New posology of potassium iodide for the treatment of cutaneous sporotrichosis: study of efficacy and safety in 102 patients

Macedo, Priscila Marques de; Lópes-Bezerra, Leila M.; Bernardes-Engemann, Andréa Reis; Orofino-Costa, Rosane

doi:10.1111/jdv.12667

Cited by 40 publications

(40 citation statements)

References 22 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The indiscriminate use of these antifungal drugs to treat classical and non-aggressive forms of sporotrichosis and other mycoses may have led to the emergence of resistance mechanisms. Sporotrichosis can be treated with non-antimycotic drugs such as potassium iodide (Bonifaz et al 2007, Macedo et al 2015) and with non-pharmacologic strategies such as hyperthermia (Bonifaz et al 2007) and cryosurgery (Almeida-Paes et al 2016), or even with a combination of low drug dosages and hyperthermia (Haruna et al 2006). The non-pharmacologic approaches are interesting because they often accelerate clinical cures, reducing treatment costs.…”

Section: Discussionmentioning

confidence: 99%

“…Studies using mouse models of experimental infection show that S. brasiliensis is highly virulent, resulting in high mortality rates in animals and a high fungal burden in several organs (Arrillaga-Moncrieff et al 2009). In humans, this species is associated with some unusual manifestations of sporotrichosis, such as hypersensitivity reactions, disseminated infection in non-AIDS patients, central nervous system tropism, and ocular involvement (Almeida-Paes et al 2014, Macedo et al 2015). …”

mentioning

confidence: 99%

“…Most patients infected with S. brasiliensis respond well to these drugs (Francesconi et al 2011, Almeida-Paes et al 2014, Macedo et al 2015), although therapeutic failures have been reported (Almeida-Paes et al 2016). In order to guide therapy, antifungal susceptibility tests were developed (CLSI 2008).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Minimal inhibitory concentration distributions and epidemiological cutoff values of five antifungal agents against Sporothrix brasiliensis

Almeida‐Paes

Brito‐Santos

Figueiredo-Carvalho

et al. 2017

Mem. Inst. Oswaldo Cruz

View full text Add to dashboard Cite

BACKGROUNDSporothrix brasiliensis is the most virulent sporotrichosis agent. This species usually responds to antifungal drugs, but therapeutic failure can occur in some patients. Antifungal susceptibility tests have been performed on this species, but no clinical breakpoints (CBPs) are available. In this situation, minimal inhibitory concentration (MIC) distributions and epidemiological cutoff values (ECVs) support the detection of identification of resistant strains.OBJECTIVES To study the MIC distributions of five antifungal drugs against S. brasiliensis and to propose tentative ECVs.METHODS MICs of amphotericin B (AMB), itraconazole (ITR), ketoconazole (KET), posaconazole (POS), and terbinafine (TRB) against 335 S. brasiliensis strains were determined by the Clinical and Laboratory Standards Institute broth microdilution method.FINDINGS The proposed ECV, in µg/mL, for AMB, ITR, KET, POS, and TRB were 4.0, 2.0, 1.0, 2.0, and 0.25, respectively. Percentages of wild-type strains in our population for the above antifungal drugs were 98.48, 95.22, 95.33, 100, and 97.67%, respectively.MAIN CONCLUSIONS These ECVs will be useful to detect strains with resistance, to define CBPs, and to elaborate specific therapeutic guidelines for S. brasiliensis. Rational use of antifungals is strongly recommended to avoid the emergence of resistant strains and ensure the therapeutic effectiveness of sporotrichosis.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Minimal inhibitory concentration distributions and epidemiological cutoff values of five antifungal agents against Sporothrix brasiliensis

Almeida‐Paes

Brito‐Santos

Figueiredo-Carvalho

et al. 2017

Mem. Inst. Oswaldo Cruz

View full text Add to dashboard Cite

show abstract

“…The patient showed important improvement in his clinical condition when itraconazole was replaced with a KI solution, which is quite effective for treating cutaneous sporotrichosis. 31,32 The in vitro tests revealed high MICs to itraconazole (4 μg/mL), which have also been reported by some studies 15,20,33,34 and which correlated with itraconazole treatment failure. Successful KI treatment has been reported in a highly endemic area of S. brasiliensis, 31,32,35 so KI could be an important alternative for treating itraconazole-resistant sporotrichosis due to S. globosa.…”

