Sulconazole nitrate 1.0 percent cream: a comparison with miconazole in the treatment of tinea pedis and tinea cruris/corporis

Sulconazole nitrate 1.0 percent cream was compared to miconazole nitrate 2.0 percent cream in a double-blind, parallel study involving ninety-six patients with cutaneous dermatophytosis. Both agents were highly effective, with no statistically significant differences in the parameters studied. Among tinea pedis patients, all of seven treated with sulconazole and six of nine treated with miconazole were mycologically cured (negative culture and potassium hydroxide test) at the end of four weeks of twice a day treatment, and there were no relapses by week 9. Among tinea cruris/corporis patients, the rates of mycological cure after three weeks of twice a day treatment with sulconazole or miconazole were, respectively, twenty-nine of thirty-two (91 percent) and 100 percent of thirty one (accompanied in all cases by complete or significant clearing of signs and symptoms); the respective relapse rates were four of twenty-five (16 percent) and eight of twenty-three (35 percent). Miconazole resulted in two cases of severe irritant dermatitis requiring discontinuation of treatment, whereas sulconazole produced no severe irritant reactions.     

Efficacy and safety of a new single-dose terbinafine 1% formulation in patients with tinea pedis (athlete''s foot): a randomized, double-blind, placebo-controlled study

BACKGROUND: Tinea pedis is a common dermatophyte infection with frequent recurrences. Terbinafine (presently used as a 1-week topical treatment of tinea pedis) is now available in a novel topical solution (film-forming solution--FFS), developed to allow single application. OBJECTIVES: To demonstrate the efficacy and safety of terbinafine 1% FFS in a randomized, double-blind, placebo-controlled, phase III trial, and to determine relapse or re-infection rate of tinea pedis at 12 weeks. PATIENTS/METHODS: Fifty-four centres (27 in France; 27 in Germany) enrolled 273 evaluable patients (2 : 1 randomization). Patients applied terbinafine 1% FFS or placebo only once between, under and over the toes, soles and sides of both feet. Efficacy assessments included direct microscopy, mycological culture, and clinical signs and symptoms at baseline, and at weeks 1, 6 and 12 after the single drug application. RESULTS: Effective treatment (negative mycology plus absent/minimal symptoms) at week 6 in the terbinafine 1% FFS group was 63%; vehicle was 17% (P相似文献   

A double-blind comparison of itraconazole and fluconazole in tinea pedis and tinea manuum

Background It has been reported that azole derivatives are useful in the treatment of dermatophytoses, also in tinea pedis and tinea manuum. Aim The aim of the present multicentre, randomized, double-blind study was to compare the efficacy and safety of oral itraconazole with fluconazole in the treatment of tinea pedis and tinea manuum. Patients and methods In this multicenter, double-blind, comparative study, 37 patients with tinea pedis or tinea manus were randomized to receive treatment with itraconazole (100 mg/day) or fluconazole (50 mg/day) for 30 days. Results Two patients were not evaluable for efficacy. Both treatments reduced the number of patients with positive mycological findings, so that at the end of treatment. 64.7% of patients receiving itraconazole and 61.1% of those treated with fluconazole had negative results. Both drugs also resulted in a marked improvement in, or elimination of all clinical symptoms; however the improvement appeared to occur more rapidly with itraconazole. The overall assessment at the end of the 6 week follow-up showed that 88.2% of patients treated with itraconazole and 72.2% of those treated with fluconazole were cured with negative mycological tests. Adverse events were reported by one patient treated with itraconazole and 5 subjects receiving fluconazole. The only changes in laboratory parameters were elevated SGOT and SGPT values in one patient in the fluconazole group, who dropped out from the study. Discussion The results suggest that itraconazole is at least as effective as fluconazole in the treatment of tinea pedis and tinea manus, the onset of improvement in clinical symptoms is more rapid an prolonged after cessation of therapy with itraconazole, and that itraconazole appears to be better tolerated.     

