Daily Archives: February 7, 2016

Topical antifungal agents

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Topical antifungals

A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes.

Topical antifungal agents are applied locally to the skin, on the nail, onto mucus membranes or vaginally, to treat fungal infections. They kill or inactivate fungi and yeast. Topical antifungal agents are available as creams, ointments, shampoos, powders and other forms, which can be applied locally on the area that needs to be treated.

What are the drugs for ringworm

Drug Name ( View by: Brand | Generic ) Bensal HP (More…)
generic name: benzoic acid/salicylic acid Blis-To-Sol Powder (More…)
generic name: undecylenic acid Extina (Pro, More…)
generic name: ketoconazole Naftin (Pro, More…)
generic name: naftifine Nizoral Topical (More…)
generic name: ketoconazole Nyamyc (Pro, More…)
generic name: nystatin Tinactin (More…)
generic name: tolnaftate Zeasorb-AF (More…)
generic name: miconazole Zeasorb-AF Drying Gel (More…)
generic name: miconazole Spectazole (Pro, More…)
generic name: econazole Vusion (Pro, More…)
generic name: miconazole/zinc oxide Loprox (Pro, More…)
generic name: ciclopirox Jublia (Pro, More…)
generic name: efinaconazole Lotrimin AF Athlete’s Foot Powder (More…)
generic name: miconazole Oxistat (Pro, More…)
generic name: oxiconazole Xolegel (Pro, More…)
generic name: ketoconazole Pedi-Dri (Pro, More…)
generic name: nystatin Penlac (Pro, More…)
generic name: ciclopirox Ertaczo (Pro, More…)
generic name: sertaconazole Lamisil AT (Pro, More…)
generic name: terbinafine Penlac Nail Lacquer (More…)
generic name: ciclopirox Nizoral A-D (More…)
generic name: ketoconazole Dermagran AF (More…)
generic name: miconazole Absorbine Athlete’s Foot (More…)
generic name: tolnaftate Absorbine Jr (More…)
generic name: tolnaftate Absorbine Jr Antifungal (More…)
generic name: tolnaftate Aftate (More…)
generic name: tolnaftate Aftate For Athletes Foot (More…)
generic name: tolnaftate Aloe Vesta (More…)
generic name: miconazole Aloe Vesta 2 in 1 Antifungal (More…)
generic name: miconazole Athletes Foot Cream (More…)
generic name: terbinafine Azolen (More…)
generic name: miconazole Baza Antifungal (More…)
generic name: miconazole Blis-To-Sol (More…)
generic name: tolnaftate Canesten (More…)
generic name: clotrimazole CNL8 Nail (Pro, More…)
generic name: ciclopirox Critic-Aid Clear AF (More…)
generic name: miconazole Cruex (More…)
generic name: undecylenic acid Cruex Prescription Strength (More…)
generic name: miconazole DermaFungal (More…)
generic name: miconazole Desenex Antifungal Atheletes Foot Spray Liquid (More…)
generic name: miconazole Desenex Antifungal Cream (More…)
generic name: clotrimazole Desenex Antifungal Foot Cream (More…)
generic name: miconazole Desenex Jock Itch (More…)
generic name: miconazole Desenex Prescription Strength (More…)
generic name: miconazole Desenex Spray (More…)
generic name: tolnaftate Dr Scholl’s Fungal Nail Management Kit (More…)
generic name: tolnaftate Ecoza (More…)
generic name: econazole Elon Dual Defense Anti-Fungal Formula (More…)
generic name: undecylenic acid Exelderm (Pro, More…)
generic name: sulconazole Exoderm (More…)
generic name: salicylic acid/sodium thiosulfate Fungatin (More…)
generic name: tolnaftate Fungi-Guard (More…)
generic name: tolnaftate FungiCURE Pump Spray (More…)
generic name: clotrimazole Fungizone Cream (More…)
generic name: amphotericin b Fungizone Lotion (More…)
generic name: amphotericin b Fungoid (More…)
generic name: miconazole Fungoid Kit (More…)
generic name: miconazole Genaspor (More…)
generic name: tolnaftate Gordochom (More…)
generic name: chloroxylenol/undecylenic acid Halotex (More…)
generic name: haloprogin Hongos (More…)
generic name: tolnaftate Iodo Plain (More…)
generic name: clioquinol Kerydin (Pro, More…)
generic name: tavaborole Ketodan (Pro, More…)
generic name: ketoconazole Kuric (More…)
generic name: ketoconazole Lamisil Solution (More…)
generic name: terbinafine Loprox TS (More…)
generic name: ciclopirox Lotrimin AF Athlete’s Foot Cream (More…)
generic name: clotrimazole Lotrimin AF For Her Athlete’s Foot Cream (More…)
generic name: clotrimazole Lotrimin AF Jock Itch Cream (More…)
generic name: clotrimazole Luzu (More…)
generic name: luliconazole Mentax (Pro, More…)
generic name: butenafine Micaderm (More…)
generic name: miconazole Micatin (More…)
generic name: miconazole Micatin Cooling Action (More…)
generic name: miconazole Micatin Foot Powder (More…)
generic name: miconazole Micatin Foot Powder Deodorant (More…)
generic name: miconazole Micatin Jock Itch (More…)
generic name: miconazole Micatin Liquid Foot (More…)
generic name: miconazole Micro-Guard (More…)
generic name: miconazole Miranel AF (More…)
generic name: miconazole Mitrazol (More…)
generic name: miconazole Monistat-Derm (Pro, More…)
generic name: miconazole Mycelex (Pro, More…)
generic name: clotrimazole Mycelex OTC (More…)
generic name: clotrimazole Mycostatin Topical (Pro, More…)
generic name: nystatin Naftin-MP (More…)
generic name: naftifine NP 27 (More…)
generic name: tolnaftate NuZole (More…)
generic name: miconazole Nystop (Pro, More…)
generic name: nystatin Ony-Clear (More…)
generic name: miconazole Pediaderm AF (Pro, More…)
generic name: nystatin Pedipirox-4 (More…)
generic name: ciclopirox Podactin (More…)
generic name: tolnaftate Protectol (More…)
generic name: undecylenic acid Q-Naftate (More…)
generic name: tolnaftate Remedy Antifungal with Olivamine (More…)
generic name: miconazole Secura Antifungal (More…)
generic name: miconazole Soothe & Cool Inzo (More…)
generic name: miconazole T-Athlete (More…)
generic name: tolnaftate Tetterine (More…)
generic name: miconazole Tinactin Jock Itch (More…)
generic name: tolnaftate Tinaderm (More…)
generic name: tolnaftate Tinamar (More…)
generic name: tolnaftate Tinaspore (More…)
generic name: tolnaftate Ting (More…)
generic name: tolnaftate Trifungol (More…)
generic name: undecylenic acid Triple Paste AF (More…)
generic name: miconazole Undelenic (More…)
generic name: undecylenic acid Versiclear (More…)
generic name: salicylic acid/sodium thiosulfate Whitfields Ointment (More…)
generic name: benzoic acid/salicylic acid Xolegel Duo (More…)
generic name: ketoconazole/pyrithione zinc
Home remedies for ringworms