Section: Discussionmentioning

confidence: 56%

Atypical Clinical Presentation of Sporotrichosis Caused by Sporothrix globosa Resistant to Itraconazole

Gompertz¹,

Rodrigues²,

Fernandes³

et al. 2016

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Sporotrichosis is a polymorphic disease of humans and animals, which is acquired via traumatic inoculation of Sporothrix propagules into cutaneous or subcutaneous tissue. The etiological agents are in a clinical complex, which includes Sporothrix brasiliensis, Sporothrix schenckii, Sporothrix globosa, and Sporothrix luriei, each of which has specific epidemiological and virulence characteristics. Classical manifestation in humans includes a fixed localized lesion at the site of trauma plus lymphocutaneous sporotrichosis with fungal spreading along the lymphatic channels. Atypical sporotrichosis is a challenge to diagnosis because it can mimic many other dermatological diseases. We report an unusual, itraconazoleresistant cutaneous lesion of sporotrichosis in a 66-year-old Brazilian man. Histopathological examination of the skin revealed vascular and fibroblastic proliferation with chronic granulomatous infiltrate composed of multinucleated giant cells. Sporothrix were isolated from the skin lesion, and phylogenetic analyses confirmed it to be sporotrichosis due to S. globosa, a widespread pathogen. Immunoblotting analysis showed several IgG-reactive molecules in autochthonous preparations of the whole cellular proteins (160, 80, 60, 55, 46, 38,35, and 30 kDa) and exoantigen (35 and 33 kDa). The patient was first unsuccessfully treated with daily itraconazole, and then successfully treated with potassium iodide.

show abstract

“…Out of all dermatosis treated with KI, most of the existing data is on sporotrichosis [13-18], and the largest study included 645 patients [32]. Nonetheless, a Cochrane review found that even in this case, there is not enough (high-quality) evidence to come to a final conclusion regarding its efficacy [33].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Potassium Iodide for Cutaneous Inflammatory Disorders: A Monocentric, Retrospective Study

et al. 2018

View full text Add to dashboard Cite

Objectives: Potassium iodide (KI) is a medication that has been used for decades in dermatology and it is mentioned as a treatment option in all major dermatology textbooks. Yet, there is little recent information on its efficacy. In our study, we wanted to retrospectively evaluate the therapy response to KI in our patients. Methods: The hospital information system was searched for patients treated with KI at the Department of Dermatology (University Hospital Zurich) in the last 20 years (January 1, 1998 to December 31, 2017). A total of 52 patients were found and, subsequently, 35 patients were included in our study. Results: KI was prescribed for the following skin conditions: erythema nodosum, disseminated granuloma anulare, necrobiosis lipoidica, nodular vasculitis, cutaneous sarcoidosis, and granulomatous perioral dermatitis/ rosacea. The median duration of KI intake was 5 ± 7.7 weeks (range 1–26). The global assessment of efficacy by the treating physician showed an improvement of disease in about a third of all patients. No response was seen in 14 patients and 9 even had a progression of disease. An adverse event was documented in 16 cases. Conclusions: Our findings show that an improvement was reached in only about a third of all cases. High response rates with only mild side effects (in 16 out of 35 patients) were observed.

show abstract

New posology of potassium iodide for the treatment of cutaneous sporotrichosis: study of efficacy and safety in 102 patients

Abstract: Through statistical analysis, the usual posology was not shown to be superior to the one proposed in this study. Serology for sporotrichosis may be used as a valuable tool in the clinical monitoring of these patients.

Cited by 40 publications

References 22 publications

Minimal inhibitory concentration distributions and epidemiological cutoff values of five antifungal agents against Sporothrix brasiliensis

Minimal inhibitory concentration distributions and epidemiological cutoff values of five antifungal agents against Sporothrix brasiliensis

Atypical Clinical Presentation of Sporotrichosis Caused by Sporothrix globosa Resistant to Itraconazole

Potassium Iodide for Cutaneous Inflammatory Disorders: A Monocentric, Retrospective Study

Contact Info

Product

Resources

About