What medicine should I use for ringworm next to my chin

Our chin is generally not prone to abnormalities, but some people will develop ringworm on their chin. When this happens, we must first determine the specific cause, determine whether it is ringworm, and then use targeted medication for treatment. The drugs used to treat ringworm are generally antifungal drugs, and the treatment effect is quite good. So, what medicine should be used for ringworm near the chin? Let’s take a look below.

1. Triazoles

Azole antifungals, including imidazoles and triazoles. Imidazoles include: ketoconazole, clotrimazole, miconazole, econazole and sertaconazole. Currently, most of them are topical medications for superficial fungal infections or candidal infections of the skin and mucous membranes. Triazoles include fluconazole, itraconazole, voriconazole, and the research-stage saconazole, pasoconazole, ravuconazole, SCH39304 (SM8668), and SDZ89-485, all of which can be used to treat deep fungal infections. The main target enzyme of azole drugs is 14-demethylase (14-DM). The 3rd or 4th nitrogen atom on the imidazole ring and triazole ring is embedded in the iron atom of the enzyme's cytochrome P450 protein, inhibiting the catalytic activity of 14-DM, preventing lanosterol from being converted into 14-demethyllanosterol, and further preventing the synthesis of ergosterol, which in turn blocks the synthesis of fungal cell membranes and causes fungal cell rupture and death.

2. Polyenes

Polyene antifungal drugs include: amphotericin B (AmB), amphotericin B lipid complex (ABLC), amphotericin sulfate cholesteryl ester (ABCD), liposomal amphotericin B (L-AmB) and nystatin. This type of drug interacts with the sterols on the phospholipid bilayer of the fungal cell membrane, causing water-soluble pores to form in the cell membrane, changing the permeability of the cell membrane, and ultimately leading to the loss of important cellular contents and causing the death of the fungus. Amphotericin B can also produce a bactericidal effect by stimulating macrophages to regulate autoimmune function. Nystatin liposome (NYS) can bind to ergosterol on the fungal cell membrane, reduce the stability of the cell membrane, and is active against a variety of fungi [2].

3. Echinocandins

These compounds are non-competitive inhibitors of 1,3-β-D-glucan synthase, which inhibit its biological activity without affecting the biosynthesis of nucleic acids and mannan. 1,3-β-D-glucan is an important substance for maintaining the integrity of fungal cell walls, but Cryptococcus lacks this substance. 1,3-β-D-glucan deficiency leads to increased fungal cell wall permeability, cell lysis, and fungal death. 1,3-β-D-glucan does not exist in human cells.

4. Nikkomycins

The main components of nikkomycin drugs are X and Z, both of which are isolated from the fermentation broth of streptomycin. Nikkomycin inhibits the chitin synthase that is specific to fungi and blocks the synthesis of chitin necessary for the fungal cell wall, causing the swelling and rupture of fungal cells. Since chitin synthase and chitin do not exist in mammalian cells, the effect of nikkomycin on fungi is selective and its toxicity to mammals is very low. Nikkomycin has a strong bactericidal effect against sensitive Candida albicans, Coccidioides, Blastomyces dermatitidis, and Histoplasma capsulatum, and also has good activity against resistant strains when used in combination with azole drugs [3].

5. Fluorouracil

The antifungal mechanism of 5-fluorouracil (5-FC) is to inhibit thymine synthase, prevent DNA synthesis, and thus inhibit the growth of fungal cells.

6. β-1,3-D-glucan synthase inhibitors

β-1,3-D-glucan is an important component of fungal cell walls, which is lacking in mammalian cells. This type of drug can specifically act on the β-1,3-D-glucan synthase, a cell wall component unique to fungi, thereby blocking the synthesis of fungal cell walls.

7. Mannoprotein synthesis inhibitor

This type of drug can bind to the mannoglycoprotein on the fungal cell wall to form a calcium-dependent ternary complex, which acts on the fungal cell membrane to cause an outflow of intracellular potassium, thereby killing the fungus.

Benamicin A is effective against almost all pathogenic fungi in vitro, and its subcutaneous and intravenous injections are also effective against Candida albicans, Aspergillus fumigatus, and Cryptococcus neoformans [4].

Prunamicin A shows strong activity against Cryptococcus, Candida, and Aspergillus, and is effective against strains resistant to fluconazole and flucytosine [5].

8. Others

Sphingomyelin antifungal drugs have a strong inhibitory effect on serine palmitoyltransferase, thereby inhibiting sphingomyelin synthesis. Currently, these drugs include: myriocin, lipoflavin, sphingolipids and chlorpyrifos.

Other antifungal drugs that act on the surface structures of fungal cells that are currently being studied include: (1) Iturins: including bacillomycin F, L and iturin A. Its mechanism of action is to affect the surface tension of the cell membrane, forming small pores on the membrane surface, thereby causing the leakage of intracellular potassium ions and other useful ions; (2) Syringomycins: including syringomycin E (SE), syringostantin A and syringotoxin B. Its mechanism of action is to increase the transmembrane efflux of ions such as potassium, hydrogen and calcium, and to increase the membrane potential of the plasma membrane of plants and yeast. SE can form potential-sensitive ion channels and change protein phosphorylation and H-ATPase activity.