Stay up-to-date with podiatric dermatology from the DERMfoot newsletter.
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DERMfoot's acclaimed faculty includes podiatrists, dermatologists, plastic surgeons and infectious disease specialists who are experts in the field of dermatology. We also invite guest speakers in the areas of practice management, medicolegal cases, and billing and coding of skin and nails that will affect our future in today's healthcare environment.
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EARLY BIRD PRICING IS ENDING!
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Biofilm & Onychomycosis: Awareness Abroad
College of Podiatry Annual Conference | Liverpool, U.K.
The College of Podiatry hosted its annual conference in Liverpool U.K. November 16-18, with the theme “Keep Moving”. Over 1500 health professionals attended this years meeting representing 22 countries.
DERMfoot Managing Member, Dr. Annette Joyce, was invited to present her short paper abstract “ Biofilm and onychomycosis: an analysis of 8816 toenail samples using qPCR and next gen sequencing”.
“The U.K. is struggling with two major threats to the future of Podiatry” according to keynote speaker, Professor Chris Nestor, University of Salford.
“ 1. A lack of awareness as to what a podiatrist is and
2. Privatizing healthcare as a priority in the Podiatry profession. The cost of University for a podiatrist could be 50,000 pounds for a 3 year degree, leading to historically low applications.”
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Expert Opinion
Aditya K. Gupta MD, PhD, FRCPC
Biofilms and Onychomycosis
Onychomycosis is a fungal nail infection associated with high recurrence rates, making it difficult to treat. Fungal biofilm formation may contribute to the recalcitrant nature of this infection. Biofilms are thought to contribute to approximately 80% of recalcitrant infections in hospital, and are often found on medical devices such as catheters
1,2
. Early work has shown dermatophytes including
Trichophyton rubrum
and
T. mentagrophytes
are capable of forming biofilms
in vitro
3
.
Biofilms consist of microbes that congregate and excrete an extracellular matrix comprised of polysaccharides and proteins, which can account for two thirds of the biofilm mass
2,4
. This is highly beneficial to the microbe, as biofilms enhance communication, virulence, and metabolism thereby promoting pathogen survival
5–7
. In the context of onychomycosis, dermatophyte biofilm formation on the nail can substantially increase resistance to antimicrobial agents, possibly mediated by drug efflux pumps and difficulty penetrating the biofilm
8–10
. Further, biofilm formation prior to immune detection can contribute to the chronic nature of onychomycosis, as mature biofilms are resistant to host immune clearance
10,11
.
As the extracellular matrix confers significant resistance to treatment, a combined approach including physical disruption of the biofilm coupled to antifungal administration may enhance treatment effectiveness
10
. Targeting extracellular polysaccharides and proteins with endopeptidases and enzymes may disrupt the biofilm
4,12–14
. Others have targeted virulence factors that contribute to colonization and evasion of the host immune system
15
. Targeting and preventing
de novo
biofilm formation may also be essential to preventing chronic infection, as killing the biofilm without removal of dead cells can leave the host vulnerable to colonization by other microorganisms
15,16
. Metabolic interference and inducing biofilm dispersal are also being studied as potential strategies to eradicate infection
16
.
In summary, onychomycosis may present as a chronic infection, resistant to different treatments. This may be mediated by biofilm formation, which promotes pathogen survival. Biofilms are particularly difficult to treat, and may require physical disruption as well as antifungal treatment. A better understanding of biofilm formation by dermatophytes is essential to the development of novel treatment options.
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Holiday Ads are the Worst, Right?
Wrong!
Marketing Tip from DERMfoot's Marketing & Admin - Sarah
It's almost over... but incase you missed it, November is/was DIABETES AWARENESS MONTH! But, did you remember to tell your patients in advance - or did you just start reminding them in the last 10, 20 days or so?
Unfortunately the ship always seems to sail faster than we think it will... and we are rudely awakened - again - with the fact that a strong marketing/promotions program takes... you guessed it... PLANNING!
I'm fairly certain that at 11:59 p.m. of Halloween night, alarms all over the advertising world rang out. Yes, the inevitable Holiday Ad Season was sprung. And while we tend to get annoyed by all the lights and decorations smothering us at stores and blinding us as we drive down the street, there's a reason the chaos ensues. Because the first day of Hannukah is coming.... because Christmas Day is coming... because the New Year weight loss challenges are coming - whether we like it or not. And Johnny Ad Man isn't going to lose market share until the day after Thanksgiving to get after it.
So, maybe you missed the opportunity of 2017 Diabetes Awareness month to engage in a community education program that will help drive referrals to your practice.... and maybe you're even too late now to implement a holiday promotion on footwear or moisturizers. But that's OK. There's always another chance to take advantage of
WHAT'S NEXT
.
Mark your calendars and start your planning NOW for:
- Flex Spending Deadline - March 15, 2018
- Foot Health Awareness Month - April, 2018
- Melanoma Awareness Month - May, 2018
It is NOT TOO EARLY to determine:
- Promotion ideas/concepts
- Budgets
- Communication channels (i.e., email; direct mail; Facebook ads; etc.)
Take a note from Holiday Ad Season CEO - Johnny Ad Man - and
start your spring planning NOW.
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DERMfoot, LLC | 301 Yamato Road, Suite 1240 | Boca Raton, FL 33431
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