2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T57b,Yellow nail syndrome (YNS) is a rare syndrome with unknown pathogenesis characterized by a clinical triad of respiratory disease, lymphedema, and xanthonychia. Diagnosis is challenging as clinical manifestations often do not occur concurrently. Due to disease rarity, few studies to date have characterized YNS or assessed therapeutics. We aimed to characterize clinical findings of YNS and compare therapeutic regimens to provide diagnostic and management recommendations. An international multi-institutional retrospective cohort study of YNS patients was conducted by a panel of nail experts. We included 111 YNS patients. Xanthonychia, increased transverse curvature, thickening, nail growth arrest, and a history of respiratory disease or lymphedema were highly suggestive of YNS. The therapeutic regimen with highest complete response rate was oral vitamin E combined with oral azole antifungals. Limitations include nonrandomized and retrospective design. Clinical details were inconsistently reported. Some treatments discussed are expert opinions and based on hypothetical and/or minimal data. We provide the largest study to date characterizing YNS. We suggest that patients with suspected YNS undergo mycologic examination and referral to pulmonology. We recommend oral vitamin E with oral azole antifungal as the first-line therapy for YNS. Reassurance/no treatment could also be considered.31:T495,Among 11 patients with T indotineae (6 male and 5 female patients; median [range] age, 39 [10-65] years), 2 were pregnant; 1 had lymphoma; and the remainder were immunocompetent. Nine patients reported previous travel to Bangladesh. All had widespread lesions with variable scale and inflammation, topical antifungal monotherapy failure, and diagnostic delays (range, 3-42 months). Terbinafine treatment failed in 7 patients at standard doses (250 mg daily) for prolonged duration; these patients also had isolates with amino acid substitutions at positions 393 (L393S) or 397 (F397L) in squalene epoxidase that correlated with elevated terbinafine minimum inhibitory concentrations of 0.5 μg/mL or higher. Patients who were treated with fluconazole and griseofulvin improved in 2 of 4 and 2 of 5 instances, respectively, without correlation between outcomes and antifungal minimum inhibitory concentrations. Furthermore, 5 of 7 patients treated with itraconazole cleared or had improvement at the last follow-up, and 2 of 7 were lost to follow-up or stopped treatment. Based on whole-genome sequencing analysis, US isolates formed a cluster distinct from Indian isolates.32:T958,Trichophyton indotineae is an emerging dermatophyte causing outbreaks of extensive tinea infections often unresponsive to terbinafine. This species has been detected worldwide and in multiple US states, yet detailed US data on infections with T indotineae are sparse and could improve treatment practices and medical understanding of transmission. To correlate clinical features of T indotineae infections with in vitro antifungal susceptibility testing results, squalene epoxidase gene sequence variations, and isolate relatedness using whole-genome sequencing. This retrospective cohort study of patients with T indotineae infections in New York City spanned May 2022 to May 2023. Patients with confirmed T indotineae infections were recruited from 6 New York City medical centers. Improvement or resolution at the last follow-up assessment. Among 11 patients with T indotineae (6 male and 5 female patients; median [range] age, 39 [10-65] years), 2 were pregnant; 1 had lymphoma; and the remainder were immunocompetent. Nine patients reported previous travel to Bangladesh. All had widespread lesions with variable scale and inflammation, topical antifungal monotherapy failure, and diagnostic delays (range, 3-42 months). Terbinafine treatment failed in 7 patients at standard doses (250 mg daily) for prolonged duration; these patients also had isolates with amino acid substitutions at positions 393 (L393S) or 397 (F397L) in squalene epoxidase that correlated with elevated terbinafine minimum inhibitory concentrations of 0.5 μg/mL or higher. Patients who were treated with fluconazole and griseofulvin improved in 2 of 4 and 2 of 5 instances, respectively, without correlation between outcomes and antifungal minimum inhibitory concentrations. Furthermore, 5 of 7 patients treated with itraconazole cleared or had improvement at the last follow-up, and 2 of 7 were lost to follow-up or stopped treatment. Based on whole-genome sequencing analysis, US isolates formed a cluster distinct from Indian isolates. The results of this case series suggest that disease severity, diagnostic delays, and lack of response to typically used doses and durations of antifungals for tinea were common in this primarily immunocompetent patient cohort with T indotineae, consistent with published data. Itraconazole was generally effective, and the