Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-03-20T19:22:10Z No. of bitstreams: 1 cesaraugustocaneschi.pdf: 5294083 bytes, checksum: 0fcaa84691e8fe3011b7448e2622257a (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-03-21T12:54:43Z (GMT) No. of bitstreams: 1 cesaraugustocaneschi.pdf: 5294083 bytes, checksum: 0fcaa84691e8fe3011b7448e2622257a (MD5) / Made available in DSpace on 2018-03-21T12:54:43Z (GMT). No. of bitstreams: 1 cesaraugustocaneschi.pdf: 5294083 bytes, checksum: 0fcaa84691e8fe3011b7448e2622257a (MD5) Previous issue date: 2018-01-12 / As onicomicoses são infecções fúngicas que se caracterizam clinicamente por alterações morfológicas no tecido ungueal proporcionadas, principalmente, por fungos filamentosos dermatófitos, seu principal agente etiológico. Esta micose é considerada um problema de saúde pública e apresenta inúmeros fatores que podem favorecer o seu início. O tratamento é considerado um grande desafio para a medicina, uma vez é prolongado, apresenta reduzida eficácia e recidivas frequentes, além de ocasionar efeitos adversos ao pacientes. Diante do exposto, surge a necessidade de obtenção de novos compostos farmacologicamente ativos para esta finalidade. Desta forma, a síntese de compostos orgânicos e a investigação do potencial antifúngico pode impulsionar a elucidação de novos antifúngicos. Logo, o objetivo deste trabalho foi avaliar a atividade antifúngica in vitro de amino álcoois e diaminas frente aos principais fungos causadores de onicomicoses. Para isso, foi realizada a análise antifúngica a fim de estabelecer as concentrações inibitória mínima (CIM) e fungicida mínima (CFM) frente as cepas de referência de Trichophyton mentagrophytes ATCC 11481, T. rubrum CCT 5507 URM 1666, Epidermophyton floccosum CCF-IOF-3757, Candida albicans ATCC 10231 e um isolado clínico de C. albicans. Para auxiliar na compreensão da ação antifúngica foi empregada a microscopia eletrônica de varredura (MEV) juntamente com a avaliação de fatores de virulência fúngica (fosfolipase e melanina). Por último, foi investigada ainda a citotoxicidade in vitro dos amino álcoois frente a células de fibroblastos (L929) e queratinócitos (HaCaT). A partir de um grupo de cinquenta moléculas sintetizadas, foram selecionados três amino álcoois com cadeia alifática com 10, 12 e 14 carbonos (C) que foram fungicidas frente às cinco cepas de fungos avaliadas com valores de CIM variando de 0,46 – 1.000 μg/mL e CFM entre 7,81 - 1.000 μg/mL. Entre estas, destaque para o amino álcool com 14 C. Por meio das eletromicrografias foi possível evidenciar alterações morfológicas nas estruturas fúngicas das cinco espécies submetidas à ação dos amino álcoois selecionados, o que demonstrou sua ação sobre os fungos avaliados. Os compostos proporcionaram interferência na excreção de fosfolipase, no entanto, não interferiram na produção de melanina. Os amino álcoois revelaram relativa toxicidade frente às células L929 e HaCaT. Por meio dos resultados apresentados neste trabalho, é possível atribuir aos amino álcoois ação antifúngica frente aos principais fungos causadores da onicomicoses, entretanto, essas moléculas apresentaram toxicidade in vitro frente a fibroblastos e queratinócitos. Deste modo, os achados contribuem para a modificação estrutural das moléculas analisadas e/ ou síntese de novos compostos mais eficazes e menos tóxicos para o tratamento de onicomicoses. / Onychomycosis is a fungal infection characterized clinically by morphological changes in the nail tissue provided mainly by dermatophyte filamentous fungi, the main etiological agent. This mycosis is considered a public health problem and presents numerous factors that may favor its beginning. Its treatment is considered a great challenge for medicine, once it is prolonged, it presents reduced efficacy and frequent recurrences, besides causing adverse effects to the patients. In view of the above, there is a need to obtain new pharmacologically active compounds for this purpose. In this context, the synthesis of organic compounds and the investigation of the antifungal potential may boost the elucidation of new antifungal agents. Therefore, the objective of this work was to evaluate the antifungal activity in vitro of diamines and amino alcohols against the main fungi causing onychomycosis. For this, antifungal analysis