Home remedies for ringworms

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How to get rid of ringworm at home fast

Ringworm infections are a group of infectious diseases of the skin / nails / hair, that are caused by a specific group of fungi (also called dermatophytes). They can affect very different body parts like the scalp, your trunk, the groin area, nails of the hands or feet etc. The pathogens causing this type of infection are quite common and can spread easily from different items or by contact with an infected person or animal. Ringworm is usually a mild disease which causes no residual problems.

Even though a lot of natural remedies are believed to be effective (like tea tree oil, vinegar and salt), only anti fungal medications can really heal it. If the disease is affecting only a small part of the skin, is not lasting more that a few weeks or is not located on the head, than over the counter drugs in the form of creams, gels or lotions will suffice. If this is not the case, than systemic treatment will have to be used. Some commonly used systemic anti fungal agents include griseofulvin, itraconasole and fluconazole.

Can dogs and cats get ringworm

Ringworm infections in domestic animals

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Fungal infections in Pets

Ringworms (also called dermatophytoses) are fungal infections of the skin, nails or hair and are one of the most common skin infections in animals. They can occur in different types of animals like dogs, cats, horses etc. By petting infected animals, the pathogens can be transferred to humans and cause disease in them. It is therefore important to recognise the signs of the disease and to take the animal to the vet in order not to get infected yourself.