Short-duration therapy with terbinafine 1% cream in dermatophyte skin infections

Summary In a multicentre, double-blind, parallel-group study, the efficacy and safety of a single application of terbinafine 1% cream was compared with 3, 5 and 7 days' once-daily therapy in the treatment of tinea pedis and tinea corporis/cruris.
Seventy-eight patients with tinea pedis (58 male, 20 female; mean age 36, range 19–80) and 21 patients with tinea corporis or tinea cruris (16 male, 5 female; mean age 37, range 22–72), presenting in general practice, were entered into the study. Of these, 65 patients with tinea pedis and 14 with tinea corporis or cruris completed the study and were evaluable.
Twenty-eight days after commencing therapy 78, 83, 82 and 83% of patients with tinea pedis in the 1-, 3-, 5-, and 7-day treatment groups, respectively, were mycologically cured, and 61, 78, 71 and 67%, respectively, were 'effectively treated'. There was no statistically significant difference between treatment groups. Similarly high cure rates were seen in patients with tinea corporis and tinea cruris. Three months after commencing therapy there was little evidence of relapse.
The study shows that there is a significant potential for short-duration therapy with terbinafine 1% cream in tinea infections of the skin, emphasized here by the high cure rates obtained following a single application.     

[开放获取] 多磺酸黏多糖乳膏协同硝酸舍他康唑乳膏治疗鳞屑角化型足癣的临床疗效

【摘要】 目的 探讨多磺酸黏多糖乳膏协同硝酸舍他康唑乳膏治疗鳞屑角化型足癣的疗效。方法 采用随机数字表法将2019年3月至2020年1月鳞屑角化型足癣患者100例平均分为2组：对照组单纯外用硝酸舍他康唑乳膏0.5 ~ 1g /次，每天2次；联合组先外用多磺酸黏多糖乳膏0.5 ~ 1 g/次，30 min后再外用硝酸舍他康唑乳膏0.5 ~ 1g/次，每天2次。共治疗4周。比较2组临床症状缓解时间、疗效及不良反应发生率，于治疗0、2、4周分析2组皮肤病生活质量指数（DLQI）评分。统计分析采用两独立样本t检验及重复测量方差分析。结果 治疗4周后，联合组瘙痒及脱屑缓解时间分别为（6.05 ± 1.98） d、（12.03 ± 3.92） d，显著短于对照组［（8.39 ± 2.11） d、（15.11 ± 4.05） d，t值分别为5.72、3.86，均P < 0.001］。4周治疗期间，两组DLQI评分均逐渐下降（均P < 0.001），治疗2、4周时联合组DLQI评分均显著低于对照组（P < 0.001）。治疗4周后，联合组总有效率为98%，显著高于对照组（82%），χ2 = 7.11，P = 0.007；两组不良反应发生率差异无统计学意义（P > 0.05）。结论 多磺酸黏多糖乳膏可提高硝酸舍他康唑乳膏治疗鳞屑角化型足癣的疗效。     

曲安奈德益康唑乳膏长疗程间歇疗法治疗局限性慢性湿疹

目的 探讨外用糖皮质激素长疗程间歇疗法治疗局限性慢性湿疹的疗效、安全性及复发情况,以指导临床用药.方法 选取门诊局限性慢性湿疹患者,外用曲安奈德益康唑乳膏短程治疗.症状积分下降指数(SSRI)≥190%的患者进入长疗程,随机分两组,分别外用曲安奈德益康唑乳膏和润肤霜,间歇用药,共治疗8周.长疗程治疗4周、8周时及长疗程治疗停药12周时各随访1次.结果 长疗程治疗8周及停药12周时,曲安奈德益康唑组SCORAD评分均显著低于润肤霜组(t值分别为3.076和2.367,P值均<0.05).长疗程治疗4周、8周及停药12周时,曲安奈德益康唑组复发率均显著低于润肤霜组(x2值分别为4.426、7.683、8.199,P值均<0.05).治疗期间不良反应发生率3.1%,无严重不良事件.结论 外用糖皮质激素长疗程间歇治疗慢性湿疹,有防止症状加重、延缓湿疹复发的作用.     

