Croconazole in the treatment of tinea pedis.

Croconazole hydrochloride is a new antifungal agent of the imidazole type. A 1% croconazole cream (Pilzcin, Merz + Co., D-Frankfurt/Main) was investigated in a multicentre trial involving 132 patients (mean age 46.7 +/- 15.5 years; 69 men, 63 women) suffering from tinea pedis (interdigital space, n = 86; other foot sites, n = 46). The fungal infections were caused predominantly by Trichophyton rubrum (interdigital space, n = 43; other foot sites, n = 33), followed by other Trichophyton and Candida species. The patients were treated once daily for a period of up to 3 weeks. In the majority of cases complete cure was achieved at both locations. On fungal microscopy no fungi were seen after 3 weeks in 82.6% of patients in the 'interdigital space' group and in 80.4% of patients in the 'other foot sites' group. Two weeks after the end of the treatment no fungi could be found in culture in 81.4% of the patients in the 'interdigital space' group and in 80.4% of patients in the other group. All skin symptoms of the mycoses (itching, scaling, erosions, reddening) decreased during the observation period. In 82.6% of patients in the 'interdigital space' group and in 76.1% of patients treated in the 'other foot sites' group efficacy was rated by the physician as good or very good. Tolerability was evaluated as good or very good in 90.7% and 89.1% of the cases. Local skin intolerabilities were not observed. The therapeutic results show that croconazole cream, when applied once a day, is an effective and well-tolerated drug for the treatment of tinea pedis, regardless of its location.

[Congenital fistula of the raphe penis]. / Congenitaler Fistelgang im Bereich der Raphe penis.

One case of a congenital fistula of the raphe penis with gonorrhoea is reported. In this case spectinomycin seemed to fail in therapy, because pus was still remaining in the fistula, but not in the urethra. As the antibiotic resistogram did not prove our assumption, we tried the double dose and succeeded in killing the bacteria.

[A new drug combination for the topical treatment of acne. Miconazole 2% + benzoyl peroxide 5% versus benzoyl peroxide 5%--a double-blind study]. / Eine neue Wirkstoffkombination für die Lokalbehandlung der Akne. Miconazol 2% + Benzoylperoxid 5% versus Benzoylperoxid 5%--eine Doppelblindstudie.

A double-blind, controlled clinical trial with 60 patients was employed in order to study the relative merits of two treatment schedules in acne vulgaris. One therapy comprised the topical application of a cream containing a combination of miconazole 2% and benzoylperoxide 5% (Acnidazil, Janssen) twice a day. In the other therapy, we applied a cream containing only benzoylperoxide 5%. Both groups of patients showed large and statistically significant reduction in the number of comedones, papules, and pustules during 12 weeks of therapy. Acnidazil, however, was found to have definitely better therapeutical results than benzoylperoxide alone: The lesions improved significantly faster, tolerance was better, and the patients overall evaluation clearly favored Acnidazil. 86,2% of the patients treated with Acnidazil rated the results good to very good, in contrast to 63% of the patients treated with benzoylperoxide only (p = 0.037).

[Peculiarities and side effects of testicular biopsy]. / Besonderheiten und Nebenwirkungen bei der Hodenbiopsie.

Testicular biopsies were performed in hospital conditions on 451 patients by whom was diagnosed oligozoospermia (56,5%), azoospermia (41,9%), teratozoospermia (1,2%) and aspermia (0,4%). 95,5% of these biopsies were bilateral. Anatomic peculiarities as well as particularities and complications observed during the operations, and lastly postoperative complications were demonstrated in this contingent of patients. In order to obtain this result the clinical documents of the department of andrology of the university hospital Hamburg-Eppendorf were used. Adhesions of the tunical layers of the testis (28,3%), as well as hydroceles (35,7%), and increased vascularisation (20,9%) could be seen in the operation field. We considered as the most frequent intraoperative step a second skin cut (4,6%). In 3,0% of the cases it was not possible to obtain a testicular parenchyma. As complication during the operation the sliding of the epididymis was observed in 4,8%, and bleeding in 2,0% of the cases. The most frequent complication after operation was bleeding in the region of the skin's suture (1,2%). Patients who presented intraoperative complications bleeded most. Orchitis and epididymitis as postoperative complications were not observed. To prevent these complications the testicular biopsies should be done in hospital conditions by well experienced operation teams.