acquisition of infection was likely in Bangladesh.33:Tc6d,ImportanceTrichophyton indotineae is an emerging dermatophyte causing outbreaks of extensive tinea infections often unresponsive to terbinafine. This species has been detected worldwide and in multiple US states, yet detailed US data on infections with T indotineae are sparse and could improve treatment practices and medical understanding of transmission.ObjectiveTo correlate clinical features of T indotineae infections with in vitro antifungal susceptibility testing results, squalene epoxidase gene sequence variations, and isolate relatedness using whole-genome sequencing.Design, Setting, and ParticipantsThis retrospective cohort study of patients with T indotineae infections in New York City spanned May 2022 to May 2023. Patients with confirmed T indotineae infections were recruited from 6 New York City medical centers.Main Outcome and MeasureImprovement or resolution at the last follow-up assessment.ResultsAmong 11 patients with T indotineae (6 male and 5 female patients; median [range] age, 39 [10-65] years), 2 were pregnant; 1 had lymphoma; and the remainder were immunocompetent. Nine patients reported previous travel to Bangladesh. All had widespread lesions with variable scale and inflammation, topical antifungal monotherapy failure, and diagnostic delays (range, 3-42 months). Terbinafine treatment failed in 7 patients at standard doses (250 mg daily) for prolonged duration; these patients also had isolates with amino acid substitutions at positions 393 (L393S) or 397 (F397L) in squalene epoxidase that correlated with elevated terbinafine minimum inhibitory concentrations of 0.5 μg/mL or higher. Patients who were treated with fluconazole and griseofulvin improved in 2 of 4 and 2 of 5 instances, respectively, without correlation between outcomes and antifungal minimum inhibitory concentrations. Furthermore, 5 of 7 patients treated with itraconazole cleared or had improvement at the last follow-up, and 2 of 7 were lost to follow-up or stopped treatment. Based on whole-genome sequencing analysis, US isolates formed a cluster distinct from Indian isolates.Conclusion and RelevanceThe results of this case series suggest that disease severity, diagnostic delays, and lack of response to typically used doses and durations of antifungals for tinea were common in this primarily immunocompetent patient cohort with T indotineae, consistent with published data. Itraconazole was generally effective, and the acquisition of infection was likely in Bangladesh.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Azole Antifungal: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Azole Antifungal (modality). Clinician-written summaries and actionable practice insights. 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Oral itraconazole led to marked clinical improvement — flattening of lesions and no new lesions — at 2 months.","limitations":"Single case report; no long-term follow-up reported beyond 2 months; no formal immunodeficiency workup detailed despite the immunocompetent label.","practice_takeaway":"In persistent or atypical papulonodular skin eruptions — especially at unusual sites — send both histopathology (PAS stain) and fungal culture, as non-dermatophytic molds like *Aspergillus niger* can cause Majocchi granuloma even in immunocompetent patients. Oral itraconazole appears effective in this setting."}},{"doi":"10.1093/ofid/ofag440","pmid":"42598483","title":"What's in a Name? Etymology and History of Antibacterials and Antifungals","journal_title":"Open Forum Infectious Diseases","journal_issn":"2328-8957","published_at":"2026-08-13T00:00:00.000Z","url":"https://doi.org/10.1093/ofid/ofag440","source_score":16,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-17T13:33:24.814Z","updated_at":"2026-08-17T13:33:24.814Z","tags":[{"paper_doi":"10.1093/ofid/ofag440","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"condition","value":"Bacterial Infections","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"condition","value":"Fungal Infections","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"condition","value":"Infectious Disease","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Aminoglycoside","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Antibacterial","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Antifungal","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Azole Antifungal","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Beta-Lactam","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Echinocandin","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Fluoroquinolone","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Glycopeptide","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Macrolide","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Oxazolidinone","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Polyene Antifungal","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Polymyxin","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"modality","value":"Tetracycline","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"warning","value":"No sample size is applicable; this is a descriptive/historical review without a study population.