Can the use of a topical antifungal nail lacquer reduce risk for diabetic foot ulceration? Results from a randomised controlled pilot study.
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Int Wound J. 2005 Jun;2(2):166-70
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This is from Lauren Crutchfiled and Nikki Frescos at Latrobe Uni:
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Interesting though that TP was found protective in this study
Prediction of Diabetic Foot Ulcer Occurrence Using Commonly Available Clinical Information - The Seattle Diabetic Foot Study
Diabetes Care 29:1202-1207, 2006
http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=2178
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Role of yeasts in diabetic foot ulcer infection
Acta Med Croatica. 2006;60(1):43-50
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Ciclopirox is said to have some antiinflammatory properties which can help during the inflammation stage of wound healing,so maybe there is a link there.Besides,onychomycosis on a diabetic patient has to be addressed aggressively with debridement plus medicines.T.pedis in this patient population is even worse,as an interdigital maceration can lead to a plantar abcess/infection.
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Prevalence of Toe Nail Onychomycosis in Diabetic Patients.
Acta Derm Venereol. 2006;86(5):425-428
Saunte DM, Holgersen JB, Haedersdal M, Strauss G, Bitsch M, Svendsen OL, Arendrup MC, Svejgaard EL.
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Effects of foot care intervention including nail drilling combined with topical antifungal application in diabetic patients with onychomycosis.
Sumikawa M, Egawa T, Honda I, Yamamoto Y, Sumikawa Y, Kubota M.
J Dermatol. 2007 Jul;34(7):456-64.
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Related threads:
Intermittent versus continuous terbinafine
Cost effectiveness of onychomycosis treatment
Onychomycosis common in children
How important is debridement in onychomycosis?
Oral terbinafine and topical ciclopirox
Onychomycosis excluded recruit from air force
Griseofulvin-v-terbinafine
Lamisil in pediatrics
Nail polish and onychomycosis
Terbinafine and alcohol
Fungal Infections in the Nasal Cavities of Podiatrists
Dermatomycosis and the environment
New bugs emerging as cause of onychomycosis -
Fungal foot infections in patients with diabetes mellitus - results of two independent investigations.
Eckhard M, Lengler A, Liersch J, Bretzel RG, Mayser P.
Mycoses. 2007 Sep;50(s2):14-19.
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Nail susceptibility to fungal infection in patients with type 1 and 2 diabetes under long term poor glycaemia control [Article in Polish]
Macura AB, Gasińska T, Pawlik B, Obłoza A.
Przegl Lek. 2007;64(6):406-9.
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Onychomycosis incidence in type 2 diabetes mellitus patients.
Manzano-Gayosso P, Hernández-Hernández F, Méndez-Tovar LJ, Palacios-Morales Y, Córdova-Martínez E, Bazán-Mora E, López-Martinez R.
Mycopathologia. 2008 Jul;166(1):41-5.
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The Incidence of Tinea Pedis in Diabetic versus Nondiabetic Patients with Interdigital Macerations. A Prospective Study
Bradford S. Legge, John F. Grady and Autum M. Lacey
Journal of the American Podiatric Medical Association; Volume 98 Number 5 353-356 2008
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Diagnosis and Prevalence of Onychomycosis in Diabetic Neuropathic Patients
An Observational Study
Isabelle J. Dumont
Journal of the American Podiatric Medical Association Volume 99 Number 2 135-139 2009
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Identification of yeast in chronic wounds using new pathogen-detection technologies.
Leake JL, Dowd SE, Wolcott RD, Zischkau AM.
J Wound Care. 2009 Mar;18(3):103-4, 106, 108
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Toenail onychomycosis in diabetic patients: issues and management.
Mayser P, Freund V, Budihardja D.
Am J Clin Dermatol. 2009;10(4):211-20.
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Fungal foot infection, cellulitis and diabetes: a review.
Bristow IR, Spruce MC.
Diabet Med. 2009 May;26(5):548-51.
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Spectrum and Prevalence of Fungi Infecting Deep Tissues of Lower Limb Wounds in Type 2 Diabetic Patients.
Chellan G, Shivaprakash S, Karimassery Ramaiyar S, Varma AK, Varma N, Thekkeparambil Sukumaran M, Rohinivilasam Vasukutty J, Bal A, Kumar H.
J Clin Microbiol. 2010 Apr 21. [Epub ahead of print]
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Clinical and mycologic characteristics of onychomycosis in diabetic patients.
Al-Mutairi N, Eassa BI, Al-Rqobah DA.
Acta Dermatovenerol Croat. 2010 Jul;18(2):84-91.
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Prevalence of Toenail Onychomycosis in Patients with Type 2 Diabetes Mellitus and Evaluation of Risk Factors
Aynur Gulcan, Erim Gulcan, Sukru Oksuz, Idris Sahin and Demet Kaya
Journal of the American Podiatric Medical Association; Volume 101 Number 1 49-54 2011
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Factors associated with presence and severity of toenail onychomycosis in patients with diabetes: A cross-sectional study.
Takehara K, Oe M, Tsunemi Y, Nagase T, Ohashi Y, Iizaka S, Ueki K, Tsukamoto K, Kadowaki T, Sanada H.
Int J Nurs Stud. 2011 Feb 28. [Epub ahead of print]
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Safety and efficacy of tinea pedis and onychomycosis treatment in people with diabetes: a systematic review.
Matricciani L, Talbot K, Jones S.
J Foot Ankle Res. 2011 Dec 4;4(1):26.
