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A clinico-cytochemical examination of 47 patients with mycosis pedis is presented. The author established that these patients showed an inhibition of the phagocytic activity of neutrophils due to imbalance of acid and alkaline phosphatases. It is considered justified to use diuciphon as a means of unspecific immunocorrection.
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Ciclopirox olamine cream 1%, a new antifungal agent has been studied in 30 patients with dermatophytosis and pityriasis versicolor. Diagnosis of dermatophytosis was confirmed by microscopic examination of KOH preparations and culture in Sabouraud medium. Pityriasis versicolor was diagnosed by direct exam preparation. Cultures and direct exam preparations were performed before starting treatment and weekly thereafter. Cultures and KOH preparations were positive in all patients. Treatment with ciclopirox olamine cream 1% was applied topically twice daily. Direct examination and cultures were negative in 26 cases (86.6%) after one week treatment and in 4 cases (13.4%) after two weeks. A parallel improvement in clinical signs and symptoms was evident with disappearance of erythema, pruritus and scaling. Clinical cure was achieved in most all cases (96.7%), between the third and fourth week of treatment.
Infections with fungi appear to be increasing in frequency. Children who are debilitated, or are receiving prolonged steroid therapy or long-term antibiotic therapy are particularly susceptible to fungal infections. C. albicans causes infections of various organs. It may also form granulomas and produce a disseminated disease. In this paper the clinical manifestations, diagnosis and treatment of candidiasis are discussed.
In the years 1980-1985 sutures were removed endoscopically from stumps and anastomoses in 52 patients operated in the years 1969-1985. The total number of bronchoscopies was 154, in 88 protruding threads into the airway lumen were removed. Interval between removal of first suture and date of surgery ranged from 0.5 to 192 months. Mycotic infection was diagnosed in 5 cases (9.6%). The causative agents being Aspergillus fumigatus and Candida albicans. In all cases removal of protruding threads lead to a complete cure. It was found that incidence of such mycotic infections decreased from 20.2% observed during the years 1962-1979 to 9.6% in the years 1980-1985.
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2.5% solution in the form of oral drops (Gist-brocades) has been used in the treatment of Candida albicans infections of the mucous membranes in children with chronic blood diseases. Out of 34 children 28 recovered completely which is 82.3% of all cases. The highest effectiveness of the preparation was found in the group of children with acute infections. In all cases of chronic candidiasis the improvement of the clinical condition was obtained. Only few children have not shown the growth of Candida albicans in the control investigations.
We have verified the local activity and tolerance of the antimycotic drug ciclopiroxolamine in an open trial. The study included 34 women suffering from clinically and mycologically diagnosed vulvovaginitis caused by Candida. The therapy consisted of inserting a 100 mg ovule of ciclopiroxolamine once a day for 3 days. The cultural examination was negative in 76.5% of cases at the 1st control after the treatment and in 82.3% of cases at the 2nd control after the treatment. All the considered subjective and objective symptoms showed a highly significant decrease of frequency and intensity. No chemical parameter was modified; only in one patient a very mild side effect was verified.
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The hydroxypyridone antifungal agent ciclopirox olamine cream 1% has been shown to be as effective in the treatment of inflamed, superficial fungal infections as a formulation in which ciclopirox 1% and hydrocortisone acetate 1% were combined. In a randomized, double-blind, parallel group comparison study, 138 patients with culture-confirmed superficial fungal diseases applied their assigned medication twice daily for 21 days. Clinical assessments were made at the baseline visit; at visits on days 4, 7, 14, and 21 during treatment; and on day 28 (one week posttreatment). Specimens for cultures were taken at baseline and on day 28. There were no differences for the 69 patients in either treatment group at any visit with respect to improvement in the signs/symptoms evaluated; mycological cures in the two treatment groups also were not significantly different.
In a multicenter prospective randomized trial, the efficacy and toxicity of low-dose (400 mg/d) and high-dose (800 mg/d) oral ketoconazole were compared in 80 patients with blastomycosis and in 54 with histoplasmosis. Among 65 patients with blastomycosis treated for 6 months or more, high-dose treatment was more effective (100% success rate compared with 79%; p = 0.001). Among 19 patients with chronic cavitary histoplasmosis treated for 6 months or more, both regimens were equally effective (overall success rate, 84%). In 20 patients with localized or disseminated histoplasmosis treated for 6 months or more, low-dose treatment was more effective (100% success rate compared with 57%; p = 0.03). The success rate for all patients with histoplasmosis treated for 6 months or more was 85%. Adverse effects occurred in 81 of 134 patients (60%) and were commoner with the high-dose regimen. Ketoconazole is effective for immunocompetent patients with non-life-threatening, nonmeningeal forms of blastomycosis and histoplasmosis. Because of the higher frequency of side effects associated with the high dose, ketoconazole therapy should be initiated with the low dose.
Stool samples of patients suffering from seborrheic eczema of the scalp, psoriasis capitis, or seborrhiasis were investigated. All patients revealed pathological flora of the bowel to a high degree, predominantly pathogenic yeasts. Therapy of the intestine seems to be of good influence to the skin disease as well.
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