Five secondary metabolites, including a new isopimarane derivative xylaroisopimaranin A (1), were isolated from the endophytic fungus Xylaralyce sp. (HM-1), and their structures were elucidated by 1D, 2D NMR, MS and CD spectra. Their bioactivities were performed to antibacterial, Hep G2 cells cytotoxicity and brine shrimp inhibition. The biological evaluation results showed that the xylaroisopimaranin A (1), xylabisboein B (2), griseofulvin (3) , 5-methylmellein (4) and mellein-5-carboxlic acid (5) displayed no significant Hep G2 cells cytotoxicity and antibacterial acitivity, but they inhibited the brine shrimp with IC₅₀ from 0.5 to 25 µmol/mL.
Artemia ; Fungi ; Griseofulvin ; Hep G2 Cells

Pigmented purpuric dermatosis (PPD) represents a group of cutaneous lesions exhibiting petechiae, pigmentation, and occasionally telangiectasia in the absence of an associated venous insufficiency or hematological disorder. PPD may resolve spontaneously but tends to persist for months to years. Various treatment modalities such as oral griseofulvin, pentoxifylline, cyclosporine, ascorbic acid, topical corticosteroids, and PUVA therapy have been used with unsatisfactory results. Recently, some studies reported that PPD showed a dramatic response to narrowband ultraviolet B (UVB) phototherapy. In these studies, narrowband UVB phototherapy was an effective treatment method with few side effects. Here, we present the case of a 7-year-old boy with generalized PPD that improved rapidly following narrowband UVB phototherapy.
Adrenal Cortex Hormones ; Ascorbic Acid ; Child* ; Cyclosporine ; Griseofulvin ; Humans ; Male ; Pentoxifylline ; Phototherapy* ; Pigmentation ; Purpura ; PUVA Therapy ; Skin Diseases* ; Telangiectasis ; Venous Insufficiency

Dermatophytosis is one of the major public health problems in tropical countries, especially the chronic recurrent type. Tinea imbricata (TI), a dermatophytosis caused by Trichophyton concentricum (TC), is endemic in several remote and isolated areas in Indonesia. This dermatophytosis is unique due to its predominant genetic predisposition, which leads to chronic recurrent conditions among the affected. Moreover, hot and humid climate, low socio-economic conditions, lack of hygiene, inadequate treatment due to difficult access to health care facilities, and persistent source of re-infections, are among other factors that maintain the chronic-recurrent state. Studies on TI in Indonesia have been done since the 1960s, encompassing the epidemiology, clinical features, and efficacy of antifungal treatment. Griseofulvin is still the mainstay treatment, but relapse rates are high. The latest effort in reducing relapse includes the training of healthcare providers and provision of fungal disinfectant for clothing and bedding to patients in West Papua in addition to standard treatment. Higher cure rate was achieved at the end of treatment and the four-month follow-up in comparison to previous studies. Parallel studies on the same patient populations showed that: 1. clothing and bedding were fomites and potential sources of re-infections; 2. sodium hypochlorite worked well as a fungal disinfectant, followed by anionic detergent and pine oil containing cleaner; 3. terbinafine was the most effective antifungal agent for TC in vitro, followed by griseofulvin; itraconazole, and fluconazole were less effective. In conclusion, to eradicate TI in endemic areas, appropriate and affordable antifungal treatment, concurrent with health education and efforts to identify and eradicate the source of re-infections are very important.
Climate ; Clothing ; Detergents ; Fluconazole ; Follow-Up Studies ; Fomites ; Genetic Predisposition to Disease ; Griseofulvin ; Health Education ; Health Personnel ; Health Services Accessibility ; Humans ; Hygiene ; Indonesia ; Itraconazole ; Naphthalenes ; Public Health ; Recurrence ; Sodium Hypochlorite ; Tinea ; Trichophyton

INTRODUCTIONInflammatory tinea capitis is an uncommon condition in Singapore. In this case report we present a patient whom we managed for this condition.

CLINICAL PICTUREA 4-year-old girl presented to us with multiple pustules over the occipital scalp for 6 weeks, associated with painful cervical lymphadenopathy. Her condition did not respond to topical and oral antibiotics.

TREATMENTThe patient was diagnosed with kerion (inflammatory tinea capitis) and fungal culture of plucked hairs from the kerion grew Microsporum species of dermatophyte. She was treated with a course of oral griseofulvin and topical selenium sulfide shampoo. She was advised to bring her pet cats to the veterinarian for screening, as well as not to share combs with her other siblings.

OUTCOMEHer condition improved with the antifungal therapy, and there was no residual alopecia.

CONCLUSIONPhysicians should consider tinea capitis when they encounter a patient with scalp folliculitis or scarring alopecia in the appropriate clinical context.

Administration, Oral ; Administration, Topical ; Antifungal Agents ; administration & dosage ; Child, Preschool ; Female ; Griseofulvin ; administration & dosage ; Humans ; Microsporum ; isolation & purification ; Selenium Compounds ; administration & dosage ; Tinea Capitis ; drug therapy ; microbiology

The imbricata or Tokelau ringworm is an unusual superficial dermatophytosis caused by the anthropophilic Trichophyton concentricum. Three cases of the Tinea imbricata observed at the Municipal Health Office of Kiamba, Sarangani Province, Philippines are reported in this study. All three patients were from an indigenous ethnic group of Sarangani Province and lived in isolated upland communities. Patient 1 was a 30 year old male, Patient 2 was a 40 year old female, and Patient 3 was a 19 year old female. Lesions lasted - 27 years, - 25 years, and 2 years, respectively. All patients presented with characteristic expensive polycyclic to serpiginous scaling lesions, with areas of sparing. Microscopic examination of skin scrapings prepared with potassium hydroxide revealed the characteristic broad, branched, septate, irregular hyphae. Trichopyton concentricum, the causative agent, was isolated in one of the patients using Mycobiotoc agar. Histopathologic examination on 2 of the patients revealed acute and chronic inflammation, and Periodic Acid Schiff- positive fungal hyphae. All patients were started on Griseofulvin 500mg tab once daily. The case series presented here is the first account of Tinea imbricata in the Philippines since the 1990s.

