title: Novel in vivo observations on double acting points of luliconazole on Trichophyton rubrum: an ultrastructural study.
abstract: Scales from lesional skin of 12 patients with tinea pedis were investigated by scanning electron microscopy (SEM) and transmission electron microscopy (TEM) to gain an insight into the spatial and morphological changes of dermatophytes after application of a clinical dosage of topical luliconazole 1% cream (Lulicon® cream 1%). In all cases, Trichophyton rubrum was identified. The scales from the lesions collected before and after topical luliconazole application were fixed with glutaraldehyde and subjected to SEM and TEM. For SEM, fixed specimens were first placed in 1N-KOH and then post-fixed and observed. SEM showed a swollen appearance of fungal hyphae as an early change, and then shrinkage of them showing a flattened and twisted appearance as a later change. TEM showed cell wall alterations with initial development of and accumulation of a granular structure in the outermost layer and subsequent amorphous and electron-lucent change of the thickened inner part of the cell wall. This is the first report of dramatic morphological changes of T. rubrum before and after topical luliconazole application in vivo demonstrated by SEM and TEM. We hypothesize that luliconazole has double acting points, on the plasma membrane and cell wall, of dermatophyte hyphae.
authors: Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago 683-8504, Japan.
authors: Keiko
authors: K
authors: Wakumoto-Nakashima
authors: Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago 683-8504, Japan nayamada@grape.med.tottori-u.ac.jp.
authors: Nanako
authors: N
authors: Yamada
authors: Laboratory of Electron Microscopy, Tottori University, Yonago, Japan, 36-1 Nishicho, Yonago 683-8504, Japan.
authors: Shinichi
authors: S
authors: Morino
authors: Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago 683-8504, Japan.
authors: Osamu
authors: O
authors: Yamamoto
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D025301:Hyphae / Q000187:drug effects / Q000648:ultrastructure; D007093:Imidazoles / Q000008:administration & dosage / Q000494:pharmacology*; D008855:Microscopy, Electron, Scanning; D046529:Microscopy, Electron, Transmission; D013048:Specimen Handling; D014005:Tinea / Q000188:drug therapy* / Q000382:microbiology; D014249:Trichophyton / Q000187:drug effects* / Q000648:ultrastructure
chemical_list: D000935:Antifungal Agents; D007093:Imidazoles; C112528:luliconazole
keywords: T. rubrum; in vivo effect; luliconazole; scanning electron microscopy; transmission electron microscopy