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Fast elimination of onychomycosis by hematoporphyrin derivative-photodynamic therapy

Silva, Ana Paula da; Kurachi, Cristina; Bagnato, Vanderlei Salvador; Inada, Natalia Mayumi
Fonte: Elsevier BV; Amsterdam Publicador: Elsevier BV; Amsterdam
Tipo: Artigo de Revista Científica
ENG
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Onychomycosis is a fungal nail disease and is one of the major onychopathy worldwide. Topical or oral antifungal therapies are used to treat this disease, but often they are inefficient and oral medications can even cause several side effects. Photodynamic therapy (PDT) is a well established technique and hence, may represent an alternative non invasive technique for the treatment of onychomycosis. In this work, we present a case of onychomycosis that was completely cured by using the porphyrin-photodynamic therapy. A 59-year-old patient, who had two nails with onychomycosis (the right and the left hallux, with more than thirty and ten years, respectively) caused by fungi was treated once a week for a period of six weeks. The nails were first treated and prepared by a specialist. An hour after the photosensitization, the nail was illuminated using a light source based on light emitting diodes (LEDs) in the red wavelength (630 nm, at a total dose of 54 J/cm2).; FAPESP/CePOF (98/14270-8); FINEP/ Gnatus (554339/2010-2); CNPq (381132/2010-2)

Onicomicoses causadas por fungos filamentosos não dermatófitos; Onychomycosis caused by filamentous fungi non-dermatophytes

Souza, Simone Felizardo Rocha de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 08/02/2008 PT
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INTRODUÇÃO: Onicomicose, infecção das unhas por fungo é a mais freqüente das doenças ungueais, constituindo aproximadamente metade de todas as alterações ungueais. Pode ser causada por dermatófitos, leveduras ou fungos filamentosos não dermatófitos. OBJETIVO: Caracterizar as onicomicoses causadas por fungos filamentosos não dermatófitos. (1) Verificar, dentre as suspeitas clínicas de onicomicose, qual a freqüência da recuperação de fungos,(2) Verificar, dentre as suspeitas clínicas de onicomicose, quais as espécies de fungos recuperadas, (3) Verificar, dentre o total das espécies identificadas, qual a freqüência das espécies de fungos filamentosos não dermatófitos. MÉTODOS: Duzentos e cinco indivíduos com suspeita clínica de onicomicose foram estudados no período de dezembro de 2003 a novembro de 2004, por meio de exames micológicos diretos e cultura para fungos. RESULTADOS: O diagnóstico de onicomicose foi estabelecido, pelo exame micológico direto, em 170 indivíduos. O diagnóstico etiológico foi estabelecido pela cultura para fungos. Dentre os 107 agentes identificados, os dermatófitos foram identificados em 78,52% (N=84), as leveduras em 13,08% (N=14) e os FFND em 8,40% (N=9) das vezes. CONCLUSÃO: É necessário que se estabeleça o diagnóstico etiológico dos casos de onicomicoses...

Inativação dos micro-organismos causadores da onicomicose por terapia fotodinâmica - estudo in vitro e clínico; Photodynamic inactivation of micro-organisms causing onychomycosis - clinical and in vitro study

Silva, Ana Paula da
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 20/02/2013 PT
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A onicomicose é a mais frequente das doenças ungueais, pode ser causada por dermatófitos, leveduras e fungos não-dermatófitos. A infecção caracteriza-se por unhas quebradiças, espessadas e despigmentadas ou com excesso de pigmentação. O tratamento convencional consiste na administração sistêmica de antifúngicos e antibióticos por longos períodos, podendo ser o responsável pelo aumento de linhagens microbianas resistentes às drogas disponíveis. Esse fator associado a alta incidência deste tipo de infecção na população tornam importante o desenvolvimento de novas tecnologias e opções terapêuticas. Esta dissertação está composta por duas partes: pesquisa básica (estudos in vitro) e aplicada (estudo clínico), além do desenvolvimento de equipamento para o tratamento da onicomicose por Terapia Fotodinâmica (TFD). A TFD consiste no emprego do fotossensibilizador (FS) ativado por luz em comprimento de onda adequado que, na presença de oxigênio, produz espécies reativas de oxigênio tóxicas que inativam as células alvo (fungos e bactérias). Nos ensaios in vitro, utilizamos um dos principais fungos causadores da onicomicose, o Trychophyton mentagrophytes e dois fotossensibilizadores diferentes: Solução de curcuminóides (PDTPharma Ltda....

