salicylates and Tinea

Tinea infections are fungal infections of the skin caused by dermatophytes. It is estimated that 10% to 20% of the world population is affected by fungal skin infections. Sites of infection vary according to geographical location, the organism involved, and environmental and cultural differences. Both tinea corporis, also referred to as 'ringworm' and tinea cruris or 'jock itch' are conditions frequently seen by primary care doctors and dermatologists. The diagnosis can be made on clinical appearance and can be confirmed by microscopy or culture. A wide range of topical antifungal drugs are used to treat these superficial dermatomycoses, but it is unclear which are the most effective.. To assess the effects of topical antifungal treatments in tinea cruris and tinea corporis.. We searched the following databases up to 13th August 2013: the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library (2013, Issue 7), MEDLINE (from 1946), EMBASE (from 1974), and LILACS (from 1982). We also searched five trials registers, and checked the reference lists of included and excluded studies for further references to relevant randomised controlled trials. We handsearched the journal Mycoses from 1957 to 1990.. Randomised controlled trials in people with proven dermatophyte infection of the body (tinea corporis) or groin (tinea cruris).. Two review authors independently carried out study selection, data extraction, assessment of risk of bias, and analyses.. Of the 364 records identified, 129 studies with 18,086 participants met the inclusion criteria. Half of the studies were judged at high risk of bias with the remainder judged at unclear risk. A wide range of different comparisons were evaluated across the 129 studies, 92 in total, with azoles accounting for the majority of the interventions. Treatment duration varied from one week to two months, but in most studies this was two to four weeks. The length of follow-up varied from one week to six months. Sixty-three studies contained no usable or retrievable data mainly due to the lack of separate data for different tinea infections. Mycological and clinical cure were assessed in the majority of studies, along with adverse effects. Less than half of the studies assessed disease relapse, and hardly any of them assessed duration until clinical cure, or participant-judged cure. The quality of the body of evidence was rated as low to very low for the different outcomes.Data for several outcomes for two individual treatments were pooled. Across five studies, significantly higher clinical cure rates were seen in participants treated with terbinafine compared to placebo (risk ratio (RR) 4.51, 95% confidence interval (CI) 3.10 to 6.56, number needed to treat (NNT) 3, 95% CI 2 to 4). The quality of evidence for this outcome was rated as low. Data for mycological cure for terbinafine could not be pooled due to substantial heterogeneity.Mycological cure rates favoured naftifine 1% compared to placebo across three studies (RR 2.38, 95% CI 1.80 to 3.14, NNT 3, 95% CI 2 to 4) with the quality of evidence rated as low. In one study, naftifine 1% was more effective than placebo in achieving clinical cure (RR 2.42, 95% CI 1.41 to 4.16, NNT 3, 95% CI 2 to 5) with the quality of evidence rated as low.Across two studies, mycological cure rates favoured clotrimazole 1% compared to placebo (RR 2.87, 95% CI 2.28 to 3.62, NNT 2, 95% CI 2 to 3).Data for several outcomes were pooled for three comparisons between different classes of treatment. There was no difference in mycological cure between azoles and benzylamines (RR 1.01, 95% CI 0.94 to 1.07). The quality of the evidence was rated as low for this comparison. Substantial heterogeneity precluded the pooling of data for mycological and clinical cure when comparing azoles and allylamines. Azoles were slightly less effective in achieving clinical cure compared to azole and steroid combination creams immediately at the end of treatme. The pooled data suggest that the individual treatments terbinafine and naftifine are effective. Adverse effects were generally mild and reported infrequently. A substantial number of the studies were more than 20 years old and of unclear or high risk of bias; there is however, some evidence that other topical antifungal treatments also provide similar clinical and mycological cure rates, particularly azoles although most were evaluated in single studies.There is insufficient evidence to determine if Whitfield's ointment, a widely used agent is effective.Although combinations of topical steroids and antifungals are not currently recommended in any clinical guidelines, relevant studies included in this review reported higher clinical cure rates with similar mycological cure rates at the end of treatment, but the quality of evidence for these outcomes was rated very low due to imprecision, indirectness and risk of bias. There was insufficient evidence to confidently assess relapse rates in the individual or combination treatments.Although there was little difference between different classes of treatment in achieving cure, some interventions may be more appealing as they require fewer applications and a shorter duration of treatment. Further, high quality, adequately powered trials focusing on patient-centred outcomes, such as patient satisfaction with treatment should be considered.

