Terbinafine versus itraconazole and fluconazole in the treatment of Vulvovaginal candidiasis.

Vulvovaginal candidiasis is one of the most frequent infections of the female genital tract with a high incidence. Although numerous antimycotical agents are available for treatment of yeast vaginitis, there are few comparative data on the in vivo and in vitro activity of these drugs. The aim of this open, randomized, and comparative study was to determine in vivo and in vitro effectiveness of the 3 systemic antifungal agents: terbinafine and 2 azoles (itraconazole and fluconazole) in the treatment of patients with Vulvovaginal candidiasis. A total of 44 patients who had signs and symptoms of Vulvovaginal candidiasis were recruited for the study. Patients were randomly assigned to 3 groups: terbinafine 500 mg/d orally was used for 7 days, itraconazole 200 mg/d orally was used for 7 days, and fluconazole 150 mg orally was used as a single dose. Both clinical and mycologic examinations were performed for posttreatment assessment at week 4. This study revealed a clinical cure rate 33.3% for terbinafine, 60% for itraconazole, and 66.6% for fluconazole (P>0.05). Mycologic cure rates were 33.3%, 10%, and 66.6% respectively (P<0.05). Overall cure rates were 33.3%, 10%, and 53.3% (P>0.05). Terbinafine could be an alternative treatment option in Vulvovaginal candidiasis because there were no significant differences in the clinical and overall cure rates among 3 antifungal agents. However, terbinafine could not be suggested as a first-line treatment in Vulvovaginal candidiasis. Systemic use of terbinafine in larger numbers of cases may give more information about the effectiveness of this drug in the treatment of patients with vulvovaginal candidiasis.

Effect of PUVA therapy on electrodermal activity parameters in vitiligo patients.

UNLABELLED: Recent electrophysiological studies on autonomic dysfunction in vitiligo patients show an autonomic dysfunction as measured by absent sympathetic skin response (SSR). Nothing is known about the reversibility of these autonomic parameters with treatment. The present study examined how Electrodermal Activity (EDA) parameters were affected from vitiligo illness before PUVA therapy and whether any electrophysiological gains acquired from PUVA therapy would influence the progression of the condition itself. We studied in 14 healthy subjectS and 14 patients with generalized vitiligo before and after treatment. EDA was recorded with a skin conductance unit connected to a personal computer. Before treatment, skin conductance level (SCL) and habituation number (HN) was higher in vitiligo group than control groups. After treatment, SCL and HN were decreased nearly to normal value. Before and after treatment, prevalence of non-responsivity was higher in vitiligo group than controls. CONCLUSION: The sympathetic nervous system might have a particular role in the pathogenesis of vitiligo. Thus, patients with vitiligo may have changes to EDA parameters that are reversible to great extent with PUVA therapy. EDA is a useful method of studying the autonomic dysfunction in humans.

Micronucleus evaluation in mitogen-stimulated lymphocytes of narrow-band (311 nm TL01) UVB-treated patients.

BACKGROUND: Narrow-band UVB (311 nm) lamps (TL01) are being increasingly used for phototherapy of psoriasis and other dermatoses, for their excellent effect compared with broad-band UVB sources and photochemotherapy. It is acknowledged that the TL01 lamp is probably two to three times more carcinogenic per minimum erythema dose than broad-band UVB, but the cumulative dose is considerably less than broadband UVB sources. Micronucleus (MN) test is used to detect both clastogenic (breaking) and aneugenic (abnormal segregation) effect of physical/chemical agents on chromosomes. The aim of this study is to evaluate MN frequencies in mitogen-stimulated lymphocytes of narrow-band UVB-treated patients. METHODS: Frequency of micronuclei in 72 h cultivated/mitogen-stimulated lymphocytes of 36 patients (age 7-73 years, mean+/-SD: 25.33+/-18.54) have been evaluated at pretreatment and after 20, 40, 60 sessions of narrowband UVB treatment. RESULTS: While the beginning MN frequency +/-SD (%) was 1.07+/-0.63, it increased to 1.47+/-0.92, 1.47+/- 0.77, 1.41+/-0.31 corresponding, respectively, to 20, 40, 60 sessions. These sessions reciprocally correspond to 0.85+/-0.23, 2.97+/-0.72, 5.68+/-1.46 J/cm(2) doses of narrow-band UVB. Difference of MN frequency was statistically significant (P=0.002). Significant differences have been observed between the initial MN frequency and after that of 20, 40, 60 sessions (P=0.001, 0.004, 0.002, respectively). CONCLUSIONS: The results of this study show that narrow-band UVB treatment causes a detectable chromosome damaging effect.