Can dogs and cats get ringworm

Fungi can affect animals of any age, but younger pets appear to be more frequently ill. Longer fur is more susceptible to these pathogens than short. The most common species of fungi causing ringworm infections are Microsporum and Trichophyton.

Infected animals are more frequent in places with poor hygiene (like shelters) and where there is a lot of animals living in a small place. Pets that are not otherwise healthy are more prone to ringworm infections and the disease can have a more severe course.

How does it look: the affected skin usually looks scaly, reddish or dark in colour, the site is frequently itchy and loses hair. Sometimes, you can see nodular, raised lesions. Most commonly, the lesions are found on the face, around the ears or on the extremities. The dog or cat can be an asymptomatic carrier which means that it carries the pathogens but has no apparent signs of infection.

Diagnosis: when you take your pet to the vet, he or she will perform some basic test to confirm the visual diagnosis. These test usually include taking small skin scrapings and examining them under a microscope or taking a small fur sample. Taking a small piece of the skin (called biopsy) is rarely necessary.

How to get rid of ringworm in cats and dogs

Treatment: the infection can a lot of times go away by itself, but applying topical treatment will speed up the recovery time of your pet. If the disease is severe and it lasts for a very long time, systemic anti fungal treatment will be used. It includes drugs such as ketoconasole, itraconasole of fluconasole. Treatment should be continued until the tests for fungi on your pets skin/hair come back negative.


Dermatophytes.reviberoammicol.com, 2015, Dermatophytes in domestic animals. [online]. 2015. [Accessed 8  February  2015]. Available from: http://www.dermatophytes.reviberoammicol.com/contents.php?104108

Merckmanuals.com, 2015, Dermatophytosis in Dogs and Cats: Dermatophytosis: Merck Veterinary Manual. [online]. 2015. [Accessed 8  February  2015]. Available from: http://www.merckmanuals.com/vet/integumentary_system/dermatophytosis/dermatophytosis_in_dogs_and_cats.html

Petmd.com, 2015, Ringworm Symptoms in Cats | PetMD.com | petMD. [online]. 2015. [Accessed 8  February  2015]. Available from: http://www.petmd.com/cat/conditions/skin/c_ct_dermatophytosis%20?page=2

Petmd.com, 2015, Ringworm in Dogs – Symptoms, Prevention, Treatment | PetMD | petMD. [online]. 2015. [Accessed 8  February  2015]. Available from: http://www.petmd.com/dog/conditions/skin/c_dg_dermatophytosis?page=2

Tinea Unguium

Tinea Unguium

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What is Tinea Unguium

Tinea unguium, also called onychomycosis is a contagious fungal infection of the nail tissue which can affect both finger and toenails. It is a common disease affecting about 14% of the adult population and can be caused by dermatophytes (fungi living on the skin), nondermatophyte types of molds or yeasts.

Tinea Unguium symptoms

Epidemiology: tinea unguium is the most commonly found nail disease. It has a greater prevalence in older people and shows an increasing rate of incidence (also in younger people and children). Probably, the increased prevalence reflects the widespread usage of immunosuppresive drugs, usage of locker rooms and wearing of modern, tight shoes. Even though it can affect almost anyone, some are at greater danger of catching this type of infection. Predisposing factors include the HIV infection, diabetes (one third of diabetics is supposed to be affected) and poor peripheral circulation. Wearing artificial nails has also been implicated as a factor in the pathogenesis. It’s a bit more common in men and in people living in urban areas of the world.

Once the infection is acquired, it will not heal spontaneously and because of that, the incidence increases with age.

Commonly, the infection of the nails is preceded by tinea pedis (fungal infection of the skin on feet) from where the pathogens can easily invade the nail tissue and act as a reservoir for other kinds of tineas (on the body, groin, scalp etc.).

