diclofenac (Oxa Gel / diclofenac, topical)

Advancements in Novel Drug Delivery Systems for Topical Management of Superficial Fungal Infections: A Detailed Review.

Mohanty Rojalika R, Panigrahi Aradhana A, Samal Himansu Bhusan HB, Habibullah S K SK et al.

Superficial fungal infections, such as dermatophytosis, candidiasis, and pityriasis versicolor, are prevalent worldwide. They put a heavy burden on healthcare systems, mainly because infections often recur, linger for months, and do not always respond well to standard treatments. The conventional topical creams and ointments fail to achieve the goal of treatment as they are often unable to penetrate deeply, do not stay long enough on the site of application, and patients mostly stop using them before the completion of the course. This review explores the biology of superficial fungal infections, the limitations of existing topical treatments, and the advancement of nanotechnology-based carriers for the topical treatment of fungal diseases. From the recent literature, it was found that there has been noticeable progress in innovative drug delivery approaches. These novel systems are designed to improve drug solubility, drug permeation, and adherence and spreadability of the formulation on the site of application. Several nanocarrier systems, such as liposomes, niosomes, ethosomes, and solidlipid nanoparticles, have demonstrated improved therapeutic outcomes compared with older topical formulations. Novel drug delivery systems do not just improve the solubility and permeation of drugs but also reduce the frequency of doses, mitigate side effects, and help bypass mechanisms that commonly cause antifungal resistance. The review highlights the biology of fungal infections, as well as the safety, clinical use, limitations, and long-term potential of novel approaches. The study provides broad insights into innovative approaches that could significantly transform treatment strategies for superficial fungal infections in the future.

A response to the comment on 'Comparison of postoperative infection risk with and without topical vancomycin in adult posterior spinal fusion: a propensity-matched cohort study of 126,910 patients'.

Arif Haad A HA, Conklin Michael J MJ

Advances in medical and surgical management of Acanthamoeba keratitis: a comprehensive review.

Azzopardi Matthew M, Chong Yu Jeat YJ, Smith Ella P EP, Barahim Eman Khalid EK et al.

SUMMARYAcanthamoeba keratitis (AK) is a rare but sight-threatening corneal infection with rising global incidence, largely driven by increased contact lens use. Management remains challenging due to limited therapeutic options, variable clinical responses, and a lack of standardized treatment guidelines. Diagnosis is frequently delayed because of the non-specific clinical presentation, and early use of topical corticosteroids can exacerbate disease severity and worsen outcomes. The formation of highly drug-resistant cysts in chronic infection further complicates treatment. Currently, prolonged combination therapy with topical biguanides and aromatic diamidines remains the mainstay of treatment. However, recent evidence supports the use of topical biguanide monotherapy (in higher concentrations) in AK with comparable outcomes to combination treatment. Adjunctive therapies, including azoles, miltefosine, and corticosteroids, may be beneficial in refractory disease. Surgical interventions, such as therapeutic keratoplasty, are often required in advanced or non-responsive cases. The choice of therapy is frequently empirical, guided by clinician experience and drug availability. Emerging therapeutic approaches, including antimicrobial peptides, synthetic polymers, bioactive natural compounds, and ultraviolet C therapy, show promise as more effective or better-tolerated alternatives. This review provides an up-to-date overview of current medical and surgical treatments, explores novel interventions in the pipeline, and highlights the need for evidence-based, individualized management strategies in AK.

Efficacy of Diode Laser Therapy in Managing Recurrent Aphthous Stomatitis and Oral Lichen Planus: A Systematic Review.

Habib Tasnia T, Islam S M Shahinul SMS, Haque Tahsinul T, Afroz Mohammed M et al.

To assess the effectiveness of photobiomodulation therapy for managing oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS), including their outcomes and patient satisfaction with the safety profile. A systematic review was conducted by searching electronic databases like PubMed Central, PubMed, Cochrane, CrossRef, Google Scholar, and Embase. Articles published until June 2025 were reviewed using MeSH (Medical Subject Heading) and various combinations of the keywords: oral lichen planus, Recurrent Aphthous Stomatitis, photobiomodulation therapy, and conventional drug therapy. We considered two different outcomes, such as pain and the size of the lesion. Due to the heterogeneity of the data, we did not conduct any statistical analysis. Initially, 560 publications were selected for this review article, and after analyzing all these, only 12 articles fulfilled the inclusion and exclusion criteria. In all those studies, the laser wavelength, power output, and duration of irradiation changed between 630-980 m, 20-30 mW, and 10 sec-15 min have been described. Topical medications used in the comparative group were amlexanox, triamcinolone acetonide, granofurin, and socosenyl. Our findings showed that the photobiomodulation laser group is more effective for decreasing the pain and lesion size of RAS and OLP in comparison with the topical medication group. We can conclude that photobiomodulation therapy was better for treating RAS and OLP with greater healing, patient satisfaction, and lower recurrence rate in comparison with other topical drug therapies.