Randomised controlled trial of topical butenafine in tinea cruris and tinea corporis.

Butenafine is a new antifungal agent similar to allyl amine antifungals. A randomized controlled trial was conducted in 75 patients to compare its efficacy with clotrimazole in tinea cruris and corporis that was diagnosed on clinical features and demonstration of hyphae in a potassium hydroxide (KOH) preparation. Twenty patients treated with butenafine once daily for 2 weeks and 20 treated with clotrimazole twice daily for 4 weeks were analysed. At the end of treatment, 2 weeks and 4 weeks later, the KOH preparation was negative in 90.9%, 95.5% and 90.9% of patients respectively in the butenafine group and 100%, 96.4% and 92.85% respectively in the clotrimazole group. There was a reduction of 81.5% in the sign and symptom score at 4 weeks following treatment in the butenafine group and 85.93% in the clotrimazole group. There was no statistically significant difference between the two groups. Adverse effects were mild in both groups and did not require discontinuation of therapy except one patient treated with clotrimazole who developed dermatitis at the site of application. Butenafine appears to be as effective as clotrimazole in the treatment of tinea cruris and corporis while requiring a single daily application for a shorter of 2 weeks.

Long-term safety and toxicity of azathioprine in patients with air-borne contact dermatitis.

Forty-six patients, 35 males and 11 females between 30 and 75 years age having patch test confirmed air-borne contact dermatitis for 6 months to 20 years were treated with azathioprine for varying periods of 3 months to 3 years. Twenty-two patients (Group 1) received azathioprine 50 mg twice daily orally for 6 months to 3 years, 12 patients (Group 2) were given the drug in a dose of 50 mg once daily and 300 mg once in four weeks orally for 3 months to 2.5 years, and the remaining 12 patients (Group 3) were treated with azathioprine 50 mg twice daily and 300 mg once in 4 weeks orally for 4 degrees months to 2.3 years. All the patients were evaluated clinically as well as biochemically every month to determine the side-effects of azathioprine. Out of these 46 patients, only 2 (4.3%) patients had severe drug-induced side-effects of gastrointestinal and hepatic origin. Three patients had transient rise in SGPT. Eighteen patients had other milder side effects which included mainly cutaneous infections.

Lichen planus treated with betamethasone oral mini-pulse therapy.

Ten Patients, 6 males and 4 females between 7-60 years of age having lichen planus for I month to 2 years were treated with betamethasone 5mg orally on two consecutive days in a week for 3 months. There was excellent (75-100%) response in 6 (60%) patients and good (50-75%) in 4 (40%) patients. None of the patients had significant side effects of the therapy and there were no treat-ment failures. Betamethasone on two consecutive days in a week as oral mini pulse therapy may be a safe, effective and a better therapeutic alternative for the treatment of lichen planus.

Hypopigmented mycosis fungoides treated successfully with puva.

Hypopigmented lesions are rarely encountered in mycosis fungoides. We here report a 22-year old female patient who presented with a 5-year history of asymptomatic progressively increasing discrete and confluent hypopigmented macules and a 1-year history of a few itchy erythematous, scaly, indurated plaques. The histological features were consistent with a clinical diagnosis of mycosis fungoides. She was successfully treated with PUVA therapy.