was carried out to establish the minimum inhibitory concentrations (MIC) and minimum fungicide (CFM) against Trichophyton mentagrophytes ATCC 11481, T. rubrum CCT 5507 URM 1666, Epidermophyton floccosum CCF-IOF-3757, Candida albicans ATCC 10231 and a clinical isolate of C. albicans. A scanning electron microscopy (SEM) along with the evaluation of fungal virulence factors (phospholipase and melanin). Finally, the in vitro cytotoxicity of amino alcohols against fibroblast cells (L929) and keratinocytes (HaCaT) was further investigated. From a group of fifty synthesized molecules, three amino acohols with 10, 12 and 14 C aliphatic chain were selected which were fungicidal against the five fungal strains evaluated with MIC values ranging from 0.46-1,000 μg/ mL and CFM between 7.81-1,000 μg/ mL. Among them, the amino alcohol with 14 C was featured. Using the electromicrographs, it was possible to show morphological changes in the fungal structures of the five species submitted to the action of the selected amino alcohols, which demonstrates their action on the evaluated fungi. The compounds provided interference in phospholipase excretion, however, did not interfere with melanin production. Amino alcohols revealed relative toxicity to L929 and HaCaT cells. Thus, the findings contribute to the structural modification of the molecules analyzed and / or synthesis of new compounds more effective and less toxic for the treatment of mycosis.

INTRODUÇÃO: Onicomicose, infecção das unhas por fungo é a mais freqüente das doenças ungueais, constituindo aproximadamente metade de todas as alterações ungueais. Pode ser causada por dermatófitos, leveduras ou fungos filamentosos não dermatófitos. OBJETIVO: Caracterizar as onicomicoses causadas por fungos filamentosos não dermatófitos. (1) Verificar, dentre as suspeitas clínicas de onicomicose, qual a freqüência da recuperação de fungos,(2) Verificar, dentre as suspeitas clínicas de onicomicose, quais as espécies de fungos recuperadas, (3) Verificar, dentre o total das espécies identificadas, qual a freqüência das espécies de fungos filamentosos não dermatófitos. MÉTODOS: Duzentos e cinco indivíduos com suspeita clínica de onicomicose foram estudados no período de dezembro de 2003 a novembro de 2004, por meio de exames micológicos diretos e cultura para fungos. RESULTADOS: O diagnóstico de onicomicose foi estabelecido, pelo exame micológico direto, em 170 indivíduos. O diagnóstico etiológico foi estabelecido pela cultura para fungos. Dentre os 107 agentes identificados, os dermatófitos foram identificados em 78,52% (N=84), as leveduras em 13,08% (N=14) e os FFND em 8,40% (N=9) das vezes. CONCLUSÃO: É necessário que se estabeleça o diagnóstico etiológico dos casos de onicomicoses, já que os fungos filamentosos não dermatófitos ocorrem com freqüência considerável e são indistinguíveis daquelas por dermatófitos. / INTRODUCTION: Onychomycosis, a nail fungus infection is the most frequent nail disease, constituting about half of all nail disorder. It can be caused by dermatophytes, yeasts and non- dermatophytes filamentous fungi. OBJECTIVE: Characterize the onychomycosis caused by filamentous fungi non- dermatophytes. (1) Verify after a clinical suspicion of onychomycosis, which are the frequency of fungi recovery, (2) examine, after a clinical suspicion of onychomycosis, which species of fungi are recovered, (3) Checking, among the total of identified species , which are the frequency of the species of filamentous fungi not dermatophytes. METHODS: Two hundred and five patients with clinical suspicion of onychomycosis were studied in the period from December 2003 to November 2004, through direct mycological examination and culture for fungus. RESULTS: The diagnosis of onychomycosis has been established by direct mycological examination, in 170 individuals. The etiological diagnosis was established by the culture for fungus. Among the 107 persons identified, the dermatophytes were recovered in 78.52% (N = 84), the yeast in 13.08% (N = 14) and filamentous fungi non- dermatophytes in 8,40% (N = 9). CONCLUSION: It is necessary to establish the etiological diagnosis of the cases of onychomycosis, as filamentous fungi non- dermatophytes occur often than ever considered and are its clinic features are indistinguishable from those of the dermatophytes.

