Publications by authors named "Shruthi Polla Ravi"
Article Synopsis
- Onychomycosis, a common nail fungus, is challenging to treat and often reoccurs, particularly in pediatric patients.
- A study analyzed 19,770 pediatric patients over 9 years, confirming that onychomycosis occurred in 37% of cases, with higher rates in younger age groups (6-11 years) and predominantly caused by dermatophytes like Trichophyton rubrum.
- The findings indicate that elementary school-aged children are at a higher risk due to factors such as puberty-related sweat production and footwear choices, highlighting the growing prevalence of Fusarium infections that may require adjusted treatment approaches.
Efinaconazole 10% solution: a comprehensive review of its use in the treatment of onychomycosis.
Expert Opin Pharmacother
October 2024
Article Synopsis
- Onychomycosis is a fungal infection affecting nails, and while oral antifungals are the main treatment for severe cases, the topical solution efinaconazole (10%) is effective and safe for mild to moderate infections, approved for ages 6 and up.
- The literature review highlights efinaconazole's pharmacokinetics, safety, and effectiveness across different populations, including children, diabetics, and the elderly, showing no systemic side effects or drug interactions.
- Efinaconazole is particularly beneficial for certain groups, such as females, children, early-stage infections, and those with mild nail involvement, making it a viable option, especially in cases of terbinafine resistance.
Article Synopsis
- Oral antifungals are the traditional and proven treatments for onychomycosis, but newer alternatives like topical antifungals and device-based therapies are being explored.
- A bibliometric analysis was conducted using literature from 1970 to present, revealing a total of 295 articles on oral treatments, 358 on topical therapies, and 158 on device-based methods, with spikes in research aligning with FDA approvals.
- Recent research has shifted towards topical and device-based treatments, though there is a shortage of high-quality studies supporting the efficacy of these newer options, especially in light of emerging therapeutic challenges like terbinafine resistance.
Article Synopsis
- - Onychomycosis is a tough fungal nail infection that can lead to further complications, prompting the need for accurate pathogen identification through testing to enhance treatment effectiveness.
- - A study analyzing over 710,000 patient records from 2015-2024 utilized PCR testing, revealing a wider range of pathogens than previously known, particularly showing that non-dermatophyte molds and yeasts are significant in female patients and older adults.
- - The use of advanced molecular diagnostics allows for quicker and more precise identification of the fungi causing onychomycosis, which can lead to better treatment choices and improved healthcare outcomes.
Introduction: There is an increasing number of reports of infections. This species is usually poorly responsive to terbinafine.
Areas Covered: A literature search was conducted in May 2024.
Article Synopsis
- - Tinea capitis is a contagious fungal infection affecting children, with significant public health implications due to its prevalence, risk factors, and potential long-term effects if untreated; regional variations exist in causative agents, primarily Trichophyton in North America and Microsporum globally.
- - Diagnosis primarily involves clinical evaluation, microscopic examination, and fungal culture, while treatment options include systemic antifungals, particularly terbinafine for Trichophyton infections; accurate diagnosis and patient education are critical for successful outcomes.
- - Preventative measures focus on early detection and healthy habits, emphasizing the need for collaboration between healthcare providers and public health agencies to improve treatment effectiveness and community awareness to reduce the infection's spread.
Background: Care for actinic keratosis (AK) can be improved with more knowledge on the relative of effect of indicated therapies.
Objectives: Using network meta-analyses, we quantitatively determined the comparative "short-term" effects of interventions in adults with facial and scalp AK.
Methods: On February 28, 2023, evidence from the peer-reviewed literature was systematically obtained from OVID, the Cochrane Central Register of Controlled Trials and ClinicalTrials.
Article Synopsis
- There is a global rise in antifungal-resistant dermatophytosis, particularly due to mutations in the SQLE gene, affecting treatments with terbinafine.
- A study analyzed 62,056 toenail samples over 18 months, finding significant increases in SQLE mutations, particularly the Phe397Leu and Phe415Ser substitutions, in onychomycosis patients.
- The findings suggest that older individuals are at a greater risk for infections, and the actual prevalence of SQLE mutations might be underestimated among affected patients.
Background: Oral finasteride and topical minoxidil formulations are the only FDA-approved drug therapies for androgenetic alopecia (AGA). Research into dutasteride, topical finasteride, and nontopical minoxidil (low-dose oral and sublingual) formulations in the treatment of AGA has spiked within recent years. Early findings show that these alternative drug therapies may have similar to improved efficacy and safety profiles relative to the conventional treatment options.
View Article and Find Full Text PDFIntroduction: The global spread of Trichophyton indotineae presents a pressing challenge in dermatophytosis management. This systematic review explores the current landscape of T. indotineae infections, emphasizing resistance patterns, susceptibility testing, mutational analysis, and management strategies.
View Article and Find Full Text PDFBackground: Pattern hair loss, the most common form of hair loss, affects millions in the United States. Americans are increasingly seeking health information from social media. It would appear that healthcare professionals contribute relatively minimally to pattern hair loss content, thereby posing serious concerns for credibility and quality of information available to the general public.
View Article and Find Full Text PDFIntroduction: The reports of resistance to antifungal agents used for treating onychomycosis and other superficial fungal infections are increasing. This rise in antifungal resistance poses a public health challenge that requires attention.
Areas Covered: This review explores the prevalence of dermatophytes and the current relationship between dermatophyte species, their minimum inhibitory concentrations (MICs) for terbinafine (an allylamine) and itraconazole (an azole), and various mutations prevalent in these species.
