Subject(s)
Basidiomycota , Tinea cruris , Tinea , Humans , Tinea cruris/drug therapy , Antifungal Agents/therapeutic use , Tinea/diagnosis , Tinea/drug therapyABSTRACT
Objective To present the case of a Latin man 68 years of age who presented to the emergency department with a rash to the right side of his groin 10 weeks after switching from simvastatin 40 mg daily to atorvastatin 40 mg daily. Background Prior to switching to atorvastatin, the patient had been taking simvastatin for 21 years without rash. The rash progressed bilaterally to his arms and hands, legs, buttocks, back, and trunk before the patient was seen by dermatology and atorvastatin was discontinued. Results Within six weeks of discontinuation of atorvastatin, the rash resolved with remaining pigmentation changes. The adverse effect was documented in the patient's chart, and dermatology recommended avoiding other statins in the future. Settings Ambulatory clinic pharmacy practice, emergency room, or urgent care centers. Practice Considerations Atorvastatin is a 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitor or statin that has been FDA approved for the prevention of atherosclerotic cardiovascular disease (ASCVD) and treatment of hypercholesterolemia since 1996. Despite widespread use of atorvastatin over many years, only a handful of published cases report drug eruption from its use. Previous case reports have found that retrial of statins may cause similar drug eruption. Conclusion Pharmacists should consider HMG-CoA reductase inhibitors as a possible cause of new onset rash and should not retrial an alternative statin.
Subject(s)
Atorvastatin , Drug Eruptions , Exanthema , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Humans , Male , Atorvastatin/adverse effects , Drug Eruptions/drug therapy , Exanthema/chemically induced , Exanthema/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Pyrroles/adverse effects , Simvastatin/therapeutic use , Tinea cruris/drug therapy , Aged , Drug SubstitutionSubject(s)
Antifungal Agents/adverse effects , Glucocorticoids/adverse effects , Granuloma, Pyogenic/chemically induced , Adult , Antifungal Agents/administration & dosage , Drug Combinations , Glucocorticoids/administration & dosage , Granuloma, Pyogenic/pathology , Humans , Male , Middle Aged , Ointments , Tinea cruris/drug therapyABSTRACT
Resistant superficial dermatophytic infections of the skin and its appendages have emerged as a major health problem in India. Mutations in Squalene epoxidase gene have led to increasing incidence of resistance to terbinafine in dermatophytic isolates. We examined six patients with recalcitrant dermatophytosis attending Dermatology OPD at a tertiary care hospital and demonstrated terbinafine resistance by molecular method. Immediate hyperitivity (IH) reaction to Trichophytin antigen was highlighted in these patients. The patients were treated with alternate antifungals after demonstration of resistance to terbinafine based on the antifungal susceptibility testing (AFST). On follow up the patients responded well to the substitute but the duration of therapy had to be prolonged beyond six weeks.
Subject(s)
Antifungal Agents/therapeutic use , Arthrodermataceae/drug effects , Arthrodermataceae/genetics , Dermatomycoses/diagnosis , Dermatomycoses/drug therapy , Drug Resistance, Fungal/genetics , Terbinafine/pharmacology , Adult , Antifungal Agents/pharmacology , Dermatomycoses/classification , Dermatomycoses/microbiology , Female , Fungal Proteins/genetics , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Mutation , Squalene Monooxygenase/genetics , Tertiary Care Centers , Tinea/diagnosis , Tinea/drug therapy , Tinea cruris/diagnosis , Tinea cruris/drug therapy , Young AdultABSTRACT
This retrospective study assessed the efficacy and safety of 1% topical clotrimazole cream for the treatment of patients with tinea cruris (TC).We included 86 patients with confirmed TC for the presence of fungal hyphae. Of those, 43 patients received 1% topical clotrimazole cream for a total of 4 consecutive weeks, and were assigned to an experimental group. The other 43 patients underwent 1% topical butenafine cream for a total of 2 consecutive weeks, and were allocated to a control group. The efficacy and safety were measured and analyzed after 4 weeks treatment.After treatment, patients in both groups achieved better improvements in erythema (Pâ<â.01), scaling (Pâ<â.01), itching (Pâ<â.01), and KOH-negative results (Pâ<â.01), compared with those in patients before the treatment. However, there were not significant differences in erythema (Pâ=â.61), scaling (Pâ=â.57), itching (Pâ=â.47), and KOH-negative results (Pâ=â.67) between 2 groups. In addition, no treatment-related adverse events were recorded in both groups.Both 1% topical clotrimazole and butenafine cream are found to be effective and safe for patients with TC. However, there is not significant difference in efficacy and safety between two groups.
