Onychomycosis is common worldwide, about 10% of all dermatomycosis being fungal infections of the nails.1 Up until now no satisfactory topical treatment has been available. Therefore, the development of any new antifungal gives rise to high expectations with regard to its effectiveness in onychomycosis. Amorolfine is a phenylpropyl morpholine derivative which has been found to be more effective than imidazole derivatives and polyene antibiotics both in vitro and in experimental infections against dermatophytes and yeasts.2,3
Amorolfine possesses two properties which give rise to hopes that it may be used to treat onychomycosis. First, it is effective at low concentrations,2 and secondly, studies of in‐vitro penetration on human nails show the presence of amorolfine in sufficient concentrations in the nail plate and the nail bed to give fungistatic and fungicidal levels.4 Furthermore, the persistence of amorolfine in the subungual keratin for 7 days5 would allow physicians to reduce the frequency of application.
Two different lacquer formulations, one methylene chloride‐based and the other ethanol based, were developed as vehicles for amorolfine for treating onychomycosis with one or two applications per week. This study was carried out in order to test the bioequivalence of the two different lacquer formulations and to see whether the antifungal activity of amorolfine in the subungual area would last longer than 7 days, as shown in a previous study.5 The measurement of the antifungal activity in the subungual area will be taken as one of the criteria for penetration of amorolfine through the human nail.
Fifty dermatophyte strains, recently obtained from clinical material, belonging to 4 different species were examined for their susceptibility to 5 systemic or topical antimycotic agents using both an agar macrodilution and a broth microdilution test. Antimycotics compared were griseofulvin, itraconazole, sertaconazole, terbinafine and ciclopiroxolamine. A comparison of the minimum inhibitory concentrations (MIC) clearly showed differences between the two test methods applied. For all 5 antimycotics, MIC data were three- to seventyfold lower in the microdilution test system. These differences, depending on the test method, have to be taken into account when comparing MIC data in the literature or when relating the in vitro data to the tissue concentrations determined in vivo.
Tinea capitis is a disease that frequently affects children. In most cases systemic antimycotic treatment is necessary Griseofulvin is still the drug of choice, but requires prolonged periods of treatment (several months). To estimate the efficiency and tolerability of terbinafine for treatment of tinea capitis in children, four patients (aged 3-9 years) with tinea capitis proven by culture were treated with terbinafine at a dose of 125 mg a day for different periods (4-10 weeks). Isolates were subjected to minimal inhibitory concentration testing against terbinafine and griseofulvin. In all four cases terbinafine treatment resulted in complete remission. The clinical response was accompanied by negative culture results on follow-up. Terbinafine was well tolerated in each case. Determination of the minimal inhibitory concentration confirmed the excellent in vitro activity of terbinafine against dermatophytes. Controlled studies involving a larger number of children are necessary to answer questions concerning dose and duration of terbinafine treatment as well as the frequency and severity of drug-related side-effects.
Zusammenfassung
Zwei Mikrosporiefälle durch Mikrosporum canis wurden in der dermatologischen Sprechstunde mit Hilfe von Woodlicht, mikroskopischer und kultureller Untersuchung diagnostiziert, obwohl beide Erkrankungen nicht typisch aussahen.
Fall 1 betraf einen 7jähr. Jungen mit Herden an Stirn, Ohr und Oberarm rechts; die Erscheinungen wurden anfangs als Hefepilzinfektion gedeutet und — erfolglos — mit Moronal u. a. behandelt.
Fall 2 war eine 51jähr. Patientin, die nach Kontakt mit Katzen in Tunesien Flecke an der linken Wange aufwies, die an ein nummuläres Ekzem denken ließen.
Die Behandlung erfolgte mit Fulcin S und Tonoftal und führte in beiden Fällen nach rascher Besserung zur völligen Abheilung.
Zusammenfassung
200 aus Krankheitserscheinungen isolierte Candida albicans‐Stämme erwiesen sich sämtlich als nystatinempfindlich. Die verwendeten Zubereitungsformen von Nystatin (Salbe und Paste) waren nach 18 monatiger Lagerung noch voll wirksam.
Zusammenfassung
In 3 Untersuchungsreihen wurden von Patienten stammende Candida albicans‐Stämme in Boviserin, Kaninchenserum, Patientenserum und Humans‐Albumin auf Keimschlauch‐bildung untersucht. Boviserin war am besten geeignet. Nach 2 Std. war die Keimschlauch‐bildung gering, nach 5 Std. hatten die meisten, jedoch nicht alle Candida albicans‐Stämme Keimschläuche gebildet. Im positiven Falle läßt sich die Diagnose also früher stellen als auf Reisagar.
Zusammenfassung
Candistatin‐Paste, eine neue galenische Nystatin‐Zubereitung zur Austrocknung des Hautmilieus bei Hefebefall und zur Eliminierung der Hefen, erwies sich im Diffusionstest auf Kimmig‐Agar trotz vorangegangener Lagerung als ausgezeichnet wirksam gegen Candida albicans und Candida parapsilosis.
Die Hemmhöfe waren nach Lagerung bei Zimmertemperatur praktisch gleich groß wie nach Lagerung im Kühlschrank. 10 monatige Lagerung erbrachte keine geringeren Hemmhöfe als 2monatige Lagerung.
Damit steht eine Applikationsform zur Verfügung, die für eine Behandlung nach dermatologischen Grundsätzen unentbehrlich ist.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.