曲安奈德益康唑乳膏长疗程间歇疗法治疗局限性慢性湿疹

目的 探讨外用糖皮质激素长疗程间歇疗法治疗局限性慢性湿疹的疗效、安全性及复发情况,以指导临床用药.方法 选取门诊局限性慢性湿疹患者,外用曲安奈德益康唑乳膏短程治疗.症状积分下降指数(SSRI)≥190%的患者进入长疗程,随机分两组,分别外用曲安奈德益康唑乳膏和润肤霜,间歇用药,共治疗8周.长疗程治疗4周、8周时及长疗程治疗停药12周时各随访1次.结果 长疗程治疗8周及停药12周时,曲安奈德益康唑组SCORAD评分均显著低于润肤霜组(t值分别为3.076和2.367,P值均<0.05).长疗程治疗4周、8周及停药12周时,曲安奈德益康唑组复发率均显著低于润肤霜组(x2值分别为4.426、7.683、8.199,P值均<0.05).治疗期间不良反应发生率3.1%,无严重不良事件.结论 外用糖皮质激素长疗程间歇治疗慢性湿疹,有防止症状加重、延缓湿疹复发的作用.     

曲安奈德益康唑乳膏长疗程间歇疗法治疗局限性慢性湿疹

目的 探讨外用糖皮质激素长疗程间歇疗法治疗局限性慢性湿疹的疗效、安全性及复发情况,以指导临床用药。方法 选取门诊局限性慢性湿疹患者,外用曲安奈德益康唑乳膏短程治疗。症状积分下降指数（SSRI）≥90％的患者进入长疗程,随机分两组,分别外用曲安奈德益康唑乳膏和润肤霜,间歇用药,共治疗8周。长疗程治疗4周、8周时及长疗程治疗停药12周时各随访1次。结果 长疗程治疗8周及停药12周时,曲安奈德益康唑组SCORAD评分均显著低于润肤霜组（t值分别为3.076和2.367,P值均 < 0.05）。长疗程治疗4周、8周及停药12周时,曲安奈德益康唑组复发率均显著低于润肤霜组（χ2值分别为4.426、7.683、8.199,P值均 < 0.05）。治疗期间不良反应发生率3.1％,无严重不良事件。结论外用糖皮质激素长疗程间歇治疗慢性湿疹,有防止症状加重、延缓湿疹复发的作用。     

Short treatment schedules of itraconazole in dermatophytosis

Patients were recruited from 1 December 1994 until 31 August 1995. Those presenting with tinea cruris/corporis received 200 mg of itraconazole every day for 7 days, whereas patients presenting with tinea pedis/manus were treated with 200 mg twice a day for 7 days. Those eligible were men and women at least 18 years of age, with a clinically diagnosed dermatophytosis, confirmed by KOH examination and culture. Pregnant or nursing patients and those who did not use adequate birth control methods were excluded. Patients with a known history of chronic liver disease or other concomitant serious disease were also excluded. Patients who had received any oral antifungal or corticosteroid therapy within 30 days before enrollment or any topical antifungal or corticosteroid treatment within a week before enrollment were not eligible.
Clinical and mycologic (KOH and culture) evaluation was carried out at baseline, at completion of therapy (day 7) and at the end of follow-up (day 28 for tinea cruris/corporis and day 35 for tinea pedis/manus). The investigator evaluated the following clinical symptoms at each visit: desquamation, erythema, infiltration, pruritus, exudation, maceration, vesiculation, and pustules. Clinical results were rated as: healed, markedly improved, considerable residual lesions, not changed, or worse. The categories healed and markedly improved were considered as responders.
All mycology was performed centrally at the Department of Microbiology, University of Malaya.     

A novel two‐step kit for topical treatment of tinea pedis – an open study

Background Tinea pedis is a common skin disease affecting most of the population during their lifetime. Topical and systemic treatments give only temporary relief. Objective To evaluate the efficacy and safety of a new topical treatment for moderate‐to‐severe tinea pedis. Methods Fifty patients suffering from tinea pedis were treated in two stages: the active stage – single use of the novel topical solution for 45 min and novel cream twice weekly for 4 weeks; the preventive stage – cream application once weekly for 10 months. Results Forty‐five patients completed the active stage and achieved 76% cure rate. The medication was well tolerated; one patient dropped from the study because of very mild irritation. No other topical or systemic side effects were noted. Another five patients were lost to follow‐up during the preventive stage. The total cure rate after the preventive stage was 70%. Conclusions This novel treatment was found to be effective, well tolerated and safe in the treatment of moderate and severe tinea pedis during the active and the preventive stages.     

