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1.
Clin Dermatol ; 28(2): 212-6, 2010 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-20347665

RESUMO

There presently exists a wide selection of choices in the treatment of superficial mycoses. The main categories of broad-spectrum agents are the allylamines and imidazoles, which have been tried and proven over more than 2 decades of usage with good safety. Nystatin and griseofulvin have even longer experience of about 5 decades but have niche usage for yeasts and dermatophytes, respectively. Although no new therapeutic groups have appeared, extensive development of vehicles and delivery systems has enhanced therapeutic results and increased patient compliance.


Assuntos
Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Azóis/uso terapêutico , Dermatomicoses/tratamento farmacológico , Administração Oral , Administração Tópica , Antifúngicos/economia , Azóis/economia , Dermatomicoses/economia , Dermatomicoses/epidemiologia , Esquema de Medicação , Farmacorresistência Fúngica/efeitos dos fármacos , Fluconazol/uso terapêutico , Griseofulvina/uso terapêutico , Humanos , Itraconazol/uso terapêutico , Cetoconazol/uso terapêutico , Morfolinas/uso terapêutico , Tolnaftato/uso terapêutico , Estados Unidos/epidemiologia
2.
Rev. méd. Chile ; 125(8): 922-6, ago. 1997. ilus
Artigo em Espanhol | LILACS | ID: lil-207131

RESUMO

We report and eight years old boy presenting with a pyogenic granuloma of the scalp, generalized alopecia, descamative plates in the neck, trunk and limbs and nail involvement. Cultures for fungus of all these lesions disclosed Microspore canis. The patient was treated with oral griseofulvin, miconazole and topical tolnaftate. Five years later and after several incomplete treatments, the patient returns with a fistulous mass of 12 x 8 cm in the dorsal area whose culture revealed Microspore canis. The mass was excised and oral ketoconazole was indicated. After three months of follow up, the patient was lost from control


Assuntos
Humanos , Masculino , Criança , Microsporum/patogenicidade , Micetoma/microbiologia , Alopecia/microbiologia , Cloxacilina/uso terapêutico , Gentamicinas/uso terapêutico , Granuloma Piogênico/cirurgia , Griseofulvina/uso terapêutico , Miconazol/uso terapêutico , Micetoma/terapia , Tolnaftato/uso terapêutico
3.
J Am Acad Dermatol ; 31(3 Pt 2): S25-30, 1994 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8077504

RESUMO

In the past dermatophytes were treated with topical agents or, in the case of more recalcitrant or extensive disease, with oral antifungals (griseofulvin or ketoconazole). Topical therapies may be effective in many cases, but they have limitations. They may be viewed as inconvenient by the patient, thereby affecting compliance. Therapy with early oral antifungals entails long treatment periods until complete cure is obtained. For ketoconazole rare but serious side effects can occur, particularly with prolonged use. Griseofulvin is still the drug of choice for the treatment of tinea capitis of the Microsporum type. In recent years a few new antimycotic agents have been developed for systemic therapy of superficial fungal infections. Itraconazole is a broad-spectrum triazole. Fluconazole belongs to the same chemical class and was used mainly in systemic yeast infections and mucosal candidosis. Terbinafine is an allylamine and has been found to be effective and safe in brief therapy of dermatophyte infections. Short-duration therapy of most dermatophyte infections is also possible with itraconazole. The high and specific activity against the causative agents, together with their pharmacokinetic properties, explains the good results obtained with these new drugs and their improved safety profile. Their mode of action, pharmacokinetics, and treatment schedules will be discussed.


Assuntos
Antifúngicos/uso terapêutico , Dermatomicoses/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/complicações , Administração Oral , Administração Tópica , Alilamina/farmacologia , Alilamina/uso terapêutico , Antifúngicos/farmacologia , Dermatomicoses/complicações , Esquema de Medicação , Fluconazol/farmacologia , Fluconazol/uso terapêutico , Griseofulvina/farmacologia , Griseofulvina/uso terapêutico , Humanos , Itraconazol/farmacologia , Itraconazol/uso terapêutico , Cetoconazol/farmacologia , Cetoconazol/uso terapêutico , Morfolinas/farmacologia , Morfolinas/uso terapêutico , Fatores de Tempo , Tolnaftato/farmacologia , Tolnaftato/uso terapêutico
4.
Ann Dermatol Venereol ; 120(1): 21-31, 1993.
Artigo em Francês | MEDLINE | ID: mdl-8393313

