DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for tinea unguium — screening already-approved drugs against its 19-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleTinea unguium maps to a 19-gene Open Targets module — the target space DeCure's AI scientist screens approved drugs against.
DeCure.ai methodSignature reversal (LINCS) plus network proximity (STRING) rank already-approved drugs likely to perturb this module — the same engine that produces DeCure.ai's repurposing hypotheses.
Repurposing thesisScreening approved medicines against this disease module, then publishing the evidence for the strongest candidate. Known pharmacology and human exposure data make the first question sharper — they do not establish safety or efficacy in a new indication.
Research record
01
ResearchComing soon
Candidate research + dossier — target rationale, drug-repurposing thesis and evidence pack.proof: Published dossier + on-chain hash
02
ValidationComing soon
In-vitro biological validation at a contract research org (CRO).proof: CRO contract + in-vitro report
03
Peer review & paperComing soon
Peer-reviewed paper published open-access (preprint + journal).proof: DOI + open-access link + on-chain hash
Current lead
No approved-drug candidate for tinea unguium is corroborated in the literature DeepSearch retrieved. Some conditions are managed with non-pharmacological care — a device, surgery or physical therapy — rather than a medicine; that may be the case here, or the literature we found may simply be too sparse yet to support a drug-repurposing angle.
Molecular view
FTO alpha-ketoglutarate dependent dioxygenase (FTO) — FTO is one of the genes genetically linked to this disease in Open Targets — shown as context, not as a drug target we're pursuing: no approved-drug candidate for this disease is yet corroborated in the literature we found.
Loading structure…
helix sheet 3-hydroxypyridin-2-yldrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 4IE5 · 1.95 Å · ligand N-[(3-hydroxypyridin-2-yl)carbonyl]glycine (MD6). Experimental structure, not a prediction.
What the evidence adds up to
A 76-year-old Japanese man with tinea faciei, tinea corporis, and tinea unguium with dermatophytoma, caused by Trichophyton rubrum, was treated with oral fosravuconazole l-lysine ethanolate. More than one year after treatment ended there was no recurrence. The authors state that this case suggests fosravuconazole is effective for tinea other than tinea unguium.
In 12 patients who had received oral terbinafine 125 mg daily for more than 20 weeks with little expected effect, topical efinaconazole was added as sequential combination therapy. During terbinafine monotherapy the percentage nail involvement decreased from 53.5% to 44.0% after a mean 37.4 weeks; the effective rate was 16.7% and the cure rate 0%. After switching to sequential topical efinaconazole while terbinafine persisted in the nail, the percentage involvement fell from 44.0% to 18.7% after a mean 28.4 weeks; the effective rate rose to 66.7% and the cure rate to 16.7%. The improvement rate per month was 12.6% for combination therapy versus 2.1% for monotherapy (p = 0.002). No serious side-effects were reported. The same abstract notes that a Cochrane review confirmed high-quality evidence for efinaconazole’s effectiveness in complete cure of tinea unguium, but that topical treatments generally have low cure rates with prolonged therapy.
Thirty-six patients with tinea unguium received itraconazole 200 mg daily for seven days each month. The authors suggested that patients with thumbnail lesions needed five months of treatment for mycological cure, while those without thumbnail lesions needed three months. In a separate case series of seven patients with dermatophytosis of the external auditory meatus, six also had tinea unguium. All were successfully treated with oral itraconazole or terbinafine; fungal cultures identified Trichophyton rubrum in five of the seven cases.
