Update in Antifungal Therapy of Dermatophytosis

Mycopathologia et mycologia applicata - Tập 166 - Trang 353-367 - 2008
Aditya K. Gupta1,2,3, Elizabeth A. Cooper3
1Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Center, Toronto, Canada
2University of Toronto, Toronto, Canada
3Mediprobe Research Incorporated, London, Canada

Tóm tắt

Treatment of dermatophyte infection involves primarily oral and/or topical formulations of azoles or allylamines, particularly itraconazole and terbinafine. Topical medications applied once or twice daily are the primary treatment indicated for tinea corporis/cruris, and tinea pedis/manuum. Use of oral antifungals may be practical where the tinea involvement is extensive or chronic, or where application of a topical is not feasible. For tinea unguium (onychomycosis) and tinea capitis, oral therapies are the primary treatments provided. Recently, topical amorolfine and ciclopirox formulations have been approved for use in milder onychomycosis cases, and their role in the treatment of the different clinical forms of onychomycosis is currently being defined. Relapse of infection remains a problem, particularly with tinea pedis/unguium. Appropriate follow-up duration and education of patients on proper foot hygiene are also important components in providing effective therapy.

Tài liệu tham khảo

Loo DS. Systemic antifungal agents: an update of established and new therapies. Adv Dermatol. 2006;22:101–24. Lecha M, Effendy I, Feuilhade de Chauvin M, Di Chiacchio N, Baran R. Treatment options—development of consensus guidelines. J Eur Acad Dermatol Venereol. 2005;19(Suppl 1):25–33. TARO Pharmaceuticals Inc. Clotrimazole cream USP, 1%. Prescribing information. Bramalea, Ontario, Canada, June 1996. TARO Pharmaceuticals Inc. Econazole nitrate cream 1%. Prescribing information. Brampton, Ontario, Canada, September 2001. Merz Pharmaceuticals. Naftin® Naftifine HCl 1% gel/cream. Prescribing information. Greensboro, NC, USA, May 2007. McNeil Consumer & Specialty Pharmaceuticals. Nizoral® (ketoconazole) 2% shampoo. Prescribing information. Fort Washington, PA, USA, October 2003. TARO Pharmaceuticals Inc. Ciclopirox olamine cream USP, 0.77%. Prescribing information. Brampton, Ontario, Canada, March 2005. MEDICIS, The Dermatology Company. Loprox® Gel (ciclopirox) 0.77%. Prescribing information. Scottsdale, AZ, USA, July 2005. BERTEK Pharmaceuticals Inc. Mentax®-TC (butenafine HCl) cream, 1%. Prescribing information. Research Triangle Park, NC, USA, October 2002. GlaxoSmithKline Consumer Healthcare LP. Oxistat® (oxiconazole nitrate cream) cream 1%; Oxistat® (oxiconazole nitrate lotion) lotion 1%. Prescribing information. Pittsburgh, PA, USA, January 2004. Gupta AK, Chow M, Daniel CR, Aly R. Treatments of tinea pedis. Dermatol Clin. 2003;21:431–62. Lamisil® (terbinafine hydrochloride tablets) Prescribing information. Novartis Pharmaceuticals Corporation. East Hanover, NJ, November 2005. Sporanox® (itraconazole) Capsules prescribing information (Ortho-McNeil Inc). Janssen Pharmaceutica Products, L.P. Titusville, NJ, June 2006. Diflucan® (fluconazole tablets) (fluconazole injection—for intravenous infusion only) (fluconazole for oral suspension) Prescribing information. Pfizer Inc, August 2004. Griseofulvin (Systemic). In: Drug information for the health care professional, USP DI, The United States Pharmacopeial Convention, Inc., ed 24, Taunton MA, 2004, Micromedex, p. 1493–6. Miscellaneous Antifungals—Griseofulvin. In: AHFS Drug Information® 2005. Bethesda, MD, 2005, American Society of Health-System Pharmacists, Inc., p. 