Background: Onychomycosis is a chronic nail disorder commonly seen by healthcare providers; toenail involvement in particular presents a treatment challenge.
Objective: To provide an updated estimate on the prevalence of toenail onychomycosis.
Methods: We conducted a literature search using PubMed, Embase and Web of Science.
Effectiveness and safety of oral terbinafine for dermatophyte distal subungual onychomycosis.
Expert Opin Pharmacother
February 2024
Introduction: Terbinafine has been a cornerstone in dermatophyte infection treatment. Despite its global efficacy, the emergence of terbinafine resistance raises concerns, requiring ongoing vigilance.
Areas Covered: This paper focuses on evaluating the efficacy and safety of terbinafine in treating dermatophyte toenail infections.
Antifungal stewardship refers to the rational use of antifungal agents. Historically, in some instances, the misuse or overuse of antifungal agents has predisposed patients to an elevated risk of systemic side-effects and treatment resistance, as well as increased healthcare costs. Superficial mycoses, such as onychomycosis, are sometimes treated without any diagnostic testing and is associated with a high likelihood of self-diagnosis and self-treatment, potentially leading to the emergence of resistance against commonly used antifungals like terbinafine.
View Article and Find Full Text PDFBackground: Combination treatments may improve the utility of approved agents for the treatment of pattern hair loss (PHL); however, head-to-head comparisons are lacking.
Objective: The aim of the study was to compare the efficacy of 5% minoxidil, platelet-rich plasma (PRP), and microneedling across adults with PHL insofar as change in total hair density at 24 weeks.
Methods: We conducted a literature search in July 2022.
Article Synopsis
- LITFULO (ritlecitinib) capsules are now approved for treating severe alopecia areata in individuals aged 12 and older, acting as a dual inhibitor to prevent immune attacks on hair follicles.
- In clinical trials, various doses of ritlecitinib were tested, with promising results showing a significant percentage of patients achieving a SALT score of ≤20 after 24 weeks.
- Common side effects reported included mild to moderate issues like headache and respiratory infections, and the recommended dosage is 50 mg taken daily without food.
ZORYVE (roflumilast) cream is a topical phosphodiesterase-4 (PDE-4) inhibitor that has been recently approved for the treatment of plaque psoriasis. It is also indicated for use in intertriginous areas. Roflumilast, the active ingredient, inhibits PDE-4, leading to the suppression of pro-inflammatory immune responses in psoriatic lesions.
View Article and Find Full Text PDFFollicular unit excision (FUE) has emerged as the preferred method for hair transplants. Standardized terms and definitions established by members of the International Society of Hair Restoration Surgery and prominent hair restoration surgeons have become the standard, enabling effective knowledge sharing. This chapter provides an overview of the terminology relating to the field.
View Article and Find Full Text PDFOnychomycosis is difficult to treat due to long treatment durations, poor efficacy rates of treatments, high relapse rates, and safety issues when using systemic antifungal agents. Device-based treatments are targeted to specific regions of the nail, have favorable safely profiles, and do not interfere with systemic agents. They may be an effective alternative therapy for onychomycosis especially with increasing reports of squalene epoxidase gene mutations and potential resistance to terbinafine therapy.
View Article and Find Full Text PDFArticle Synopsis
- Mesotherapy is a procedure where lower doses of medication are injected into the skin to treat conditions like hair loss, allowing for longer-lasting effects and improved patient compliance.
- A systematic review analyzed 27 studies from a pool of 416 records to assess the effectiveness of mesotherapy for hair loss, focusing on various therapeutic agents used in treatment.
- While some studies indicate significant hair growth improvement from mesotherapy, the lack of standardized treatment protocols and potential side effects highlight the need for more extensive clinical trials.
There is an ongoing epidemic of chronic, relapsing dermatophytoses caused by Trichophyton indotineae that are unresponsive to one or multiple antifungal agents. Although this new species may have originated from the Indian subcontinent, there has been a notable increase of its reporting in other countries. Based on current literature, antifungal susceptibility testing (AFST) showed a large variation of terbinafine minimum inhibitory concentrations (MICs) (0.
View Article and Find Full Text PDFResistance to oral terbinafine, the most commonly used antifungal to treat dermatophytosis and onychomycosis worldwide, is being increasingly reported. In this study, we aimed to investigate the species distribution and prevalence of squalene epoxidase mutations among toenail dermatophyte isolates. Samples from 15,683 patients suspected of onychomycosis visiting the offices of dermatologists and podiatrists in the United States were analyzed.
View Article and Find Full Text PDFBackground: The prevalence of work-related musculoskeletal disorders (WRMD) is increasing among all surgical specialties.
Objective: Results of a cross-sectional survey of hair transplant surgeons were analyzed, with the aims to (1) determine the prevalence of WRMD, (2) assess risk factors associated with musculoskeletal (MSK) symptoms, and (3) identify mitigation measures.
Materials And Methods: A survey pertaining to demographics, MSK-related symptoms and its impacts, and pain mitigation measures taken, if any, were distributed to 834 hair transplant surgeons.
Background: With an ever-growing influence of social media in healthcare, concurrent with increased emphasis on patient autonomy and shared decision-making, dermatologists treating hair loss need to be cognizant of online interest trends and the types of information disseminated across popular platforms.
Objectives: To evaluate recent health-related interest trends and assess engagement, quality, and accuracy of alopecia areata (AA) and pattern hair loss (PHL, androgenetic alopecia) contents on social media.
Methods: Relative search volumes (RSVs) were extracted from Google Trends using the search category 'alopecia areata' and 'pattern hair loss'.