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Research Article
Efficacy and Safety of Combination Treatment of Oral Terbinafine and Itraconazole in Patients with Extensive Superficial Dermatophytes
Mohammad Enamul Hoque*,
Suraiya Akhter,
Wahida Rahman,
Md. Mominul Hoque
Issue:
Volume 7, Issue 1, June 2024
Pages:
1-5
Received:
8 January 2024
Accepted:
24 January 2024
Published:
5 February 2024
Abstract: Background: Dermatophytosis, a prevalent fungal infection, is instigated by species like Trichophyton, Epidermophyton and Microsporum. The current approach for treating dermatophytosis involves a blend of systemic and topical antifungal therapies, applicable to all patients except those with localized, untreated Tinea. Notably, there is a growing incidence of inadequate response to the standard treatment regimen in recent times. Objective: To evaluate the efficacy and safety of combination treatment of oral terbinafine and itraconazole in patients with extensive superficial dermatophytes. Materials and Methods: This research comprised a randomized clinical trial involving 50 individuals diagnosed with extensive superficial dermatophytosis. Study conducted at the Department of Dermatology and Venereology, Combined Military Hospital Cumilla, the study spanned from July 2022 to June 2023. During the six-week duration, patients underwent treatment with terbinafine and itraconazole, with follow-up examinations every two weeks, including relevant investigations. Evaluation of treatment outcomes occurred at both four and six weeks. Statistical analysis was performed using version 25 of the Statistical Package for the Social Sciences (SPSS). Results: This study shows the majority of the participants within the age range of 16-30 years (56.0%) and the average age of the participants is 31.74±11.77 years. In terms of gender, the majority are male (78.0%). The most prevalent diagnosis is Tinea corporis (68.0%), followed by Tinea cruris (36.0%), Tinea faciei (28.0%), and Tinea incognito (12.0%). The majority of participants (85.0%) have had the disease for 12 months or less. The most common sites are the trunk (35.0%), whole body (26.0%), and crural area (24.0%). The majority of participants experience severe itching (56.0%), followed by moderate itching (34.0%), and a smaller percentage report mild itching (10.0%). The majority of participants showed improvement, with percentages increasing from 66.0% after 2 weeks to 84.0% after 4 weeks. The percentage of cured individuals also increased over time, reaching a substantial 90.0% after 6 weeks. Conclusion: The amalgamation of terbinafine and itraconazole demonstrates a superior clinical cure rate compared to use of single systemic antifungals. However, the observed clinical cure rate percentage is lower when juxtaposed with findings from previous studies. Notably, none of the used combination of systemic antimycotic medication has displayed success against tinea infections previously treated with topical formulations containing steroids.
Abstract: Background: Dermatophytosis, a prevalent fungal infection, is instigated by species like Trichophyton, Epidermophyton and Microsporum. The current approach for treating dermatophytosis involves a blend of systemic and topical antifungal therapies, applicable to all patients except those with localized, untreated Tinea. Notably, there is a growing i...
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Research Article
Use of Abzolem ® in Pressure Injuries: Experience of an Exploratory Study
Fernando Valenzuela*,
Catalina Retamal Altbir,
Dan Hartmann Schatloff,
Roberto Bustos,
Nicolas Moya
Issue:
Volume 7, Issue 1, June 2024
Pages:
6-10
Received:
22 January 2024
Accepted:
1 February 2024
Published:
20 February 2024
Abstract: Introduction: Pressure injuries represent a significant and prevalent public health problem in bedridden and institutionalized patients. The correct management of pressure injuries is essential for preventing complications, enhancing patient well-being, and reducing the overall burden on healthcare systems. It underscores the importance of a holistic and patient-centered approach to wound care. Preventive measures and the action of a multidisciplinary team are essential to the correct treatment of pressure injuries. There are multiple active dressings and topical solutions to treat and protect the wounds, among them the hyperoxygenated fatty acids, such as Abzolem®. Objective: Evaluate and verify the effectiveness and safety of the use of Abzolem® in the treatment of patients with pressure injuries grade I and II. Materials and methods: an exploratory study was carried out on 6 patients residing in a long-term establishment in Santiago of Chile with grade I and II pressure injuries in which Abzolem® was used for twice-daily dressings. Results: The use of Abzolem® led to a significant improvement in grade I pressure injuries in 10 ± 3 days and grade II pressure injuries in 15 ± 3 days, without related adverse events and with good tolerance by patients. Conclusion: The use of hyperoxygenated fatty acids, such as Abzolem® corresponds to a safe therapeutic alternative, easy to apply, and effective in the treatment of grade I and II pressure injuries.