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"warning","value":"Scope is limited to antibacterials and antifungals; antivirals, antimycobacterials, and antiparasitics are not covered.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"warning","value":"Several drug name etymologies are explicitly speculative or unverified in the public domain (e.g., meropenem, ertapenem, daptomycin, durlobactam, relebactam prefixes). Clinicians should not rely on these as authoritative.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"warning","value":"Sex and age group tags are not applicable to this review type and have been omitted.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag440","tag_type":"warning","value":"This is a narrative review with no systematic search methodology described; it is educational and historical rather than evidence-synthesizing. Level of evidence assigned as 7 (expert opinion/narrative review).","value_numeric":null}],"summaries":{"what_studied":"This narrative review traces the historical discovery, etymological origins, and naming conventions of currently available antibacterial and antifungal agents — from penicillin to echinocandins — covering natural products, semisynthetic derivatives, and fully synthetic compounds. Antivirals and antimycobacterials are excluded.","key_result":"Drug names historically encoded chemical structure, producing organism, or geography (e.g., 'penicillin' from *Penicillium*'s paintbrush-shaped conidiophores; 'terramycin' from Latin *terra* for earth and Terre Haute, Indiana). Modern naming, governed by USAN and WHO INN, prioritizes 2-syllable prefixes chosen for pronounceability and global linguistic compatibility, with class-specific suffixes maintained (e.g., '-cillin,' '-penem,' '-mycin,' '-azole,' '-fungin').","limitations":"- No primary data; conclusions rest on published histories and manufacturer disclosures, with several etymologies unverifiable or speculative (e.g., meropenem's 'mero-,' daptomycin's 'dap-').\n- Pharmaceutical companies were notified and invited to clarify naming but had no editorial role, leaving gaps where public documentation is absent.\n- Antivirals and antimycobacterials are outside scope, limiting comprehensiveness.","practice_takeaway":"Understanding drug name stems (e.g., '-cillin' = penicillin class, '-mycin' vs '-micin' = *Streptomyces* vs *Micromonospora* origin, '-azole' = imidazole/triazole antifungal) helps clinicians quickly identify drug class, mechanism, and potential cross-reactivity. Naming conventions also explain why newer agents (e.g., ceftaroline, tedizolid) have less structurally informative prefixes — they are chosen for global pronounceability rather than chemistry."}},{"doi":"10.1111/myc.70196","pmid":"42257528","title":"Efficacy Evaluation of Luliconazole‐Loaded Nanostructured Lipid Carriers in Treatment‐Resistant Dermatophytosis: A Randomized Clinical Trial","journal_title":"Mycoses","journal_issn":"0933-7407","published_at":"2026-06-08T00:00:00.000Z","url":"https://doi.org/10.1111/myc.70196","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-12T13:24:33.573Z","updated_at":"2026-06-12T13:24:33.573Z","tags":[{"paper_doi":"10.1111/myc.70196","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"condition","value":"Antifungal-Resistant Fungal Infection","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"condition","value":"Dermatophytosis","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"condition","value":"Trichophyton indotineae Infection","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"generic","value":"itraconazole","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"generic","value":"luliconazole","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"generic","value":"terbinafine","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"modality","value":"Azole Antifungal","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"modality","value":"Nanostructured Lipid Carrier","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"sample_size","value":"n=48","value_numeric":48},{"paper_doi":"10.1111/myc.70196","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"warning","value":"ITZ monotherapy showed 0% recovery, which may partly reflect subtherapeutic drug levels (no therapeutic drug monitoring performed) rather than resistance alone.","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"warning","value":"Level of evidence assigned as 2 (RCT); however, the open-label, single-center, small-sample design substantially limits confidence compared to a full-scale phase III trial.","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"warning","value":"Open-label design with no placebo control; blinding