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Fungal Infections among Diabetic Foot Ulcer- Patients Attending Diabetic Clinic in Kenyatta National Hospital, Kenya
AM Gitau, ZW Ng’ang’a, W Sigilai, C Bii, M Mwangi
East African Medical Journal > Vol 88, No 1 (2011)
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Fungal infection of the diabetic foot: The often ignored complication
Paul Chadwick
Diabetic Foot Canada, 2013, Vol 1, No 2, pages 20–24
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Dermatomycosis in lower limbs of diabetic patients followed by podiatry consultation.
Parada H, Veríssimo C, Brandão J, Nunes B, Boavida J, Duarte R, Peerally Z, Oliveira R, Rosado L, Sabino R.
Rev Iberoam Micol. 2013 Apr-Jun;30(2):103-8.
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Hello
Forgive me for any errors or misgivings in this reply - iam but a student!
I read this "thread" with interest as I was interested in looking at "fungal infection of the diabetic foot" and performing an audit (with regard to best practice - sampling, treatments etc.). I have been looking through NICE Guidelines and other local policies for a "standard" for the management of fungal nail or skin infection in diabetic patients. So far I cannot find anything specific? I will of continue to search documents/literature, but if anyone could point me in the right direction, or advise on local policies, I would very much appreciate it.
Many thanks. -
hi
as taking samples cost money I think for me it is on clinical risk from the presenting infection.
for example a 82 year old diabetic with longstanding O/X nails and suspected fungal nail infection that is causing no clinical risk factors.
do we take samples?
what is or plan?
what is the most effective treatment for them?
are we achieving any purpose.
I do think laser is the way forward for toe mycotic infections -
Skin and nail mycoses in patients with diabetic foot.
Papini M, Cicoletti M, Fabrizi V, Landucci P.
G Ital Dermatol Venereol. 2013 Dec;148(6):603-608.
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Thankyou - I think from all the papers I have read - and observation in clinic, the question I have for diabetic patients, is whether the presence of onychomycosis (or indeed tinea pedis), is a "risk factor" in itself? With or without other diabetic risk factors. If it is classed as a "skin/nail change", does that put the diabetic patient at increased risk for ulceration - and therefore require treatment and possibly referral?
The subject of "what treatment" does interest me (previous career in Medical Microbiology!) - perhaps that should be my next literature review.
Again, I apologise if my questions appear obvious - Iam now a student in Podiatry. Any advice is very much appreciated. -
Proportion of lower limb fungal foot infections in patients with type 2 diabetes at a tertiary care hospital in Sri Lanka.
Wijesuriya TM, Weerasekera MM, Kottahachchi J, Ranasinghe KN, Dissanayake MS, Prathapan S, Gunasekara TD, Nagahawatte A, Guruge LD, Bulugahapitiya U, Fernando SS.
Indian J Endocrinol Metab. 2014 Jan;18(1):63-9. doi: 10.4103/2230-8210.126556.
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Diabetic foot ulcers and Candida co-infection: a single centered study
J.Nithyalakshmi, S.Nirupa and G.Sumathi
Int.J.Curr.Microbiol.App.Sci (2014) 3(11) 413-419
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Study protocol
Laser therapy for onychomycosis in patients with diabetes at risk for foot complications: study protocol for a randomized, double-blind, controlled trial (LASER-1)
Leonie Nijenhuis-Rosien, Nanne Kleefstra, Maurice J Wolfhagen, Klaas H Groenier, Henk JG Bilo and Gijs WD Landman
Trials 2015, 16:108 doi:10.1186/s13063-015-0622-4
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Aspergillus species: An emerging pathogen in onychomycosis among diabetics
TM Wijesuriya et al
Indian J Endocr Metab 2015;19:811-6
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Tinea pedis and onychomycosis frequency in diabetes
mellitus patients and diabetic foot ulcers:
A cross sectional ? observational study
Gamze Akkus et al
Pak J Med Sci. 2016;32(4):
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Identification, antifungal resistance profile, in vitro biofilm formation and ultrastructural characteristics of Candida species isolated from diabetic foot patients in Northern India.
Kumar D et al
Indian J Med Microbiol. 2016 Jul-Sep;34(3):308-14
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Tinea pedis and onychomycosis frequency in diabetes mellitus patients and diabetic foot ulcers. A cross sectional - observational study.
Akkus G et al
Pak J Med Sci. 2016 Jul-Aug;32(4):891-895.
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A Study of Prevalence and the Profile of Fungal Infections in Diabetic Foot Ulcers in a Tertiary Care Hospital of Kerala
Venkatachalam P, Udayaravi M P
International Journal of Contemporary Surgery; Year : 2017, Volume : 5, Issue : 1
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Frequency of Cutaneous Fungal Infections and Azole Resistance of the Isolates in Patients with Diabetes Mellitus.
Raiesi O et al
Adv Biomed Res. 2017 Jun 6;6:71. doi: 10.4103/2277-9175.191003. eCollection 2017.
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Prevalence and epidemiology of tinea pedis and toenail onychomycosis and antifungal susceptibility of the causative agents in patients with type 2 diabetes in Turkey.
Oz Y et al
Int J Dermatol. 2017 Jan;56(1):68-74. doi: 10.1111/ijd.13402
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A Cross Sectional study on prevalence of fungal infections in
Diabetic foot ulcer
Shailendra Kumar Singh et al
INDIAN JOURNAL OF APPLIED RESEARCH
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