Padrões de dermatoscopia da placa ungueal nas onicomicoses; Nail plate dermoscopy patterns on onychomycosis

Bet, Diego Leonardo
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 01/07/2015 PT
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INTRODUÇÃO: Onicomicose é a infecção fúngica das unhas e é considerada a onicopatia mais frequente em adultos. Representa até 50% das lesões ungueais, sendo necessária confirmação diagnóstica com exame complementar que demostre a presença do fungo na unha, sendo o exame micológico direto e a cultura para fungos os mais utilizados. A dermatoscopia é um exame não invasivo, rápido e de baixo custo cujos padrões para onicomicose relatados na literatura em estudos retrospectivos chegam a 100% de sensibilidade e especificidade. Deste modo realizamos um estudo prospectivo para comparar a dermatoscopia frente ao exame micológico. MÉTODOS: Estudo prospectivo, transversal avaliando 109 pacientes e 202 unhas com suspeita diagnóstica de onicomicose. Os padrões dermatoscópicos encontrados foram descritos através de fotografias digitais. A sensibilidade e especificidade dos padrões de onicomicose distal-lateral foram determinados de acordo com o resultado do exame micológico. RESULTADOS: Foram significativos (p < 0,05) para o diagnóstico de onicomicose distal lateral e tiveram sensibilidade/especificidade calculadas os padrões: borda recortada (80,2% / 65,3%), borda linear (12,6% / 42,9%), estrias irregulares (81,1% / 65...

Efficacy and safety of itraconazole pulse therapy: Brazilian multicentric study on toenail onychomycosis caused by dermatophytes

Ramos-e-Silva, M.; Marques, S. A.; Gontijo, B.; Zaitz, C.; Campbell, I; Veloso, S. T.
Fonte: Elsevier B.V. Publicador: Elsevier B.V.
Tipo: Artigo de Revista Científica Formato: 109-116
ENG
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Background Itraconazole is a large spectrum triazole with known efficacy in both continuous and pulse therapy for various mycoses.Objectives Evaluate the efficacy and tolerability of itraconazole pulse therapy for onychomycosis of the toenails due to dermatophytes, in a prospective, open, non-comparative and multicentric investigation.Patients and methods the trial was completed by 72 patients of an initial total of 89. Treatment consisted of four cycles of itraconazole, 200 mg twice a day, for seven consecutive days each month. Patients were evaluated clinically, mycologically and biochemically before, during and at the end of the investigation, and were divided into two groups according to the measure of normal portion of the most affected nail (target nail), as follows: Group 1. 0-5.9 mm; and Group 2: more than 6 mm.Results Improvement was satisfactory and progressive. Results were statistically significant, when comparing the three moments of the study: pre-treatment, end of therapy (fourth month) and follow-up (ninth month) in both groups.Conclusions Itraconazole pulse therapy was efficient and safe for the treatment of onychomycosis caused by dermatophytes, although a much higher daily dosage than the known continuous administration was used. Group 1...

Toenail onychomycosis in a Portuguese geriatric population

Dias, Nicolina; Portela, M.; Santos, C.; Lima, Nelson
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica
Publicado em /07/2011 ENG
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Onychomycosis is a common fungal infection of the nail but few data of mycological features in geriatric Portuguese population are yet available. The aim of this study was to perform a mycological examination and characterization of fungal nail pattern of a geriatric population from the north of Portugal clinically suspected of onychomycosis. A total of 108 patients attending the Podology Service in the Centro Hospitalar do Alto Ave (Portugal) from October 2007 to January 2009 were enrolled. All were suspected of having onychomycosis by the abnormal appearance of their nails. From these, 59.3% were diabetic. Distal and lateral subungual onychomycosis was the more common clinical pattern followed by total dystrophic onychomycosis. In 21.3% cases, every nail in both feet had an abnormal appearance. In 86%, the hallux was involved in at least one foot. Fifty samples were culture positive, and fifty-four isolates were reported regardless of the questionable pathogenicity of the infectious agent. In three cases, clinical feature of the nail, direct microscopy, and culture were consistent with Scopulariopsis infection. Fusarium spp. were identified in three cases; however, only one isolate was preceded by the observation of branching septate filaments by direct microscopy. No mixed infections with dermatophytes were reported. Trichophyton rubrum was the dermatophyte most frequently isolated (83.3%) followed by Trichophyton interdigitale. In Portugal...