was not feasible due to different routes of administration (oral vs. topical), which may introduce performance and detection bias.","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — findings are promising but require confirmation in larger, multi-center trials before adoption as standard care.","value_numeric":null},{"paper_doi":"10.1111/myc.70196","tag_type":"warning","value":"Very small per-group sample size (n=12) makes this an exploratory pilot; authors acknowledge it is underpowered to detect smaller between-group differences.","value_numeric":null}],"summaries":{"what_studied":"This open-label randomized clinical trial (n=48 adults, 4 weeks) compared four treatments for confirmed terbinafine-resistant *T. indotineae* dermatophytosis: oral itraconazole (ITZ) alone, topical luliconazole (LCZ) gel, nanostructured lipid carrier–loaded luliconazole (NLC-LCZ) gel, or ITZ + NLC-LCZ gel (n=12 per group).","key_result":"Complete recovery (clinical + mycological cure) rates were: ITZ + NLC-LCZ 83.3%, NLC-LCZ 75%, LCZ 58.3%, and ITZ alone 0% (p<0.01). NLC-LCZ and LCZ had MIC90 of 0.016 μg/mL vs. ITZ MIC90 8 μg/mL and TRB MIC90 4 μg/mL. DLQI scores at 4 weeks: NLC-LCZ 2, ITZ+NLC-LCZ 3, LCZ 5, ITZ 10 (p<0.001). Adverse events were mild (overall 18.8%) and required no discontinuation.","limitations":"- Small single-center pilot (n=12/group); risk of type II error for smaller between-group differences.\n- Short 4-week follow-up with no relapse data, a notable gap given high *T. indotineae* recurrence rates.\n- Open-label design and no pharmacokinetic assessment (skin penetration, drug retention) to confirm proposed NLC delivery mechanisms.","practice_takeaway":"For terbinafine-resistant *T. indotineae* dermatophytosis, topical NLC-LCZ gel—alone or combined with oral itraconazole—achieved far higher cure rates than itraconazole monotherapy, which failed entirely. Clinicians managing refractory cases may consider this combination approach pending larger confirmatory trials."}},{"doi":"10.2147/ccid.s561833","pmid":"41211306","title":"A Presumptive Case of Mucocutaneous and Visceral Leishmaniasis in Nonendemic Country","journal_title":"Clinical, Cosmetic and Investigational Dermatology","journal_issn":"1178-7015","published_at":"2025-11-10T00:00:00.000Z","url":"https://doi.org/10.2147/ccid.s561833","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-11-08","doi":"10.2147/ccid.s561833","days":"7","issn":"1178-7015","rank":"9","field":"Clinical Medicine","score":"1","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.2147/CCID.S561833","title":"A Presumptive Case of Mucocutaneous and Visceral Leishmaniasis in Nonendemic Country.","journal":"Clinical, cosmetic and investigational dermatology","methods":"","results":"","abstract":"Leishmaniasis is a complex disease caused by ","keywords":["mucocutaneous leishmaniasis","non-endemic country","visceral leishmaniasis"],"pubmed_id":"41211306","conclusions":"","publication_date":"2025-11-10T00:00:00"},"crossref":{"DOI":"10.2147/ccid.s561833","URL":"https://doi.org/10.2147/ccid.s561833","ISSN":["1178-7015"],"link":[{"URL":"https://www.dovepress.com/article/download/108455","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.dovepress.com/article/download/108455","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":"2887-2894","type":"journal-article","issue":null,"score":1,"title":["A Presumptive Case of Mucocutaneous and Visceral Leishmaniasis in Nonendemic Country"],"author":[{"given":"Hendra","family":"Gunawan","sequence":"first","affiliation":[]},{"given":"Risa","family":"Hidayah","sequence":"additional","affiliation":[]},{"given":"Miranti","family":"Pangastuti","sequence":"additional","affiliation":[]},{"given":"Oki","family":"Suwarsa","sequence":"additional","affiliation":[]},{"given":"Srie","family":"Gondokaryono","sequence":"additional","affiliation":[]},{"given":"Eva","family":"Sutedja","sequence":"additional","affiliation":[]},{"given":"Marshel","family":"Budiarsa","sequence":"additional","affiliation":[]},{"given":"Fitri","family":"Yulianti","sequence":"additional","affiliation":[]},{"given":"Yovita","family":"Hartantri","sequence":"additional","affiliation":[]},{"given":"Hermin","family":"Usman","sequence":"additional","affiliation":[]},{"given":"Nisa","family":"Fauziah","sequence":"additional","affiliation":[]},{"given":"Ayu","family":"Sabila","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2025,11]]},"member":"301","prefix":"10.2147","source":"Crossref","volume":"Volume 18","created":{"date-time":"2025-11-03T08:30:12Z","timestamp":1762158612000,"date-parts":[[2025,11,3]]},"indexed":{"date-time":"2025-11-03T08:34:39Z","timestamp":1762158879793,"date-parts":[[2025,11,3]]},"license":[{"URL":"https://creativecommons.org/licenses/by-nc/3.0/","start":{"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000,"date-parts":[[2025,11,1]]},"delay-in-days":0,"content-version":"unspecified"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://www.dovepress.com/a-presumptive-case-of-mucocutaneous-and-visceral-leishmaniasis-in-none-peer-reviewed-fulltext-article-CCID"}},"subtitle":[],"deposited":{"date-time":"2025-11-03T08:30:17Z","timestamp":1762158617000,"date-parts":[[2025,11,3]]},"issn-type":[{"type":"electronic","value":"1178-7015"}],"published":{"date-parts":[[2025,11]]},"publisher":"Informa UK Limited","reference":[{"DOI":null,"key":"ref1","year":"2019","issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"ref2","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"National Center for Emerging and Zoonotic Infectious Diseases. 