Abstract: Introduction: Pressure injuries represent a significant and prevalent public health problem in bedridden and institutionalized patients. The correct management of pressure injuries is essential for preventing complications, enhancing patient well-being, and reducing the overall burden on healthcare systems. It underscores the importance of a holist...
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Research Article
A Qualitative Study on the Perception of Atopic Dermatitis by Malagasy Young Patients Regarding Self-Management
Naina Harinjara Razanakoto*,
Fandresena Arilala Sendrasoa,
Tsiory Iarintsoa Razafimaharo,
Mendrika Fifaliana Rakotoarisaona,
Herin’Ny Fitiavana Princia Andriatahina,
Tiana Sylvia Rasolofonarivo,
Fenohasina Rakotonandrasana,
Leophonte Samison Ramily,
Rakotomanana Mbolatiana Kiady Armando,
Voahanginirina Nathalie Ralimalala,
Volatantely Tobiniaina Ratovonjanahary,
Moril Sata,
Onivola Raharolahy,
Malalaniaina Andrianarison,
Irina Mamisoa Ranaivo,
Lala Soavina Ramarozatovo,
Fahafahantsoa Rabenja Rapelanoro
Issue:
Volume 7, Issue 1, June 2024
Pages:
11-15
Received:
14 February 2024
Accepted:
1 March 2024
Published:
13 March 2024
Abstract: Atopic dermatitis (AD) is a chronic disease that usually begins in childhood and can persist at any age. It is essential for adolescents entering to adulthood to have a complete understanding of this disease, including its self-management responsibilities. This study aimed to explore Malagasy adolescents and young adults’ perceptions of atopic dermatitis regarding the concept of self-management. This is a qualitative study using semi-structured interviews with adolescent and young adult patients suffering from AD, who were followed up at the Dermatology Department of the University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar. Interviews were recorded, transcribed verbatim, and analyzed using NVivo software version 10.2.2 (QSR International, Doncaster, Australia). Five male and seven female patients with mild to severe AD were included according to the Patient-Oriented Eczema Measure (POEM). The mean age was 19.83 years and the mean interview duration was 21.3 minutes. Despite a relatively long duration of AD, the nature of this condition, and the principles and goals of treatment are still poorly understood among young people. Consequently, many still hope for a complete cure for their AD. Our patients adhered to treatment and did not fear topical corticosteroids. This study highlights the importance of providing information about atopic dermatitis during childhood, and emphasizes the need to recommunicate this information directly to these patients during adolescence, aiming for an optimal transition process regarding disease self-management.
Abstract: Atopic dermatitis (AD) is a chronic disease that usually begins in childhood and can persist at any age. It is essential for adolescents entering to adulthood to have a complete understanding of this disease, including its self-management responsibilities. This study aimed to explore Malagasy adolescents and young adults’ perceptions of atopic derm...
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Research Article
Treatment Adherence Among Malagasy Patients with Atopic Dermatitis Seen at the Department of Dermatology, Antananarivo, Madagascar
Naina Harinjara Razanakoto*,
Fandresena Arilala Sendrasoa,
Mendrika Fifaliana Rakotoarisaona,
Tsiory Iarintsoa Razafimaharo,
Leophonte Samison Ramily,
Rakotomanana Mbolatiana Kiady Armando,
Voahanginirina Nathalie Ralimalala,
Volatantely Tobiniaina Ratovonjanahary,
Moril Sata,
Onivola Raharolahy,
Malalaniaina Andrianarison,
Irina Mamisoa Ranaivo,
Lala Soavina Ramarozatovo,
Fahafahantsoa Rabenja Rapelanoro
Issue:
Volume 7, Issue 1, June 2024
Pages:
16-23
Received:
16 February 2024
Accepted:
1 March 2024
Published:
13 March 2024
Abstract: Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritic eczematous lesions. Poor adherence to treatment is a major factor limiting treatment outcomes in patients with AD. This study aimed to assess treatment adherence in Malagasy patients with AD. It was conducted over one year in children and adult patients with AD seen at the Department of Dermatology University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar. Morisky Medication Adherence Scale-8 (MMAS-8) was used to assess patients’ treatment adherence. We included 44 children and 21 adults. The mean age was 4.29 ± 4.13 years and 35.28 ± 16.88 years, respectively. All of our patients receive topical treatment and no specific oral treatment such as biotherapy or immunosuppressant. A low adherence rate was observed in 61.90% of adult patients and the mean MMAS-8 score was 2.56 ± 1.6. In children, the mean MMAS¬8 score was 5.9 ± 1.53 and poor adherence was seen in 45.45%. The adherence level was significantly associated with age, educational status, and marital status (p < 0.05). Low treatment adherence is preponderant among Malagasy patients with AD. We did not find significant correlations between adherence levels and monthly income, frequency of follow-up, severity of AD, or insurance coverage.
