Infecţiile dermatofitice în diabetul zaharat: prevalenţă, diagnostic şi tratament

Abstract

High prevalence, but also the constantly increasing incidence of dermatophytic infections of the skin and its appendages in whole the world, induced a continuous interest in studying the etiology, the development of new diagnostic methods, and the improvement of their therapy. The risk of dermatophytosis is determined both by pathogenic properties of fungal strains and host characteristics: age, dietary habits, social conditions, and inherited and acquired immunological deficiencies (AIDS, tumors, diabetes, and other endocrinopathies). The relationship between diabetes and dermatophyte infections is controversial: some authors sustain and others negate a correlation between the prevalence of these infections and blood levels of glucose. A correlation was found between the frequency of dermatophytosis and levels of glycosylated hemoglobin only in patients with diabetes mellitus type 2. Trichophyton rubrum and Trichophyton mentagrophytes are the most common pathogens responsible for more than 90% of infections. Therapeutic regimens for dermatophytosis in patients with diabetes are similar to those for nondiabetic patients. Treatment options include oral antifungal agents, topical therapy, and combination therapy. Oral antifungal agents are effective therapy but have been associated with systematic adverse events and drug interactions. The use of these agents may be limited due to abnormal laboratory parameters and concomitant interacting drug therapy in the diabetic population especially in those patients with significant multiple comorbidities.