Topics: Administration, Cutaneous; Adrenal Cortex Hormones; Allylamine; Antifungal Agents; Azoles; Benzoates; Drug Combinations; Female; Humans; Male; Naphthalenes; Pruritus; Randomized Controlled Trials as Topic; Salicylates; Terbinafine; Tinea

Difficult-to-treat dermatophytosis is an emerging public health problem in Sri Lanka. Safe, effective and affordable treatment is needed to solve this problem. Therefore this study has assessed the effectiveness and safety of modified Whitfield ointment applied twice daily with oral griseofulvin 500 mg daily given over 8 weeks in patients with difficult-to-treat dermatophytosis.. A randomized, double-blind, within-patient-placebo-controlled trial was conducted in patients with clinico- mycologically (history, physical examination, direct light microscopy examination of scales in potassium hydroxide mount) confirmed difficult-to-treat dermatophytosis. Lesions were randomized to receive modified Whitfield ointment (5% benzoic acid and 5% salicylic acid) or emulsifying ointment. All patients were given oral griseofulvin 500mg once daily. The outcome measures were clinical assessment of disease severity, the total surface area of the lesions and the patient's perception of the disease severity at baseline and every two weeks up to a maximum of 8 weeks.. Thirty patients completed the study. At two weeks, there was a statistically significant improvement in modified Whitfield ointment arm in the clinical assessment of disease severity and the patients' perception. There was a 7.59% reduction in the surface area of lesions in modified Whitfield ointment arm and a 5.83% increase in the surface area of lesions in the emulsifying ointment arm at two weeks. The difference between the two arms in surface area changes was not statistically significant (p = 0.107, df = 29).. A combination of modified Whitfield ointment with griseofulvin is significantly effective, safe and affordable option for treating difficult-to-treat dermatophytosis in the tropics.

Topics: Antifungal Agents; Benzoates; Double-Blind Method; Drug Combinations; Drug Therapy, Combination; Griseofulvin; Humans; Salicylates; Skin; Sri Lanka; Tinea; Treatment Outcome

Topics: Animals; Anti-Infective Agents; Antifungal Agents; Benzoates; Cattle; Cattle Diseases; Drug Combinations; Drug Therapy, Combination; Female; Male; Propolis; Salicylates; Tinea; Trichophyton

A double-blind trial was undertaken in Karonga District, Northern Malawi comparing Whitfield's cream (3% salicylic acid and 6% benzoylic acid) and clotrimazole cream in the treatment of dermatophyte infections of the skin. To date, 138 patients have been reviewed; 65 of these patients received Whitfield's cream and 73 received clotrimazole cream. Within 4 weeks to 4 months after the beginning of treatment, there were six definite treatment failures in each group. In view of the considerable difference in price between the two preparations, Whitfield's cream should be considered as the treatment of choice in tropical primary health care.

Topics: Administration, Topical; Adolescent; Adult; Benzoates; Benzoic Acid; Clotrimazole; Double-Blind Method; Drug Combinations; Humans; Salicylates; Salicylic Acid; Tinea

Topics: Administration, Topical; Benzoates; Benzoic Acid; Drug Combinations; Humans; Salicylates; Salicylic Acid; Tinea

Topics: Adolescent; Adult; Animals; Candidiasis; Clinical Trials as Topic; Clotrimazole; Dermatomycoses; Erythrasma; Female; Humans; Imidazoles; Male; Middle Aged; Nystatin; Rats; Salicylates; Tinea; Tinea Versicolor

Topics: Administration, Topical; Adolescent; Adult; Aged; Benzoates; Candida albicans; Candidiasis, Cutaneous; Clinical Trials as Topic; Corynebacterium; Female; Humans; Imidazoles; Malassezia; Male; Middle Aged; Nocardia Infections; Nystatin; Salicylates; Tinea; Tinea Versicolor; Trichophyton; Trityl Compounds

