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:T49a,The search yielded 96 studies (1954-2025) documenting 134 patients. The number of reports has notably increased since the 21st century; however, diagnosis remains challenging due to possible dermatophyte adaptation in the dermal/subcutaneous environment. Trichophyton rubrum is the most frequently isolated pathogen. Acquired immunodeficiencies (e.g. renal transplant recipients) and primary immunodeficiencies (e.g. CARD9, STAT3 mutations) elevate the risk of deep dermatophytosis. Systemic dissemination, often accompanied by lymphadenopathy, was reported in 24 patients, with the most common being infection of the axillary and inguinal lymph nodes. Infections of the bones, lungs, and brain were also reported. Terbinafine (125-1000 mg/day) and itraconazole (100-400 mg/day), with adjunctive topical antifungals and surgical interventions, have been tried for deep dermatophytosis. The use of newer triazoles (voriconazole, posaconazole) should follow the principles of antifungal stewardship and therapeutic drug monitoring recommendations. Multidrug resistance is a potential concern in immunocompromised patients who will often require extended or lifelong treatment.31:T89b,Dermatophytes-a group of obligate keratinophilic fungi that infect the skin, hair and nails-represent the most common cause of fungal infections worldwide. In immunocompromised individuals, a growing body of literature has documented rare instances of dermatophyte infections of the dermis and subcutaneous tissue, which can lead to deep dermatophytosis with systemic dissemination and pseudomycetoma as secondary complications. To assess patient characteristics, risk factors, diagnostic evidence and treatment options for deep dermatophytosis. A systematic review was conducted in June 2025 to identify patients presenting with deep dermatophytosis of the glabrous skin; all cases were validated by confirmatory testing per histopathologic examination and fungal culture. Majocchi's granuloma diagnoses were excluded. The search yielded 96 studies (1954-2025) documenting 134 patients. The number of reports has notably increased since the 21st century; however, diagnosis remains challenging due to possible dermatophyte adaptation in the dermal/subcutaneous environment. Trichophyton rubrum is the most frequently isolated pathogen. Acquired immunodeficiencies (e.g. renal transplant recipients) and primary immunodeficiencies (e.g. CARD9, STAT3 mutations) elevate the risk of deep dermatophytosis. Systemic dissemination, often accompanied by lymphadenopathy, was reported in 24 patients, with the most common being infection of the axillary and inguinal lymph nodes. Infections of the bones, lungs, and brain were also reported. Terbinafine (125-1000 mg/day) and itraconazole (100-400 mg/day), with adjunctive topical antifungals and surgical interventions, have been tried for deep dermatophytosis. The use of newer triazoles (voriconazole, posaconazole) should follow the principles of antifungal stewardship and therapeutic drug monitoring recommendations. Multidrug resistance is a potential concern in immunocompromised patients who will often require extended or lifelong treatment. Healthcare providers should be cognizant that dermatophytosis may become invasive and disseminated in immunocompromised populations. Testing and early treatment should not be overlooked in these patients.32:Ta45,AbstractBackgroundDermatophytes—a group of obligate keratinophilic fungi that infect the skin, hair and nails—represent the most common cause of fungal infections worldwide. In immunocompromised individuals, a growing body of literature has documented rare instances of dermatophyte infections of the dermis and subcutaneous tissue, which can lead to deep dermatophytosis with systemic dissemination and pseudomycetoma as secondary complications.ObjectivesTo assess patient characteristics, risk factors, diagnostic evidence and treatment options for deep dermatophytosis.MethodsA systematic review was conducted in June 2025 to identify patients presenting with deep dermatophytosis of the glabrous skin; all cases were validated by confirmatory testing per histopathologic examination and fungal culture. Majocchi's granuloma diagnoses were excluded.ResultsThe search yielded 96 studies (1954–2025) documenting 134 patients. The number of reports has notably increased since the 21st century; however, diagnosis remains challenging due to possible dermatophyte adaptation in the dermal/subcutaneous environment. Trichophyton rubrum is the most frequently isolated pathogen. Acquired immunodeficiencies (e.g. renal transplant recipients) and primary immunodeficiencies (e.g. CARD9, STAT3 mutations) elevate the risk of deep dermatophytosis. Systemic dissemination, often accompanied by lymphadenopathy, was reported in 24 patients, with the most common being infection of the axillary and inguinal lymph nodes. Infections of the bones, lungs, and brain were also reported. Terbinafine (125–1000 mg/day) and itraconazole (100–400 mg/day), with adjunctive topical antifungals and surgical interventions, have been tried for deep dermatophytosis. The use of newer triazoles (voriconazole, posaconazole) should follow the principles of antifungal stewardship and therapeutic drug monitoring recommendations. Multidrug resistance is a potential concern in immunocompromised patients who will often require extended or lifelong treatment.ConclusionsHealthcare providers should be cognizant that dermatophytosis may become invasive and disseminated in immunocompromised populations. Testing and early treatment should not be overlooked in these patients.