Made available in DSpace on 2016-12-23T13:56:03Z (GMT). No. of bitstreams: 1 dissertacao-simonebrmaifrede.pdf: 1273260 bytes, checksum: d5439bcf28dc75da348359e5efa529ef (MD5) Previous issue date: 2009-03-06 / INTRODUÇÃO: Onicomicose é a infecção da unha causada por amplo espectro de espécies fúngicas, incluindo leveduras e fungos filamentosos dermatófitos e nãodermatófitos. Devido à variável suscetibilidade dos diversos agentes etiológicos às drogas antifúngicas, o diagnóstico laboratorial vem sendo considerado uma ferramenta importante para se estabelecer a etiologia e auxiliar na escolha do tratamento da onicomicose. Com base na elevada porcentagem de falha terapêutica no tratamento da onicomicose, tem-se evidenciado o interesse na padronização de testes de suscetibilidade in vitro de fungos filamentosos. OBJETIVOS: Estabelecer a freqüência das onicomicoses em relação a outras dermatomicoses; definir a etiologia das onicomicoses através do isolamento e identificação dos fungos; comparar o padrão de suscetibilidade entre fungos dermatófitos e não-dermatófitos às drogas fluconazol, cetoconazol, itraconazol, miconazol, ciclopirox, terbinafina e griseofulvina. MÉTODOS: As amostras clínicas foram colhidas através de raspagem e/ou fragmentação da unha e o exame microscópico direto foi realizado através do tratamento destas amostras com hidróxido de potássio (KOH) a 20% e tinta Parker. As culturas foram realizadas nos meios de ágar Sabouraud dextrose adicionado de 0,05 mg.mL-1 de cloranfenicol e ágar Mycose, incubados à temperatura ambiente e por um período de até 15 dias. A identificação dos fungos filamentosos foi baseada na observação de suas características macroscópicas e microscópicas e os testes de suscetibilidade in vitro a drogas antifúngicas foram baseados no Documento M38-A do CLSI. RESULTADOS: O diagnóstico laboratorial das dermatomicoses foi estabelecido em 69% dos 1.008 pacientes com lesões sugestivas de dermatomicoses encaminhados ao Laboratório de Diagnóstico Micológico do Depto. de Patologia / UFES, no período de 12/03/2004 a 14/08/2008. Onicomicose foi diagnosticada em 333 pacientes e os grupos de fungos mais isolados foram: leveduras 55,6%, fungos filamentosos não-dermatófitos 27,2% e dermatófitos 17,3%. Fungos dermatófitos foram mais inibidos in vitro que fungos não-dermatófitos. As drogas fluconazol e griseofulvina inibiram apenas fungos dermatófitos, enquanto a terbinafina foi a droga que mais inibiu os dois grupos de fungos e em baixas concentrações. A quantificação do inóculo por contagem em hemocitômetro e em placas de ágar Sabouraud revelou que o acerto do inóculo em espectrofotômetro pode ter uma boa correspondência se estabelecido em faixas de transmitância diferenciadas para os diversos tipos de fungos. CONCLUSÃO: É necessário estabelecer o diagnóstico laboratorial das onicomicoses, já que estas podem ser causadas por diversos agentes etiológicos e com diferentes suscetibilidades in vitro a várias drogas antifúngicas. / INTRODUCTION: Onychomycosis is the nail infection caused by a wide spectrum of fungi species, including yeasts, dermatophyte and nondermatophyte mould. Due to the variable susceptibility of the several etiologic agents to the antifungal drugs, the laboratorial diagnosis is being considered an important tool to establish the etiology and to help in the choice of the treatment of onychomycosis. Based on the high percentage of therapeutic flaw in the treatment of onychomycosis, there has been some evident interest in the standardization of the susceptibility tests in vitro of filamentous fungi. OBJECTIVES: To establish the frequency of the onychomycosis in relation to other dermatomycosis; to define the etiology of the onychomycosis by the isolation and identification of the fungi; to