# Nanoarchitectures in Management of Fungal Diseases: An Overview
## 3 Currently Available Treatment Strategies for Fungal Diseases  
The treatment of fungal diseases involves systemic and topical antifungal agents, depending on the type of fungal skin disease, infection area, and skin penetration. Topical treatment is the most common for all kinds of skin infections. The classes of antifungals approved for treating patients with invasive fungal infections (IFIs) are triazoles, polyenes, and echinocandins [18]. Historically, Fluconazole and Itraconazole, among other azole drugs (first-generation), started in the 19 th century and showed a potent broad-spectrum action of the deoxy-cholate preparation with fewer side effects. Voriconazole, Posaconazole, and Isavuconazole (second-generation azole drugs) showed a prolonged spectrum of activity against filamentous fungi. Antifungal topical azole drugs treated _Pitytiasis versicol_ when applied in the form of solutions, sprays, creams, and shampoos [19]. The azoles exert their effect by inhibiting CYP-dependent C-14 n-demethylase, an enzyme involved in converting lanosterol to ergosterol. It leads to the depletion of ergosterol, the essential sterol of the fungal cell membrane, and, ultimately, compromises cell membrane integrity [18]. Amphotericin B (AmB), a polyene antifungal agent with a broad range of activity against yeasts and molds, targets ergosterol. AmB is effective against _Cryptococcus neoformans_, _Candida_ spp., _Aspergillus_ spp., and agents of mucormycosis. However, some fungi, including _Candida lusitaniae_, _Aspergillus_ _terreus_, _Trichospor_ spp., _Geotrichum_ spp., and _Scedosporium_ spp., are resistant to AmB [19]. In the 20 th century, the Echinomaths drugs (Mycafungin, Casopfungin, and Anidulafungin) offered significant activity against candida infections and were commercially available only in the parenteral form. Echinomaths are cyclic lipopeptides that work by interfering with fungal wall synthesis. In a noncompetitive manner, they inhibit the synthesis of Casopfungin and an essential constituent of the fungal cell wall [19]. In contrast, because there are no \(\beta\)-glucans or \(\beta\)-glucan synthases in humans, these agents are less toxic than other antifungals [20]. The synthesis of ergosterol is interfered with terbinafine. It shows fungicidal action. It is effective against dermatophytes such as _Microsporum_ spp., _Trichophyton_ spp., and _Epidermophyton_. Fungistatic flucytosine interferes with the synthesis of protein and DNA. It is a fluorinated pyrimidine analog that is active against _Candida_ spp. It is used in combination with azole or AmB. Hepatotoxicity and thrombocytopenia are associated with high concentrations, i.e., \(>\)100 mg/mL [19; 20]. Tolnafate, an antifungal agent, is a synthetic thiocarbamate that is used to treat ringworm, athlete's foot, and jock itch [19]. A synthetic antifungal agent, Cicoliprox, is active against superficial mycoses, particularly _Tinea versicolor_. It acts by the chelation of trivalent cations (Fe\({}^{3+}\) and Al\({}^{3+}\)), inhibiting the metal-dependent enzymes and interrupting the transport of amino acids and nutrients. Amorolfine is used to treat onychomycosis. Orally active Griseofulvin is effective against dermatophytes [10]. Various antifungal drugs are used to treat _tinea_ and cutaneous _candidiasis_ infections (Table 1 and Figure 1) [1; 21; 22].