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She received IV amphotericin B 50 mg/day but deteriorated by day 6 and died of respiratory failure.","limitations":"Diagnosis was presumptive without PCR, culture, or species identification, and no visceral tissue biopsy demonstrated parasites. This is a single-patient report from a non-endemic center with limited diagnostics, and treatment response to itraconazole could not be assessed.","practice_takeaway":"In non-endemic settings, “volcanic” noduloulcerative lesions with mucosal erosions should prompt suspicion for leishmaniasis and pursuit of tissue diagnosis and, where available, PCR. For VL, amphotericin B is recommended (WHO notes 2–3 mg/kg/day for 20 days), and timely diagnosis is critical to prevent progression and HLH."}},{"doi":"10.1016/j.jaad.2025.07.039","pmid":"40692045","title":"Diagnosis and management of yellow nail syndrome: An international multi-institutional retrospective cohort study of 111 cases by an expert panel","journal_title":"Journal of the American Academy of Dermatology","journal_issn":"0190-9622","published_at":"2025-07-22T00:00:00.000Z","url":"https://doi.org/10.1016/j.jaad.2025.07.039","source_score":12,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-10-21","doi":"10.1016/j.jaad.2025.07.039","days":"7","issn":"0190-9622","rank":"8","field":"Clinical Medicine","score":"12","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1016/j.jaad.2025.07.039","title":"Diagnosis and management of yellow nail syndrome: An international multi-institutional retrospective cohort study of 111 cases by an expert panel.","journal":"Journal of the American Academy of Dermatology","methods":"","results":"We included 111 YNS patients. Xanthonychia, increased transverse curvature, thickening, nail growth arrest, and a history of respiratory disease or lymphedema were highly suggestive of YNS. The therapeutic regimen with highest complete response rate was oral vitamin E combined with oral azole antifungals.","abstract":"$30","keywords":["chronic cough","diagnosis","fluconazole","itraconazole","lymphedema","management","minoxidil","nail growth","sinusitis","vitamin E","xanthonychia","yellow nail syndrome","yellow nails"],"pubmed_id":"40692045","conclusions":"We provide the largest study to date characterizing YNS. We suggest that patients with suspected YNS undergo mycologic examination and referral to pulmonology. We recommend oral vitamin E with oral azole antifungal as the first-line therapy for YNS. 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based on last follow‑up, and two patients on itraconazole were lost to follow‑up or stopped treatment.","value_numeric":null}],"summaries":{"what_studied":"A retrospective cohort case series from six New York City centers (May 2022–May 2023) examined 11 patients with confirmed Trichophyton indotineae, correlating clinical features with antifungal minimum inhibitory concentrations, squalene epoxidase mutations, and whole‑genome sequencing; outcome was improvement or resolution at last follow‑up.","key_result":"Terbinafine (250 mg daily) failed in 7 patients, and their isolates carried SQLE L393S or F397L with elevated terbinafine MICs ≥0.5 μg/mL. Improvement occurred in 2/4 on fluconazole and 2/5 on griseofulvin (no outcome–MIC correlation); 5/7 on itraconazole cleared or improved (2/7 lost to follow‑up or stopped), and U.S. isolates formed a distinct cluster from Indian isolates; 9/11 reported travel to Bangladesh.","limitations":"Small sample (n=11) and single‑city, multi‑center case series limit generalizability. Uncontrolled, retrospective design with heterogeneous treatments and incomplete follow‑up (2 of 7 on itraconazole lost or stopped) constrains outcome interpretation.","practice_takeaway":"Expect terbinafine failure associated with SQLE mutations and elevated MICs in T indotineae; in this series, itraconazole led to clearance or improvement in 5 of 7 treated patients. Take a travel history—most patients reported travel to Bangladesh—and consider susceptibility testing when terbinafine fails."}}],"initialOffset":6,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Azole Antifungal"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Azole Antifungal"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Azole Antifungal"}}}]]

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