ABSTRACT
To compare the efficacy and safety of 2% ketoconazole soap in treatment of tinea versicolor [TV] and to compare it with stat 400mg dose of ketoconazole. Patients of TV confirmed by potassium hydroxide [KOH] mount were divided by block randomization into 2 groups. Group 1 received 400mg of oral ketoconazole single dose and a non-medicated soap for daily bath. Group 2 received 2% ketoconazole soap for daily bath. The lather from the soap while bathing was to be left on the skin for 3 minutes. Patients were assessed at the end one month and KOH repeated from index lesion. Twelve patients out of 25 completed the study, 6 in each group. Four patients [66%] were mycologically cured in group 1 while two patients [34%] were mycologically cured in group 2. All these patients were compliant with the usage of soap. Ketoconazole soap is at best an adjunct in the treatment of TV. It might however be useful in the prophylactic management of patients with chronic TV as bathing is almost a daily routine in most patients especially in tropics. Further studies are required in this aspect
Subject(s)
Humans , Female , Antifungal Agents/pharmacology , Ketoconazole/administration & dosage , Tinea Versicolor/drug therapy , Treatment Outcome , Soaps , Safety , Random Allocation , Administration, Topical , Administration, OralABSTRACT
BACKGROUND: Pityriasis versicolor is a fungal infection caused by Malassezia spp. that has frequent relapses. OBJECTIVES: The main objective of this research was to perform phase I and II clinical studies, using formulations containing essential oil of Cymbopogon citratus in patients with pityriasis versicolor. METHODS: Phase I study included twenty volunteers to ascertain the safety of the formulations. In phase II, 47 volunteers randomly received essential oil formulations at 1.25 μL/mL concentration, for forty days. The shampoo should be applied three times a week and the cream twice a day. A control group in phase II, consisting of 29 volunteers, received the same formulations but with 2% ketoconazole as the active ingredient. RESULTS: No significant adverse events were observed in volunteers during Phase I. In Phase II, 30 (63.83%) volunteers using essential oil and 18 (62.07%) using ketoconazole remained until the end of the study. We observed a predominance of lesions in disseminated form, with M. sympodialis detected as the predominant agent identified in cultures. After 40 days of treatment, the rate of mycological cure was 60% (p <0.05) for the group treated with essential oil of C. citratus and over 80% (p <0.05) for the group treated with ketoconazole formulations. CONCLUSIONS: Notwithstanding the safety and antifungal effects observed in this study after application of formulations containing the essential oil of C. citratus, further studies with larger populations should be performed to confirm the actual potential of these formulations in the treatment of patients with Pityriasis versicolor. .
FUNDAMENTOS: Pitiríase versicolor é uma micose causada pela Malassezia spp., e que apresenta frequentes recidivas. OBJETIVOS: Este trabalho objetivou realizar estudos clínicos de fase I e II, para essa patologia, com óleo essencial de Cymbopogon citratus. MÉTODOS: Na fase I, participaram vinte voluntários para averiguar a segurança das formulações. Na fase II, 47 voluntários receberam as formulações do óleo essencial a 1,25 μL/mL, as quais deveriam ser utilizadas por quarenta dias, sendo o xampu três vezes por semana e o creme duas vezes ao dia. Um grupo controle na fase II, constituído por 29 voluntários recebeu as mesmas formulações, com cetoconazol a 2%. RESULTADOS: Verificada a segurança das formulações com a finalização da fase I, onde nenhuma reação adversa significativa foi observada nos indivíduos sadios, conduziu-se a fase II. Nesta segunda fase, 30 (63,83%) voluntários utilizando óleo essencial e 18 (62,07%) cetoconazol permaneceram até o final do estudo. Observaram-se nos pacientes com pitiríase versicolor predomínio de lesões na forma disseminada e M. sympodialis foi o agente predominante identificado em cultura. Após 40 dias de tratamento, obteve-se um percentual de cura micológica de 60% (p < 0,05) para o grupo tratado com óleo essencial de C. citratus e superior a 80% (p < 0,05) para o grupo tratado com cetoconazol. CONCLUSÕES: Apesar da segurança e efeito antifúngico observados após aplicação das formulações contendo óleo essencial de C. citratus, outros estudos com maior número de portadores de pitiríase versicolor precisam ser realizados para confirmar o real potencial destas f...