Onychomycosis in Patients with Chronic Leg Ulcer and Toenail Abnormalities

Cabete, J; Apetato, M; Galhardas, C; Lestre, S
Fonte: Scielo Publicador: Scielo
Tipo: Artigo de Revista Científica
Publicado em //2015 ENG
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Nails have a limited number of reactive patterns to disease. Accordingly, toenail changes of different etiologies may mimic onychomycosis. OBJECTIVE To determine the prevalence of toenail onychomycosis among patients with leg ulcer and toenail abnormalities attending a dermatology clinic. METHODS A cross-sectional study was conducted through the analysis of clinical records and results of mycological examination. RESULTS A total of 81 patients were included, with a median age of 76.0 years. Most ulcers were of venous etiology, followed by those of mixed and arterial pathogenesis. The mycological evaluation confirmed the diagnosis of onychomycosis in 27.2% of the patients. The etiologic agent was a dermatophyte in 59.1% of isolates in nail samples, while Trichophyton interdigitale was the most frequent fungal species (40.9%). CONCLUSIONS Most toenail abnormalities in patients with chronic leg ulcer were not onychomycosis. This study highlights the importance of systematic mycological examination in these patients, in order to avoid overtreatment with systemic antifungals, unnecessary costs and side effects.

Onychomycosis in Patients with Chronic Leg Ulcer and Toenail Abnormalities

Cabete, J; Apetato, M; Galhardas, C; Lestre, S
Fonte: Scielo Publicador: Scielo
Tipo: Artigo de Revista Científica
Publicado em //2015 ENG
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Nails have a limited number of reactive patterns to disease. Accordingly, toenail changes of different etiologies may mimic onychomycosis. OBJECTIVE To determine the prevalence of toenail onychomycosis among patients with leg ulcer and toenail abnormalities attending a dermatology clinic. METHODS A cross-sectional study was conducted through the analysis of clinical records and results of mycological examination. RESULTS A total of 81 patients were included, with a median age of 76.0 years. Most ulcers were of venous etiology, followed by those of mixed and arterial pathogenesis. The mycological evaluation confirmed the diagnosis of onychomycosis in 27.2% of the patients. The etiologic agent was a dermatophyte in 59.1% of isolates in nail samples, while Trichophyton interdigitale was the most frequent fungal species (40.9%). CONCLUSIONS Most toenail abnormalities in patients with chronic leg ulcer were not onychomycosis. This study highlights the importance of systematic mycological examination in these patients, in order to avoid overtreatment with systemic antifungals, unnecessary costs and side effects.

Onychomycosis in Ceará (Northeast Brazil): epidemiological and laboratory aspects

Brilhante,RSN; Cordeiro,RA; Medrano,DJA; Rocha,MFG; Monteiro,AJ; Cavalcante,CSP; Meireles,TEF; Sidrim,JJC
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2005 EN
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Knowledge of epidemiological and mycological characteristics of onychomycosis has been noted by many authors as being an important tool for control of these fungal infections. This study seeks to improve knowledge of onychomycosis epidemiology and mycological features. Samples were taken from infected fingernails and toenails of 976 patients undergoing treatment at a respected Dermatology Center in Ceará, Fortaleza, CE, Brazil. Specimens from 512 patients (52%) were positive for onychomycosis. From the culture-positive samples, yeasts of the genus Candida (C. albicans, C. tropicalis, C. krusei, C. parapsilosis) were dominant. The dermatophytes isolated (Trichophyton rubrum, T. tonsurans, T. mentagrophytes var. mentagrophytes) were dominant in 46 patients (12.99%). The mould Fusarium spp. was isolated from 29 patients (8.19%). Yeast of the genus Candida is the main causal factor in onychomycosis in our region. Also, the study showed the importance of performing direct examination and culture in diagnosis of onychomycosis.

