Comparison of a single 400 mg dose versus a 7-day 200 mg daily dose of itraconazole in the treatment of tinea versicolor.

BACKGROUND: Tinea (pityriasis) versicolor is a superficial infection of the stratum corneum by the lipophilic fungus known as Malassezia furfur. OBJECTIVE: To evaluate the efficacy and safety of a 400 mg single dose or 7-day 200 mg daily dose of itraconazole capsules in the treatment of mycologically confirmed pityriasis versicolor. METHODS: A total of 50 patients were entered into a randomized, open, clinical trial comparing a 400 mg single dose (n = 24 for group 1) with a 7-day 200 mg daily dose (n = 26 for group 2) of itraconazole. Clinical signs and symptoms and mycologic evaluation (potassium hydroxide preparation and Wood's lamp) were performed before treatment, and at weeks 3 and 6 after treatment. RESULTS: Both regimens of itraconazole were effective. Our results showed that there were no significant differences in efficacy and safety between the two treatment regimens (chi-square tests, p > 0.05). CONCLUSIONS: On the basis of these findings, a single dose of itraconazole 400 mg/day was as effective as the 7-day 200 mg daily dose in the treatment of pityriasis versicolor.

Efficacy and safety assessment of 0.5% and 1% colchicine cream in the treatment of actinic keratoses.

BACKGROUND: Topical colchicine has been reported to be an effective treatment for actinic keratoses, but the optimal concentration has not been fully defined. OBJECTIVE: The aim of this study was to further support the beneficial effect of topical colchicine therapy for actinic keratoses, and to compare the efficacy and safety of two different concentrations of colchicine cream, 0.5% and 1%. METHODS: Sixteen patients with actinic keratoses were enrolled in this comparative randomized study. Eight patients applied 1% colchicine cream, twice daily on their lesions while the other eight were treated with a 0.5% colchicine cream for 10 days. Some patients were applied a second course of 10 days' therapy. Patients were examined before treatment and at 10 days, and followed up at 1, 2 and 6 months of treatment. Visible and palpable actinic keratoses lesions in each group were counted. Safety and efficacy were also assessed by clinical examination at each study visit. Routine laboratory tests were performed before and after treatment. RESULTS: Actinic keratoses lesions showed significant clinical improvement following treatment with 0.5% and 1% colchicine cream. Complete healing of actinic keratoses were observed in six of the eight patients in the 1% colchicine group, and in seven of the eight patients in the 0.5% colchicine group. The reduction rate in number of actinic keratoses at the end of treatment in the 1% colchicine group was 73.9% (48/65) (p < 0.001), and the reduction rate in the 0.5% colchicine group was 77.7% (52/67) in total (p < 0.001). The reduction in number of actinic keratoses (mean +/- SD) at the end of treatment was similar in the 1% colchicine group (0.7 +/- 1.3), and the 0.5% colchicine group (mean 0.6 +/- 1.7) (p > 0.05). Systemic side effects were not seen in either concentration. CONCLUSIONS: Topical colchicine is an effective and safe alternative agent. Cream containing 0.5% of colchicine is equally effective as 1% colchicine cream in the treatment of actinic keratoses.

Focal epithelial hyperplasia treated with interferon alpha-2a.

BACKGROUND: Focal epithelial hyperplasia (FEH) is an uncommon benign oral condition that occurs mainly in young individuals of certain racial groups. METHODS: A 21-year-old Caucasian man presented with FEH of the oral mucosa. The patient was treated with interferon alpha-2a three times a week for 14 weeks intramuscularly (a total of 162 million units). RESULTS: At 2 months after the end of therapy, the papular lesions showed partial regression. CONCLUSION: This treatment modality should be used in cases with diffuse focal epithelial hyperplasia.

An open, randomized, comparative study of oral fluconazole, itraconazole and terbinafine therapy in onychomycosis.

BACKGROUND/AIM: In this open, randomized and comparative study, the safety and efficacy of systemic fluconazole, itraconazole and terbinafine was investigated in 50 patients with distal subungual toenail onychomycosis diagnosed clinically and mycologically. The patients with positive mycology and also the patients with positive microscopy and negative culture were investigated. METHODS: The treatment duration was 3 months, and the follow-up period was 6 months. Patients were randomly assigned: 16 patients received 150 mg fluconazole once weekly, 18 patients received 200 mg itraconazole twice daily with meals during the first week of each month, and 16 patients received 250 mg/day terbinafine during the treatment period. RESULTS: In a clinical evaluation, at the endpoint of the follow-up period, the clinical cure rates were 81.3% (13/16) in the terbinafine group, 77.8% (14/18) in the itraconazole group, and 37.5% (6/16) in the fluconazole group. The mycological cure rates were 75% (12/16), 61.1% (11/18) and 31.2% (5/16), respectively. The overall assessment rates were 62.5% (10/16), 61.1% (11/18) and 31.2% (5/16), respectively. Statistically significant intra-group reductions from baseline symptom severity values were seen at the endpoint of treatment and at the endpoint of the follow-up period for all three treatment groups in onycholysis, subungual hyperkeratosis, affected-area percentage score and total score parameters (p < 0.001). At the endpoint of the follow-up period, statistically significant differences between the treatment groups were seen in clinical, mycological and overall assessment (p < 0.05). However, while no statistically significant difference between the terbinafine and itraconazole groups was seen, there was a clinical and statistical difference between the other groups and the fluconazole group. Treatment was not stopped for side effects such as mild gastrointestinal and central nervous system symptoms. These effects were noted in four patients in the fluconazole group (25%), five patients in the itraconazole group (27.8%), and three patients in the terbinafine group (18.75%). The clinical laboratory data on all three drug groups did not show any statistically or clinically significant intra-group changes from baseline values at the endpoint (p > 0.05). CONCLUSION: This comparative study of systemic fluconazole, itraconazole and terbinafine showed that all three drugs were effective and safe in the treatment of onychomycosis. However, fluconazole, at these doses and treatment durations, was the least effective. With regard to cost-effectiveness, side effects and the cure rates, terbinafine could be the drug of choice in the short-term treatment of toenail onychomycosis.