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antifungal Agents/therapeutic use , Cymbopogon/chemistry , Ketoconazole/therapeutic use , Oils, Volatile/administration & dosage , Phytotherapy , Tinea Versicolor/drug therapy , Hair Preparations/therapeutic use , Malassezia , Pilot Projects , Plant Preparations/therapeutic useABSTRACT
FUNDAMENTO: A pitiríase versicolor é uma doença infecciosa causada por várias espécies de Malassezia com uma tendência a se tornar recidivante ou crônica. OBJETIVOS: Este trabalho foi conduzido na tentativa de conhecer a evolução clínica da pitiríase versicolor em relação ao número de recidivas após um tratamento adequado no período de 12 meses e correlacionar o número de recidivas com as espécies de Malassezia isoladas. MATERIAL E MÉTODOS: Cento e dois pacientes com diagnóstico clínico e laboratorial de pitiríase versicolor foram acompanhados por um período de 12 meses para observarmos o número de recidivas da doença. RESULTADOS: A pitiríase versicolor, após um tratamento adequado, apresentou três tipos de evolução clínica num período de 12 meses: pitiríase versicolor sem nenhum episódio de recidiva (32,35 por cento); pitiríase versicolor recidivante, com um a quatro episódios de recidiva (52,94 por cento) devidos a fatores de predisposição relacionados; e pitiríase versicolor crônica, com mais de quatro episódios de recidiva (14,70 por cento) sem nenhuma relação com fatores de predisposição. CONCLUSÕES: A pitiríase versicolor apresentou uma evolução clínica de acordo com o número de episódios de recidiva da doença analisados durante um período de 12 meses que pode ser considerada da seguinte maneira: pitiríase versicolor com cura clínica e micológica, pitiríase versicolor recidivante e pitiríase versicolor crônica.
BACKGROUND: Pytiriasis versicolor is an infectious disease caused by several Malassezia species which has a tendency to become relapsing or chronic. OBJECTIVES: This study was conducted in an attempt to investigate the clinical course of pityriasis versicolor with regard to the number of relapses after a 12-month therapy and correlate this number with isolates of Malassezia species. MATERIAL AND METHODS: 102 patients with clinical and laboratory diagnosis of pityriasis versicolor were monitored for 12 months to investigate the number of relapsing episodes of the disease. RESULTS: After appropriate treatment, pityriasis versicolor presented three types of clinical course: pity - riasis versicolor without relapsing episodes (32.35 percent), relapsing pityriasis versicolor with one to four relapsing episodes (52.94 percent ) due to associated predisposing factors, and chronic pityriasis versicolor with more than four relapsig episodes (14.70 percent) with no relation to predisposing factors. CONCLUSIONS: The clinical course of pityriasis versicolor varied according to the number of relapsing episodes of the disease analyzed over a period of 12 months and can be classified as follows: pityriasis versiolor with clinical and mycological clearing, relapsing pityriasis versicolor and chronic pityriasis versicolor.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Young Adult , Malassezia/isolation & purification , Tinea Versicolor/prevention & control , Age Distribution , Antifungal Agents/therapeutic use , Ketoconazole/therapeutic use , Malassezia/classification , Prospective Studies , Recurrence , Sex Distribution , Tinea Versicolor/classification , Tinea Versicolor/drug therapyABSTRACT
