Once-weekly oral doses of fluconazole 150 mg in the treatment of tinea corporis/cruris and cutaneous candidiasis.

Ninety-five adult out-patients with tinea corporis and/or tinea cruris participated in a multicentre open non-comparative study investigating the safety and efficacy of 1-4 once-weekly doses of oral fluconazole 150 mg. Trichophyton rubrum was isolated most frequently (67 of 86 mycologically evaluable patients). A mean of 2.6 doses of fluconazole was administered; patients infected with Candida albicans or Epidermophyton floccosum required an average of 2 doses compared to 3-4 doses in patients infected with other organisms. Clinical cure was obtained in 85 of 92 (92%) patients at the last post-treatment evaluation, with the remaining seven patients being substantially improved. At long-term follow-up, 28-30 days after the last dose, 80 of 91 (88%) patients were assessed as clinically cured, three (3%) patients were improved and eight (9%) patients failed. Among the long-term clinical failures, there was one diagnosis of tinea corporis (3% failure rate) and seven diagnoses of tinea cruris (12% failure rate). Mycological evidence of infection occurred in only 1 of 86 patients assessed at the last post-treatment follow-up. Mycological relapse occurred in nine (11%) patients at long-term follow-up; one patient was infected with Trichophyton mentagrophytes and eight patients were infected with T. rubrum. Relapse occurred in 2 of 29 (7%) patients with tinea corporis and eight of 57 (14%) patients with tinea cruris (one patient who relapsed had both tinea corporis and cruris). There was no correlation between the number of doses received and the mycological response or relapse rates at long-term follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Doses unicas semanais orais de fluconazol 150 mg no tratamento de tinea corporis/cruris e candidiase cutanea / Doses weekly only you pray of fluconazol 150 mg in the treatment of cutaneous tinea corporis/cruris and candidiasis

Noventa e cinco pacientes ambulatoriais com tinea corporis e/ou tinea cruris participaram de um estudo multicentrico nao comparativo aberto para investigar a seguranca e eficacia de 1-4 doses unicas semanais de fluconazol oral na dose de 150 mg. O trichophyton rabrum foi o organismo mais frequentemente isolado (67 de 86 pacientes avaliados micologicamente). Uma media de 2,6 doses de fluconazol foi administrada; pacientes infectados com Candida albicans ou Epidermophyton floccosum necessitaram, em media, de 2 doses enquanto foram necessarias 3-4 doses em pacientes infectados com outros organismos. A cura clinica foi obtida em 85 de 92 (92%) dos pacientes na ultima avaliacao depois do tratamento, tendo os sete pacientes restantes melhorado substancialmente. No seguimento a longo prazo, 28-30 dias apos a ultima dose, 80 de 91 (88%) pacientes foram considerados clinicamente curados, tres (3%) apresentaram melhora e oito (9%) tiveram insucesso terapeutico. Dentre os fracassos clinicos a longo prazo, houve um diagnostico de tinea corporis (3%) de taxa de insucesso) e sete diagnosticos de tinea cruris (12% de taxa de insucesso). Evidencias micologicas de infeccao ocorreram em apenas 1 de 86 pacientes seguidos ate o final do seguimento a longo prazo. Recidiva micologica ocorreu em nove (11%) dos pacientes do seguimeto a longo prazo; um paciente estava infectado pelo Trichophyton mentagrphytes e oito pacientes, pelo T. rubrum. Houve recidiva em 2 de 29 (7%) pacientes com tinea corporis e oito de 57 (14%) com tines cruris (um paciente que recidivou tinha tinea corporis e cruris). Nao se verificou correlacao entre o numero de doses recebidas e a resposta micologica ou as taxas de recidiva a longo prazo. O fluconazol foi bem tolerado; somente 5 de 95 pacientes tratados com fluconazol referiram efeitos adversos, um dos quais resultou em descontinuacao da terapia (urticaria moderada). A boa tolerancia comparada a dos outros antifugicos orais e a conveniencia de um esquema de dose unica semanal oral em comparacao aos tratamentos topicos e orais existentes tornam a dose unica oral semanal de fluconazol uma elternativa valiosa no tratamento da tinea corporis/cruris

[Epidemiologic study of mycetomas in Mexico. Apropos of 502 cases]. / Etude épidémiologique des mycétomes au Mexique. A propos de 502 cas.

The epidemiological data of 502 mycetomas studied in the Department of Mycology, "Centro Dermatológico Pascua", Mexico City, were analysed. Mycetomas prevail in males (79.7%), they are more frequent between 16 and 45 years of age (75%) and among rural workers (62.5%); they preferentially affect lower limbs (62.5%); these data are generally similar to the known publications on the matter. Actinomycetomas are the most frequent with 97.2% of the cases, distributed as follows: Nocardia: 85.6% among which 71.9% are N. brasiliensis, Actinomadura madurae: 9.6%, Streptomyces somaliensis: 1.6%, Actinomadura pelletieri: only one case: 0.2%. Eumycetomas, a total of 9, are due to Madurella mycetomi (2), Madurella grisea (2), an undetermined black grain (1), Acremonium sp. and Fusarium sp. (1), Fusarium, sp. (1), Pseudallescheria boydii (1), and an undetermined white grain (1).

Itraconazole for deep mycoses: preliminary experience in Mexico.

Itraconazole has been used as oral therapy for deep mycoses since July 1984 in our institution. So far, therapy has been evaluated for eight patients: one with cutaneous coccidioidomycosis; two with chromomycosis (Fonsecaea pedrosoi); and five with sporotrichosis (three fixed, one lymphangitic, and one disseminated). Clinical and mycologic evaluations were done at the beginning of treatment, 15 days after the initiation of treatment, and monthly thereafter. Dosage was 100-200 mg per day, and duration of treatment was based on response. The cases of coccidioidomycosis and lymphangitic sporotrichosis were mycologically cured after two and seven months of treatment with 100 mg per day, respectively. The six other patients required higher doses. Two patients with sporotrichosis and one with chromomycosis were cured, and one patient with sporotrichosis and one with chromomycosis were markedly improved. In one patient with sporotrichosis, treatment was discontinued because of the slow response. No adverse reactions to treatment were reported.