griseofulvin and Chronic-Disease

We report the clinicomycologic study of 27 culture-proven cases of tinea capitis from southern Taiwan during the years 1988 to 1990. The series is notable for its predominance of adults (63%), of women (89%), and of Trichophyton violaceum infection (74%). The age distribution was clearly bimodal; the median age was 6 years for children and 56 years for adults (older than 18 years). Whether or not these findings represent a new trend of tinea capitis in southern Taiwan remains to be determined. Clinically, our cases of black-dot ringworm caused by T. violaceum often presented with subtle changes of scaling, hair loss, and black dots. The keys to the correct diagnosis are (1) a high clinical index of suspicion with careful inspection of the scalp for the presence of black dots, and (2) microscopic examination and culturing of the black dots or plucked hairs.

Topics: Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; Chronic Disease; Female; Griseofulvin; Humans; Ketoconazole; Male; Middle Aged; Sex Factors; Taiwan; Tinea Capitis; Trichophyton

We conducted a double-blind comparative study of terbinafine, 250 mg twice daily, versus griseofulvin, 500 mg twice daily, for 6 weeks in chronic dermatophyte infections of the feet or hands. All but three patients (total 31) had Trichophyton rubrum infection. At 12-week follow-up, 100% of the terbinafine-treated group were free from infection compared with 45% of those treated with griseofulvin. Therapy in 75% of the terbinafine-treated group and in 35% of those given griseofulvin was rated as effective overall at long-term follow-up, although these differences were not statistically significant. Six months after treatment all nine patients whose skin had cleared with terbinafine therapy remained in remission versus only one of seven patients treated with griseofulvin. None of the patients in either group experienced serious adverse effects.

Topics: Antifungal Agents; Chronic Disease; Double-Blind Method; Female; Follow-Up Studies; Foot Dermatoses; Griseofulvin; Hand Dermatoses; Humans; Male; Nail Diseases; Naphthalenes; Recurrence; Terbinafine; Tinea

Topics: Adolescent; Adult; Aged; Aspirin; Bismuth; Child; Child, Preschool; Chloroquine; Chronic Disease; Clinical Trials as Topic; Drug Combinations; Drug Evaluation; Female; Griseofulvin; Humans; Isoniazid; Lichen Planus; Male; Middle Aged; Prednisolone

Forty nine patients with mycologically confirmed Tinea cruris were investigated for the association of hypersensitivity to trichophytin and the isolation of dermatophytes from clinically normal sites with chronicity and recurrence of infection. At the end of six months following specific therapy, 24 patients returned for follow up and they were similarly studied. Dermatophytes were isolated from clinically asymptomatic sites in 46% patients before treatment and in 21% of the patients on follow up. Immediate weal reaction and increased concentration of IgE antibodies were seen in 73% and 80% of the patients respectively. However, the delayed hypersensitivity reaction was more associated with patients having lesions for more than 6 months (48%) in comparison with patients with a short history (17%). On follow up after 6 months, the different hypersensitivity reactions and IgE antibody concentration maintained more or less the same association. Therefore in persistent or recurrent Tinea cruris infection, besides potential carriage in clinically normal sites, hypersensitivity to antigens of dermatophytes possibly plays an important role in pathogenicity.

Topics: Adolescent; Adult; Aged; Antifungal Agents; Arthrodermataceae; Carrier State; Chronic Disease; Griseofulvin; Humans; Hypersensitivity, Immediate; Immunoglobulin E; Intradermal Tests; Male; Middle Aged; Recurrence; Skin; Tinea; Trichophytin

Most nail disorders seen by primary care physicians are due to maceration, dryness, trauma, or infection. Some cases may be treated simply by having the patient remove a bandage to allow the skin to dry; other cases, such as subungual abscess, require local anesthesia and drainage for relief. Fungal infections may need to be treated for as long as a year. Patients with a tumor under the nail should be referred to a specialist.

