Miconazole therapy for endemic fungal disease

Fulton, J. E.

doi:10.1001/archderm.111.5.596

Cited by 10 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many topical azoles have been used effectively (134). Tioconazole has been found somewhat more effective than the widely used miconazole cream, itself an efficaceous agent (42,68). Sulconazole nitrate 1% cream has been shown to be effective against the fungi in uncomplicated lesions and also to effect a significant decrease in erythema and scaling during the course of healing (157).…”

Section: Tinea Pedismentioning

confidence: 99%

The dermatophytes

1995

View full text Add to dashboard Cite

The etiologic agents of the dermatophytoses (ringworm) are classified in three anamorphic (asexual or imperfect) genera, Epidermophyton, Microsporum, and Trichophyton. Species capable of reproducing sexually belong in the teleomorphic genus, Arthroderma, of the Ascomycota. On the basis of primary habitat association, they may be grouped as geophilic (soil associated), zoophilic, and anthropophilic. Adaptation to growth on humans by most geophilic species resulted in diminished loss of sporulation, sexuality, and other soil-associated characteristics. The dermatophytes have the ability to invade keratinized tissue (skin, hair, and nails) but are usually restricted to the nonliving cornified layer of the epidermis because of their inability to penetrate viable tissue of an immunocompetent host. However, invasion does elicit a host response ranging from mild to severe. Acid proteinases, elastase, keratinases, and other proteinases reportedly act as virulence factors. The development of cell-mediated immunity correlated with delayed hypersensitivity and an inflammatory response is associated with clinical cure, whereas the lack of or a defective cell-mediated immunity predisposes the host to chronic or recurrent dermatophyte infection. Chronic dermatophytosis is mostly caused by Trichophyton rubrum, and there is some evidence that mannan produced by this fungus suppresses or diminishes the inflammatory response. Since dermatophytes cause a communicable disease, modes of transmission and control are discussed as well as a survey of recent trends in therapy. Collection of specimens, culture media, and tests for identification are also presented. Genetic studies have led to an understanding of incompatibility mechanisms, pleomorphism and variation, resistance to griseofulvin, and virulence. Molecular biology has contributed to our knowledge of the taxonomy and phylogenetic relationships of dermatophytes.

show abstract

Section: Tinea Pedismentioning

confidence: 99%

The dermatophytes

1995

View full text Add to dashboard Cite

show abstract

“…Of the 364 references identified from the searches, 129 studies met our inclusion criteria . However, 63 of these contained no usable or retrievable data owing mainly to the unavailability of separate data for the different tinea infections (Table S1; see Supporting Information) . The characteristics of the remaining 66 studies are summarized in Table…”

Section: Resultsmentioning

confidence: 99%

Evidence-based topical treatments for tinea cruris and tinea corporis: a summary of a Cochrane systematic review

2015

View full text Add to dashboard Cite

Tinea cruris and tinea corporis are common fungal infections. Most can be treated with a variety of topical antifungals. This review aimed to assess the evidence for the effectiveness and safety of topical treatments for tinea cruris and tinea corporis. Searches included the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, Medline, Embase, LILACS and ongoing trials registries (August 2013). One hundred and twenty-nine randomized controlled trials (RCTs) with 18 086 participants evaluated a range of interventions - mostly azoles. Pooling of data for several outcomes was only possible for two individual treatments. In five studies, terbinafine showed a statistically significant higher clinical cure rate compared with placebo [risk ratio (RR) 4·51, 95% confidence interval (CI) 3·10-6·56]. Data for mycological cure could not be pooled owing to substantial heterogeneity. Across three studies, mycological cure rates favoured naftifine (1%) compared with placebo (RR 2·38, 95% CI 1·80-3·14) but the quality of the evidence was low. Combinations of azoles with corticosteroids were slightly more effective than azoles for clinical cure, but there was no statistically significant difference with regard to mycological cure. Sixty-five studies were assessed as 'unclear' and 64 as being at 'high risk' of bias; many were over 20 years old, and most were poorly designed and inadequately reported. Although most active interventions showed sufficient therapeutic effect, this review highlights the need for further, high-quality, adequately powered RCTs to evaluate the effects of these interventions, which can ultimately provide reliable evidence to inform clinical decision making.

show abstract

“…Topical antifungal agents have been suggested for the prophylaxis of tinea pedis and these include tolnaftate, econazole spray powder, fenticonazole, bifonazole 1% powder, and miconazole spray powder 123–132 . It may be possible for a nail lacquer such as ciclopirox or amorolfine to be used as a prophylactic to prevent the development of onychomycosis 24 …”

Section: Strategies To Reduce Reappearance Of Onychomycosismentioning

confidence: 99%

Onychomycosis: strategies to improve efficacy and reduce recurrence

Gupta

Baran

Summerbell

2002

Acad Dermatol Venereol

View full text Add to dashboard Cite

Fungal infections may be difficult to treat for several reasons. It is important to obtain the correct diagnosis, and select the appropriate antifungal agent and route. General considerations that may be associated with recurrent infections are, a genetic predisposition and suboptimal bioavailability of drug, resulting in insufficient concentration at the target site. The aetiologic organism, the severity of disease, other coexisting diseases, concomitant drug intake, and the presence of fungal infection at other sites are some factors that determine the choice of antifungal therapy and its route of administration, oral vs. topical lacquer. Local factors such as the thickness of the nail, presence of lateral onychomycosis, longitudinal spike, dermatophytoma and severe onycholysis are some factors that may determine the choice of secondary measures such as mechanical or topical treatment. Booster or supplemental therapy may be of benefit when the response to initial treatment is poorer than expected and unlikely to result in complete response. Steps should be taken to reduce the possibility of recurrence once cure has been achieved.

show abstract

Miconazole therapy for endemic fungal disease

Cited by 10 publications

References 0 publications

The dermatophytes

The dermatophytes

Evidence-based topical treatments for tinea cruris and tinea corporis: a summary of a Cochrane systematic review

Onychomycosis: strategies to improve efficacy and reduce recurrence

Contact Info

Product

Resources

About