compare the pattern of susceptibility among dermatophytes and nondermatophytes mould to drugs such as fluconazole, cetoconazole, itraconazole, miconazole, ciclopirox, terbinafine and griseofulvine. METHODS: The clinical samples were collected by the scratching and/or fragmentation of the nail and the direct microscopic examination was made by the treatment of these samples with potassium hydroxide (KOH) at 20% and Parker ink. The cultures were made in dextrose agar Sabouraud with 0,05 mg.mL-1 of cloranphenicol and agar Mycosel, incubated to room temperature and for a period of up to 15 days. The identification of the filamentous fungi was based on the observation of its macroscopic and microscopic characteristics and the tests of susceptibility in vitro to the antifungal drugs were based on CLSI M38-A reference method. RESULTS: The laboratorial diagnosis of the dermatomycosis was established in 69% of the 1.008 patients with lesions that suggested dermatomycosis sent to the Laboratory of Mycologic Diagnosis from the Dept. of Pathology / UFES, in the period of 03/12/2004 to 08/14/2008. Onychomycosis was diagnosed in 333 patients and the groups of more isolated fungi were: yeasts 55,6%, nondermatophyte mould 27,2% and dermatophytes 17,3%. Dermatophytes were more inhibited in vitro than nondermatophytes ones. Drugs such as fluconazole and griseofulvine inhibited just dermatophytes fungi while terbinafine was the drug which most inhibited both groups of fungi and in low concentrations. The quantification of the inoculum for counting in haemocytometer and in plates of agar Sabouraud revealed that the correctness of the inoculum in espectrofotometer may have established a good correspondence in transmission bands differentiated for the various types of fungi. CONCLUSION: It is necessary to establish the laboratorial diagnosis of the onychomycosis, as these may be caused by several etiologic agents and with different susceptibilities in vitro to several antifungal drugs.

Made available in DSpace on 2016-12-23T13:56:10Z (GMT). No. of bitstreams: 1 Dissertacao de Adrielle Hoffmann.pdf: 1434617 bytes, checksum: 427eb50baa714de01ab9deab183c0308 (MD5) Previous issue date: 2011-08-10 / As onicomicoses, infecções fúngicas de unhas, são causadas por fungos filamentosos dermatófitos e não-dermatófitos e leveduras e representam as micoses superficiais mais difíceis de serem diagnosticadas e tratadas. O tratamento é através do uso tópico e/ou oral com drogas antifúngicas e pode ainda envolver a remoção da unha. O uso de agentes tópicos concomitante à terapia sistêmica leva à melhores resultados clínicos e micológicos. A eficácia da associação medicamentosa pode estar associada à ação complementar entre as drogas, envolvendo diferentes níveis de penetração ungueal e, dependendo dos antifúngicos, de diferentes alvos de ação na célula fúngica. O objetivo do presente estudo consistiu em estabelecer a ocorrência de fungos filamentosos na etiologia das onicomicoses e a suscetibilidade in vitro destes às drogas terbinafina, ciclopirox olamina, cetoconazol e itraconazol, conforme o documento M38-A2 (2008) do CLSI. Foi tambem avaliada a combinação entre estas drogas antifúngicas através do cálculo do índice fracionário de concentração inibitória (IFCI). Nossos resultados demonstraram que prevalência das onicomicoses, no período de janeiro de 2009 a abril de 2011, em Vitória, ES, foi de 50% dentre as dermatomicoses. A maioria dos isolados (77%) foi obtido de pacientes do sexo feminino e o local de maior acometimento foram as unhas dos pés para ambos os sexos. As unhas das mãos foram mais acometidas por leveduras e as unhas dos pés, por fungos filamentosos. Em geral, os gêneros de fungos filamentosos mais predominantes na etiologia das onicomicoses foram Trichophyton spp (21,7%), Fusarium spp. (11,2%) e Scytalidium spp.