To evaluate the efficacy and safety of single dose [450mg] of fluconazole in the treatment of pityriasis versicolor. Patients suffering from pityriasis versicolor presenting to department of dermatology, Hayatabad Medical Complex, Peshawar were enrolled in the study. Diagnosis of PV was made by Wood`s lamp and confirmed by examination of scales in KOH preparation. 30 patients were included in the study. 30 patients completed the study including 24 males and 6 females. Their age ranged from 14 years to 45 years [mean 25.3 years]. Eighteen patients [60%] had complete cure and their clinical and laboratory parameters remained negative at 3 weeks and 6 weeks after completion of treatment. Twelve [40%] had no response to treatment. Treatment was well-tolerated and there were no adverse affects reported with single 450mg of fluconazole. Fluconazole 450mg as a single dose was effective in the treatment of pityriasis versicolor and well tolerated. However, long term comparative studies should be done to establish the efficacy of fluconazole as a single dose treatment in PV
Subject(s)
Humans , Male , Female , Tinea Versicolor/drug therapy , Fluconazole/administration & dosage , Tinea Versicolor/diagnosis , Treatment OutcomeABSTRACT
Terbinafine a member of allylamines group is a new class of antimycotic agents that blocks sterol biosynthesis in the fungi through inhibition of sequalene epoxidase and with consequent sequalene accumulation due to a primarily fungicidal process. Terbinafine is very effective on various fungi as an oral and topical antifungal agent. The aim of this study was to compare the antifungal efficacy of terbinafine 1% cream with clotrimazole 1% in patients with pityriasis versicolor. This clinical trial study was performed on 50 patients [30 males and 20 females] with mean age of 20 years [aged between 15-55 years] who randomly treated with terbinafine and clotrimazole for 4 weeks. The efficacy of drug and improving process evaluated mycologically and clinically before starting the study and at the end of each week. A patient was considered mycologically cured when direct microscopy was negative and clinically cured when all clinical parameters were considered negative. Negativizations of all clinical parameters were observed within 2 weeks in 60% of terbinafine and 35% clotrimazole recipients. At the end of four weeks, disappearance of lesions were seen in 90% and 80%, respectively [p<0.05]. The percentage of negativization of direct microscopy in terbinafine group was 1.4 fold higher than that clotrimazole group after 2 weeks of treatment. At the end of therapy, 95% of terbinafine and 90% of clotrimazole treated subjects were clinically cured [p>0.05]. Both drug eruptions and intolerance in two treated groups were similar. Although the efficacy of the both drugs is similar, but considering the expense of therapy, clotrimazole is preferred regimen for therapy of tinea versicolor
Subject(s)
Humans , Male , Female , Tinea Versicolor/drug therapy , Naphthalenes , Clotrimazole , Treatment OutcomeSubject(s)
Humans , Male , Female , Tinea Versicolor/drug therapy , Ketoconazole/administration & dosage , Prospective StudiesABSTRACT
A crude aqueous and ethanolic extracts of Myrtus conmmunis L. [Myrtaceae] leaves were tested to show antifungal effect against the growth of causative agents of Tinea versicolor disease [Pityrosporum orbiculare and/or pityrosporum ovale]. The ethanolic extract had shown more effect at MIC 1 mg/ml than aqueous extract [at MIC 8 mg/ml for P. ovale and 5 mg/ml for P. orbiculare]
Subject(s)
Tinea Versicolor/drug therapy , Phytotherapy , Myrtaceae , Plant ExtractsSubject(s)
Humans , Male , Child, Preschool , Adolescent , Female , Infant , Malassezia , Tinea Versicolor/diagnosis , Diagnosis, Differential , Tinea Versicolor/drug therapySubject(s)
Humans , Male , Infant , Malassezia , Tinea Versicolor/diagnosis , Eyebrows , Ketoconazole , Malassezia , Tinea Versicolor/etiology , Tinea Versicolor/drug therapyABSTRACT
La aparición de tres nuevos antimicóticos de uso oral: itraconazol, floconazol y terbinafina, ha permitido acortar la duración de las terapias antifúngicas, mejorar la adherencia, y en algunos casos, aumentar el porcentaje de curación. Se revisan las indicaciones de estos tres fármacos en onicomicosis y en las diversas formas de tiña: capitis, corporis, cruris, pedis y versicolor, y los esquemas terapéuticos recomendados en cada caso
Subject(s)
