amphotericin-b and Tinea

Not only have the systemic mycoses clearly increased in number but also mycoses of the skin are more common than presumed in the past. Today onychomycosis is found in up to 10% of human beings. Onychomycosis can compromise quality of life markedly. Common tinea pedis is one of the most important risk factors for erysipelas of the lower legs. The clinical presentation of oral candidosis in HIV-infected patients is changing; Candida dubliniensis has been identified as another important causative microorganism. Onychomycosis today in most cases can be cured using terbinafine or itraconazole. When choosing the ideal drug in a given case, both the benefit risk ratio and the benefit cost ratio have to be taken into account. Liposomally encapsulated amphotericin B represents a major breakthrough in the treatment of systemic mycoses or fever of unknown origin. The same applies to liposomally encapsulated econazole with respect to tinea pedis. In regard to the pathogenesis of Candida infections the family of secreted aspartic proteinases plays a major role as a virulence factor and possible future target for antimycotic treatment.

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Aspartic Acid Endopeptidases; Axilla; Candida albicans; Candidiasis; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Case-Control Studies; Child; Clinical Trials as Topic; Dermatomycoses; Female; Humans; Liposomes; Microscopy, Immunoelectron; Multicenter Studies as Topic; Multivariate Analysis; Naphthalenes; Onychomycosis; Practice Guidelines as Topic; Prospective Studies; Risk Factors; Terbinafine; Tinea; Tinea Pedis; Trichophyton

Topics: Actinomycosis; Adolescent; Adult; Amphotericin B; Animals; Aspergillosis; Basidiomycota; Blastomycosis; Candidiasis; Cephalosporins; Child; Chromoblastomycosis; Coccidioidomycosis; Conjunctiva; Cryptococcosis; Drug Synergism; Eye Diseases; Female; Fungi; Geotrichosis; Guinea Pigs; Histoplasmosis; Humans; Male; Mucor; Mycetoma; Mycoses; Natamycin; Nystatin; Penicillium; Pityriasis; Rabbits; Rhinosporidiosis; Sporotrichosis; Tinea

Despite the common, worldwide, occurrence of dermatophytes, little information is available regarding susceptibility profiles against currently available and novel antifungal agents. A collection of sixty-eight clinical Trichophyton species and Epidermophyton floccosum were previously identified and verified to the species level by sequencing the internal transcribed spacer (ITS) regions of rDNA. MICs of amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, isavuconazole, terbinafine and MECs of caspofungin and anidulafungin were performed based on CLSI M38-A2. The resulting MIC90 s of all strains were, in increasing order, as follows: terbinafine (0.063 mg l(-1) ); posaconazole (1 mg l(-1) ); isavuconazole and anidulafungin (2 mg l(-1) ); itraconazole, voriconazole, amphotericin B, and caspofungin (4 mg l(-1) ) and fluconazole (>64 mg l(-1) ). These results confirm that terbinafine is an excellent agent for treatment of dermatophytosis due to T. rubrum, T. mentagrophytes, T. verrucosum, T. schoenleinii and E. floccosum. In addition, the new azoles POS and ISA are potentially useful antifungals to treat dermatophytosis. However, the clinical effectiveness of these novel antifungals remains to be determined.

Topics: Amphotericin B; Anidulafungin; Antifungal Agents; Caspofungin; Echinocandins; Epidermophyton; Fluconazole; Humans; Itraconazole; Lipopeptides; Microbial Sensitivity Tests; Naphthalenes; Nitriles; Pyridines; Terbinafine; Tinea; Triazoles; Trichophyton; Voriconazole

Topics: Amphotericin B; Antifungal Agents; Child; Contracture; Humans; Hydronephrosis; Male; Tinea; Trichophyton

Trichophyton rubrum is the most widely encountered dermatophyte infection, and is usually regarded as exclusively keratinophilic often leading to chronic cutaneous and nail infections, even in healthy individuals. We present three patients with acute leukaemias, with ill-defined pre-existent cutaneous eruptions that were treated with a potent topical corticosteroid. All three patients received aggressive marrow toxic chemotherapy. These patients had progression of their cutaneous disease, which showed deep dermal invasion of T. rubrum, invading directly from the epidermis with no evidence of systemic spread. We conclude that systemic pancytopenia, in association with prolonged local immunosuppression, may increase the risk of direct dermal invasion of dermatophyte infections. However, even in these patients, the risk of systemic spread still appears very low. Amphotericin B did not appear effective in treating these dermatophyte infections.

