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Antifungal drugs are used to treat mycoses. Depending on the nature of the infection, a topical or systemic agent may be used.
Example of antifungals include: fluconazole which is the basis of many over-the-counter antifungal treatments. Another example is amphotericin B which is more potent and used in the treatment of the most severe fungal infections that show resistance to other forms of treatment and it is administered intravenously.
Drugs to treat skin infections are the azoles: ketoconazole, itraconazole, terbinafine among others.
Yeast infections in the vagina, caused by "Candida albicans", can be treated with medicated suppositories such as tioconazole and pessaries whereas skin yeast infections are treated with medicated ointments.
Chromoblastomycosis is very difficult to cure. The primary treatments of choice are:
- Itraconazole, an antifungal azole, is given orally, with or without flucytosine.
- Alternatively, cryosurgery with liquid nitrogen has also been shown to be effective.
Other treatment options are the antifungal drug terbinafine, an experimental drug posaconazole, and heat therapy.
Antibiotics may be used to treat bacterial superinfections.
Amphotericin B has also been used.
Keeping the skin clean and dry, as well as maintaining good hygiene, will help larger topical mycoses. Because fungal infections are contagious, it is important to wash after touching other people or animals. Sports clothing should also be washed after use.
Sulfonamides are the traditional remedies to paracoccidiodomycosis. They were introduced by Oliveira Ribeiro and used for more than 50 years with good results. The most-used sulfa drugs in this infection are sulfadimethoxime, sulfadiazine, and co-trimoxazole. This treatment is generally safe, but several adverse effects can appear, the most severe of which are the Stevens-Johnson syndrome and agranulocytosis. Similarly to tuberculosis treatment, it must be continued for up to three years to eradicate the fungus, and relapse and treatment failures are not unusual.
Antifungal drugs such as amphotericin B or itraconazole and ketoconazole are more effective in clearing the infection, but are limited by their cost when compared with sulfonamides.During therapy, fibrosis can appear and surgery may be needed to correct this. Another possible complication is Addisonian crisis. The mortality rate in children is around 7-10%.
No vaccine is available. Simple hygienic precautions like wearing shoes or sandals while working in fields, and washing hands and feet at regular intervals may help prevent the disease.
Drugs like ketoconazole,
voriconazole, and itraconazole are generally employed in treating the infection. Actinomycetes usually respond well to medical treatment, but the eumycetes are generally resistant and may require surgical interventions including amputation.
Treatment for phycomycosis is very difficult and includes surgery when possible. Postoperative recurrence is common. Antifungal drugs show only limited effect on the disease, but itraconazole and terbinafine hydrochloride are often used for two to three months following surgery. Humans with "Basidiobolus" infections have been treated with amphotericin B and potassium iodide. For pythiosis and lagenidiosis, a new drug targeting water moulds called caspofungin is available, but it is very expensive. Immunotherapy has been used successfully in humans and horses with pythiosis. Treatment for skin lesions is traditionally with potassium iodide, but itraconazole has also been used successfully.
One approach involves shaving the affected areas. Another approach involves the use of antifungal medication.
Fumagillin has been used in the treatment.
Another agent used is albendazole.
The most common method of treatment includes radiotherapy and/or surgical excision .
"Actinomyces" bacteria are generally sensitive to penicillin, which is frequently used to treat actinomycosis. In cases of penicillin allergy, doxycycline is used.
Sulfonamides such as sulfamethoxazole may be used as an alternative regimen at a total daily dosage of 2-4 grams. Response to therapy is slow and may take months.
Hyperbaric oxygen therapy may also be used as an adjunct to conventional therapy when the disease process is refractory to antibiotics and surgical treatment.
The prognosis for chromoblastomycosis is very good for small lesions. Severe cases are difficult to cure, although the prognosis is still quite good. The primary complications are ulceration, lymphedema, and secondary bacterial infection. A few cases of malignant transformation to squamous cell carcinoma have been reported. Chromoblastomycosis is very rarely fatal.
Mycosis fungoides can be treated in a variety of ways. Common treatments include simple sunlight, ultraviolet light (mainly NB-UVB 312 nm), topical steroids, topical and systemic chemotherapies, local superficial radiotherapy, the histone deacetylase inhibitor vorinostat, total skin electron radiation, photopheresis and systemic therapies (e.g. interferons, retinoids, rexinoids) or biological therapies. Treatments are often used in combination.
In the “Stanford technique” of Total skin electron therapy the patient stands about 10 meters from a radiation source, with a large acrylic sheet in between to scatter the electrons across a broad area. Then the patient carefully assumes six different positions. In severe cases that progress to Sézary disease
Stanford University has been pioneering low-dose radiation (1/3 of the standard), followed by stem-cell transplantation without chemo, as a potential cure with promising results.
In 2010, the U.S. Food and Drug Administration granted orphan drug designation for naloxone lotion, a topical opioid receptor competitive antagonist used as a treatment for pruritus in cutaneous T-cell lymphoma.
Otomycosis is treated by debridment followed with topical azole antifungals, and symptomatically managed with oral antihistamines. Per a study in Iran 10cc acetic acid 2% plus 90 cc of isopropyl alcohol 70% was effective.
Subcutaneous cysts may be surgically opened to remove less mature bots. If more matured, cysts may be opened and "cuterebra" may be removed using mosquito forceps. Covering the pore in petroleum jelly may aide in removal. If larvae are discovered within body tissues, rather than subcutaneously, surgical removal is the only means of treatment. Ivermectin may be administered with corticosteroids to halt larval migration in cats presenting with respiratory cuterebriasis, but this is not approved for use in cats. There is not yet a known cure for cerebrospinal cuterebriasis.
