[Treatment of dermatomycoses with 1% canesten cream].
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Tioconazole is a new imidazole antifungal agent with broad-spectrum activity. Its in vitro activity against common dermal pathogens is generally better than miconazole by a factor of 2-8. This activity is paralleled by good topical efficacy in a guinea pig dermatomycosis model. Pharmacokinetic studies in animals have demonstrated minimal systemic exposure following dermal application. Acute general pharmacology studies have shown that the compound is well tolerated in animals and unlikely to produce side-effects in man.
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According to current concepts in the first place T-lymphocytes have an important part in the defense mechanism against dermatomycosis. This theory is strengthened by investigations in which we were not able to demonstrate an increase of the immunoglobulins A, G and M in 36 patients suffering from this disease. To gather further information we determined the values of the immunoglobulin E in 16 cases of dermatomycosis. Taking into account a larger variation of the normal value in healthy persons, we found in at least 3 cases an increased amount of IgE. As we observe now and then an immediate reaction of Type I (according to COOMBS and GELL) after intracutaneous injection of trichophytin, it appears that IgE plays a role in certain fungal infections of the skin.
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A survey is given of twenty published open clinical studies carried out outside Europe. They concern the topical action of 6-cyclohexyl-1-hydroxy-4-methyl-2(1H)-pyridone, 2-aminoethanol salt (ciclopiroxolamine, Cic, Hoe 296, Batrafen) in 991 cases of skin disorders, mostly mycoses. 70.7% of the disorders were dermatophytoses, 18.9% candidoses. 6.1% pityriasis versicolor, and 4.2% other skin infections. Four trials were done with 1% Cic cream (o/w-type-emulsion) in 157 dermal disorders and 16 trials with 1% Cic solution (vehicle: polyethylene glycol 400) in 834 cases. Several selected studies are reported in detail, the other are parts of a summarizing survey. After a treatment period which, as a rule, was limited to 3 weeks, the global success rate was 96% (healing and distinct improvement). Any side effects were only seldom recorded.
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