Identifying novel drugs with new modes of action for neglected tropical fungal skin diseases (fungal skinNTDs) using an Open Source Drug discovery approach: Expert Opinion on Drug Discovery: Vol 0, No ja

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Article highlights

• Antifungal drug discovery for the three fungal skinNTDs chromoblastomycosis, mycetoma and sporotrichosis have been fragmented and there are only a few drugs which were evaluated for causative agents of all three skinNTDs.

• Except for the azoles and iodoquinol, there were no antifungal classes active against all the causative agents of all three fungal skinNTDs.

• Since all causative agents form melanin and inhibiting melanin enhances the antifungal activity of different antifungal agents, combining melanin inhibition with antifungal therapy should be further explored for fungal skinNTDs.

• Of the azoles, ravuconazole and posaconazole showed the strongest activity against the causative agents of all three fungal skinNTDs, clinical evaluation of fosravuconazole for mycetoma treatment is underway, however currently no evaluation for chromoblastomycosis and sporotrichosis are reported.

• Studies on combination treatment, treatment intensity and duration of treatment in fungal skinNTDs are lacking and should be performed...."