European Journal of Cardiovascular Medicine

Background: Onychomycosis is the commonly encountered problem especially in  adults. Appears as a simple cosmetic  problem  infected  nails, but have significant effect on patients emotional, occupational and social aspects, also  serve  as  reservoir  of  mycotic  infection  and  can give rise to repeated skin infections. Dermatophytes are the principal pathogens.  Objectives: Isolation and identification of fungal agents causing onychomycosis and to study the predisposing factors with their clinical presentations. Methods:  Appropriate samples from 50 patients with a diagnosis of onychomycosis were included in study for a duration of one year, from July 2012 to August-2013. Nails were collected in sterile black craft paper envelopes of 5x5 cms after disinfection and nail borings from nail bed. These were subjected to 20 to 40% KOH mount, routine Culture on SDA with antibiotics and cycloheximide. Isolates were identified based on colony morphology and biochemical reactions. Results: In a sample size of 50, dermatophytes were predominant agents 70.58% compared to non-dermatophytes 29.4%, 78% were males and 22% were females. In these cases distal and lateral sububgual onychomycosis (60%) was the most common clinical presentation followed by proximal subungual onychomycosis (20%). Total positive culture cases were 17 (34%), among which Trichophyton rubrum 41.17% was predominant followed by T.mentagrophytes 17.6%. Conclusion:  Not all nail dystrophies are fungal in origin, an accurate laboratory diagnosis of onychomycosis is must, as been shows in this study.  Dermatophytes were predominant etiological agents among which T.rubrum was most common Changing. Systemic and local predisposing factors were diabetes, anemia, traumatic injury, hands submerged in water for prolonged time.

Background: Chronic renal failure (CRF) is manifested by various skin symptoms. New changes have been described continuously since the advent of hemodialysis, which increases life expectancy and allows time for these changes to occur. Objective: The aim of this study was to determine the frequency of skin manifestations in chronic renal failure (CRF) patients receiving hemodialysis.  Methods: it was a cross sectional observational study in which skin changes were studied in a total of 500 CRF patientsreceiving hemodialysis attending dermatology OPD in a tertiary hospital in central India.  Results: 80% of the patients complained of some skin problems.However, at examination, all patients had at least one skin condition caused by CRF. The most common finding was xerosis (80%), followed by pallor (70%), itching (50%), and skin hyperpigmentation (40%). Other skin manifestations include Kell's disease (20%), fungal (40%), bacterial (15%),  purpura (10%) and dermatitis (2%). Nail changes include koilonychia (25%), onychomycosis (20%), subungual hyperkeratosis (10%), onycholysis (10%) and hemorrhages (5%), Mee’s line (5%), Muehrcke lines (5%) and Beau's lines (2%). Hair changes include thinning hair (35%) and brittle and dull hair (15%). Oral changes include striated macroglossia (40%), xerostomia (30%), ulcerative stomatitis (30%), angular cheilitis (15%), and uremic breath (10%). Some rare side effects of CRF have also been observed, such as uremic frostbite, gynecomastia, and pseudoKaposi's sarcoma.  Conclusion: CRF is associated with a complex set of cutaneous manifestations caused by disease or treatment. The most common are xerosis and pruritus, and early recognition of skin symptoms can reduce pain and morbidity.

Background: Tinea corporis, also known as ‘ringworm,’ is a superficial dermatophyte infection of the skin, other than on the hands (tinea manuum), feet (tinea pedis), scalp (tinea capitis), bearded areas (tinea barbae), face (tinea faciei), groin (tinea cruris), and nails (onychomycosis or tinea unguium).1 Tinea corporis is most commonly caused by dermatophytes belonging to one of the three genera, namely, Trichophyton (which causes infections  There are certain risk factors like age, sex, status of diabetes influence the occurrence of  Tinea Corporis among diabetes. on skin, hair, and nails), Microsporum (which causes infections on skin and hair), and Epidermophyton (which causes infections on skin and nails).1–3 Dermatophytes are grouped as either anthropophilic, zoophilic, or geophilic, depending on whether their primary source is human, animal, or soil, respectively.4,5 Because tinea corporis is common and many other annular lesions can mimic this fungal infection, physicians must familiarize themselves with its etiology and its treatment. Aims and Objectives: To study Prevalence of Tinea Corporis in general population and evaluate its association with Diabetes patient. Methods: This study was conducted among 60 diabetes patients attending tertiary care hospital diabetes OPD to find out occurrence of Tinea Corporis. The patients were selected randomly. The clinical examination of Tinea Corporis   was done. The blood investigation like blood sugar, HbA1c and Thyroid function were performed. The statistical analysis as Chi-square test was applied. Results: Among the study population 56% were female and 44% were male. The prevalence of Tinea Corporis was 66.6% in India among all skin diseases. The Tinea Corporis found in 29% of the female compare to 9% among male, this increase occurrence in female was statistically significant. This study found out the uncontrolled diabetes was one of the major risk factor for Tinea Corporis. Conclusions: The uncontrolled diabetes rather than duration of the diabetes is also major cause for Tinea Corporis. It is the duty of the Dermatologist and the patient to control the diabetes to prevent the Tinea Corporis.

Onchomycosis is the most common fungal infections of nail commonly caused by dermatophytes. Till nineteenth century it was difficult to cure as several attempts failed to deliver drug due to rigid structural nail barrier. Not only prolonged duration of treatment but also high cost of therapy involved a great problem of treatment.  In recent times continuous ongoing research with the intervention of novel drug delivery systems like nanoparticles to deliver antifungal drugs has overcome those challenges. Although oral drugs are effective but most of them are hepatotoxic. Local treatment tried with nail liqueur contained antifungal drugs amorolfine and ciclopirox but was not very successful. This underscores the need of some innovative drug delivery system, In this article we will review   some novel drug delivery system of topical antifungals for treatment of onychomycosis