Abstract: Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritic eczematous lesions. Poor adherence to treatment is a major factor limiting treatment outcomes in patients with AD. This study aimed to assess treatment adherence in Malagasy patients with AD. It was conducted over one year in children and adult patients...
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Case Report
Eruptive Xanthomas – A Case Report with a Review of the Literature
Issue:
Volume 7, Issue 1, June 2024
Pages:
24-29
Received:
15 April 2024
Accepted:
10 May 2024
Published:
30 May 2024
Abstract: Eruptive xanthomas are most often the result of impaired lipid metabolism. They can be caused by a primary dysregulation in lipid metabolism (familial hyperlipoproteinemias) or by an increase in serum lipids from concomitant diseases (diabetes mellitus, obesity, chronic renal failure, nephrotic syndrome, pancreatitis, hypothyroidism, rarely hyperthyroidism, alcohol abuse, cholestasis or biliary cirrhosis, monoclonal gammopathy, multiple myeloma and leukemia) or from the use of certain medications (beta-blockers, estrogens, retinoids, protease inhibitors, cyclosporine, the antimycotic Miconazole and the antipsychotic Olanzapine (secondary hyperlipoproteinemias). Early diagnosis and adequate therapy of the skin changes and the comorbid underlying disease prevent serious life-threatening complications. A case of a 34-year-old man with papular yellowish lesions on the elbows is presented. The patient has accompanying diseases of diabetes mellitus, alcohol addiction, liver cirrhosis, chronic acute pancreatitis and chronic cholecystitis. The clinical diagnosis of eruptive xanthomas was confirmed by histopathological examination revealing foam cells in the dermis. Laboratory blood tests revealed an accelerated ESR and elevated blood glucose, transaminases, uric acid, total cholesterol, and triglycerides. Hepatoprotective and antidiabetic therapy combined with a dietary regimen improved the patient's condition and laboratory parameters. A partial reversal of skin lesions occurred. An overview of the epidemiology, etiopathogenesis, clinical picture, laboratory tests, differential diagnosis, dietary regimen, and treatment of eruptive xanthomas are presented.
Abstract: Eruptive xanthomas are most often the result of impaired lipid metabolism. They can be caused by a primary dysregulation in lipid metabolism (familial hyperlipoproteinemias) or by an increase in serum lipids from concomitant diseases (diabetes mellitus, obesity, chronic renal failure, nephrotic syndrome, pancreatitis, hypothyroidism, rarely hyperth...
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Case Report
Urticaria Pigmentosa – A Case Report with a Review of the Literature
Issue:
Volume 7, Issue 1, June 2024
Pages:
30-35
Received:
23 May 2024
Accepted:
7 June 2024
Published:
19 June 2024
Abstract: Mastocytosis encompasses a rare group of diseases characterized by the accumulation of mast cells, primarily in the skin or internal organs. In the 2016 revised WHO classification, mastocytosis is divided into cutaneous mastocytosis (CM), systemic mastocytosis (CM), and localized mast cell tumor. Cutaneous mastocytosis (CM) includes maculo-papular CM/urticaria pigmentosa (UP), diffuse CM and cutaneous mastocytoma. Urticaria pigmentosa is the most common skin variant. It presents with erythematous brownish macules or papules, often accompanied by pruritus. A case of a 48-year-old woman with disseminated, mildly pruritic, sharply demarcated, livid-brownish macules on the skin of the trunk and extremities is presented. A positive Darier symptom was established. Laboratory tests revealed granulocytosis (73%) and lymphocytosis (19.8%). Serum tryptase and 24-hour urine 5-hydroxyindoleacetic acid were not elevated. The diagnosis of urticaria pigmentosa was confirmed by the histopathological examination revealing perivascular infiltrates of mast cells, mainly in the deep dermis. Screening performed did not detect systemic involvement. Symptomatic treatment with H1 and H2 blockers and topical corticosteroid was carried out. Avoidance of triggers is recommended. The patient's condition has improved. Both a historical review of mastocytosis and a revised classification, as well as the epidemiology, etiology with triggering factors, clinical presentation, laboratory investigations, and management of urticaria pigmentosa are presented.
Abstract: Mastocytosis encompasses a rare group of diseases characterized by the accumulation of mast cells, primarily in the skin or internal organs. In the 2016 revised WHO classification, mastocytosis is divided into cutaneous mastocytosis (CM), systemic mastocytosis (CM), and localized mast cell tumor. Cutaneous mastocytosis (CM) includes maculo-papular ...
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,
Valentina Broshtilova