RESUMO

New antifungals for topical and systemic treatment of superficial mycotic infections of the skin and nails have been developed in the last decade. Terconazole is a potent drug in treating topically vaginal candidiasis. Amorolfine belongs to the chemical class of morpholine derivatives and is topically active against a wide range of fungal infections. Also naftifine and terbinafine, two new allylamines, can be used in local therapy of superficial mycotic infections of the skin. Itraconazole and fluconazole are both new triazoles for systemic use. Itraconazole has a broader spectrum and a higher safety profile than ketoconazole, caused by a greater specificity for the fungal cytochrome P 450 14-alpha-demethylase. The pharmacokinetic properties result in shorter treatments, even in onychomycosis. The mode of action of fluconazole is the same as for the azoles. This drug was being studied particularly in systemic mycoses and mucosal candidiasis. The activity of orally terbinafine is directed mainly against dermatophytes. This drug offers new therapeutic possibilities in the treatment of onychomycosis, caused by dermatophytes.


Assuntos
Antifúngicos/uso terapêutico , Dermatomicoses/tratamento farmacológico , Administração Tópica , Antifúngicos/administração & dosagem , Azóis/uso terapêutico , Fluconazol/uso terapêutico , Humanos , Itraconazol , Cetoconazol/análogos & derivados , Cetoconazol/uso terapêutico , Naftalenos/uso terapêutico , Terbinafina , Tolnaftato/uso terapêutico
5.
Australas J Dermatol ; 33(3): 145-9, 1992.
Artigo em Inglês | MEDLINE | ID: mdl-1303075

RESUMO

Tea tree oil (an essential oil derived primarily from the Australian native Melaleuca alternifolia) has been used as a topical antiseptic agent since the early part of this century for a wide variety of skin infections; however, to date, the evidence for its efficacy in fungal infections is still largely anecdotal. One hundred and four patients completed a randomized, double-blind trial to evaluate the efficacy of 10% w/w tea tree oil cream compared with 1% tolnaftate and placebo creams in the treatment of tinea pedis. Significantly more tolnaftate-treated patients (85%) than tea tree oil (30%) and placebo-treated patients (21%) showed conversion to negative culture at the end of therapy (p < 0.001); there was no statistically significant difference between tea tree oil and placebo groups. All three groups demonstrated improvement in clinical condition based on the four clinical parameters of scaling, inflammation, itching and burning. The tea tree oil group (24/37) and the tolnaftate group (19/33) showed significant improvement in clinical condition when compared to the placebo group (14/34; p = 0.022 and p = 0.018 respectively). Tea tree oil cream (10% w/w) appears to reduce the symptomatology of tinea pedis as effectively as tolnaftate 1% but is no more effective than placebo in achieving a mycological cure. This may be the basis for the popular use of tea tree oil in the treatment of tinea pedis.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Óleos Voláteis/uso terapêutico , Óleos Vegetais/uso terapêutico , Plantas Medicinais , Tinha dos Pés/tratamento farmacológico , Tolnaftato/uso terapêutico , Adolescente , Adulto , Idoso , Anti-Infecciosos Locais/administração & dosagem , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Óleos Voláteis/administração & dosagem , Placebos , Óleos Vegetais/administração & dosagem , Pele/efeitos dos fármacos , Pele/microbiologia , Pele/patologia , Óleo de Melaleuca , Tinha dos Pés/microbiologia , Tinha dos Pés/patologia , Tolnaftato/administração & dosagem , Trichophyton/efeitos dos fármacos , Trichophyton/isolamento & purificação
6.
Arzneimittelforschung ; 41(8): 847-51, 1991 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-1781809

RESUMO

In vitro and in vivo antifungal activities of the new imidazole derivative latoconazole ((+-)-(E)-[4-(2-chlorophenyl)-1,3-dithiolan-2-ylidene]-1- imidazolylacetonitrile, NND-318; CAS 101530-10-3) were studied in comparison with three major topical agents, clotrimazole, bifonazole and tolnaftate. The in vitro activity of latoconazole against dermatophytes was much stronger than that of any reference agent tested. Both the recently developed tinea pedis model and the conventional tinea model in guinea pigs were employed for evaluation of topical usefulness of latoconazole. The 1% solution or cream preparation of latoconazole was highly effective in both of the two tinea models and its 5 or more doses achieved almost complete mycological cure. However, both tinea models, especially the former, were considerably resistant to the therapeutic treatment of all of the reference drugs. These results suggest that latoconazole is a promising topical antifungal agent, probably applicable to the treatment of tinea pedis as well as other types of dermatomycoses.