Identification of fungi species in the onychomycosis of institutionalized elderly

Vasconcellos,Cidia; Pereira,Carolina Queiroz Moreira; Souza,Marta Cristina; Pelegrini,Andrea; Freitas,Roseli Santos; Takahashi,Juliana Possato
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2013 EN
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BACKGROUND: Superficial fungal infections are caused by dermatophytes, yeasts or filamentous fungi. They are correlated to the etiologic agent, the level of integrity of the host immune response, the site of the lesion and also the injured tissue. OBJECTIVE: The purpose of this study is to isolate and to identify onychomycosis agents in institutionalized elderly (60 years old +). METHODS: The identification of the fungi relied upon the combined results of mycological examination, culture isolation and micro cultures observation under light microscopy from nail and interdigital scales, which were collected from 35 elderly with a clinical suspicion of onychomycosis and a control group (9 elderly with healthy interdigital space and nails). Both groups were institutionalized in two nursing homes in Sao Bernardo do Campo, SP, Brazil. RESULTS: The nail scrapings showed 51.40% positivity. Of these, dermatophytes were found in 44.40% isolates, 27.78% identified as Trichophyton rubrum and 5.56% each as Trichophyton tonsurans, Trichophyton mentagrophytes and Microsporum gypseum. The second more conspicuous group showed 38.89% yeasts: 16.67% Candida guilliermondii...

The use of the Er:YAG 2940nm laser associated with amorolfine lacquer in the treatment of onychomycosis

Morais,Orlando Oliveira de; Costa,Izelda Maria Carvalho; Gomes,Ciro Martins; Shinzato,Dayane Higa; Ayres,Guilherme Marreta Cavalcanti; Cardoso,Rayane Marques
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2013 EN
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Onychomycosis is a common disease, accounting for up to 50% of all ungual pathologies. We have been developing a clinical trial (ClinicalTrials.gov: NCT01528813) using a 2940nm Er:YAG laser to fractionally ablate human nails in vivo, aiming to increase topical amorolfine lacquer delivery to the nail unit, increasing the efficacy of topical treatment of distal and lateral subungual onychomycosis. Partial results have shown an increase in areas of nail plate free of disease. We believe that ablative lasers can increase the efficacy of topical onychomycosis treatment.

An observational and descriptive study of the epidemiology of and therapeutic approach to onychomycosis in dermatology offices in Brazil

Chiacchio,Nilton Di; Suarez,Maria Victoria; Madeira,Celso Luís; Loureiro,Walter Refkalefsky
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2013 EN
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BACKGROUND: Onychomycosis is a type of fungal infection that accounts for over 50% of all onycopathies. Some authors consider superficial mycosis the most difficult to be treated. Very few studies have been carried out in order to assess the epidemiology of onychomycosis in Brazil. OBJECTIVE: To describe the epidemiological profile of onychomycosis in Brazilian dermatology offices and to assess the etiology of the disease, how often mycosis exams are requested, and the treatment adopted. METHODS: A descriptive, observational study was carried out between May and July, 2010. Thirty-eight dermatologists from different Brazilian regions participated in the study, and 7,852 patients with any skin diseases who had all of their nails examined were included in the study. RESULTS: Of the 7,852 patients, 28.3% were clinically diagnosed as having onychomycosis. Women over 45 years old who practiced exercises or with a personal history of the disease showed greater likelihood of having onychomycosis. The disease was most seen in the feet, and the majority of cases involved the hallux. On the hands, the index finger was the most affected. Mycosis exams were not requested for all clinically suspected cases. When exams were done...

Onychomycosis: clinical, mycological and in vitro susceptibility testing of isolates of Trichophyton rubrum

Azambuja,Christiane Venske de Almeida; Pimmel,Luciana Alves; Klafke,Gabriel Baracy; Xavier,Melissa Orzechowski
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2014 EN
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BACKGROUND: Onychomycosis or nail fungal infection is the most common nail disease. Despite the wide range of studies on this condition, it remains difficult to establish the correct diagnosis and effective treatment. OBJECTIVES: To evaluate the efficacy of classical laboratory methods for the diagnosis of onychomycosis, and the in vitro susceptibility of the its main etiological agent to antifungals used in routine. METHODS: Nail samples of 100 patients with clinically suspected feet onychomycosis were collected to confirm the diagnosis by direct mycological examination and fungal culture. In vitro antifungal susceptibility testing was performed against strains of the main dermatophyte isolated by microdilution, according to the standardized protocol (M38-A2 - CLSI) RESULTS: Clinical diagnosis of onychomycosis was confirmed by laboratory analysis in 59% of patients. Of these, 54.2% were positive only in direct mycological examination, 44.1% in direct mycological examination and culture, and one case (1.7%) was positive only in culture, resulting in weak agreement between these tests (Kappa = 0.385; p <0.001) High minimum inhibitory concentration values of fluconazole and itraconazole were observed in 66.7% and 25.0% of isolates of T. rubrum tested. Additionally...

