Rapid relief of intertrigo‐associated pruritus due to Candida albicans with isoconazole nitrate and diflucortolone valerate combination therapy

Abstract

A 43-year-old male, with intertrigo due to Candida albicans located at the inguinal folds and accompanied by severe pruritus, was treated with topical 1% isoconazole nitrate and 0.1% diflucortolone valerate (2 applications/day for 7 days). An improvement of pruritus was reported 2 days after the beginning of the treatment. Skin lesions improved after 3 days of treatment. Complete remission of both skin lesions and pruritus was observed at day 7. No side effects were observed.

Synergic Anti-Pruritus Mechanisms of Action for the Radix Sophorae Flavescentis and Fructus Cnidii Herbal Pair

“…Chemokines are related to the development of atopic dermatitis itch [ 55 ]. The chemokine and TLR signaling pathways are associated with chronic mucocutaneous candidiasis (CMC), which is associated with pruritus and Candida albicans [ 56 ]. The neurotrophin signaling pathway is associated with acne inversa/hidradenitis suppurativa, which is also associated with pruritus [ 57 ].…”

The association topical antifungals/topical corticosteroids in superficial mycoses of the skin: A critical review of the literature and personal experience

“…Although the clinical results of all these studies were considered as satisfactory, it was observed that, by means of the Warburg assay, antifungal activity of clotrimazole, econazole and ketoconazole was significantly impaired when triamcinolone acetonide or prednisolone‐21‐hemisuccinate‐sodium at high concentrations (10–25 times higher than the concentrations of imidazoles) were present in the test flasks 13 . Since 2008, the most studied combination was isoconazole/diflucortolone 14–35 . In particular, two sponsor‐free studies were carried out at the Dermatology Unit of the University of Milan in patients with tinea cruris 27 and tinea corporis 35 .…”

“…This study in atopic children with tinea corporis superinfected by S. aureus confirmed that the association isoconazole/diflucortolone was useful and safe. Anecdotic cases of patients successfully treated with this combination were reported in tinea faciei , 31,33 tinea corporis , 19–21,31–33 tinea cruris , 16–18,33 tinea pedis , 25,26,30 intertrigo 22–24,34 and balanitis by Candida albicans 24 …”

“…This study in atopic children with tinea corporis superinfected by S. aureus confirmed that the association isoconazole/diflucortolone was useful and safe. Anecdotic cases of patients successfully treated with this combination were reported in tinea faciei, 31,33 tinea corporis, [19][20][21][31][32][33] tinea cruris, [16][17][18]33 tinea pedis, 25,26,30 intertrigo [22][23][24]34 and balanitis by Candida albicans. 24 According to literature data and our personal clinical experience, a topical therapy with a combination of an antifungal and a corticosteroid can be useful for several reasons: (a) topical corticosteroids induce a rapid improvement of inflammatory signs (erythema and swelling) and itching, that are very frequently associated with some epidermophytoses, such as tinea corporis in atopic children and tinea cruris: this swift improvement of itching encourages patients' adherence and compliance to treatment; (b) the increased bioavailability of the antifungal in the skin, when applied with a topical corticosteroid: due to the local vasoconstrictive action of the corticosteroid, the dispersal of the imidazole via the circulation is delayed.…”