535–7. Azoles—Ketoconazole. In: AHFS Drug Information® 2005. Bethesda, MD, 2005, American Society of Health-System Pharmacists, Inc., p. 510–6. Gupta AK, Cooper EA, Montero-Gei F. The use of fluconazole to treat superficial fungal infections in children. Dermatol Clin. 2003;21:537–42. Gupta AK, Cooper EA, Ginter G. Efficacy and safety of itraconazole use in children. Dermatol Clin. 2003;21:521–35. Gupta AK, Cooper EA, Lynde CW. The efficacy and safety of terbinafine in children. Dermatol Clin. 2003;21:511–20. Gupta AK, Ryder JE. The use of oral antifungal agents to treat onychomycosis. Dermatol Clin. 2003;21:469–79. Antifungals, Azole (Systemic). In: Drug information for the health care professional, USP DI, The United States Pharmacopeial Convention, Inc., ed 24, Taunton MA, 2004, Micromedex. p. 315–23. Padhye AA, Weitzman I. The dermatophytes. In: Collier L, Balows A, Sussman M, Ajello L, Hay RJ, editors. Topley and Wilson’s medical mycology. New York: Oxford University Press; 1998. p. 215–36. Noble SL, Forbes RC, Stamm PL. Diagnosis and management of common tinea infections. Am Fam Physician. 1998;58:163–8. Crawford F, Hollis S. Topical treatments for fungal infections of the skin and nails of the foot. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD001434. Gupta AK, Cooper EA, Ryder JE, et al. Optimal management of fungal infections of the skin, hair, and nails. Am J Clin Dermatol. 2004;5:225–37. Crawford F. Athlete’s foot. In: Williams H, Bigby M, Diepgen T, Herxheimer A, Naldi L, Rzany B, editors. Evidence based dermatology. London: BMJ Books; 2003. p. 436–40. Gupta AK, Chaudhry M, Elewski B. Tinea corporis, tinea cruris, tinea nigra, and piedra. Dermatol Clin. 2003;21:395–400. Gupta AK, De Doncker P, Heremans A, et al. Itraconazole for the treatment of tinea pedis: a dose of 400 mg/day given for 1 week is similar in efficacy to 100 or 200 mg/day given for 2 to 4 weeks. J Am Acad Dermatol. 1997;36:789–92. Faergemann J, Mork NJ, Haglund A, et al. A multicentre (double-blind) comparative study to assess the safety and efficacy of fluconazole and griseofulvin in the treatment of tinea corporis and tinea cruris. Br J Dermatol. 1997;136:575–7. Stary A, Sarnow E. Fluconazole in the treatment of tinea corporis and tinea cruris. Dermatology. 1998;196:237–41. Suchil P, Montero Gei F, Robles M, et al. Once-weekly oral doses of fluconazole 150 mg in the treatment of tinea corporis/cruris and cutaneous candidiasis. Clin Exp Dermatol. 1992;17:397–401. Haroon TS, Asghar HA, Aman S, et al. An open, non-comparative study for the evaluation of oral fluconazole in the treatment of tinea corporis. Specialist. 1997;13:417–23. Papini M, Difonzo EM, Cilli P, et al. Itraconazole versus fluconazole, a double-blind comparison in tinea corporis. J Mycol Méd. 1997;7:77–80. Kotogyan A, Harmanyeri Y, Tahsin Gunes A, et al. Efficacy and safety of oral fluconazole in the treatment of patients with tinea corporis, cruris or pedis or cutaneous candidiasis. A multicentre, open, non-comparative study. Clin Drug Investig. 1996;12:59–66. Gomez M, Arenas R, Salazar JJ, et al. Tinea pedis. A multicentre trial to evaluate the efficacy and tolerance of a weekly dose of fluconazole. Dermatol Rev Mex. 1996;40:251–5 (Spanish). Del Aguila R, Montero Gei F, Robles M, et al. Once-weekly oral doses of fluconazole 150 mg in the treatment of tinea pedis. Clin Exp Dermatol. 1992;17:402–6. Gupta AK, Ryder JE, Chow M, Cooper EA. Dermatophytosis: the management of fungal infections. Skinmed. 2005;4:305–10. Trent JT, Federman D, Kirsner RS. Common viral and fungal skin infections. Ostomy Wound Manage. 