(8,4%). Para fungos filamentosos, os testes de suscetibilidade in vitro mostraram que isolados de dermatófitos foram mais sensíveis que isolados do grupo não-dermatófitos. Entre os nãodermatófitos, Fusarium spp. foi menos inibido que Scytalidium spp., que por sua vez, foi menos inibido que o dermatófito Trichophyton spp. Dentre as combinações testadas não houve nenhum efeito antagônico e,, com exceção daquela entre itraconazol e cetoconazol, as demais apresentaram efeito sinérgico sobre algum isolado. A combinação entre drogas apresentou maiores índices de sinergismo para o gênero Scytalidium spp. O melhor resultado para este gênero foi também obtido pela combinação itraconazol e terbinafina / The onychomycosis, fungal nail infections, are caused by filamentous fungi dermatophytes and non-dermatophytes and yeasts and represent the most difficult superficial mycosis to be diagnosed and treated. Treatment involves use of topical and/or oral antifungal drugs, as well as removal of the nail. The use of topical agents concomitant to systemic therapy leads to better clinical and mycological results. The efficacy of combination therapy may be associated with a complementary action between the drugs, involving different levels of nail penetration and, depending on the antifungal, different targets of action in the fungal cell. The purpose of this study was to establish the occurrence of filamentous fungi in the etiology of onychomycosis and in vitro susceptibility to the drugs terbinafine, ciclopirox olamine, ketoconazole and itraconazole, according to document M38-A2 (2008) CLSI. It was also evaluated the combination among these antifungal drugs by calculating the fractional inhibitory concentration index (FICI). Our results showed that the prevalence of onychomycosis in the period from January 2009 to April 2011, in Vitoria, ES, Brazil, was 50% among the dermatomycosis cases. Most of the isolates (77%) were obtained from female patients and toenails were the local with greater involvement for both sexes. The fingernails were more affected by yeast and toenails, by filamentous fungi. In general, the genera of filamentous fungi more prevalent in the etiology of onychomycosis was Trichophyton spp (21.7%), Fusarium spp. (11.2%) and Scytalidium spp. (8.4%). For filamentous fungi, the in vitro susceptibility testing showed that dermatophytes were more susceptible than non-dermatophytes isolates. Among non-dermatophytes, Fusarium spp. was less inhibited than Scytalidium spp., which in turn, was less inhibited than the dermatophyte Trichophyton spp. Among the combinations tested, there was no antagonistic effect and,, with exception of ketoconazole and itraconazole, those ones showed synergistic effect for isolates. The best results were presented for combinations involving itraconazole and terbinafine. The drug combination with greater synergistic effect was observed for genus Scytalidium spp. being that the combination itraconazole and terbinafine presented also the best results for this genus

INTRODUÇÃO: Onicomicose, infecção das unhas por fungo é a mais freqüente das doenças ungueais, constituindo aproximadamente metade de todas as alterações ungueais. Pode ser causada por dermatófitos, leveduras ou fungos filamentosos não dermatófitos. OBJETIVO: Caracterizar as onicomicoses causadas por fungos filamentosos não dermatófitos. (1) Verificar, dentre as suspeitas clínicas de onicomicose, qual a freqüência da recuperação de fungos,(2) Verificar, dentre as suspeitas clínicas de onicomicose, quais as espécies de fungos recuperadas, (3) Verificar, dentre o total das espécies identificadas, qual a freqüência das espécies de fungos filamentosos não dermatófitos. MÉTODOS: