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  • 1
    Electronic Resource
    Electronic Resource
    Oxford BSL : Blackwell Science Ltd
    British journal of dermatology 140 (1999), S. 0 
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Trichophyton mentagrophytes is a common cosmopolitan dermatophyte species composed of two varieties: T. mentagrophytes var. interdigitale (anthropophilic form) and T. mentagrophytes var. mentagrophytes (zoophilic form). We used a random amplified polymorphic DNA (RAPD) method to study the genetic diversity of 46 clinical isolates of the T. mentagrophytes complex collected from 38 patients with different geographical origins (Europe, Africa, South America). The T. mentagrophytes were isolated either from a unique lesion for 31 patients, including two patients living together, or from at least two sites for seven patients. Only one primer of 15 primers tested showed DNA polymorphism in the isolates, producing 23 distinct patterns belonging to three clusters. There was no specific cluster grouping isolates from the same geographical origin. The same pattern is shared by all the four T. mentagrophytes var. mentagrophytes and 13 of 42 T. mentagrophytes var. interdigitale. An identity of strains responsible for several lesions in seven individuals suggests an homogeneous T. mentagrophytes population in the case of multiple lesions. In contrast, the dissimilarity of two strains recovered from two patients living together argues against person-to-person transmission in that case. This study indicates that RAPD can be successfully applied to show genetic diversity among T. mentagrophytes isolates.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Journal of the European Academy of Dermatology and Venereology 19 (2005), S. 0 
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  There are currently three main treatment strategies for onychomycosis: topical, oral and combination. Amorolfine nail lacquer appears to be the most effective form of topical monotherapy. However, the best mycological and clinical cure rates are obtained with combination therapy. Combination therapy increases antifungal spectrum, fungicidal activity and safety. New antifungals (triazoles and echinocandins) were recently developed, enabling new protocols.Objectives  To review available therapies. To design an algorithm for the management of onychomycoses in daily practice.Results  Therapeutic choice should be based on numerous factors including patient's age and health, aetiology, extent of involvement and clinical form.The consensus was that topical monotherapy is recommended when 〈 50% of the nail is affected without matrix area involvement. Oral monotherapy or combination therapy is indicated when 〉 50% of the nail, including the matrix area, is involved. Topical treatments should not be used alone when topical drug transport is suboptimal (i.e. when dermatophytoma, onycholysis or spikes are present). Chemical or mechanical removal should also be considered whenever applicable (interruption of drug transport).Conclusion  In conclusion, treatment decision-making tools (e.g. an illustrated booklet or CD-ROM presenting each type of onychomycosis and criteria to be considered before selecting treatment regimen) would be valuable supports for the successful treatment of onychomycoses.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Journal of the European Academy of Dermatology and Venereology 19 (2005), S. 0 
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives  To review current diagnostic strategies. To review alternative diagnostic techniques.Results  The pathogen(s) responsible for onychomycosis must be identified to optimize treatment. Mycological examination is currently the most common diagnostic technique. This typically involves clearing with potassium hydroxide followed by microscopy. This direct test rapidly differentiates between living and dead hyphae. Sensitivity can be enhanced by using dimethyl sulfoxide (DMSO) or stains such as Chlorazol Black E. However, microscopy must always be combined with culture, allowing correct species identification. Accurate diagnosis depends on the expertise of laboratory staff and biologists and on the quality of the nail sample: samples should always be taken from the most proximal infected area.In the absence of experienced mycological laboratories, new laboratory techniques have been developed. Histological analysis by nail plate clipping has been shown to be an easy and efficient method for diagnosis. However, nail clipping is not an optimal technique for fungal culture and a large proportion of nonpathogenic but contaminant moulds can grow on culture medium. Moreover, histological analysis provides no information about causal agent or vitality. In vivo confocal microscopy and flow cytometry are powerful but complicated and costly techniques, making them unsuitable for routine use. Finally, polymerase chain reaction (PCR) (low proportion of positive results) and PCR–restriction fragment length polymorphism (PCR–RFLP) (suitable even for patients receiving antifungals) techniques have been developed. These molecular methods are cost-intensive and require highly skilled staff, meaning they are reserved exclusively for laboratories that process numerous nail samples.Conclusion  In conclusion, mycological examination remains the gold standard technique; it provides the most information, at a reasonable cost with little inconvenience to the patient.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Journal of the European Academy of Dermatology and Venereology 19 (2005), S. 0 
