amphotericin-b and Dermatitis--Atopic

Fifty patients with a diagnosis of psoriasis, eczematous dermatitis, atopic dermatitis, or neurodermatitis and with bilateral symmetric lesions of equal severity participated in this study. A double-blind paired comparison technique was used in which halcinonide-neomycin-amphotericin ointment was applied to the lesions on one side of the body and hydrocortisone ointment to similar lesions on the other side according to a randomized schedule. The halcinonide-containing combination was statistically superior (p less than 0.05) to hydrocortisone ointment in the treatment of psoriasis patients. No statistically significant difference between the two drugs was obtained for the three other indications studied. No side effects with either ointment were observed. Halcinonide as formulated in this combination is an effective and safe corticosteroid.

Topics: Administration, Topical; Adult; Aged; Amphotericin B; Anti-Inflammatory Agents; Clinical Trials as Topic; Dermatitis; Dermatitis, Atopic; Double-Blind Method; Drug Evaluation; Drug Therapy, Combination; Female; Glucocorticoids; Humans; Hydrocortisone; Infant; Male; Neomycin; Neurodermatitis; Ointments; Pregnenediones; Psoriasis

To investigate immediate and delayed-type reactivity for fungi in atopic dermatitis (AD) patients and the effect of antifungal therapy.. We examined immediate and delayed-type reactivity in AD patients for Candida albicans and Malassezia furfur by skin prick test (SPT), and estimated the effect of amphotericin B (AMPH) and itraconazole (ITCZ).. Twenty eight of 40 patients showed positive immediate-type reaction and 10 of 27 patients did delayed-type reaction for Candida albicans. As for Malassezia furfur, positive immediate-type reaction was shown in 30 of 40 patients and positive delayed-type reaction did in 4 of 27 patients. The RAST score of specific IgE to Candida albicans was low in the patients with positive delayed-type skin reaction for Candida albicans, while the score was high in the patients with the negative delayed-type skin reaction. Both of AMPH and ITCZ were effective to the patients with positive immediate-type reaction for Candida albicans in SPT. The skin reaction for Malassezia furfur was stronger in the patients treated with ITCZ effectively than in the patients treated not effectively. In addition, ITCZ was effective in all patients except one, who showed positive reaction for Malassezia furfur accompanied with negative reaction for Candida albicans in SPT.. Fungal allergy is one of the aggravation factors of AD, and SPT is useful to evaluate fungal allergy and to choose effective antifungal therapy.

Topics: Adult; Amphotericin B; Antifungal Agents; Candida albicans; Dermatitis, Atopic; Female; Humans; Hypersensitivity, Delayed; Hypersensitivity, Immediate; Itraconazole; Malassezia; Male; Middle Aged

We studied whether fungal allergens play a role in exacerbating the clinical symptoms of atopic dermatitis (AD). We found that the percentage of the patients who showed CAP-RAST positive (2 < or = score) to Candida albicans (Ca) was significantly higher in the patients with severe symptoms and high serum IgE level than those with mild symptoms and lower IgE. This was also true for the patients with CAP-RAST positive to Pityrosporum ovale (Po). AD patients with their symptoms localized to head and neck showed significantly higher tendency to have positive CAP-RAST (2 < or = score) to Ca and Po when compared to those with their eruption distributing to the extremities. We then evaluated the efficacy of oral therapy with antifungal agents in 140 cases of refractory AD with positive CAP-RAST to Ca. Good or excellent response was obtained in 60% with fluconazole, 35% with itraconazole, 31% with amphotericin B, 28% with nystatin. The present finding that amphotericin B and nystatin, both of which are not absorbed through intestine, were effective for approximately a third of the patients indicates that Ca in the intestine plays an important role in triggering AD symptoms. Fluconazole was more effective than amphotericin B and nystatin, suggesting that fungal colonizing in other parts of the body but the digestive tract also play a role in the exacerbation of AD symptoms.

Topics: Administration, Oral; Adult; Allergens; Amphotericin B; Antifungal Agents; Antigens, Fungal; Candida albicans; Dermatitis, Atopic; Female; Fluconazole; Humans; Itraconazole; Male; Nystatin