Several antibiotics are available for the treatment of redmouth disease in fish. Vaccines can also be used in the treatment and prevention of disease. Management factors such as maintaining water quality and a low stocking density are essential for disease prevention.
Paracoccidioidomycosis (PCM) (also known as "Brazilian blastomycosis," "South American blastomycosis,","Lutz-Splendore-de Almeida disease" and "paracoccidioidal granuloma") is a fungal infection caused by the fungus "Paracoccidioides brasiliensis". Sometimes called "South American blastomycosis", paracoccidioidomycosis is caused by a different fungus than that which causes blastomycosis.
Necrotic ring spot can be managed through chemical and cultural controls. Cultural control includes the use of ammonium sulfate or other acidifying fertilizers to suppress the pathogen by lowering the pH of the soil to between 6.0 and 6.2. The more acidic soil discourages the activity of "O. korrae" (9) When reducing pH to these levels, additional manganese applications should be undertaken to compensate for lower pH. As of now, there are only two resistant cultivars of bluegrass, which are ‘Riviera’, and ‘Patriot’ (9). One component of their resistance could be that they are tolerant to low temperature, because the grass is more susceptible to the pathogen under colder temperatures(8). In addition, reducing watering inputs and growing turf on well drained soils can lessen disease symptoms.
Many different fungicides are used to control the pathogen, Fenarimol, Propiconazole, Myclobutanil, and Azoxystrobin (8). Historically, Fenarimol and Myclobutanil were predominantly used (14). In a study where diluted pesticides were sprayed throughout infested test plots, Fenarimol was found to be the most effective with a 94.6% reduction of the disease. Myclobutanil also decreased the amount of disease, but only by 37.7% (8). Myclobutanil is generally recognized as a very weakly acting demethylation inhibitor (DMI) fungicide and fenarimol is no longer registered for turf so a number of other DMI fungicides have been employed successfully, including Propiconazole, Tebuconazole, Metconazole and others. Pyraclostrobin and Fluoxastrobin have also been used to control the pathogen.
Entomophthoramycosis (or Entomophthoromycosis) is a mycosis caused by Entomophthorales.
Examples include basidiobolomycosis and conidiobolomycosis.
Experimental treatments include Resimmune or A-dmDT390-bisFv(UCHT1) which is an anti-T cell immunotoxin in a Phase II clinical trial.
Mogamulizumab (KW-0761) had a phase 3 clinical trial for Relapsed/Refractory CTCL (including mycosis fungoides). After preliminary results on mycosis fungoides in 2017 the US FDA granted it a priority review for CTCL.
White piedra (or tinea blanca) is a mycosis of the hair caused by several species of fungi in the genus "Trichosporon". It is characterized by soft nodules composed of yeast cells and arthroconidia that encompass hair shafts.
Treatment typically includes some combination of photodynamic therapy, radiation therapy, chemotherapy, and biologic therapy.
Treatments are often used in combination with phototherapy and chemotherapy, though pure chemotherapy is rarely used today. No single treatment type has revealed clear-cut benefits in comparison to others, treatment for all cases remains problematic.
When choosing a site for plantation establishment, it is typically good practice to ensure it exhibits good drainage and is non shaded. It should not be next to old Scotch pine stands, which could still hold the "Cyclaneusma". The trees in the plantation should have adequate spacing to allow for proper air circulation. Additionally, the owner should invest in tree stock which displays resistance or tolerance to "Cyclaneusma." After planting, attentive tree care must be undertaken, including nutrient management and water and weed control, to ensure robust, healthy trees. To scout for the disease, the threshold level is 20% of sampled trees showing signs. At this point, the owner should consider treating the entire plantation. In some areas, it is possible to control the disease through the silvicultural practice of thinning, selecting for trees with resistance to "Cyclaneusma".
"Cyclaneusma" presents somewhat of a challenge to manage, as infected needles remain part of the tree throughout the winter and spring months. The creation of spores as well as infection can occur in freezing temperatures with wet needles. Inoculated needles may not develop symptoms for up to a year from the infection date, proving difficult for the effectiveness of pesticides applied in the first season to be judged. Infected needles on or under the tree retain the ability to release spores any time during the growing season, so they should be removed as soon as possible. It is typically recommended to apply five treatments of fungicide, such as chlorothalonil or dodine, when the threshold level is met, beginning in March and continuing roughly every 5–6 weeks through October. If the infection level of a Christmas tree plantation is not yet too high, the aesthetics of the tree can be saved by using a leaf blower to remove infected needles from the tree.
Sarcoidosis involves the skin in about 25% of patients. The most common lesions are erythema nodosum, plaques, maculopapular eruptions, subcutaneous nodules, and lupus pernio. Treatment is not required, since the lesions usually resolve spontaneously in two to four weeks. Although it may be disfiguring, cutaneous sarcoidosis rarely causes major problems.
Pagetoid reticulosis (also known as "acral mycoses fungoides", "localized epidermotropic reticulosis", "mycosis fungoides palmaris et plantaris", "unilesional mycosis fungoides", and "Woringer–Kolopp disease") is a cutaneous condition, an uncommon lymphoproliferative disorder, sometimes considered a form of mycosis fungoides.