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Polyene Antifungal: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Polyene Antifungal (modality). Clinician-written summaries and actionable practice insights. 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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":"10.2147/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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b","value_numeric":null},{"paper_doi":"10.2147/ccid.s561833","tag_type":"generic","value":"itraconazole","value_numeric":null},{"paper_doi":"10.2147/ccid.s561833","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.2147/ccid.s561833","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.2147/ccid.s561833","tag_type":"modality","value":"Azole Antifungal","value_numeric":null},{"paper_doi":"10.2147/ccid.s561833","tag_type":"modality","value":"Polyene Antifungal","value_numeric":null},{"paper_doi":"10.2147/ccid.s561833","tag_type":"sample_size","value":"n=1","value_numeric":1},{"paper_doi":"10.2147/ccid.s561833","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.2147/ccid.s561833","tag_type":"study_design","value":"Case Report","value_numeric":null},{"paper_doi":"10.2147/ccid.s561833","tag_type":"warning","value":"Diagnosis remained presumptive; PCR/culture and species identification were not performed.","value_numeric":null},{"paper_doi":"10.2147/ccid.s561833","tag_type":"warning","value":"No visceral tissue biopsy demonstrated parasites; amphotericin B formulation and weight-based dosing were not specified.","value_numeric":null},{"paper_doi":"10.2147/ccid.s561833","tag_type":"warning","value":"Single-patient case report; findings are not generalizable.","value_numeric":null}],"summaries":{"what_studied":"A single presumptive case of mucocutaneous and visceral leishmaniasis in a 20-year-old woman in Indonesia, a non-endemic setting, describing clinical features, available diagnostics (histopathology and smear), and treatments used over days to weeks.","key_result":"Histology and Giemsa smear showed structures resembling Leishman–Donovan bodies; after 12 days of itraconazole 200 mg/day, she developed dyspnea with CT ground-glass opacities, bone marrow features of HLH, and hepatomegaly. 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. 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effect estimates are descriptive and non-comparative.","value_numeric":null},{"paper_doi":"10.1111/jdv.70115","tag_type":"warning","value":"The review excludes Majocchi's granuloma; ensure diagnostic criteria align when applying these data.","value_numeric":null},{"paper_doi":"10.1111/jdv.70115","tag_type":"warning","value":"Treatment response rates reflect reported outcomes and may be influenced by reporting bias and variable follow-up.","value_numeric":null}],"summaries":{"what_studied":"A systematic review (search June 2025) of histopathology- and culture-confirmed deep dermatophytosis of glabrous skin, excluding Majocchi's granuloma; 96 studies from 1954–2025 describing 134 patients.","key_result":"Median age was 51 years (IQR 22); 70.1% (94/134) were male, and Trichophyton rubrum was most frequent. Dissemination occurred in 24/134 patients (lymph node involvement confirmed in 15), with bone (5 cases) and brain abscesses (4 cases) reported; among therapies, improvement was reported with terbinafine in 64.8% (35/54), itraconazole in 46.5% (33/71), posaconazole in 58.8% (10/17), and voriconazole in 38.5% (5/13).","limitations":"Most included reports were case reports or small series, creating publication bias; antifungal susceptibility testing and therapeutic drug monitoring data were sparse, and some treatment data were incompletely reported.","practice_takeaway":"In immunocompromised patients with atypical nodules, ulcers, abscesses, or lymphadenopathy, obtain histopathology and culture to diagnose deep dermatophytosis and treat concomitant superficial tinea to reduce autoinoculation risk. Oral terbinafine or itraconazole are commonly used; if newer triazoles are needed, follow antifungal stewardship with therapeutic drug monitoring and watch for drug–drug interactions."}}],"initialOffset":3,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Polyene Antifungal"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Polyene Antifungal"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Polyene Antifungal"}}}]]

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