A double-blind clinical trial of fenticonazole (2%) spray versus naftifine (1%) spray in patients with cutaneous mycoses.

A multi-centre, double-blind trial was carried out in 100 patients with cutaneous mycotic infections, confirmed by direct microscopy and/or culture, to compare the efficacy and tolerability of spray formulations of 2% fenticonazole and 1% naftifine. On entry, patients were allocated at random to receive once daily topical applications of one or other drug over a period of 2 to 4 weeks, treatment being stopped when patients had recovered or substantially improved. Clinical and mycological assessments were made before (baseline), at weekly intervals during treatment and, if possible, 2 to 3 weeks after the end of treatment (drug-free period). Treatment was continued for 19.25 days with fenticonazole and 19.62 days with naftifine. All patients had positive mycological findings on entry. The most frequently isolated pathogens were dermatophytes, mainly Trichophyton rubrum; however, Candida albicans was present in 33.3% of patients in the fenticonazole group and in 20.8% of those treated with naftifine. At the end of treatment, only 3 (6.3%) and 5 (10.4%) patients, respectively, of the 48 patients assessed in each group still had positive mycological findings. Assessments of symptoms indicated comparable, significant improvement in both groups, and at the end of treatment the overall opinion of doctors and patients was that about 90% of patients were cured or greatly improved. The end of the drug-free period evaluation showed that, of the patients assessed as cured or greatly improved at the end of treatment, only 1 (3.2%) patient who had received fenticonazole and 2 (6.3%) who had received naftifine were confirmed mycologically as having relapsed.(ABSTRACT TRUNCATED AT 250 WORDS)

[Predisposing factors in candidiasis. Animal experimental studies and clinical findings with special regard to immunity]. / Prädisponierende Faktoren bei der Candidosis. Tierexperimentelle Untersuchungen und klinische Befunde unter besonderer Berücksichtigung der Immunität.

In the presence of predisposing factors which are considered as a local or general impairment of the host's defence mechanisms, the opportunistically pathogenic character of Candida albicans transforms into a parasitic one thus favoring the development of candidosis. The clinically reporting part of the paper deals with the predisposing factors and clinical features of candidosis. In animal experiments, we attempted to find out to what extent and whether exclusively the cellular immune system protects the host from Candida albicans infection. Our findings suggest that the cell-mediated immunity and phagocytosis are of fundamental importance in overcoming a candidosis and in resistance to Candida albicans. The humoral immune system plays a minor role, which may be limited to the stimulation of macrophages.

[Predisposing factors in candidiasis]. / Prädisponierende Faktoren bei der Candidosis.

The Candida mycosis is an infection by Candida albicans and other Candida species. This disease is not initiated by contact of Candida with the normal skin and mucous membranes or by invasion into the healthy host. On the contrary the presence of predisposing factors is important to Candida mycosis. These predisposing factors are considered as an impairment of local and/or general immunity and transform the opportunistically pathogenic character of the fungus into a parasitic one. Thus the host's defence mechanisms alone favour the development of Candida mycosis.

[Skin syphilids, only incidental findings]. / Hutsyphilide, nur Zufallsbefunde

Six cases of syphilides- rarely seen cutaneous manifestations today--are reported and the difficulties in finding the correct diagnosis are stressed. Considerations with particular reference to the differential diagnosis of clinically and histomorphologically similar diseases are discussed. Beside case history and serological tests it is of overall importance to bear in mind the possibility of late syphilis.

[Successful zinc treatment of a severe case of acrodermatitis enteropathica (author's tteropathica]. / Labensrettende Zinkbehandlung der Acrodermatitis enteropathica

A 24-year-old patient treated with hydroxychinoline preparations without cure for acrodermatitis enteropathica since he was nine years old was given zinc oxide orally, at first 50 mg three times, later twice daily. Zinc concentrations in blood plasma, whole blood and sputum were serially determined. At the start of treatment they were significantly below that in four healthy controls. One week after starting zinc therapy the blood level had returned to normal and with it the changes in skin, hair and nails had regressed, as had the emotional disturbances.