Tinea Unguium pictures

tinea unguium pictures

Photo Credit: http://www.treatmentforonychomycosis.com/

Aetiology: in most of the patients, the infection can be attributed to the next species of fungi: Trichophyton rubrum, Trichophyton interdigitale (these two are found in about 90% of the cases), Trichophyton tonsurans and Epidermophyton floccosum. Just about 10% of the toenail infections are caused by other organisms (nondermatophyte molds and yeasts) like: Acremonium, Aspergillus, Fusarium, Scopulariopsis brevicaulis and Scytalidium. About 30% of all the fingernails infections are caused by Candida spp.

Transmission: is similar to all the other ringworm tinea infections. The organisms can invade the nails after a direct contact with an infected individual or with items that contain infected particles of skin (common transmission between family members). Some species live in the environment and are not transmitted between humans.

Clinical manifestation of onychomycosis: about 80% of nail fungal infections occur on toe nails (especially the big toes).

There are four classic types of onychomycosis:

  • The distal lateral subungual onychomycosis: where a white patch is visible on the distal or lateral undersurface of the nail and the nail bed. If the infection is not treated, the nail becomes opaque, thickened, cracked and raised. It is the most common form of onychomycosis.
  • The white superficial onychomycosis: where on the proximal nail plate there is a white, chalk like plaque. This type is almost never seen on the fingernails, just on the toenails. It is sometimes misdiagnosed as keratin granulations (a reaction to nail polish). The distal lateral subungual and the white superficial type can coexist at the same time.
  • The proximal subungual onychomycosis: which occurs usually on the toenails and looks like a white spot. With time, the spot moves distally and can involve most of the undersurface of the nail. It is more commonly found in immuno compromised patients (patients with this type of disease should be screened for HIV).
  • The Candida onychomycosis: where Candida is the offending organism. Prior to the infection, usually there has been trauma or infection of the nails.

Differential diagnosis: tinea unguium can sometimes look a lot like psoriasis, eczema, Reiter syndrome, onycogryphosis, some congenital nail dystrophies, chemical or traumatic injuries to nails, lichen planus, yellow nail syndrome and Darier-White syndrome.

Diagnosis: with onychomicosis, clinical diagnosis (just by looking at the nails) is usually not enough. The doctor has to take a bit of the nail to examine it under a microscope or plant it into a medium to grow a fungal culture.

Treatment: of the nails infected with fungi is difficult because the organisms that cause the infection are inside the tissue and difficult to reach. In order for the nail to be truly healthy, a new one must completely replace the old one. The medications used in the treatment are anti fungals, which can be taken orally or applied topically.

  • Topical agents (available as lotions or lacquers) are usually just moderately effective. They have to be applied for a long time (about a year) and include ciclopirox nail paint amorolfine and efinaconazole. Even if topical therapy alone is not considered adequate, it might be an option in patients who cannot take systemic treatment.
  • Systemic agents include terbinafine, itraconazole and fluonazole. The indications for prescribing these type of drugs include affected fingernails, limited function of the infected part, pain, a greater potential for bacterial infections, physical and other disabilities.
  • Removing the diseased part of the infected nails is advised.

Prognosis: as mentioned before, fungal infection of the nails will not go away if not treated. The pathogens will gradually spread to other toenails and skin areas (body, groin, hands). Because of the disease, the protective barrier of the skin is damaged and other organisms (like bacteria) can enter into the blood easily (happens frequently after a vein from the leg has been taken in a heart operation). Even after a successful course of treatment, the infection can often reoccur. Diabetic patients are at a significantly greater risk of having fungal nail infections and should be screened regularly.

Prevention: it is important to keep the feet dry and clean. The toenails should be regularly clipped and one should avoid walking bare feet in areas where the infection is possible (locker rooms,swimming, bathing areas). Shoes must allow the feet to breathe and mustn’t be too tight.


Arnold, Harry L, Odom, Richard B, James, William D and Andrews, George Clinton, 1990, Andrews’ diseases of the skin. Philadelphia : Saunders.

Fitzpatrick, Thomas B and Freedberg, Irwin M, 2003, Fitzpatrick’s dermatology in general medicine. New York : McGraw-Hill, Medical Pub. Division.

Rook, Arthur and Burns, Tony, 2010, Rook’s textbook of dermatology. Chichester, West Sussex, UK : Wiley-Blackwell.