Broad spectrum herbal therapy against superficial fungal infections

Skin disease associated with keratinized tissues in animal and human beings has been investigated. The essential oil of Eucalyptus pauciflora in vitro showed strong antifungal activity at 1.0 microl/ml against human pathogenic fungi, viz. Epidermophyton floccosum, Microsporum audouinii, M. canis, M. gypseum, M. nanum, Trichophyton mentagrophytes, T. rubrum, T. tonsurans and T. violaceum. The oil has heavy doses of inoculum potential at 1.0 microl/ml. Moreover, it did not exhibit any adverse effects on mammalian skin up to 5% concentrations. Further, we formulated the oil in the form of ointment 'BSHT' (broad spectrum herbal therapy) (1% v/v) and subjected it to topical testing on patients attending the outpatient department of M.L.N. Medical College, Allahabad. Fifty patients were selected on the basis of KOH-positive results and diagnosed as either tinea pedis, tinea corporis or tinea cruris. After the second week of treatment, all patients were KOH-negative. At the end of medication, 60% of patients recovered completely and 40% showed significant improvement from the disease. No KOH-negative cases of relapse were observed when patients were re-examined after 2 months following the end of treatment. Thus, the ointment can be exploited commercially after undergoing successful multicenter clinical trials, which are in progress.     

皮肤癣菌培养基和鉴定培养基分离鉴定皮肤癣菌的实验室和临床研究

目的:研究2种皮肤癣菌分离鉴定培养基对实验室保存菌株及临床标本的皮肤癣菌分离鉴定情况.方法:实验室保存菌株包括皮肤癣菌65株,其他霉菌38株,酵母菌30株.临床标本取自28例体股癣及足癣患者.分别将菌种和皮屑接种于1个皮肤癣菌培养基(DTM)、2个皮肤癣菌鉴定培养基(DIM)和1个含氯霉素的沙堡培养基(SDA).SDA、DTM和1个DIM在30℃培养2周,另1个DIM在37℃培养2周.每天观察培养基颜色变化及菌落生长情况.结果:30℃时1周内DIM和DTM上分别有89.2%和100%的皮肤癣菌变色.37℃时,DIM上只有31株能够生长.非皮肤癣菌30℃条件下在DIM上有32株生长,8株变色;在DTM培养基上有37株生长,14株变色.37℃条件下DIM培养基上有17株生长,6株变色.结论:DIM和DTM均能简便、快速、准确地分离鉴定皮肤癣菌,并有效控制细菌和真菌的污染.     

利拉萘酯乳膏治疗体股癣及足癣的多中心随机双盲对照观察

目的 探讨2%利拉萘酯乳膏治疗体股癣、足癣的临床疗效和安全性。方法 采用多中心随机双盲阳性药平行对照法，分别在3个中心进行，入选288例患者，2%利拉萘酯乳膏试验组144例，1% 联苯苄唑乳膏对照组144例；每组中体股癣患者各72例，足癣患者各72例。每日涂药1次，足癣疗程4周，每2周复诊1次；体股癣疗程2周，每周复诊1次；停药后2周均再复诊1次。结果 试验组体股癣患者中有１例脱落。停药时体股癣试验组的痊愈率和有效率分别为59.2%和94.4%，足癣试验组分别为41.7%和81.9%，与对照组比较，差异均无统计学意义（P ＞ 0.05）。在用药结束后2周时，体股癣试验组的痊愈率和有效率分别为67.6%和94.4%，足癣试验组分别为54.2%和81.9%，与对照组比较，差异无统计学意义（P ＞ 0.05）。在用药结束后2周，体股癣和足癣试验组符合方案分析集真菌学清除率分别为97.18%和90.28%，试验组和对照组差异均无统计学意义（P ＞ 0.05）。用药后发生的不良反应表现为用药部位红肿、疼痛，其中体股癣试验组不良反应发生率为2.78%。结论 2%利拉萘酯乳膏治疗体股癣、足癣有良好的疗效和安全性。     

