The Microbiology of Skin, Soft Tissue, Bone and Joint Infections

Kateryna Kon,Mahendra Rai

• Éditeur: Academic Press
• Année: 2017
• ISBN:
  9780128110935
• Sujet: Sciences biologiques
• Sous-sujet: Microbiologie

The Microbiology of Skin, Soft Tissue, Bone and Joint Infections: Volume 2 discusses modern approaches in diagnosis, treatment, and prophylaxis of skin, soft tissue, bone, and joint infections. The volume has been divided into three sections.

The first section includes chapters on diagnosis, treatment, and prophylaxis of skin and soft tissue infections. It discusses antimicrobial and surgical treatment of wounds, diabetic foot, and different soft tissue infections. Ten chapters are devoted to cutaneous and musculoskeletal infections in special groups of patients, which have their own specificity, i.e. in pediatric and HIV-infected patients. Together with chapters on commonly present diseases, there are chapters which discuss interesting but not well studied pathologies (natal cleft pilonidal sinus) and pathogens (Malassezia and Shewanella spp.).

The second section reviews etiology, pathogenesis, diagnosis and treatment of bone and joint infections, mainly osteomyelitis and prosthetic joint infections. Also, one chapter in this section discusses a newly emerging bacterial pathogen that causes skeletal infections, Kingella kingae. The third section incorporates alternative and new approaches—such as nanotechnology, ultrasound, novel delivery approaches and phyto-derived medicines—to the treatment and prophylaxis of skin, soft tissue, bone, and joint infections.

• Encompasses a broad range of skin, soft tissue, bone, and joint infections, including questions of etiology, pathogenesis, diagnosis, prognosis, treatment, and prophylaxis
• Written by highly professional and eminent surgeons, microbiologists, and infectious disease specialists
• Discusses topics using modern insight, providing all necessary scientific information on each aspect
• Includes scientific understanding and practical guidelines, which make it interesting for both research scientists and practitioners working with skin, soft tissue, bone, and joint infections

Section III

Alternative and Novel Approaches to the Diagnosis and Treatment of Skin, Soft Tissue, Bone, and Joint Infections

Chapter 11

Nanotechnology for the Treatment of Fungal Infections on Human Skin

M. Rai*; A.P. Ingle*; R. Pandit*; P. Paralikar*; I. Gupta*; N. Anasane*; M. Dolenc-Voljč^{† *} SGB Amravati University, Amravati, India
^† University of Ljubljana, Ljubljana, Slovenia

Abstract

Skin diseases in humans are common and can cause complications if not treated properly. A number of antifungal drugs are exploited for the treatment of fungal skin infections, but most of the pathogenic fungi, especially yeasts, can develop resistance towards antifungal drugs. Adverse effects of topical and systemic antifungal drugs can sometimes also limit their use. Nanoparticles offer a lower risk of systemic side effects for the treatment of skin infections. Nanoparticles such as silver, copper, gold, sulfur, titanium dioxide, zinc oxide, and some others have been employed for the management of skin disorders such as skin candidiasis, pityriasis versicolor, tinea, folliculitis, and seborrhoeic dermatitis. Nanoparticle-based formulations have been gaining importance due to their targeted delivery, increased skin permeability, and controlled release for the treatment of skin infections. They also offer an advantage by increasing bioavailability of active components with prolonged effect at the site of infection. The present chapter is focused on different nanoparticles and their formulations used for the treatment of various skin infections caused by fungi in humans.

Keywords

Antifungal drug; Candidiasis; Dermatophytosis; Nanoparticles; Nanoformulations

1 Introduction

Currently, skin diseases are one of the most common among all illnesses in humans and represent a huge public health problem on a global scale.^1,2 They affect 20%–25% of the world's population and are causative agents of infections that vary from country to country.³ Superficial mycoses involve infections of skin, nails, and hairs which are caused by different groups of fungi.⁴ In tropical countries, fungal infections are more common and often reoccur due to favorable climatic conditions. There is a wide range of fungal infections, from superficial, affecting skin, skin appendages and mucous membranes, to systemic infections with invasion of internal organs. Superficial fungal infections are not life threatening, but they spread to other skin regions and may become widespread, be transmitted to other people, and can cause secondary bacterial skin infections and permanent hair loss, negatively affecting the quality of a person's life. They are also disturbing from an aesthetical point of view.⁵ The pathogenesis of infection depends on the causative agent, environmental conditions, and immunological status of the host.⁶ Mostly, these diseases are spread from person to person. Infective spores can be present on footwear, combs, brushes, towels, and the floor in swimming pools and other sports facilities. Outbreaks of disease can also occur via direct contact with infected animals. Cutaneous mycoses are classified on the basis of the causative fungal agents into dermatophytosis, yeast infections (including Pityriasis versicolor, candidiasis and some other yeast infections) and mold infections.⁷

The most common places where skin infection can occur are the skin of the scalp, feet, fingers, mouth, and vagina. Warm and wet places are most favorable for fungal growth. These organisms thrive on skin, especially between toe, armpit, and groin. Tinea and candida are most common in the skin of the toes. Different names are given to tinea infections, depending on the part of the skin where it is affected. Candida also causes skin infection on different parts of the body. Fungal skin infection can pass from person to person through bathroom floor, towel, clothing, etc. For example, athlete's foot is a fungal infection between toes; if the skin infection is untreated it can spread to the foot. White patches, cracked skin, and red colored marks on the foot are generally observed in the patients. Most common symptoms observed are burning, itching, and unpleasant odor from toes.

“Jock itch” is another skin infection, which occurs mostly in males and affecting the groin and inner thigh region. Red colored patches and swelling are the most common symptoms observed in infected patients.

Ringworm is a term used for infections caused by dermatophytes. Patches of ringworm are red, circular, and itchy. Candida causes thrush in mouth and vagina. The common symptoms of vaginal thrush include itching, irritation, and burning sensation. Oral thrush mainly creates white patches on the tongue and is most commonly reported in children.

The present chapter is focused on different nanoparticles and their formulations used for the treatment of various skin infections caused by fungi in humans.

2 Different Types of Skin Infections

2.1 Dermatophytosis

Dermatophytes are the causative agents of dermatophytosis (tinea). They are the group of parasitizing filamentous fungi that are able to infect the keratinized tissues such as the stratum corneum of the epidermis, nails and hairs.^8–10 Dermatophytes induce a dermal inflammatory response which leads to erythema and scaling, which cause intense itching.⁷ The pathogenesis of tinea include many steps, beginning with the contact of infective spores with the skin, adherence to the superficial cells, invasion of keratin layers by the secretion of the keratinases and induction of inflammation.⁶ Keratinases degrade the hard keratin into components of low molecular weight which can be utilized by dermatophytes.¹¹ Dermatophytes are subcategorized into different groups. On the basis of their microscopic characteristics they are classified into Trichophyton species, Epidermophyton species, and Microsporum species. According to their normal habitats, they are classified as anthropophilic spec...