Oral ketoconazole in the treatment of leishmaniasis.
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Biomedical subjects
Publications and source records attributed to N Zaias.
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Chromomycosis is a general term to express human and animal fungal infections caused by members of the family Dematiaceae (dark brown or black fungi). Unique host-parasite relationships produce a wide spectrum of clinical disease, sometimes difficult to treat. Four major categories are recognized: 1) Superficial Chromomycosis--A pigmented macule produced by fungus inhabiting exclusively the dead horny layer (stratum corneum) of the skin, as in tinea nigra palmaris. 2) Chromoblastomycosis--A verrucous, slow growing nodule or plaque produced by fungi, characteristically and exclusively present as large brown spherical bodies (chromo bodies) in the dermis. 3) Chromohyphomycosis--A dermal nodule produced by fungi displaying typical brown septated hyphae. Rarely, the fungus may appear as a yeast. It may occur in deeper tissues, i.e., muscles, bone and brain or it may also involve the eye (Keratomycosis). 4) Chromomycetoma--Tumefaction, draining sinuses and presence of colony of organisms as "grain". Dematiaceae are found more frequently in veterinary than in human medicine.
A protocol for determining the antifungal efficacy of systemic or topical drugs in tinea pedis is presented. In this study, (1) no patient had concomitant onychomycosis; (2) the clinical types were separated into (a) plantar scaling, (b) intertriginous, and (c) vesicular instep; (3) the soles were treated for three months (time related to the shedding of all stratum corneum); (4) the follow-up period for soles was three months (related to characteristics of the drug and its depot effect on the target area, the horny layer); (5) the final evaluation related to the percentage of patients "clinically and mycologically cured" at the end of the follow-up period. With this protocol, ultramicrosize griseofulvin (Gris-PEG) alone, topical clotrimazole (Lotrimin) alone, and a combination of the two were tested in seventy-three patients with tinea pedis. The results were as follows: for plantar scaling type of tinea pedis, the combination was not better than griseofulvin alone; for intertriginous tinea pedis, the combination was definitely better than griseofulvin alone; and topical 1 percent clotrimazole was much less effective than griseofulvin.
A 1% clotrimazole solution was used as an antifungal for Tinea versicolor, Cutaneous Candidiasis and Dermatophytosis. All studies were double-blind and controlled, active vs vehicle. The final evaluation was made at a two-week follow-up after the treatment was stopped, which for most of the clinical conditions studied, was 28 days. The 1% clotrimazole solution was found to be effective with no local irritation noted.
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