Wolff, Klaus, Johnson, Richard Allen and Fitzpatrick, Thomas B, 2009, Fitzpatrick’s color atlas and synopsis of clinical dermatology. New York : McGraw-Hill Medical.






What is Tinea versicolor

Tinea versicolor

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What is Tinea versicolor

Tinea versiolor (also called dermatomycosis furfuracea, pityriasis versicolor or tinea flava) is a common skin fungal infection that occurs usually on the chest and back.

Aetiology and epidemiology

it is caused by fungi from the species Malassezia (once called Pityrosporum). This organism is normally found on the skin of many different animals an humans (by some estimates it has been found on 18% of infants and 90-100% of the adults). It is present on the areas of the skin that show disease in and those that appear completely normal. Even though it may not cause any disease, it is thought to be associated many different skin conditions like: Pityrosporum folliculitis, confluent and reticulate papillomatosis, seborrheic dermatitis, and atopic dermatitis.

Malassezia is present worldwide and is more common in areas with high humidity and temperatures.

Tinea versicolor is a benign disease which is thought to be non contagious (because it already is present on the skin of people as part of the normal flora). The prevalence is not associated with race or sex and it is more common in people aged fifteen to twenty – four years.

Appearance: normally, the main compliant of the patients is the cosmetic effect of Malassezia – it causes small, round patches of skin discolouration. The affected skin can look hypo or hyperpigmentated (too light or too dark discolouration of the skin). The lesions are covered by very fine scales and are usually found on the trunk, back, abdomen and the proximal part of the limbs. Just sometimes, the affected skin can be mildly itchy.

Tinea versicolor Picture

Tinea versicolor

Photo Credit: https://www.dermquest.com/


 because its distinctive look, the disease can often be diagnosed just by clinical examination. If the origin of the lesions is not so clear, the doctor might use a special lamp called Wood’s lamp that makes Malassezia glow or examine a small part of the skin under a microscope.

Tinea versicolor Cure

Treatment of the condition consists of:

  • Topical anti fungal medications: like ketoconazole or selenium sulphide shampoos.
  • Oral, systemic antifungal treatment: is the disease affects a very large area of the skin or if the topical treatment is not effective.


Tinea versicolor has a very good prognosis. It does not leave any marks or scars and the skin discolouration should disappear in about one to two months after the treatment has been initiated. However, recurrence is quite common and the treatment regimen frequently has to be repeated.

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What is Tinea nigra

Tinea nigra

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What is Tinea nigra

Tinea nigra (also called superficial phaeohyphomycosis or tinea nigra palmaris et plantaris) is a uncommon infection of the skin usually caused by Hortaea werneckii (a species of fungi).

The involved fungus is not rare in Central and South America, Asia and Africa. As the fungus is not very common is the United states, patients have usually travelled elsewhere (especially to the Caribbean islands) prior to noticing the lesions on the skin.

Tinea nigra Picture

Tinea nigra picture

Photo Credit: http://www.ijmm.org/

Presentation: a lot of times, the pathogen does not cause any signs of the disease. When symptoms are present, they usually consist of dark brown or even black patches on the skin of the hands and feet (usually on the palmar and plantar side). The shape can vary from round to completely irregular and it may grow larger with time.

Diagnosis is frequently achieved with clinical examination alone. Rarely, microscopic examination of small skin scrapings or a fungal culture are performed. Because of its typical colour, melanoma should be ruled out.

Treatment: tinea nigra is an infection that responds well to topical anti fungal treatment in about two to four weeks. If treated appropriately, it does not reoccur.



What is Tinea corporis


Tinea corporis

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What is Tinea corporis

Tinea corporis also known as ringworm infection, tinea circinata or tinea glabrosa is a skin fungal infection that affects the skin of the trunk, arms, legs or neck but does not appear on the feet, hands, scalp or the groin area.


the transmission of the pathogens occurs by direct contact with an infected person or animal, by contact with an item that contains infected particles of skin or by spreading it from one’s feet that have been previously affected. In children, the most common way of getting the disease is by touching animals. Fungi affect both males and females and the prevalence peaks in the pre-adolescent children.

