New formulation for topical treatment of onychomycoses

BACKGROUND: In order to treat onychomycosis, topical and systemic medications are available. The choice of a systemic or topic treatment depends on numerous factors, such as patient's age, the presence of comorbidity, responsible fungal species, the clinical form of onychomycosis, its location (fingernails or toenails), the number of nails affected and the percentage of the nail plate infected. As for topical medications, given that nail plate has an insufficiently permeable structure, it is necessary to use appropriate formulae that create in the surface of the nail plate a film able, in turn, to function both as an active ingredient's deposit and moisturising agent in nail's superficial layers in order to facilitate the spread of the active ingredient. In this manuscript, we wanted to evaluate the effectiveness and tolerability rate of a new topical formulation (Miconal Nails®, Morgan srl, Vicenza, Italy) composed of hydrogenated castor oil, hydroxyethyl cellulose, and other ingredients (urea, climbazole, piroctone olamine, undecylenic acid). METHODS: We selected 25 patients of both sexes whose median age was between 20 and 70 years, and were affected by onychomycosis in a single toe. Their onychomycosis was a distolateral subungual type (with a <50% invasion of nail plate and sparing of lunula) and white superficial. The treatment was evaluated with the following possible outcomes: Complete healing, improvement, stationarity, worsening. RESULT S: Patients were 11 female subjects and 14 male subjects, whose median age was 45. A complete healing was achieved in 15 patients. In 3 cases the clinical presentation appeared unchanged with a persistence of mycological evidence. The response to the treatment was assessed as improvement in 7 patients. CONCLUSIONS: In our experience, this new product is an effective weapon that enhances the therapeutic selection of topical formulae for treating onychomycosis. If used alone in the cases that meet inclusion criteria for topical treatment, it allowed us to achieve a complete healing just with a 5-month treatment in 60% of cases, data that reached 76% on the follow-up visit

An uncommon onychomadesis in adults

Onychomadesis can be attributed to a wide variety of causes, including allergic contact dermatitis, paronychia,pustular psoriasis, and trauma, and most cases are considered to be idiopathic. Onychomadesis at the same level involving several nails suggests a systemic cause, such as fever, erythroderma, use of drugs such as anti-tumoral chemotherapeutics, carbamazepine, lithium salts, retinoids and, at the infantile age, viral infections such as Kawasaki disease, and hand, foot, and mouth disease (HFMD). HFMD generally affects children younger than 10 years old and in adults has minor manifestations and thereby easily goes unrecognized

Generalized Granuloma annulare and non-hodgkin's lymphoma

Granuloma annulare (GA) is a common, infammatory disorder, which is usually considered to have a benign progression. The generalized variant of GA is relatively rare and has been reported in association with diabetes, HIV and some malignant neoplasias, such as breast, cer- vical, lung, prostate, stomach and ovarian carcinoma. In particular, the relatively rare association of generalized GA with malignant lymphomas is not well-recognized. We describe here the presence of both generalized GA and Hodgkin’s disease (HD) in a 64-year-old woman

Scleroderma-like hands in a 16-year-old boy

Viene presentato il caso di un bambino nato con porfiria eritropoietica che sviluppa lesioni a tipo sclerodermia localizzata a livello di entrambe le mani

Fingertip necrosis as a sign of carpal tunnel syndrome

Skin lesions such as finger erythema, nail dystrophy,and blisters have been described in patients with severe damage to themotor, sensory, and autonomic fibers of the median nerve. The pathogenetic hypothesis is that fingertip necrosis is caused by a transitory alteration of autonomic innervation associated with impaired arterial vascularization as a result of a lesion in the vasa nervorum. These 2 cases highlight an advanced stage of CTS as a cause of fingertip necrosi

Pomade crust of the face

A 15-year-old Chinese boy presented to us with symmet- (a) ric crusts on his cheeks and the dorsal surface of his nose. Pomade disease (or pomade crust) is a misdiagnosed thick crusting excessively treated with topical ointments and 1 oils and not responsive to topical corticosteroids