Onychomycosis in patients with chronic leg ulcer and toenail abnormalities

Cabete,Joana; Galhardas,Célia; Apetato,Margarida; Lestre,Sara
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2015 EN
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Nails have a limited number of reactive patterns to disease. Accordingly, toenail changes of different etiologies may mimic onychomycosis. OBJECTIVE To determine the prevalence of toenail onychomycosis among patients with leg ulcer and toenail abnormalities attending a dermatology clinic. METHODS A cross-sectional study was conducted through the analysis of clinical records and results of mycological examination. RESULTS A total of 81 patients were included, with a median age of 76.0 years. Most ulcers were of venous etiology, followed by those of mixed and arterial pathogenesis. The mycological evaluation confirmed the diagnosis of onychomycosis in 27.2% of the patients. The etiologic agent was a dermatophyte in 59.1% of isolates in nail samples, while Trichophyton interdigitale was the most frequent fungal species (40.9%). CONCLUSIONS Most toenail abnormalities in patients with chronic leg ulcer were not onychomycosis. This study highlights the importance of systematic mycological examination in these patients...

Successive mycological nail tests for onychomycosis: a strategy to improve diagnosis efficiency

Meireles,Tereza Elizabeth Fernandes; Rocha,Marcos Fábio Gadelha; Brilhante,Raimunda Sâmia Nogueira; Cordeiro,Rossana de Aguiar; Sidrim,José Júlio Costa
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2008 EN
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Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts and moulds, accounting for about 50% of onychopathies. A high frequency of onychomycosis caused by Candida species has been reported during the last few years in northeast Brazil, as well as in other regions of the world. A clinical diagnosis of onychomycosis needs to be confirmed through laboratory exams. We evaluated the importance of serial repetition of direct microscopic exams and fungal culture for the diagnosis of onychomycosis in the city of Fortaleza, Ceará, in northeast Brazil. We first made a retrospective study of 127 patients with onychomycosis, identifying the fungi that had been isolated from fingernails and toenails. We then made a prospective study of 120 patients, who were submitted to three successive mycological examinations. Ungual residues were scraped off and directly examined with a microscope and fungal cultures were made. In the retrospective study, in which only one sample was analyzed, the incidence of onychomycosis was 25.0%. In our prospective study, in which we had data from successive mycological examinations, 37.8% had onychomycosis. The most commonly isolated fungi in both studies were yeasts from the genera Candida, especially C albicans...

Microsporum spp. onychomycosis: disease presentation, risk factors and treatment responses in an urban population

Martínez,Erick; Ameen,Mahreen; Tejada,Diana; Arenas,Roberto
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2014 EN
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BACKGROUND: Dermatophytes are the main causative agent of all onychomycosis, but genus Microsporum is infrequent and the risk of acquiring the infection is often associated with exposure to risk factors. OBJECTIVES: To describe clinical characteristics of onychomycosis due to Microsporum onychomycosis in an urban population. METHODS: This was a retrospective analysis of the epidemiological and clinical features of 18Microsporum onychomycosis cases of a total of 4220 of onychomycosis cases diagnosed between May 2008 and September 2011 at the tertiary referral center for mycology in Guatemala. RESULTS: Eighteen cases of Microsporum onychomycosis (M. canis, n=10; M. gypseum, n=7; M. nanum, n=1) were identified (prevalence=0.43%). Infection was limited to nails only and disease duration ranged from 1 month to 20 years (mean=6.55 years). The toenails were affected in all cases except for a single M. gypseum case of fingernail. The most common clinical presentation was distal lateral subungual onychomycosis (12/18) followed by total dystrophic onychomycosis (5/18), and superficial white onychomycosis (1/18). M. gypseumpresented in 6 cases as distal lateral subungual onychomycosis and in 1 case like total dystrophic onychomycosis. Five cases (27.78%) were associated with hypertension...