Duzentos e cinco indivíduos com suspeita clínica de onicomicose foram estudados no período de dezembro de 2003 a novembro de 2004, por meio de exames micológicos diretos e cultura para fungos. RESULTADOS: O diagnóstico de onicomicose foi estabelecido, pelo exame micológico direto, em 170 indivíduos. O diagnóstico etiológico foi estabelecido pela cultura para fungos. Dentre os 107 agentes identificados, os dermatófitos foram identificados em 78,52% (N=84), as leveduras em 13,08% (N=14) e os FFND em 8,40% (N=9) das vezes. CONCLUSÃO: É necessário que se estabeleça o diagnóstico etiológico dos casos de onicomicoses, já que os fungos filamentosos não dermatófitos ocorrem com freqüência considerável e são indistinguíveis daquelas por dermatófitos. / INTRODUCTION: Onychomycosis, a nail fungus infection is the most frequent nail disease, constituting about half of all nail disorder. It can be caused by dermatophytes, yeasts and non- dermatophytes filamentous fungi. OBJECTIVE: Characterize the onychomycosis caused by filamentous fungi non- dermatophytes. (1) Verify after a clinical suspicion of onychomycosis, which are the frequency of fungi recovery, (2) examine, after a clinical suspicion of onychomycosis, which species of fungi are recovered, (3) Checking, among the total of identified species , which are the frequency of the species of filamentous fungi not dermatophytes. METHODS: Two hundred and five patients with clinical suspicion of onychomycosis were studied in the period from December 2003 to November 2004, through direct mycological examination and culture for fungus. RESULTS: The diagnosis of onychomycosis has been established by direct mycological examination, in 170 individuals. The etiological diagnosis was established by the culture for fungus. Among the 107 persons identified, the dermatophytes were recovered in 78.52% (N = 84), the yeast in 13.08% (N = 14) and filamentous fungi non- dermatophytes in 8,40% (N = 9). CONCLUSION: It is necessary to establish the etiological diagnosis of the cases of onychomycosis, as filamentous fungi non- dermatophytes occur often than ever considered and are its clinic features are indistinguishable from those of the dermatophytes.

Die Onychomykose ist eine sehr häufige Erkrankung, deren Auftreten weltweit zunimmt und mit einer Pilzinfektion der Nägel einhergeht. Die Ineffizienz der verabreichte Antimykotika motiviert Bemühungen, nach alternativen Behandlungsmethoden zu suchen. Diese Dissertation untersucht die Auswirkungen der photodynamischen Inaktivierung (PDI) auf Dermatophyten und Schimmelpilze. Als Modellorganismen werden drei der Onychomykose auslösenden Pathogene untersucht: Trichophyton rubrum, Trichophyton interdigitale und der Schimmelpilz Scopulariopsis brevicaulis. Um das Potenzial der PDI gegen Onychomykose verursachende Pathogene, abzuschätzen, wurden Phototoxizitätstests mit drei Photosensibilisatoren (PS) durchgeführt: 5,10,15,20-Tetrakis(1-methylpyridinium-4-yl) porphyrintetra(p-toluenesulfonate) (TMPyP) und and 5,10,15-tris-(1-methylpyridinium-2-yl) corrolato-(trans-dihydroxo) phosphorus(V) (PCor+) sowie 4',5',7'-tetrabromo-3',6'-dihydroxyspiro[2-benzofuran-3,9'-xanthene] -1-one (Eosin G). Neben den Phototoxizitätstests wurden zeitaufgelöste Singulettsauerstoff-Lumineszenz Scans aufgenommen, die zur Verifizierung der PDI Effizienz genutzt wurden. Alle drei PS zeigen in vitro eine hohe phototoxische Wirkung. Diese konnte mit Singulettsauerstoff-Lumineszenzmessungen korreliert werden, bei denen ein hohes Singulettsauerstoff-Lumineszenzsignal erfasst wurde. An infizierten menschlichen Nägeln konnten die PS keinen phototoxischen Effekt induzieren. Singulettsauerstoff-Scans, die für einen Einblick in die zugrundeliegenden Ursachen durchgeführt wurden, zeigten fast kein