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives  To review recent data – what is new in the epidemiology of onychomycoses? To identify the most relevant diagnostic criteria for effective therapy.Methods  The preliminary results of the European Onychomycosis Observatory (EUROO) study were analysed. In this international study, physicians completed questionnaires concerning patient profile and the disease.Results  One of the most interesting novel findings was that sampling requests were often not made [only 3.4% of general physicians (GPs) and 39.6% of dermatologists]. This means that no information about causative agent(s) was available, hindering appropriate treatment choice. Furthermore, contrary to previous findings, 70.7% of participants did not practice sports. Lastly, these preliminary findings showed that treatment strategy depends largely on the type of treating physician, with GPs preferring monotherapy and dermatologists preferring combination therapy.Conclusions  A consensus was reached that treatment strategy should depend on the severity of nail involvement and the causative fungus. It is thus important to promote the importance of sampling. To simplify the choice of an appropriate treatment, onychomycosis may be divided into just two clinical groups: onychomycosis with and without nail matrix area involvement. However, the distinct clinical findings (number and type of affected nails, multimorbidity, drug interaction, etc.) in each individual case must be taken into account to ensure an appropriate treatment decision.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Clinical and experimental dermatology 19 (1994), S. 0 
    ISSN: 1365-2230
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A 35-year-old man presented with nodular suppurative lesions of the buttocks and the neck evolving over 20 years. A diagnosis of botryomycosis was established. Staphylococcus aureus, Acinetubacter baumanii and coagulase negative Staphylococcus were isolated from the biopsy specimen. Surgical excision was performed with success on the buttock.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Journal of the European Academy of Dermatology and Venereology 16 (2002), S. 0 
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Epidemiological studies suggest that 15% of the population in industrial countries suffer from tinea pedis (athlete’s foot) and that persons who do sports are a high-risk population.Objective To investigate the responsibility of dermatophytes in interdigital lesions of the feet in European marathon runners and to identify associated risk factors.Subjects and methods Runners of the 14th Médoc Marathon (n = 147) were interviewed on risk factors for tinea pedis and underwent physical and mycological examinations.Results Interdigital lesions of the feet were found in 66 runners (45%). A dermatophyte was isolated in 45 runners (31%), 12 of whom were asymptomatic. Trichophyton interdigitale and T. rubrum accounted for 49% and 35.5%, respectively, of the cases of tinea pedis. Thirty-three (22%) of the 102 runners free of dermatophyte infection had lesions resembling those of tinea pedis. Increasing age and use of communal bathing facilities were predictive of T. rubrum culture.Conclusions Marathon runners are at high risk for tinea pedis, but dermatophytes are responsible for only half of the foot lesions found in runners. The existence of asymptomatic carriers calls for prophylactic measures.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1574-6968
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology
    Notes: The fungi Scytalidium dimidiatum (Nattrassia mangiferae synanamorph) and Scytalidium hyalinum are mainly encountered in (sub)tropical areas as plant pathogens and agents of human dermatomycosis. Because the classification and differentiation of these two species is unclear, we studied 22 S. dimidiatum and 15 S. hyalinum isolates in order to identify potential species-specific insertions and polymorphisms in the 18S subunit ribosomal gene. The presence of an IE intron in S. dimidiatum, together with a single polymorphism (A in S. dimidiatum, G in S. hyalinum) in the coding region, allowed us to differentiate these two species in most cases. Moreover, in one S. dimidiatum isolate we found a group IC1 intron containing a putative truncated His-Cys endonuclease gene. This enzyme shows strong similarity to the intronic homing endonuclease of Physarum polycephalum. Based on these results and our previous findings, we propose an evolutionary pathway for 18S rDNA S. dimidiatum insertions, implying independent events.
    Type of Medium: Electronic Resource
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