Humans , Dermatomycoses/drug therapy , Onychomycosis/drug therapy , Tinea Versicolor/drug therapy , Age Factors , Allylamine/administration & dosage , Drug Interactions , Fluconazole/administration & dosage , Itraconazole/administration & dosageABSTRACT
La pustulosis neonatal por Malassezia furfur es una erupción papulopustulosa no folicular de cara, cuero cabelludo y cuello que aparece en el primer mes de vida. Se presentan cuatro neonatos con lesiones clínicas de pustulosis por Malassezia furfur en los cuales se confirmó el diagnóstico por examen micológico directo del material obtenido de pústulas. Se realiza diagnóstico diferencial con otras pustulosis del recién nacido, particularmente con el acné neonatal. Se observó buena respuesta terapéutica al ketoconazol tópico en forma de crema al 2 por ciento, aplicada dos veces al día durante dos semanas
Subject(s)
Humans , Male , Female , Infant, Newborn , Malassezia/drug effects , Tinea Versicolor/complications , Ketoconazole/therapeutic use , Malassezia/isolation & purification , Malassezia/pathogenicity , Tinea Versicolor/diagnosis , Tinea Versicolor/drug therapyABSTRACT
El propósito del presente trabajo es presentar un caso de Enfermedad de Darier y pitiriasis versicolor, con lesiones localizadas en la frente y otras áreas atípicas, en un paciente masculino de 35 años. El diagnóstico se estableció por exámenes histopatológicos, micológicos y bacteriológicos. Se trató al paciente con fluconazol 150 mg., medicación tópica con ciclopirox, antipruriginosos, cremas hidratantes y ketoconazol champú; con lo cual se obtuvo la remisión de la infección y la mejoría del cuadro general del paciente. En la bibliografía consultada no se encontraron casos de esta asociación
Subject(s)
Humans , Male , Adult , Darier Disease/diagnosis , Tinea Versicolor/diagnosis , Darier Disease/complications , Darier Disease/drug therapy , Dermatomycoses , Fluconazole , Fluconazole/therapeutic use , Malassezia/pathogenicity , Tinea Versicolor/complications , Tinea Versicolor/drug therapySubject(s)
Humans , Dermatitis, Seborrheic/diagnosis , Malassezia/pathogenicity , Tinea Versicolor/diagnosis , Keratolytic Agents/therapeutic use , Dermatitis, Seborrheic/drug therapy , Dermatitis, Seborrheic/etiology , Dermatomycoses/etiology , Dermatomycoses/immunology , Fungemia/etiology , Itraconazole , Itraconazole/therapeutic use , Ketoconazole , Ketoconazole/therapeutic use , Malassezia/drug effects , Malassezia/isolation & purification , Opportunistic Infections/etiology , Tinea Versicolor/etiology , Tinea Versicolor/drug therapyABSTRACT
Foram tratados 30 pacientes com pitiríase versicolor na posologia de duas cápsulas de 100mg cada, uma vez ao dia, junto com o almoço por cinco dias. A diagnose foi clínica, comprovada por exame em luz de Wood e exame direto. Os doentes foram avaliados no décimo quinto e trigésimo dia após o término do tratamento pelos mesmos parâmetros iniciais. Os resultados após 30 dias mostraram cura clínica e micológica em 27(90%) dos doentes e falha em três (10%). A tolerabilidade foi excelente observando-se apenas dois casos de efeitos adversos de natureza leve, transitória, com desaparecimento espontâneo após término do tratamento
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Tinea Versicolor/physiopathology , Tinea Versicolor/drug therapyABSTRACT
A simple agar-well diffusion bioassay method for measurement of ketoconazole was evaluated in which a medium containing 0.7% trypticase peptone and a strain of Candida pseudotropicalis as assay organism were used. A linear relationship between zone diameters and Log 10 concentrations of the drug over the pharmacologically relevant ranges of 0.5-20 mug/ml was obtained [F=1324.038; p <0.001]. The variability among measurements was found to be 0.3421 denoting that the technique was precise and hence was used to monitor serum level of patients of this study. Twenty two patients with pityriasis versicolor therapeutically received a ten-day course of