There are some environmental factors that predispose to the infection and are typical for fungi. They include worm, moist climates and wearing tight-fitting, occlusive clothing. Small injuries and frequent skin-to-skin contact favours the invasion of the pathogens. Such conditions are encountered in those who practice contact sports (wrestling for example) and are often called Tinea corporis gladiatorum. It occurs most commonly on the head, neck or arms.

What causes ringworm infection

Aetiology of the infection: the disease can, in fact, be caused by any dermatophyte (fungi that infect the skin) but is most commonly attributed to the next species: Trichophyton rubrum, Epidermophyton floccosum, Trichophyton interdigitale, Microsporum canis (found on cats and dogs), Trichophyton tonsurans and Trichophyton concentricum (this one, however, is limited to the Far East, the South Pacific and South and Central America).

How does Tinea corporis look

Usually, there is a circular patch with a red, scaly, a bit raised border. With time, the changes progress outwards and show a almost complete central clearing with some scaling. The ring-shaped lesion can be one or they might be multiple. The types of fungi which have been contracted from animals usually show a more pronounced immune response.

A very broadly spread disease can be the first sign of AIDS or it might follow the use of topical corticosteroids (anti – inflammatory drug).

Tinea corporis can be acute or chronic (mild disease which persist for a long time).

Differential diagnosis: ringworm infection can sometimes look a lot like nummular eczema, psoriasis, tinea versicolor, infection with candida, lupus erythematosus or different types of dermatitis (contact, atopic, seborrhoeic).

Diagnosis: beside its typical appearance, the doctor might have to scrape a bit the border of the lesion and examine the specimen under a microscope. In cases, where the diagnosis of ringworms is suspected but cannot be proven otherwise, the specimen can be put in a culture medium and in about a week or two, the organism should show signs of growth.

How to treat ringworm infections

Treatment: with localised disease, topical anti fungal drugs are usually effective enough. Typically, they have to be applied twice daily for about two to four weeks (but the regimen depends on the drug) and another seven days after the symptoms have disappeared. If the disease has spread to a larger area, if there is involvement of the hair follicles or if the infection does not respond to topical treatment, systemic anti-fungal agents have to be taken.

Other forms of tinea corporis:

  • Fungal folliculitis (infection of the hair follicles): also called Majocchi granuloma is a deeper form of tinea corporis which can resemble a carbuncle (localized skin infection from which pus can be passed) or kerion (a very nasty form of ringworm of the scalp). It’s usually caused by Trichophyton rubrum or Trichophyton mentagrophytes and shows up in places where hairs have been shaved. In patients with a compromised immune system (cancer, AIDS etc.), lesions appear to be even more deeply located and nodule-like. Orally taken medications are necessary in order to cure this type of infection.
  • Tinea incognito: is a term which describes a ringworm infection of the skin which has been previously treated with corticosteroids because it was mistaken for another dermatological disease. Because of this treatment, lesions do not appear as typical as always and a biopsy is sometimes in order. Systemic anti fungal treatment is usually indicated.

Prognosis: cure rates for ringworm infection of the body are very good. Most of the times, topical treatment cures all the symptoms of the disease. If other parts of the body are infected (like nails or feet) they should be cured in order to prevent the tinea to reoccur.

How to avoid ringworms

Prevention: avoid sharing objects of personal hygiene (like towels, combs etc.), having close contact with infected people or animals, wash hands with hot water and soap after petting animals. All the pets should be checked for ringworms and treated if they have it.


Arnold, Harry L, Odom, Richard B, James, William D and Andrews, George Clinton, 1990, Andrews’ diseases of the skin. Philadelphia : Saunders.

Fitzpatrick, Thomas B and Freedberg, Irwin M, 2003, Fitzpatrick’s dermatology in general medicine. New York : McGraw-Hill, Medical Pub. Division.

Rook, Arthur and Burns, Tony, 2010, Rook’s textbook of dermatology. Chichester, West Sussex, UK : Wiley-Blackwell.

Wolff, Klaus, Johnson, Richard Allen and Fitzpatrick, Thomas B, 2009, Fitzpatrick’s color atlas and synopsis of clinical dermatology. New York : McGraw-Hill Medical.






What is Jock Itch