Topics: Chronic Disease; Griseofulvin; Humans; Infections; Nail Diseases; Paronychia; Psoriasis; Warts

The efficacy of ketoconazole was evaluated in twenty patients with chronic dermatophyte infections who had failed to clear with griseofulvin therapy. Trichophyton rubrum was the causative organism in nineteen of the patients, and Trichophyton mentagrophytes in one patient. Three of twelve organisms tested showed in vitro resistance to griseofulvin. Duration of infection ranged from 2 to 28 years. Patients received 200 to 400 mg of ketoconazole daily for periods up to 8 months. In addition, patients were followed for 5 months post-therapy to monitor recurrences. Clearing was seen clinically as early as 2 weeks, and by 18 weeks all patients showed marked improvement or clinical clearing, though only six achieved complete mycologic cure. Improvement followed a predictable sequence of sites, with lesions of the trunk healing first, followed by hands, feet, and finally, nails. After 8 months, though all patients showed proximal nail clearing, onychomycosis persisted in thirteen of twenty affected sites. By 5 months post-therapy, four of six patients who had achieved clearing of skin and nails showed recurrences. No significant side effects were observed during therapy, though rare, apparently idiosyncratic cases of hepatotoxicity have been reported. Ketoconazole is an affective therapeutic agent for griseofulvin-resistant dermatophytosis. Apparent cures may subsequently recur after discontinuation of therapy.

Topics: Adult; Antifungal Agents; Chronic Disease; Dermatomycoses; Drug Resistance; Follow-Up Studies; Griseofulvin; Humans; Imidazoles; Ketoconazole; Piperazines; Recurrence; Trichophyton

Topics: Adolescent; Adult; Antifungal Agents; Chronic Disease; Dermatomycoses; Female; Griseofulvin; Humans; Imidazoles; Ketoconazole; Male; Middle Aged; Piperazines

One hundred and six patients with chronic dermatophytosis unresponsive to griseofulvin were studied. Trichophyton rubrum was the causative organism in 93% of cases. Chronic dermatophyte infections caused by organisms other than T. rubrum occurred predominantly, but not exclusively, in patients with underlying diseases. Forty-nine percent of the patients had a personal or family history of atopy but other abnormalities included disorders of keratinization, collagen vascular disease and systemic steroid therapy. The commonest sites of infection were the palms and soles, as opposed to toe webs or groins in control patients with griseofulvin-responsive dermatophyte infections. A significant proportion of chronically infected patients had raised IgE levels. Only 11% of the chronically infected group showed delayed hypersensitivity responses to intradermal trichophytin but 58% showed immediate hypersensitivity responses to trichophytin as well as other fungal and non-fungal allergens.

Topics: Adolescent; Adult; Aged; Child; Chronic Disease; Dermatomycoses; Female; Griseofulvin; Humans; Hypersensitivity; Hypersensitivity, Immediate; Immunoglobulin E; Male; Middle Aged; Skin Tests; Tinea

Topics: Child; Chronic Disease; Dermatomycoses; Female; Focal Infection; Griseofulvin; Humans; Male; Microsporum; Nasopharyngeal Diseases; Pharyngeal Diseases; Scalp Dermatoses; Tonsillitis

A proportion of dermatophyte infections fail to respond to normally adequate courses of griseofulvin and topical antifungal therapy. The organism Trichophyton rubrum was isolated from 96% of 50 patients studied, but no instances of in vitro resistance were seen. Of these patients, 57% had an underlying condition, commonly hay fever/asthma, atopic eczema, collagen disease or ichthyosis. Defective delayed type hypersensitivity responses and leucocyte migration inhibition to the specific antigen, trichophytin, were demonstrated. Immediate type hypersensitivity was seen in 58% and this was partially suppressible with chlorpheniramine and cimetidine. The relationship between these abnormalities and failure of treatment is discussed.

Topics: Adolescent; Adult; Aged; Cell Migration Inhibition; Chronic Disease; Collagen Diseases; Dermatomycoses; Female; Griseofulvin; Humans; Hypersensitivity; Ichthyosis; Immunity, Cellular; Male; Middle Aged; Trichophyton

Chronic generalized trichophytosis in a 44-year-old female is reported. The disease began when she was 15 and gradually spread from the scalp. Surviving hairs on the scalp and eyebrows showed an endothrix invasion. Enlargement and fistulization of the cervical and axillary lymph nodes were also present. Trichophyton schoenleinii was cultured from the scalp while Trichophyton violaceum was isolated from the body skin, the nail and lymph nodes. Griseofulvin produced significant improvement with occasional relapses. The possible role of the basic cell-mediated immune defect, as revealed by the decreased number of the T and B cells, is discussed.

