Advances in Topical and Systemic Antifungals

Zhang, Alexandra Y.; Camp, William L.; Elewski, Boni E.

doi:10.1016/j.det.2007.01.002

Cited by 70 publications

(73 citation statements)

References 71 publications

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“…Vulvovaginal candidiasis is a common syndrome affecting many otherwise healthy women (2), while systemic candidiasis is a lifethreatening infection of immunocompromised patients (1). The organism is capable of biofilm formation on the surface of medical device implants, and nosocomial infections are becoming an increasing concern, especially due to the toxicity issues of currently used antifungal treatments (3)(4)(5). Additionally, systemic candidiasis is difficult to diagnose, leading to delays in the administration of antifungal drugs that combined with either native or acquired drug resistance of Candida species, contribute to Ͼ40% mortality rates associated with systemic infection (1,6,7).…”

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confidence: 99%

Molecular Recognition of Candida albicans (1→2)-β-Mannan Oligosaccharides by a Protective Monoclonal Antibody Reveals the Immunodominance of Internal Saccharide Residues

Johnson

Cartmell

Weisser

et al. 2012

Journal of Biological Chemistry

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Molecular Recognition of Candida albicans (1→2)-β-Mannan Oligosaccharides by a Protective Monoclonal Antibody Reveals the Immunodominance of Internal Saccharide Residues

Johnson

Cartmell

Weisser

et al. 2012

Journal of Biological Chemistry

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“…Occasionally, patients may experience irritation with a burning sensation at the site of application. Allergic contact dermatitis with erythema, edema, urticaria, and pruritus has been reported rarely [10]. However there is a paucity of studies in the literature on use of this drug in SD.…”

Section: Citationmentioning

confidence: 99%

“…Approximately 5% of the drug is found to penetrate into the hair keratin 12 hours after a single shampoo. It is classified as a pregnancy category C drug [10]. Various studies conducted on ketoconazole have used it in varying doses.…”

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confidence: 99%

“…range from 0.001 to 0.125μg/ml.36 The drug is well tolerated and rarely side effects like burning sensation or eye stinging has been observed, but they are usually mild in nature [39]. It is classified as a pregnancy category B drug [10].To date, ciclopirox has been used in 13 studies so far.6 In a multicenter, randomized, double-blind, vehicle controlled study of 178 subjects, the efficacy of ciclopirox gel in treating SD of the scalp was evaluated and it was observed that more ciclopiroxtreated subjects achieved over 75% improvement in the global evaluation scores, based on a scale of 0-5 (100% clearance to flare of treatment area), compared with vehicle at days 22, 29, and endpoint (P <0.01) [40]. Another randomized, parallel-group, double-blind, vehicle-controlled trial was designed to compare three different application frequencies of ciclopirox 1% shampoo: once, twice, and three times weekly.…”

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confidence: 99%

“…After six weeks, it was found that both drugs were effective in treating symptoms such as itching, peeling, dry or oily skin, but 1% ketoconazole shampoo showed superior efficacy, with a statistically significant difference in all symptoms. Eighty percent of patients in the ketoconazole group and 13 percent of the climbazole group were observed to achieve clinical cure at end of treatment (p = 0.0001) [29].Fluconazole: Fluconazole, a member of the triazole antifungal family, was approved by the FDA for oral use in the early 1990s [10]. After oral administration, fluconazole accumulates in eccrine sweat and diffuses rapidly and extensively in the stratum corneum.…”

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2017

JBMOA

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Seborrheic dermatitis is a common inflammatory condition mainly affecting scalp, face and other seborrheic sites, characterized by a chronic relapsing course. The mainstay of treatment includes topical therapy comprising antifungals (ketoconazole, ciclopirox olamine) and anti-inflammatory agents along with providing symptomatic relief from itching. Oral antifungals and retinoids are indicated only in the severe, recalcitrant cases. The objective of this review is to discuss various topical antifungals available for use in seborrheic dermatitis of scalp, face and flexural areas, discuss their efficacy and safety profiles from relevant studies available in the literature along with upcoming novel delivery methods to enhance the efficacy of these drugs. Keywords: Seborrheic dermatitis; Antifungal agents; Ketoconazole; Ciclopirox Topical Antifungals used for Treatment of Seborrheic Dermatitis 2/8Copyright: ©2017 Chowdhry et al. . Absorption of ketoconazole through the skin is insignificant, with no ketoconazole detected in plasma after topical application of ketoconazole cream or shampooing. Approximately 5% of the drug is found to penetrate into the hair keratin 12 hours after a single shampoo. It is classified as a pregnancy category C drug [10]. Various studies conducted on ketoconazole have used it in varying doses. The most frequent dose was 2% twice daily every day over face and 2% twice a week over scalp [6]. CitationOther formulations of this drug have also yielded similar efficacy as the cream formulation. Elewski et al. [13] evaluated the efficacy and safety of twice-daily treatment with ketoconazole 2% foam for seborrheic dermatitis on the scalp, body, and face on 1162 patients and concluded that it was as effective as twice daily use of ketoconazole 2% cream. Another study evaluated the efficacy and safety of a once-daily, ketoconazole 2% gel treatment in moderate to severe seborrheic dermatitis in 459 patients and observed that a significantly greater percentage of subjects were successfully treated with this gel compared with vehicle (25.3% vs. 13.9%, P = 0.0014) [14].The Cochrane Skin Group recently conducted a meta-analysis for studies published so far on the use of topical antifungals for SD and they concluded that as compared to placebo group, participants taking ketoconazole were 31% less likely to have symptoms persisting at four weeks of follow-up. It was usually well tolerated but common side effects included increased skin redness or itching, burning sensation and hair loss [6]. The US FDA in 2013 has issued a safety guideline stating that angioedema can be caused by ketoconazole 2% shampoo [15].Ortonne et al. [16] in a single-blinded study observed 62 patients with SD over scalp, face and chest who were treated topically with a 2% ketoconazole foaming gel or with a 0.05% betamethasone dipropionate lotion for 4 months. At the end of treatment, the response rate for ketoconazole 2% foaming gel was significantly higher than that for betamethasone dipropionate 0.05% lotion according to ...

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