Assuntos
Antifúngicos/uso terapêutico , Compostos Heterocíclicos/uso terapêutico , Imidazóis/uso terapêutico , Tinha dos Pés/tratamento farmacológico , Animais , Clotrimazol/uso terapêutico , Cobaias , Masculino , Testes de Sensibilidade Microbiana , Tinha dos Pés/microbiologia , Tolnaftato/uso terapêutico , Trichophyton/efeitos dos fármacos
7.
Antimicrob Agents Chemother ; 33(12): 2118-25, 1989 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-2619275

RESUMO

Piritetrate (M-732), a new topical antifungal agent belonging chemically to the thiocarbamates, was demonstrated to possess a potent selective antidermatophytic activity. In terms of its MICs in susceptibility testing, mainly done by using Sabouraud dextrose agar plates, piritetrate exhibited several- to 10-fold-stronger antidermatophytic activity than tolnaftate, a reference thiocarbamate. Furthermore, piritetrate was found to show a broader antifungal spectrum than tolnaftate; relatively many species and strains of dematiaceous fungi, dimorphic fungi, and some other filamentous fungi as well as a few strains of Cryptococcus neoformans were fairly susceptible to piritetrate, while almost all the tested species and strains were resistant to tolnaftate. All the tested species of the genus Candida were, however, resistant to both compounds. Variables which can influence antimicrobial activity caused few changes in the MICs of either compound against Trichophyton mentagrophytes; however, an increase in the inoculum size resulted in a significant increase in the MICs. The antidermatophytic activities of piritetrate and tolnaftate were fungistatic but not fungicidal. Piritetrate also exhibited a more potent in vitro anti-T. mentagrophytes activity than clotrimazole or tolciclate. Piritetrate and tolnaftate had no antibacterial activity. The in vivo activity of topically administered piritetrate against experimental dermal infection of guinea pigs with T. mentagrophytes was more effective than that of tolnaftate both mycologically and clinically. Piritetrate manifested no acute toxicity in laboratory animals when administered even in large quantities by the oral, intraperitoneal, and topical routes.


Assuntos
Antifúngicos/farmacologia , Fungos/efeitos dos fármacos , Tolnaftato/análogos & derivados , Animais , Antifúngicos/uso terapêutico , Bactérias , Meios de Cultura , Cobaias , Concentração de Íons de Hidrogênio , Masculino , Camundongos , Testes de Sensibilidade Microbiana , Tinha/tratamento farmacológico , Tolnaftato/farmacologia , Tolnaftato/uso terapêutico
9.
Folha méd ; 95(5/6): 381-4, nov.-dez. 1987. tab
Artigo em Português | LILACS | ID: lil-47931

RESUMO

Vinte e oito pacientes com diagnóstico clínico e laboratorial de dermatofitose foram aleatoriamente divididos em dois grupos. Um grupo foi tratado com creme de oxiconazol a 1%. O outro grupo foi tratado com creme de tolnaftato. A medicaçäo em ambos os grupos foi aplicada duas vezes ao dia por 40 dias. Em uma segunda fase foram estudados 19 pacientes com diagnóstico clínico e laboratorial de dermatofitose, tratados com uma única aplicaçäo diária de creme de oxiconazol a 1% por 40 dias. O creme de oxiconazol a 1% foi täo eficaz quanto o creme de tolnaftato e causou menor incidência de efeitos colaterais. uma única aplicaçäo diária de creme de oxiconazol a 1% levou à cura micológica em 94,7% dos pacientes após 40 dias


Assuntos
Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Dermatomicoses , Imidazóis/uso terapêutico , Tolnaftato/uso terapêutico
11.
Artigo em Inglês | MEDLINE | ID: mdl-2940791

RESUMO

There is a wide variety of highly effective topical antifungal agents available for the treatment of dermatophytosis. In more widespread infections or those involving hair or nails oral therapy with griseofulvin or ketoconazole can be used. With both forms of therapy certain types of dermatophyte infection are clinically resistant to treatment. These include onychomycosis, infections of the sole caused by T.rubrum and certain forms of tinea capitis (e.g. favus) or tinea corporis. In future consideration needs to be given to find the optimum duration and frequency of treatment and better methods of allowing penetration of drugs into nails and heavely keratinised sites.


Assuntos
Tinha/tratamento farmacológico , Administração Oral , Administração Tópica , Griseofulvina/uso terapêutico , Humanos , Imidazóis/uso terapêutico , Cetoconazol/uso terapêutico , Onicomicose/tratamento farmacológico , Éteres Fenílicos/uso terapêutico , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha dos Pés/tratamento farmacológico , Tolnaftato/uso terapêutico
14.
Mycopathologia ; 90(1): 47-54, 1985 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-4039795