Human ; Male ; Female ; Adult ; Agar ; Ethnic Groups ; Griseofulvin ; Hydroxides ; Hyphae ; Inflammation ; Periodic Acid ; Philippines ; Polynesia ; Potassium Compounds ; Skin ; Tinea ; Trichophyton ; Tinea Capitis

A 7 year-old boy visited our hospital with a 2 week history of inflammatory, pustular, tender patches and plaques on the right scalp and face area. He had been treated with topical steroid and antibiotics in a private clinic. In a KOH smear mount, multiple hyphaes and spores appeared on stratum corneum of the outer root sheath layer of his hair. The diagnosis of kerion celsi induced by dermatophytes was made. The patient was treated with oral griseofulvin, and on the 2nd day after starting treatment, multiple erythematous and tendered subcutaneous nodules occurred on his shin. A photosensitive dermatitis like lesion also occurred on his periorbital area. Griseofulvin changed to terbinafine. On the 6th day after treatment, the skin lesions on his face and scalp had improved, as had his shin lesions. The interest of this case lies in the unusual association of kerion and erythema nodosum, of which only eleven cases have been reported in dermatologic literature, and all cases were kerion induced Trichophyton species.
Anti-Bacterial Agents ; Arthrodermataceae ; Child* ; Dermatitis ; Diagnosis ; Erythema Nodosum* ; Erythema* ; Griseofulvin ; Hair ; Humans ; Hyphae ; Male ; Scalp ; Skin ; Spores ; Tinea Capitis* ; Trichophyton

Trichophyton (T.) tonsurans is an anthrophophilic dermatophyte and children are the primary target population. The "seborrheic" type is the most common clinical type of tinea capitis caused by T. tonsurans but kerion celsi is much less common. We report a case of kerion celsi caused by T. tonsurans in a 21-year-old woman. The patient had various-sized, erythematous nodules and pustules with irregular alopecia on the scalp. On mycological investigation, T. tonsurans was identified within the lesion. The patient did not respond to itraconazole therapy but was successfully treated with ultramicronized griseofulvin.
Adult* ; Alopecia ; Arthrodermataceae ; Child ; Female* ; Griseofulvin ; Health Services Needs and Demand ; Humans ; Itraconazole ; Scalp ; Tinea Capitis* ; Trichophyton* ; Young Adult

Tinea capitis in the neonatal period is extremely rare. To our knowledge, there have been only a few reports of neonatal tinea capitis in the Korean dermatologic literature. We report an additional case of neonatal tinea capitis caused by Microsporum canis. The patient was successfully treated with oral griseofulvin.
Griseofulvin ; Humans ; Microsporum ; Tinea Capitis* ; Tinea*

Tacrolimus and pimecrolimus represent a new class of topical non-steroidal medication currently used in the treatment of a variety of inflammatory skin lesions. We report a case of a patient in whom topical pimecrolimus therapy resulted in tinea incognito. Mycologic examination, including a KOH smear and fungal culture, was positive for hyphae and colonies of trichophyton mentagrophytes. The lesion was treated with oral griseofulvin and topical clotrimazole.
Clotrimazole ; Griseofulvin ; Humans ; Hyphae ; Skin ; Tacrolimus ; Tinea* ; Trichophyton

INTRODUCTION: As the number of diabetics increase with younger onset and longer duration, patients are confronted with higher incidence of diabetes related complications such as distal extremity vasculopathy, neuropathy and various infectious diseases. Such diabetics are more prone to a much higher rate of onychomycosis compared to normal subjects and because this could trigger irreversible consequences, confirmation of fungal involvement should be promptly taken care of. Itraconazole is a widely used drug nowadays and compared to drugs such as griseofulvin and ketoconazole, has many advantages in efficacy, cost, duration of therapy which eventually results in better patient compliance. OBJECTIVE: Our study was designed to better dictate the usage of itraconazole in diabetics so these patient can receive quality treatment when it is needed. METHOD: The study consisted of 101 patients with both onychomycosis and diabetes who were receiving treatment in Eulji hospital. They all received 3 pulses of itraconazole and were evaluated for efficacy and safety of their treatment. The patients were observed on routine examinations for 36 weeks and at their visits they were interviewed and received microscopic examinations. RESULT: Eighty four percent of the patients showed clinical and mycological improvement with 33% of them showing total clearance. There were no hypo- or hyperglycemic events and 17 patients complained of mostly mild side effects such as indigestion. Two patients dropped out of the study due to epigastric pain and peripheral extremity swelling. CONCLUSION: The use of itraconazole in the treatment of onychomycosis seemed to be effective and relatively safe for diabetics.
Communicable Diseases ; Diabetes Complications ; Dyspepsia ; Extremities ; Griseofulvin ; Humans ; Incidence ; Itraconazole* ; Ketoconazole ; Onychomycosis* ; Patient Compliance