2001;47:28–34. De Doncker P, Gupta AK, Marynissen G, et al. Itraconazole pulse therapy for onychomycosis and dermatomycoses: an overview. J Am Acad Dermatol. 1997;37:969–74. Parent D, Decroix J, Heenen M. Clinical experience with short schedules of itraconazole in the treatment of tinea corporis and/or tinea cruris. Dermatology. 1994;189:378–81. Gupta AK, Summerbell RC. Tinea capitis. Med Mycol. 2000;38:255–87. Roberts BJ, Friedlander SF. Tinea capitis: a treatment update. Pediatr Ann. 2005;34:191–200. Lipozencic J, Skerlev M, Orofino-Costa R, et al. A randomized, double-blind, parallel-group, duration-finding study of oral terbinafine and open-label, high-dose griseofulvin in children with tinea capitis due to Microsporum species. Br J Dermatol. 2002;146:816–23. Gupta AK, Skinner AR. Onychomycosis in children: a brief overview with treatment strategies. Pediatr Dermatol. 2004;21:74–9. Tosti A, Piraccini BM, Iorizzo M. Management of onychomycosis in children. Dermatol Clin. 2003;21:507–9. Chan Y, Friedlander SF. New treatments for tinea capitis. Curr Opin Infect Dis. 2004;17:97–103. Haroon TS, Hussain I, Aman S, et al. A randomized double-blind comparative study of terbinafine for 1, 2 and 4 weeks in tinea capitis. Br J Dermatol. 1996;135:86–8. Friedlander SF, Aly R, Krafchik B, et al. Terbinafine in the treatment of Trichophyton tinea capitis: a randomized, double-blind, parallel-group, duration-finding study. Pediatrics. 2002;109:602–7. Lipozencic J, Skerlev M, Orofino-Costa R, et al. A randomized, double-blind, parallel-group, duration-finding study of oral terbinafine and open-label, high-dose griseofulvin in children with tinea capitis due to Microsporum species. Br J Dermatol. 2002;146:816–23. Gupta AK, Solomon RS, Adam P. Itraconazole oral solution for the treatment of tinea capitis. Br J Dermatol. 1998;139:104–6. Dastghaib L, Azizzadeh M, Jafari P. Therapeutic options for the treatment of tinea capitis: griseofulvin versus fluconazole. J Dermatolog Treat. 2005;16:43–6. Montero Gei F. Fluconazole in the treatment of tinea capitis. Int J Dermatol. 1998;37:870–1. Gupta AK, Dlova N, Taborda P, et al. Once weekly fluconazole is effective in the treatment of tinea capitis: a prospective, multicentre study. Br J Dermatol. 2000;142:965–8. Gupta AK, Scher RK. Management of onychomycosis: a North American perspective. Dermatol Ther. 1997;3:58–65. Gupta AK, Ryder J, Bluhm R. Onychomycosis. In: Williams H, Bigby M, Diepgen T, Herxheimer A, Naldi L, Rzany B, editors. Evidence based dermatology. London: BMJ Books; 2003. p. 441–68. Tavakkol A, Fellman S, Kianifard F. Safety and efficacy of oral terbinafine in the treatment of onychomycosis: analysis of the elderly subgroup in Improving Results in Onychomycosis-Concomitant Lamisil® and Debridement (IRONCLAD®), an open-label, randomized trial. Am J Geriatr Pharmacother. 2006;4:1–13. Potter LP, Mathias SD, Raut M, et al. The impact of aggressive debridement used as an adjunct therapy with terbinafine on perceptions of patients undergoing treatment for toenail onychomycosis. J Dermatolog Treat. 2007;18:46–52. Daniel CR III. Traditional management of onychomycosis. J Am Acad Dermatol. 1996;35:S21–5. King B. Pain at first dressing change after toenail avulsion: the experience of nurses, patients and an observer: 1. J Wound Care. 2003;12:5–10. Seebacher C, Brasch D, Abeck O, et al. Onychomycosis. Mycoses. 