Tinea pedis in Korean children

BACKGROUND: Tinea pedis is an infrequent disease in children before the age of puberty. There are few epidemiologic and clinical data regarding cases of tinea pedis observed in children. Materials and methods We prospectively collected all cases of tinea pedis in children diagnosed during the years 1995-1997. Only those showing a positive result with potassium hydroxide preparation were included in the study. We performed fungal cultures in Sabouraud's agar in all cases to document the etiologic fungi. The clinical characteristics were investigated. RESULTS: A total of 21 children, aged 3 months to 14 years, were included. Fifteen patients were boys and six were girls. The mean age was 7.1 years. All the children were otherwise healthy. Prior to the establishment of the diagnosis of tinea pedis, 17 patients (80.9%) were treated for eczema without improvement. The intertriginous type was most common (53.3%). The first or second toe-webs were the sites of predilection (32.3%). Eighteen children (86%) had a family history of tinea pedis and more than half of cases (52.4%) showed occurrence in the summer. The results of fungal cultures were positive in 13 patients (57%). Trichophyton rubrum was the most commonly isolated pathogen (69.2%). The other associated dermatoses were onychomycosis (33.3%), atopic dermatitis (14%), plantar warts (10%), and chronic urticaria (5%). Tinea pedis and onychomycosis cleared after treatment with topical antifungals with or without systemic antifungals in all cases. CONCLUSIONS: Tinea pedis in children can occur more frequently than suspected. Our study shows the strong association with a family history and the seasonal relationship with occurrence in summer in more than half of cases. We suggest that tinea pedis should be considered in the differential diagnosis of foot dermatitis in children.     

The use of 40% urea cream in the treatment of moccasin tinea pedis

Moccasin tinea pedis is a chronic dermatophyte infection of the foot that is recalcitrant to topical antifungal therapy. Furthermore, most patients with moccasin tinea pedis also have onychomycosis, thus adding to the recalcitrant nature of the infection. The topical antifungals used as sole therapy are generally ineffective because the scale on the plantar surface impedes or limits the absorption of the antifungal agent. The aim of this study was to evaluate the efficacy of 40% urea cream as an adjunct to topical antifungals in the treatment of moccasin tinea pedis. Patients with untreated moccasin tinea pedis were selected from the general dermatology clinic. The diagnosis of moccasin tinea pedis was made clinically and confirmed with a potassium hydroxide test or a positive fungal culture. A total of 12 patients with moccasin tinea pedis were treated with 40% urea cream once daily and ciclopirox cream twice daily. Patients then were evaluated after 2 to 3 weeks of treatment for the presence of erythema, scaling, and pruritus. After 2 to 3 weeks, a 100% cure rate was achieved in the 12 patients treated with topical 40% urea cream and ciclopirox cream concomitantly.     

Itraconazole compared with griseofulvin in the treatment of tinea corporis/cruris and tinea pedis/manus: an interpretation of the clinical results of all completed double-blind studies with respect to the pharmacokinetic profile.

Itraconazole is an orally active triazole antifungal which has been compared to griseofulvin in a number of double-blind trials. In dermatophytosis with a non-fixed treatment regimen for a maximum of 3 months, itraconazole 100 mg o.d. has produced a 100% mycological cure rate as compared with a 67% rate with griseofulvin 500 mg o.d. (p less than 0.01). Based on the pharmacokinetic profile, 100 mg itraconazole daily was then compared with 500 mg ultramicronized griseofulvin daily using a fixed treatment schedule of 15 days in tinea corporis and/or cruris and 30 days in tinea pedis and/or manus. In all studies in tinea corporis/cruris (n = 277), the superiority of itraconazole was shown for the clinical outcome at the last follow-up visit 2 weeks post-therapy (88 vs. 69%, p less than 0.01) and in the mycological outcome at the last follow-up visit (81 vs. 65%, p less than 0.05). In tinea pedis/manus (n = 210), the clinical response was virtually the same for the two treatment groups, but the most important finding was the mycological outcome with a significantly better result in favor of itraconazole at the end of treatment (77 vs. 61%, p less than 0.05) even more pronounced at the follow-up visit (85 vs. 48%, p less than 0.01). We conclude that itraconazole 100 mg daily in the treatment of tinea corporis/cruris and in tinea pedis/manus is significantly more effective than 500 mg griseofulvin daily when fixed treatment regimens are used. Furthermore, the best results are obtained with itraconazole 2-3 weeks after the end of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)     