RESUMO

Guinea pigs and athymic nude (RNU/RNU) rats were used to assess the efficacy of three orally administered antifungal agents--Tolciclate, Tolnaftate, and Ketoconazole--against Trichophyton mentagrophytes dermatophytosis. All three antifungal agents inhibited the test strain of T. mentagrophytes in vitro. Antifungal agents were tested in intervention (oral therapy started 5 days after challenge) or prophylaxis (oral therapy started 5 days before challenge) protocols. Oral treatment of dermatophytosis on guinea pig skin demonstrated that Tolciclate and Tolnaftate alleviated clinical symptoms and shortened the duration of the dermatophytosis, in comparison to nontreated controls. Assessment of antifungal efficacy in the guinea pig model was time consuming (30-35 days) and variability in the duration and severity of clinical symptoms on guinea pig skin was common. Oral therapy of chronically infected athymic rats demonstrated that Tolciclate, Tolnaftate, and ketoconazole were effective antifungal agents in vivo. Obvious improvement in clinical symptoms of dermatophytosis (i.e. less erythema and fewer lesions) was evident with all three antifungal agents within 10 days of starting oral therapy. By day 20, athymic rats that were treated with either Tolciclate or Ketoconazole showed marked clinical improvement of the chronic dermatophytosis. Chronically infected athymic rats, which lack thymus matured T-cells, are a promising new model to evaluate the efficacy of antifungal agents by culture, histology, and visual observations of clinical symptoms.


Assuntos
Antifúngicos , Cetoconazol/uso terapêutico , Tiocarbamatos/uso terapêutico , Tinha/tratamento farmacológico , Tolnaftato/uso terapêutico , Administração Oral , Animais , Antifúngicos/administração & dosagem , Feminino , Cobaias , Camundongos , Ratos , Ratos Endogâmicos F344 , Fatores de Tempo
16.
Sabouraudia ; 22(4): 311-4, 1984.
Artigo em Espanhol | MEDLINE | ID: mdl-6505909

RESUMO

Aphanoascus fulvescens was isolated from lesions resembling a dermatophyte infection in a 45-year-old woman who had used steroid cream for several months to treat a dermatosis of the neck. Treatment with griseofulvin and tolnaftate cured the lesions in 6 weeks. The microscopic characteristics of the isolate and its size differed slightly from those described by several other authors, and bore a closer resemblance to isolates previously described from Australia and New Guinea.


Assuntos
Dermatomicoses/microbiologia , Ascomicetos/isolamento & purificação , Dermatomicoses/tratamento farmacológico , Dermatomicoses/patologia , Quimioterapia Combinada , Feminino , Griseofulvina/uso terapêutico , Humanos , Pessoa de Meia-Idade , Pele/microbiologia , Tolnaftato/uso terapêutico
18.
Sabouraudia ; 20(2): 101-8, 1982 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-7112334

RESUMO

The hair root invasion test is a new method for preclinical evaluation of the antimycotic efficacy of chemical compounds in vivo based on their antifungal activity against dermatophytes located at hair roots in the depth of the hair follicles of guinea-pigs. The test design allows for semi-quantitative assessment of the invasion density of the hair follicles in mycotic foci of treated and untreated animals. Conditions that must be met in order to yield satisfactory results are discussed and test results from standard antimycotics are presented.


Assuntos
Antifúngicos/uso terapêutico , Avaliação Pré-Clínica de Medicamentos/métodos , Cabelo/microbiologia , Tinha/tratamento farmacológico , Trichophyton/efeitos dos fármacos , Administração Oral , Alilamina/análogos & derivados , Alilamina/uso terapêutico , Animais , Antifúngicos/administração & dosagem , Relação Dose-Resposta a Droga , Econazol/uso terapêutico , Cobaias , Masculino , Tolnaftato/uso terapêutico , Trichophyton/crescimento & desenvolvimento
19.
J Int Med Res ; 10(1): 28-31, 1982.
Artigo em Inglês | MEDLINE | ID: mdl-7060822

RESUMO

Forty-six patients with acute tinea pedis were treated with either 1% tolnaftate aerosol spray powder or 2% miconazole nitrate aerosol spray powder, not previously available. Products were coded, and the study was conducted in a double-blind manner. At the end of 28 days of therapy, 68% of the miconazole-treated group achieved therapeutic cure, versus 50% in the tolnaftate-treated group. Symptomatic relief and mycological clearing based on potassium hydroxide examination took place in less time for the patients treated with miconazole nitrate. The aerosol spray powder form is an effective alternative vehicle to both cream and solution.


Assuntos
Antifúngicos/uso terapêutico , Imidazóis/uso terapêutico , Miconazol/uso terapêutico , Compostos de Potássio , Tinha dos Pés/tratamento farmacológico , Doença Aguda , Aerossóis , Feminino , Humanos , Hidróxidos , Masculino , Potássio , Pós , Tinha dos Pés/diagnóstico , Tolnaftato/uso terapêutico , Trichophyton/isolamento & purificação
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