2007;50:321–7. Baran R, Hay RJ, Haneke E, Tosti A. Review of current antifungal treatment. Onychomycosis: the current approach to diagnosis and therapy. London: Martin Dunitz Ltd.; 1999. p. 44–69. Hay RJ, Baran R, Haneke E. Fungal (onychomycosis) and other infections involving the nail apparatus. In: Baran R, Dawber RPR, de Berker DAR, Haneke E, Tosti A, editors. Baran and Dawber’s diseases of the nails and their management. Osney Mead, Oxford: Blackwell Science Ltd.; 2001. p. 129–71. Grover C, Bansal S, Nanda S, et al. Combination of surgical avulsion and topical therapy for single nail onychomycosis: a randomized controlled trial. Br J Dermatol. 2007;157:364–8. Baran R, Kaoukhov A. Topical antifungal drugs for the treatment of onychomycosis: an overview of current strategies for monotherapy and combination therapy. J Eur Acad Dermatol Venereol. 2005;19:21–9. Penlac® Nail Lacquer (ciclopirox) Topical Solution, 8% Prescribing information. Dermik Laboratories (a division of Sanofi-Aventis). Bridgewater, NJ, July 2006. Gupta AK, Ryder JE, Skinner AR. Treatment of onychomycosis: pros and cons of antifungal agents. J Cutan Med Surg. 2004;8:25–30. Warshaw EM, St Clair KR. Prevention of onychomycosis reinfection for patients with complete cure of all 10 toenails: results of a double-blind, placebo-controlled, pilot study of prophylactic miconazole powder 2%. J Am Acad Dermatol. 2005;53:717–20. Daniel CR, Gupta AK, Daniel MP, Daniel CM. Two feet-one hand syndrome: a retrospective multicenter survey. Int J Dermatol. 1997;36:658–60. Sigurgeirsson B, Elewski BE, Rich PA, et al. Intermittent versus continuous terbinafine in the treatment of toenail onychomycosis: a randomized, double-blind comparison. J Dermatolog Treat. 2006;17:38–44. Finch JJ, Warshaw EM. Toenail onychomycosis: current and future treatment options. Dermatol Ther. 2007;20:31–46. Olafsson JH, Sigurgeirsson B, Baran R. Combination therapy for onychomycosis. Br J Dermatol. 2003;149(Suppl 65):15–8. Evans EGV. Drug synergies and the potential for combination therapy in onychomycosis. Br J Dermatol. 2003;149(Suppl 65):11–3. Nandedkar-Thomas MA, Scher RK. An update on disorders of the nails. J Am Acad Dermatol. 2005;52:877–87. Gupta AK, Onychomycosis Combination Therapy Study Group. Ciclopirox topical solution, 8% combined with oral terbinafine to treat onychomycosis: a randomized, evaluator-blinded study. J Drugs Dermatol. 2005;4:481–5. Baran R. Topical amorolfine for 15 months combined with 12 weeks of oral terbinafine, a cost-effective treatment for onychomycosis. Br J Dermatol. 2001;145(Suppl 60):15–9. Lecha M. Amorolfine and itraconazole combination for severe toenail onychomycosis: results of an open randomized trial in Spain. Br J Dermatol. 2001;145(Suppl 60):21–6. Binstock JM. Molecular biology techniques for identifying dermatophytes and their possible use in diagnosing onychomycosis in human toenails. J Am Podiatr Med Assoc. 2007;97:134–44. de Assis Santos D, de Carvalho Araujo RA, Kohler LM, et al. Molecular typing and antifungal susceptibility of Trichophyton rubrum isolates from patients with onychomycosis pre- and post-treatment. Int J Antimicrob Agents. 2007;29:563–9. Brillowska-Dabrowska A, Saunte DM, Arendrup MC. Five-hour diagnosis of dermatophyte nail infections with specific detection of Trichophyton rubrum. J Clin Microbiol. 2007;45:1200–4. Savin C, Huck S, Rolland C, et al. Multicenter evaluation of a commercial PCR-enzyme-linked immunosorbent assay diagnostic kit (Onychodiag) for diagnosis of dermatophytic onychomycosis. J Clin Microbiol. 2007;45:1205–10. Gupta AK, Zaman M, Singh J. Fast and sensitive detection of Trichophyton rubrum DNA from the nail samples of patients with onychomycosis by a double-round polymerase chain reaction-based assay. Br J Dermatol. 2007;157:698–703.