Topics: Adolescent; Adult; Amphotericin B; Anti-Inflammatory Agents; Antifungal Agents; Antineoplastic Combined Chemotherapy Protocols; Female; Fluconazole; Humans; Immunocompromised Host; Leukemia, Myeloid, Acute; Leukemia, Promyelocytic, Acute; Male; Middle Aged; Naphthalenes; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Steroids; Terbinafine; Tinea; Treatment Outcome; Trichophyton

The therapeutic potential of UK-49,858, a difluorophenyl bis-triazole derivative, has been assessed by evaluating its activity against systemic infections with Candida albicans in normal mice and rats and in mice with impaired defence mechanisms, against vaginal infections with C. albicans in mice, and against dermal infections with Trichophyton mentagrophytes in guinea pigs. Orally administered ketoconazole was used as a comparative agent throughout, and parenterally administered amphotericin B was included in the study of C. albicans systemic infection in normal mice. The activity of UK-49,858 given orally to mice or rats infected systemically with C. albicans was far superior to that of ketoconazole. In addition, UK-49,858 showed activity comparable to that of amphotericin B when given parenterally, although the latter gave more prolonged protection. UK-49,858 was also effective orally in curing experimental candidal vaginitis in mice and trichophytosis in guinea pigs, against which it was approximately 10 times more active than ketoconazole. These data suggest that UK-49,858 may be of value in the treatment of both C. albicans and dermatophyte fungal infections in man.

Topics: Amphotericin B; Animals; Antifungal Agents; Candidiasis; Candidiasis, Vulvovaginal; Dermatomycoses; Female; Fluconazole; Guinea Pigs; Immunosuppression Therapy; Ketoconazole; Mice; Rats; Rats, Inbred Strains; Tinea; Triazoles

Topics: Administration, Oral; Amphotericin B; Antifungal Agents; Candidiasis; Candidiasis, Oral; Dermatomycoses; Flucytosine; Griseofulvin; Humans; Imidazoles; Injections, Intravenous; Ketoconazole; Miconazole; Piperazines; Tinea; Tinea Versicolor

A 25-year-old black man had generalized tinea corporis for 19 years and had associated subcutaneous mycotic granuloma of the scalp and nape of the neck for 17 years. The dermatophyte from the skin was identified as Microsporum audouinii and responded to oral griseofulvin treatment. Biopsy specimens of the subcutaneous nodules revealed yellowish granules containing masses of irregularly septated hyaline hyphae with frequent vesicles. This fungus differed only in gross colonial morphology from the M. audouinii isolated from the skin and has also been identified as M. audouinii. The subcutaneous nodules were treated and controlled by amphotericin B and are still under treatment.

Topics: Adult; Amphotericin B; Griseofulvin; Humans; Male; Microsporum; Mycetoma; Skin; Tinea

In the local treatment of various forms of dermatophytosis tolnaftate used to be the most convincing drug. More recent developments have led to a group of imidazol derivatives which have a broader spectrum and are also effective against yeasts. Polyene antibiotics are still very useful in the treatment of Candida mycoses. There are only few drugs available for systemic treatment of mycoses. Grisefulvin is only effective against dermatophytes. Amphotericin B, given intravenously, is a very useful drug against a series of systemic mycoses but it's value is decreased by serious side effects. Fluorocytosin shows less unwanted effects than Amphotericin B, but many fungi are resistent against this antimycotic or may become so during treatment. Of the imidazol group only miconazole is available for systemic intravenous therapy. Further developments of systemic antimycotics are of great importance.

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Child; Flucytosine; Griseofulvin; Humans; Imidazoles; Miconazole; Polyenes; Tinea; Tolnaftate

Topics: Adult; Amphotericin B; Antigens, Fungal; Bone and Bones; Central Nervous System; Chronic Disease; Complement Fixation Tests; Digestive System; Drug Therapy, Combination; Female; Griseofulvin; Humans; Iodine; Lymph Nodes; Male; Skin; Tinea; Trichophyton; USSR

Comparative review of widely used classic and modern antimycotic agents - Polyene-group, Griseofulvin, Tolnaphthate, 5-Fluorcytosin and the new Imidazolyl-group - in view of antimycotic, pharmacocinetic and therapeutic properties.

Topics: Administration, Oral; Amphotericin B; Animals; Antifungal Agents; Clotrimazole; Griseofulvin; Guinea Pigs; Humans; Miconazole; Skin; Structure-Activity Relationship; Tinea; Tolnaftate

Topics: Acute Disease; Adult; Aged; Amphotericin B; Antibodies, Fungal; Antigens, Fungal; Arthrodermataceae; Candidiasis; Cell Adhesion; Cell Count; Chronic Disease; Dermatomycoses; Female; Hand Dermatoses; Humans; Immune Adherence Reaction; Immunity, Cellular; Inguinal Canal; Leukocytes; Male; Middle Aged; Onychomycosis; Prednisone; Scrotum; Tinea; Tinea Pedis

Topics: Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis; Candidiasis, Oral; Diaper Rash; Drug Resistance, Microbial; Female; Griseofulvin; Humans; Male; Mouth Diseases; Nystatin; Ointments; Paronychia; Pruritus Ani; Skin Diseases; Tinea; Tinea Pedis; Tinea Versicolor

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Griseofulvin; Humans; Nystatin; Recurrence; Tinea; Tinea Pedis; Tolnaftate

Topics: Amphotericin B; Griseofulvin; Humans; Natamycin; Onychomycosis; Tinea; Tinea Pedis

Topics: Administration, Oral; Amphotericin B; Animals; Mice; Tinea

Topics: Adult; Amphotericin B; Antifungal Agents; Child; Dermatomycoses; Griseofulvin; Humans; Nystatin; Tinea