If the cell membrane is made sufficiently leaky by these pores the fungal cell will die from loss of ATP and other effects which can include calcium disregulation. These pores are believed to open at about 10 minutes following topical application of sertaconazole. One hour following topical application, approximately 90% of fungal cells die from lack of energy (due to ATP loss) and general loss of homeostasis. Sertaconazole is thought to be the only Benzothiophene antifungal with this mechanism of action. Sertaconazole has also antiinflammatory and antipruritic action. It inhibits the release of proinflammatory cytokines from activated immune cells. It has been shown that sertaconazole activates the p38/COX2/PGE2 pathway. PGE2 can have a variety of important effects in the body including activation of the bodys fever response. Sertaconazole also has antibacterial action. It is hypothesized that the mechanism of action again involves sertaconazoles ability to form pores by mimicking tryptophan. It has also been shown that sertaconazole can kill Trichomonas vaginalis in vitro. The exact mechanism of action is as yet unknown. Sertaconazole also appears to inhibit the dimorphic transformation of Candida albicans into pathogenic fungi. The following fungal organisms, among others, are known to be susceptible to sertaconazole:

Candida albicans
Epidermophyton floccosum
Trichophyton mentagrophytes
Trichophyton rubrum

Chemistry
Sertaconazole contains a stereocenter and consists of two enantiomers. The pharmaceutical drug is a racemate, an equal mixture of the (R)- and (S)-forms. References
External links
"Sertaconazole". Drug Information Portal. U.S. National Library of Medicine. "Sertaconazole nitrate". Drug Information Portal. U.S. National Library of Medicine.
Palpation thyroiditis refers to the development of thyroid inflammation due to mechanical damage to thyroid follicles. This can occur by vigorous repeated palpation (as with thyroid examination) or surgical manipulation (as can occur with radical neck dissection). It is a type of subacute thyroiditis. Pathology shows multifocal granulomatous folliculitis. T cells predominate compared to B cells. There may be initial transient hyperthyroidism due to leakage of preformed thyroid hormone in blood. == References ==