Cargando…
Dermatophytomas: Clinical Overview and Treatment
Dermatophytomas are characterized as a hyperkeratotic fungal mass in the subungual space, showing as dense white or yellow, typically in longitudinal streaks or patches. Masses can be visualized by traditional microscopy or histology. Newer technologies such as dermoscopy and optical coherence tomog...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323405/ https://www.ncbi.nlm.nih.gov/pubmed/35887497 http://dx.doi.org/10.3390/jof8070742 |
_version_ | 1784756542420025344 |
---|---|
author | Gupta, Aditya K. Wang, Tong Cooper, Elizabeth A. |
author_facet | Gupta, Aditya K. Wang, Tong Cooper, Elizabeth A. |
author_sort | Gupta, Aditya K. |
collection | PubMed |
description | Dermatophytomas are characterized as a hyperkeratotic fungal mass in the subungual space, showing as dense white or yellow, typically in longitudinal streaks or patches. Masses can be visualized by traditional microscopy or histology. Newer technologies such as dermoscopy and optical coherence tomography also provide visual features for dermatophytoma diagnosis. The density of fungal mass, and lack of adherence to the nail structures, as well as possible biofilm development, may play a role in the reduction in drug penetration and subsequent lack of efficacy with traditional oral therapies such as terbinafine and itraconazole. A combination of drug treatment with mechanical or chemical debridement/avulsion has been recommended to increase efficacy. The topical antifungal solutions such as tavaborole, efinaconazole, and luliconazole may reach the dermatophytoma by both the transungual and subungual routes, due to low affinity for keratin and low surface tension. Current data indicates these topicals may provide efficacy for dermatophytoma treatment without debridement/avulsion. Similarly, fosravuconazole (F-RVCZ) has an improved pharmacological profile versus ravuconazole and may be an improved treatment option versus traditional oral therapies. The availability of improved treatments for dermatophytomas is crucial, as resistance to traditional therapies is on the increase. |
format | Online Article Text |
id | pubmed-9323405 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93234052022-07-27 Dermatophytomas: Clinical Overview and Treatment Gupta, Aditya K. Wang, Tong Cooper, Elizabeth A. J Fungi (Basel) Review Dermatophytomas are characterized as a hyperkeratotic fungal mass in the subungual space, showing as dense white or yellow, typically in longitudinal streaks or patches. Masses can be visualized by traditional microscopy or histology. Newer technologies such as dermoscopy and optical coherence tomography also provide visual features for dermatophytoma diagnosis. The density of fungal mass, and lack of adherence to the nail structures, as well as possible biofilm development, may play a role in the reduction in drug penetration and subsequent lack of efficacy with traditional oral therapies such as terbinafine and itraconazole. A combination of drug treatment with mechanical or chemical debridement/avulsion has been recommended to increase efficacy. The topical antifungal solutions such as tavaborole, efinaconazole, and luliconazole may reach the dermatophytoma by both the transungual and subungual routes, due to low affinity for keratin and low surface tension. Current data indicates these topicals may provide efficacy for dermatophytoma treatment without debridement/avulsion. Similarly, fosravuconazole (F-RVCZ) has an improved pharmacological profile versus ravuconazole and may be an improved treatment option versus traditional oral therapies. The availability of improved treatments for dermatophytomas is crucial, as resistance to traditional therapies is on the increase. MDPI 2022-07-19 /pmc/articles/PMC9323405/ /pubmed/35887497 http://dx.doi.org/10.3390/jof8070742 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Gupta, Aditya K. Wang, Tong Cooper, Elizabeth A. Dermatophytomas: Clinical Overview and Treatment |
title | Dermatophytomas: Clinical Overview and Treatment |
title_full | Dermatophytomas: Clinical Overview and Treatment |
title_fullStr | Dermatophytomas: Clinical Overview and Treatment |
title_full_unstemmed | Dermatophytomas: Clinical Overview and Treatment |
title_short | Dermatophytomas: Clinical Overview and Treatment |
title_sort | dermatophytomas: clinical overview and treatment |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323405/ https://www.ncbi.nlm.nih.gov/pubmed/35887497 http://dx.doi.org/10.3390/jof8070742 |
work_keys_str_mv | AT guptaadityak dermatophytomasclinicaloverviewandtreatment AT wangtong dermatophytomasclinicaloverviewandtreatment AT cooperelizabetha dermatophytomasclinicaloverviewandtreatment |