Topics: Adult; Chronic Disease; Female; Griseofulvin; Humans; Onychomycosis; Tinea Capitis; Trichophyton

Topics: Candidiasis; Child; Chronic Disease; Female; Griseofulvin; Humans; Tinea

Topics: Adult; Anaphylaxis; Chronic Disease; Female; Griseofulvin; Humans; Tinea

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

Topics: Administration, Oral; Chronic Disease; Folliculitis; Griseofulvin; Humans; Male; Middle Aged; Tinea; Tinea Pedis; Trichophyton; Wrist

A 36-year-old female was admitted to hospital for debridement of chronically inflamed tendon sheaths and adjacent tissues near the left ankle. Despite antibiotic therapy and initial surgical interventions, the inflammation had progressed slowly over 16 months. Histopathological examination of excised tissues in September 1973 revealed a chronic granulomatous inflammation of tendon sheaths and muscle. Many branched hyphal segments, intercalary swollen cells, and a few conidia-like bodies were seen in sections, and also in KOH- and PAS-stained slides prepared from homogenized tissues. Culture of homogenized tissues yielded pure colonies of Scopulariopsis brevicaulis. Sensitivity tests were initially begun with amphotericin B, potassium iodide, and potassium tartrate (0.05-15 mug/ml of the phytone-yeast extract agar), and no inhibitory effect was observed. Subsequently, amphotericin B, antimony, 5-fluorocytosine (5-FC), griseofulvin, hamycin, and mycostatin were tested (25-300 mug/ml of the phytone-yeast extract agar). Of these chemicals, griseofulvin and hamycin proved to be most effective. Antimony and 5-FC were ineffective, and mycostatin produced a negligible effect on growth. The four strains of Lysobacter antibioticus, the producer of myxin antibiotic, strongly inhibited the growth of the fungus.

Topics: Adult; Amphotericin B; Ankle Joint; Antimony; Chronic Disease; Female; Flucytosine; Granulation Tissue; Griseofulvin; Humans; Microbial Sensitivity Tests; Mitosporic Fungi; Mycoses; Natamycin; Nystatin; Potassium Iodide; Staining and Labeling; Tartrates; Tendinopathy

Topics: Acrodermatitis; Atrophy; Chronic Disease; Female; Griseofulvin; Humans; Middle Aged; Penicillins; Syndrome

Topics: Antibodies, Fungal; Child; Chronic Disease; Complement Fixation Tests; Female; Griseofulvin; Hemagglutination Tests; Humans; Male; Tinea; Trichophyton

Topics: Child; Child, Preschool; Chronic Disease; Female; Griseofulvin; Humans; Male; Microsporum; Tinea

Topics: Adult; Ampicillin; Chronic Disease; Erythema; Female; Griseofulvin; Humans; Male; Middle Aged

Topics: Adolescent; Adult; Aged; Blood Sedimentation; Child; Child, Preschool; Chronic Disease; Dermatomycoses; Eosinophilia; Feeding and Eating Disorders; Female; Griseofulvin; Headache; Humans; Infant; Leukocytosis; Mycoses; Nausea; Suspensions; Tinea; Tinea Favosa; Vomiting

Topics: Chronic Disease; Erythema; Female; Griseofulvin; Humans; Male; Tick Toxicoses

Topics: Adult; Chronic Disease; Diagnosis, Differential; Female; Granuloma; Griseofulvin; Humans; Lymphography; Male; Middle Aged; Skin; Tinea Capitis; Tinea Pedis; Trichophyton

Topics: Adolescent; Adult; Child; Chronic Disease; Female; Griseofulvin; Hair Removal; Humans; Middle Aged; Ointments; Salicylates; Sulfur; Tinea Capitis

Topics: Chronic Disease; Dermatomycoses; Griseofulvin; Humans; Male; Middle Aged; Trichophyton; Urticaria

Topics: Aged; Chronic Disease; Griseofulvin; Humans; Onychomycosis

Topics: Arthrodermataceae; Chronic Disease; Communicable Diseases; Dermatomycoses; Griseofulvin

Topics: Chronic Disease; Communicable Diseases; Griseofulvin; Nails; Skin; Tinea