Onychomycosis due to opportunistic molds

Martínez-Herrera,Erick Obed; Arroyo-Camarena,Stefanie; Tejada-García,Diana Luz; Porras-López,Carlos Francisco; Arenas,Roberto
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2015 EN
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Abstract BACKGROUND: Onychomycosis are caused by dermatophytes and Candida, but rarely by non- dermatophyte molds. These opportunistic agents are filamentous fungi found as soil and plant pathogens. OBJECTIVES: To determine the frequency of opportunistic molds in onychomycosis. METHODS: A retrospective analysis of 4,220 cases with onychomycosis, diagnosed in a 39-month period at the Institute of Dermatology and Skin surgery "Prof. Dr. Fernando A. Cordero C." in Guatemala City, and confirmed with a positive KOH test and culture. RESULTS: 32 cases (0.76%) of onychomycosis caused by opportunistic molds were confirmed. The most affected age group ranged from 41 to 65 years (15 patients, 46.9%) and females were more commonly affected (21 cases, 65.6%) than males. Lateral and distal subungual onychomycosis (OSD-L) was detected in 20 cases (62.5%). The microscopic examination with KOH showed filaments in 19 cases (59.4%), dermatophytoma in 9 cases (28.1%), spores in 2 cases (6.25%), and filaments and spores in 2 cases (6.25%). Etiologic agents: Aspergillus sp., 11 cases (34.4%); Scopulariopsis brevicaulis, 8 cases (25.0%); Cladosporium sp., 3 cases (9.4%); Acremonium sp., 2 cases (6.25%); Paecilomyces sp., 2 cases (6.25%); Tritirachium oryzae...

The association of fractional CO2 laser 10.600nm and photodynamic therapy in the treatment of onychomycosis

Oliveira,Guilherme Bueno de; Antonio,João Roberto; Antonio,Carlos Roberto; Tomé,Fernanda Alves
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2015 EN
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AbstractBACKGROUND:Onychomycosis is a fungal infection of the nails caused in most cases by dermatophytes Trichophyton rubrum and Trichophyton mentagrophytes. Despite numerous available antifungal drugs for therapy of this infection, the cure rate is low, with high rates of relapse after treatment and side effects.OBJECTIVES:To present a new option for the treatment of onychomycosis, in search of a more effective and rapid method than conventional ones.METHODS:Patients underwent two sessions of CO2 fractional laser 10.600nm associated with photodynamic therapy. Mycological and digital photography were performed before and after the treatment.RESULTS:McNemar test with continuity correction and degrees of freedom = 1: for clinical cure rate, 13.06, with p=0.00005; for mycological cure, 17.05, with p=0.00005; 72% felt fully satisfied with the procedure.CONCLUSIONS:The use of fractional CO2 laser 10.600nm associated with photodynamic therapy can be effective in the treatment of onychomycosis, decreasing the risk of systemic lesions that may be triggered with prolonged use of oral antifungals.

The effectiveness of laser treatments for onychomycosis in adults in the community: a systematic review thesis.

Glaser, Heather Joy
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2014
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Background There is growing public interest in the application of laser therapy to common nail conditions such as onychomycosis, where traditional pharmaceutical options are long-term, expensive, messy and often unsuccessful, and suited to a limited demographic. Recent reviews highlighting the potential of laser therapies to offer effective, convenient, short duration treatment regimens have not demonstrated the effectiveness of different laser types and treatment modalities creating the need for further detailed research. This systematic review identifies, critically appraises, synthesises and presents the best available evidence for the effectiveness of laser treatments on onychomycosis of the nails in adults living in the community. The specific review question was: can laser treatment of onychomycotic nails produce outcomes comparable to the current 'gold standard’ treatment of oral terbinafine over a minimum 12 week treatment period, for adults living in the community? Methods A three step search strategy for published and unpublished studies in English language, in the date range 1/1/1985 to 30/6/2013 resulted in nine studies being critically appraised by two independent reviewers using the Joanna Briggs Institute Meta Analysis of Statistics...

The effectiveness of laser treatments for onychomycosis in adults in the community: a systematic review

Glasser, H.; Lockwood, C.S.; Lisy, K.
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
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BACKGROUND There is growing public interest in laser therapy to treat onychomycosis, where traditional pharmaceutical options are long-term, expensive, unsuccessful, and suited to a limited demographic. Recent reviews highlighting the potential of laser therapies to offer effective, convenient, short duration treatment regimens and the need for further detailed research have not demonstrated the effectiveness of different laser types and treatment modalities. This systematic review identifies, critically appraises, synthesizes and presents the best available evidence for the effectiveness of laser treatments on onychomycosis of the nails in adults living in the community. The specific review question addressed was the following: Can laser treatment of onychomycotic nails produce outcomes comparable to the current ‘gold standard’ treatment of oral terbinafine over a minimum 12 week treatment period, for adults living in the community? METHODS This systematic review is based on the development and publication of an a priori protocol where population, intervention comparator and outcomes, and inclusion and exclusion criteria are clearly defined. A three step search strategy for published and unpublished studies in English language...