Singulettsauerstoff-Lumineszenzsignal an menschlichen Nägeln. Könnten die verschiedenen bekannten Herausforderungen im Zusammenhang mit PDI an infizierten menschlichen Nägeln bewältigt werden, hätte die PDI das Potenzial, eine schnellwirkende Behandlung dieser Pilzinfektion im Zehennagel zu werden. Diese Studie zeigt erstmals den Zusammenhang zwischen der PDI-Behandlung von Onychomykose und Singulettsauerstoff. / Onychomycosis is a very common illness that befalls an increasing number of individuals worldwide and involves a fungal infection of the nails. The inefficiency of current treatments justifies the efforts to look for alternative treatment modalities. This dissertation investigates the impact of photodynamic inactivation (PDI) against dermatophytes and molds. Three of the causing pathogens of onychomycosis are under investigation: Trichophyton rubrum (T. rubrum), Trichophyton interdigitale (T. interdigitale) and the mold Scopulariopsis brevicaulis (S. brevicaulis). To assess the potential of PDI against onychomycosis causing pathogens, phototoxicity tests were performed using three photosensitizers (PSs): the cationic 5,10,15,20-Tetrakis(1-methylpyridinium-4-yl) porphyrintetra(p-toluenesulfonate) (TMPyP) and 5,10,15-tris-(1-methylpyridinium-2-yl) corrolato-(trans-dihydroxo) phosphorus(V) (PCor+) as well as the anionic 4',5',7'-tetrabromo-3',6'-dihydroxyspiro[2-benzofuran-3,9'-xanthene]-1-one (Eosin Y). Alongside the phototoxicity tests, time resolved singlet oxygen luminescence scans were conducted to serve as a control method of PDI. All three PSs proved to have a high phototoxic effect against the three fungi species in vitro. Those could be correlated with singlet oxygen measurements, where a high singlet oxygen luminescence signal was acquired. Contrary to the expectations from the in vitro experiments were the results obtained ex vivo: On infected human nails, the PSs were not able to induce a phototoxic effect. Singlet oxygen scans conducted to get insight into the reasons behind these results showed nearly no singlet oxygen luminescence signal on human nails. Addressing the various known challenges associated with PDI on infected human nails PDI would have a great impact within short time on treating the toenail fungal infection. This study, for the first time, shows the correlation between PDI treatment of onychomycosis and singlet oxygen.

Introduction: Examination of subungual pigmented lesions is sometimes a diagnostic challenge for clinicians. Objectives: The study was aimed to investigate characteristic patterns in optical coherence tomography (OCT) of subungual hematomas and determine distinctive features that can differentiate them from subungual melanocytic lesions. Methods: VivoSight® (Michelson Diagnostics, Maidstone, UK) was used to examine 71 subungual hematomas and 11 subungual melanocytic lesions in 69 patients (18 female and 51 male patients). Results: On OCT, bleeding was related to sharply defined black sickle-shaped (p < 0.001) or globular regions (not significant [ns]) with a hyperreflective margin (0.002), a grey center (0.013), hyperreflective lines in the area (ns) or periphery (p = 0.031), peripheral fading (p = 0.029), and red dots in the area (p = 0.001). In the 1 case of melanoma in situ examined, we found curved vessels with irregular sizes and distribution on the dermis of the nailbed, while subungual hematomas and subungual benign nevi presented as clustered red dots and/or regularly distributed curved vessels. Conclusion: Our findings indicate that the use of OCT in addition to dermoscopy provides high-resolution optical imaging information for the diagnosis of subungual hematoma and facilitates the differential diagnosis of subungual hematomas and subungual melanocytic lesions.