 60 (21.7%) animals harboured potentially zoonotic parasites, mainly recovered in dogs (Ancylostomatidae, Eucoleus aerophilus, Toxocara canis, and Giardia duodenalis) and a cat (G. duodenalis). Nannizzia gypsea and Paraphyton mirabile, potential agents of cutaneous mycosis, were isolated in a dog and a horse, respectively. No ectoparasites were found. AAIs might represent a source of infections either directly or via environmental contamination. Thus, active surveillance is necessary and animal screenings should be planned and scheduled according to the risk of exposure.

CHROMOBLASTOMYCOSIS: A REPORT OF 2 CASES WITH LITERATURE REVIEW

Chromoblastomycosis is primarily a cutaneous mycosis caused by demetiaceous fungi. Microscopic examination with findings of muriform bodies are pathognomonic for the diagnosis of Chromoblastomycosis and if not specifically looked for, there is a chance of missing the diagnosis leading to improper treatment and complications. Here we report 2 cases, one of a middle aged woman, the other of an elderly man presenting with lower limb skin lesions histopathologically diagnosed as chromoblastomycosis.

Mycosis Fungoides of the True Vocal Folds: A Case Report

Objectives: To report a case of laryngeal involvement of mycosis fungoides and its symptomatic treatment with laser-assisted surgical ablation. Methods: Case report and literature review. Results: A 76-year-old woman with longstanding MF previously treated with Brentuximab Vedotin who developed persistent cough and dysphonia. The patient’s laryngeal disease burden was treated with KTP-laser ablation and further reduced with doxorubicin and radiotherapy. Conclusions: Although laryngeal, and especially glottic, involvement is a rare finding, suspicion should be maintained in symptomatic patients with cutaneous mycosis fungoides. This the first reported surgical laser treatment of laryngeal symptoms in this context, which can greatly improve a patient’s quality of life.

Emerging threat in antifungal resistance on superficial dermatophyte infection

Background: Dermatophytosis are most common fungul infection globally and according to WHO the prevalence is about 20-25% and does not spare people of any race or age. Over the past few years antifungal resistance has been emerged due to irrational use of antifungal drugs in cutaneous mycosis. Objective: The aim of the study is to evaluate the efficacy of different antifungul drugs (Terbinafin. Fluconazole, Itraconazole, Griseofulvin) on superficial mycosis depending on various factors. Methods: This prospective study was conducted among the Superficial fungul infected patients from April' 2017 to October 2017 in Khulna Medical College Hospital (KMCH) and dermatologist's private chamber in Khulna city. All the enrolled patients were put on oral Terbinafin, Fluconazole, Itraconazole and Griseofulvin. Each patient was given single antifungal drug orally. These cases were thus followed up after two months of treatment to look for persistent infection, cure or any relapse clinically. Result: Among 194 patient 89 were given Tab. Terbinafin (250mg) where resistance cases were 20.22%. More cases (33.96%) were resistant to Cap. Fluconazol (50mg). High percentage of cases were resistant to Cap. Itraconazole (76.47%). Griseofulvin resistant cases were observed in 25.71%. Drug response is very poor (69%) in patient who had been suffering from diabetes mellitus. Conclusion: Appropriate antifungal drugs should be chosen with strict indication, dose, duration, selection of perfect local preparation and taking laboratory facilities where necessary. Bang Med J (Khulna) 2018; 51 : 21-24