Treatment of Superficial and Deep‐seated Mycoses with Oral Ketoconazole

Conti‐Díaz, I.A.; Civila, Eduardo; Asconegui, F

doi:10.1111/j.1365-4362.1984.tb04514.x

Cited by 10 publications

(9 citation statements)

References 4 publications

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“…These observations are novel not only for the tested drug but also for the class of oral antifungals. Indeed, oral ketoconazole, itraconazole and terbinafine had previously shown efficacy in treating seborrheic dermatitis [20,21,22,23], and these antifungals had proven their in vitro efficacy against Malassezia species [36, 37]. However, the sequence of events on the fungi and the skin changes had never been exposed so far.…”

Section: Discussionmentioning

confidence: 99%

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A Pilot Study on Seborrheic Dermatitis Using Pramiconazole as a Potent Oral Anti-<i>Malassezia</i> Agent

Pierard

Ausma²,

Henry

et al. 2007

Dermatology

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Background: Seborrheic dermatitis is considered to be a Malassezia-driven disease. Little objective information is available so far from biometrological quantitative assessments of this skin condition. Pramiconazole is a novel triazole with potent in vitro antifungal activity, especially against Malassezia spp. Objective: To study the sequential effects of pramiconazole on Malassezia, inflammation and epidermal changes. Method:This study was performed in 2 groups of subjects suffering from seborrheic dermatitis. The first group (n = 17) remained untreated and was used as control. Clinical, mycological and biometrological assessments were performed at inclusion and during the following 2 weeks. The second group of subjects (n = 10) received a single 200-mg oral dose of pramiconazole at inclusion. Clinical, mycological and biometrological evaluations were performed before and during 1 month following the single antifungal intake. For both parts of the study, several parameters were assessed including yeast density, desquamation, erythema, itching and sebum excretion. Results: In the control group, no significant changes were observed in any of the parameters during the observation period. The findings were markedly different in the pramiconazole-treated subjects. The yeast density was significantly improved on days 3, 7 and 28. Desquamation, erythema, itching, and the global clinical evaluation as assessed by the patients and investigators became significantly improved on days 7 and 28. A trend in decrease of scaliness was noted. No effect on sebum excretion was evidenced. In conclusion, a single 200-mg dose of pramiconazole exhibitsin vivo efficacy in controlling some important clinical aspects of seborrheic dermatitis. Following a reduction in the number of yeasts on day 3, a decrease in the severity of clinical signs and symptoms occurred from day 7 onwards. Sebum excretion appeared uninvolved in the clearing process of seborrheic dermatitis. Conclusion: A single 200-mg dose of pramiconazole appears to abate seborrheic dermatitis. The density in Malassezia present on lesional skin is first decreased, followed by clearing of the clinical signs.

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Section: Discussionmentioning

confidence: 99%

“…For such a purpose, oral administration of the drug is preferable in order to avoid any interference with the effect of a topical vehicle. Oral ketoconazole [20, 21], itraconazole [22] and terbinafine [23] have already shown efficacy in this indication.…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study on Seborrheic Dermatitis Using Pramiconazole as a Potent Oral Anti-<i>Malassezia</i> Agent

Pierard

Ausma²,

Henry

et al. 2007

Dermatology

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“…Azoles may also be effective. Ketoconazole, however, in at least some studies has achieved remission in only approximately 60% of patients (44,103). The allylamine agent terbinafine has proven highly effective (263), as has the triazole itraconazole (159).…”

Section: Tinea Capitismentioning

confidence: 99%

The dermatophytes

1995

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The etiologic agents of the dermatophytoses (ringworm) are classified in three anamorphic (asexual or imperfect) genera, Epidermophyton, Microsporum, and Trichophyton. Species capable of reproducing sexually belong in the teleomorphic genus, Arthroderma, of the Ascomycota. On the basis of primary habitat association, they may be grouped as geophilic (soil associated), zoophilic, and anthropophilic. Adaptation to growth on humans by most geophilic species resulted in diminished loss of sporulation, sexuality, and other soil-associated characteristics. The dermatophytes have the ability to invade keratinized tissue (skin, hair, and nails) but are usually restricted to the nonliving cornified layer of the epidermis because of their inability to penetrate viable tissue of an immunocompetent host. However, invasion does elicit a host response ranging from mild to severe. Acid proteinases, elastase, keratinases, and other proteinases reportedly act as virulence factors. The development of cell-mediated immunity correlated with delayed hypersensitivity and an inflammatory response is associated with clinical cure, whereas the lack of or a defective cell-mediated immunity predisposes the host to chronic or recurrent dermatophyte infection. Chronic dermatophytosis is mostly caused by Trichophyton rubrum, and there is some evidence that mannan produced by this fungus suppresses or diminishes the inflammatory response. Since dermatophytes cause a communicable disease, modes of transmission and control are discussed as well as a survey of recent trends in therapy. Collection of specimens, culture media, and tests for identification are also presented. Genetic studies have led to an understanding of incompatibility mechanisms, pleomorphism and variation, resistance to griseofulvin, and virulence. Molecular biology has contributed to our knowledge of the taxonomy and phylogenetic relationships of dermatophytes.

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“…The resulting efficacy outcome of fluconazole varied greatly from no difference compared with placebo therapy to clinical improvement in all patients [8]. Only a continuous regimen of ketoconazole has been reported for SD, which led to a high rate of clinical improvement and/or cure but has been associated with frequent adverse events [9,10]. Both pulse and continuous regimens for terbinafine were associated with clinical improvement [11][12][13].…”

Section: Introductionmentioning

confidence: 97%