ketoconazole to investigate the efficacy of this short course of the drug. Patients were assessed both clinically [for scaling and pigmentation] and laboratory [KOH scraping] before starting ketoconazole therapy, at the end of the course [day 10] and on day [30]. Serum ketoconazole levels of patients ranged from 0-6.9 mug/ml on the second day of therapy and 0.9-7.1 mug/ml on day [10]. Before starting therapy, all patients showed positive KOH preparation, 21 [95.5%] showed scaly lesion and 12 patients [45.5%] had pigmented lesion. On day [30] only one patient had scaly lesion while two patients still had pigmented lesion and KOH positive smear. The improvement seen in both clinical and laboratory parameters in the follow-up period was highly significant [P <0.001] when compared to pretreatment figures. The 10-day course of ketoconazole in the treatment of pityriasis versicolor was recommended
Subject(s)
Humans , Tinea Versicolor/drug therapy , Biological AssayABSTRACT
Cinqüenta pacientes com pitiríase versicolor foram tratados com dose única de 400 mg de cetoconazol e avaliados um mês depois. Todos os pacientes responderam ao tratamento; 43 (86%) estavam completamente curados quando examinados com a luz de Wood e exame microscópico com hidróxido de potássio a 20% e sete (14%) apresentaram melhora acentuada do quadro. A droga foi bem tolerada, tendo sido observada como efeito adverso apenas náusea leve em três pacientes. Estes resultados indicam que 400 mg de cetoconazol em dose única säo seguros e efetivos no tratamento da pitiríase versicolor
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Ketoconazole/therapeutic use , Tinea Versicolor/drug therapy , Ketoconazole/administration & dosage , Skin TestsABSTRACT
Observaram-se 97 pacientes com micoses superficiais, sendo 55 portadores de tinha da pele glabra e 42 de pitiríase versicólor, com diagnóstico direto e/ou cultura. A amostra foi dividida em dois grupos: um, com 47 pacientes, tratados com nitrato de isoconazol em creme a 1% e o outro, com 50 pacientes, tratados com tioconazol em creme a 1%, a ambos em aplicaçäo única diária por duas a oito semanas. Usaram-se como parâmetros de eficácia do tratamento a percentagem de regressäo das manifestaçöes clínicas, a opiniäo do paciente sobre o tratamento e a avaliaçäo global do médico sobre os resultados. O nitrato de isoconazol mostrou 100% de regressäo em 72,34% dos pacientes. Os casos onde remissäo foi igual ou superior a 75% somaram 97,87%, com ausência de efeitos colaterais em 95,74% da amostra. O tioconazol promoveu cura em 70% dos pacientes, sendo que os casos onde a regressäo foi igual ou superior a 75% somaram 94%, com ausência de efeitos colateais em 94%. Conclui-se que as medicaçöes, em aplicaçäo única diária, se equivalem em eficácia e tolerabilidade. O nitrato de isoconazol é recomendado, pois como opçäo terapêutica efetiva, bem tolerada e de posologia cômoda
Subject(s)
Humans , Male , Female , Administration, Topical , Antifungal Agents/therapeutic use , Dermatomycoses/drug therapy , Tinea Versicolor/drug therapyABSTRACT
Os autores analisam os resultados obtidos no tratamento da pitríase versicolor com o Itraconazol em estudo aberto, comparativo, na dose de 200 mg/dia por 5 e 7 dias. A diagnose foi estabelecida pelo exame clínico, fluorescência pela luz de Wood exame micológico direto, sendo os pacientes reavaliados no 21§ e 35§ dia após o início de terapêutica. Ambos os esquemas de tratamento utilizados mstraram-se eficazes. Os índices de cura clínica e micológica, obtidos no último controle, foram de 90% para o grupo tratado por 5 dias e 95% para o grupo tratado por 7 dias. A tolerância à droga foi boa, tendo sido registrados efeitos colaterais em dois pacientes do grupo tratado por 7 dias e em um paciente do grupo tratado por 5 dias. Como näo houve diferença estatisticamente significante entre os grupos tratados, os autores recomendam o esquema de tratamento mais curto, ou seja, 20 mg/dia por 5 dias