综合疗法治疗复发性念珠菌性包皮龟头炎

目的探讨口服氟康唑胶囊、外用曲安奈德益康唑乳膏联合包皮环切术防治复发性念珠菌包皮龟头炎的疗效。方法采用随机分组法,治疗组(46例)给予氟康唑胶囊200mg,1次/d,连服3d,外用曲安奈德益康唑乳膏,早、晚各1次,2周为1个疗程,炎症控制后行包皮环切术。对照组(40例)给予氟康唑胶囊连服6d,曲安奈德益康唑乳膏外用2周。治疗后2周及2,4和6个月时随访。结果 2周后,两组痊愈率分别为89.13%和85.00%,差异无统计学意义(P>0.05)。两组有效率分别为100.00%和95.00%,差异无统计学意义(P>0.05)。2,4,6个月治疗组复发率分别为4.88%,9.76%和9.76%,对照组复发率分别为23.53%,38.24%和50.00%,两组比较差异均有统计学意义(P均<0.05)。结论综合疗法治疗复发性念珠菌包皮龟头炎安全有效,并能有效减少复发。     

Bifonazole for the topical treatment of surface mycoses--progress!

69 patients with superficial mycosis were treated with 1% Bifonazol cream once a day. 48 of them who suffered from tinea pedis interdigitalis received Bifonazol for 3 weeks, the remaining 21 patients who had superficial candidiasis applied it over a period of 4 weeks. The local tolerance of the cream has been very good. Control examinations 3 and 14 days after treatment proved 59 (89%) of all patients to be cured, i.e. 40 of those who had suffered from tinea pedis and 19 of the group with candidiasis.     

Topical griseofulvin in the treatment of dermatophytoses

Whether griseofuilvin, which pioneered oral antifungal therapy, works topically has long been an open question. The effectiveness of a 1% griseofulvin spray formulation and the vehicle alone against experimentally induced Trichophyton mentagrphytes lesions on the forearms of 16 healthy volunteers and in the treatment of 100 tinea pedis patients (various dermatophytes) was evaluated in a double-blind study. After treatment of teh58 induced lesions twice daily for 14 days with topical griseofulvin (28) of placebo(30),80% of lesions receiving griseofulvin were mycologically negative compared with 30% in the placebo group (p<0.001), In the tinea pedis patients who applied medication once daily for 4 week and 80.9% 2 weeks post-treatment. Resurgence of dermatophytes quickly followed the end of treatment in the placebo group only, which had a mycological cure rate of 34%(week6) Administration of a ropical formulation of griseofulvin thus may be an effective treatment for interdigital dermatophyte infections.     

Neue Entwicklungen in der medizinischen Mykologie

Not only have the systemic mycoses clearly increased in number but also mycoses of the skin are more common than presumed in the past. Today onychomycosis is found in up to 10% of human beings. Onychomycosis can compromise quality of life markedly. Common tinea pedis is one of the most important risk factors for erysipelas of the lower legs. The clinical presentation of oral candidosis in HIV-infected patients is changing; Candida dubliniensis has been identified as another important causative microorganism. Onychomycosis today in most cases can be cured using terbinafine or itraconazole. When choosing the ideal drug in a given case, both the benefit risk ratio and the benefit cost ratio have to be taken into account. Liposomally encapsulated amphotericin B represents a major breakthrough in the treatment of systemic mycoses or fever of unknown origin. The same applies to liposomally encapsulated econazole with respect to tinea pedis. In regard to the pathogenesis of Candida infections the family of secreted aspartic proteinases plays a major role as a virulence factor and possible future target for antimycotic treatment.