What remains missing is prospective randomised data comparing fosravuconazole directly with established oral antifungals for tinea unguium, and larger trials of the sequential efinaconazole–terbinafine regimen that can confirm the 16.7% cure rate seen in 12 patients. No study here addresses the cost of these regimens, the optimal duration of combination therapy, or whether patient stratification by nail thickness or fungal load would improve outcomes.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Medical Mycology Journal · 2021 · 8 citations · open access
A Case of Tinea Faciei, Tinea Corporis, and Tinea Unguium with Dermatophytoma Successfully Treated with Oral Fosravuconazole L-lysine Ethanolate
AbstractWe present a 76-year-old Japanese male with tinea faciei, tinea corporis, and tinea unguium with dermatophytoma. We performed fungal culture and confirmed the causative fungus to be Trichophyton rubrum. We treated the patient using oral fosravuconazole l-lysine ethanolate (F-RVCZ). More than one year has passed since the end of treatment, but there has been no recurrence. This case suggests that F-RVCZ is effective for tinea other than tinea unguium.
The Journal of Dermatology · 2021 · 4 citations · open access
Topical efinaconazole: A sequential combination therapy with oral terbinafine for refractory tinea unguium
AbstractEfinaconazole is a topical antifungal drug approved in Japan for tinea unguium. Although topical treatments generally have low cure rates with a prolonged therapy period, a Cochrane review confirmed that high-quality evidence supports the effectiveness of efinaconazole for the complete cure of tinea unguium. Combination therapy is a way to improve the cure rate of onychomycosis. In this study, topical efinaconazole was administrated to 12 patients who had been treated with oral terbinafine (125 mg daily) for more than 20 weeks with little expected effect. Because terbinafine accumulates for a long time in the nail, treatment immediately followed by other drugs can be considered sequential combination therapy. During terbinafine monotherapy, the percentage involvement decreased from 53.5% to 44.0% after 37.4 weeks and the effective and cure rates were 16.7% and 0%, respectively. During sequential topical efinaconazole therapy combined with lasting terbinafine in the nail, the percentage involvement decreased from 44.0% to 18.7% after 28.4 weeks, and the effective and cure rates were 66.7% and 16.7%, respectively. The improvement rate per month of combination therapy (12.6%) was higher than that with monotherapy (2.1%) (p = 0.002). There were no serious side-effects. This sequential combination therapy with efinaconazole was effective in poor terbinafine responders, making it a promising regimen for improving the cure rate of tinea unguium.
Evaluation of the Efficacy of Small-dose Itraconazole Pulse Therapy(200mg/day) for Tinea Unguium.
AbstractThirty-six patients with tinea unguium were treated with 200 mg of itraconazole daily for 7 days each month. We suggested that a patient who had a lesion in the thumbnail needed 5 months of treatment for mycologial cure, while in a patient without thumbnail lesion, 3 months of treatment was enough.
AbstractDermatophytosis of the external auditory meatus is believed to be a fairly rare disease. In the past three and a half years we have had seven cases of dermatophytosis in the external auditory meatus. All cases except one were associated with tinea of other lesions. Case 1: A 44-year-old man had tinea of the auricle, tinea pedis and tinea unguium. Case 2: A 14-year-old boy, the son of case 1 had no tinea elsewhere on his body, including the auricle. He scratched the auditory meatus with an earpick which his father had used. Case 3: A 62-year-old man had tinea of the auricle, tinea pedis and tinea unguium. Case 4: A 50-year-old man had tinea of the auricle, tinea pedis and tinea unguium. Case 5: A 36-year-old man had tinea of the auricle, tinea pedis, tinea unguium and tinea cruris. Case 6: A 30-year-old woman had tinea of the auricle. Case 7: A 68-year-old man had tinea of the auricle, tinea pedis, tinea unguium and tinea manuum. Endoscopic examination (except for cases 4 and 7) revealed dry cerumen from cartilaginous to bony region of the external auditory meatus. Direct examination using KOH method of the cerumen in all cases demonstrated numerous fungal elements. Fungal cultures identified Trichophyton rubrum except for cases 3 and 6. All cases were successfully treated with oral itraconazole or terbinafine. We suggest that tinea of the external auditory meatus is frequently associated with that of the auricle.
Disease module: DeepOracle (Open Targets). Structures: RDKit from PubChem SMILES. Literature: retrieved by DeepSearch across 234,678,978 indexed works (targeted per-candidate search), resolved on OpenAlex.
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