Topics: Benzoates; Clinical Trials as Topic; Follow-Up Studies; Humans; Nails; Ointments; Pyrrolidinones; Salicylates; Tinea; Tinea Pedis

Topics: Adolescent; Adult; Amides; Antifungal Agents; Candidiasis; Child; Child, Preschool; Clinical Trials as Topic; Female; Humans; Hydrocortisone; Infant; Male; Middle Aged; Salicylates; Tinea

Topics: Adolescent; Adult; Aged; Castor Oil; Child; Clinical Trials as Topic; Epidermophyton; Female; Griseofulvin; Humans; Male; Middle Aged; Ointments; Pharmaceutical Vehicles; Placebos; Salicylates; Time Factors; Tinea; Tinea Pedis; Trichophyton

Topics: Benzoates; Dermatologic Agents; Drug Combinations; Griseofulvin; Humans; Miconazole; Salicylates; Tinea

A study on the use of thiabendazole in the treatment of bovine dermatophytosis caused by Trichophyton verrucosum was conducted. Fifteen infected animals were included in the study. Ten animals were treated with a thiabendazole-DMSO-salicylic acid mixture and 5 animals were left untreated as controls. The thiabendazole mixture was used topically on the skin lesions. Lesions resolved after 12 applications and 80% of the treated animals proved negative on mycological examination. All lesions healed completely after 16 applications. Thiabendazole proved to be fungicidal on specimens of skin scrapings infected with the arthroconidia and mycelial elements of the dermatophyte. The killing effect was achieved using dilutions of 1:10 000 and 1:20 000 at 4 and 7 days, respectively.

Topics: Administration, Topical; Animals; Cattle; Cattle Diseases; Dimethyl Sulfoxide; Salicylates; Salicylic Acid; Skin; Thiabendazole; Tinea; Trichophyton

Topics: Animals; Australia; Benzoates; Drug Combinations; Econazole; Female; Hedgehogs; Humans; Salicylates; Tinea; Trichophyton

Topics: Adult; Animals; Benzoates; Child; Dermatomycoses; Dogs; Female; Griseofulvin; Guinea Pigs; Humans; Male; Microsporum; Salicylates; Tinea; Zoonoses

Trichophyton violaceum infection was found in 26% of 69 children attending a public boarding school. The possible source of infection may have been the adult women from the gypsy community discussed. Treatment with systemic griseofulvin and external sulphur salicylic ointment eliminated the infection in all affected individuals.

Topics: Adolescent; Adult; Child; Child, Preschool; Griseofulvin; Humans; India; Infant; Infant, Newborn; Male; Middle Aged; Salicylates; School Health Services; Skin Diseases, Infectious; Socioeconomic Factors; Tinea; Trichophyton

Topics: Administration, Topical; Adolescent; Adult; Child; Female; Humans; Male; Recurrence; Salicylates; Scalp Dermatoses; Tinea

Topics: Adult; Female; Hand Dermatoses; Humans; Mitosporic Fungi; Salicylates; Skin; Tinea

Topics: Acne Vulgaris; Antifungal Agents; Dermatomycoses; Dexamethasone; Erythema; Humans; Pharmaceutic Aids; Salicylates; Thiazoles; Tinea; Tinea Versicolor

Topics: Adult; Benzoates; Dermatomycoses; Diagnosis, Differential; Female; Humans; Lanolin; Male; Middle Aged; Petrolatum; Resorcinols; Salicylates; Tinea

Topics: Clinical Laboratory Techniques; Communicable Disease Control; Glycerol; Humans; Iodides; Iodine; Laboratories; Occupational Medicine; Ointments; Onychomycosis; Potassium; Salicylates; Tinea; Tinea Pedis

Topics: Analgesics; Anilides; Animals; Lepidoptera; Salicylates; Tinea

Topics: Hair; Hair Removal; Humans; Ointments; Salicylanilides; Salicylates; Scalp; Tinea