SYSTEMIC ANTIFUNGAL THERAPY - 03/09/11

Doi : 10.1016/S0733-8635(05)70228-X

Meena Moossavi, MD ^{^{*
Department of Dermatology, Columbia University College of Physicians and Surgeons, New York City, New York}}, Bita Bagheri, MD ^{^{*
Department of Dermatology, Columbia University College of Physicians and Surgeons, New York City, New York}}, Richard K. Scher, MD ^{^{*
Department of Dermatology, Columbia University College of Physicians and Surgeons, New York City, New York}}

Résumé

Five oral antifungal agents are available on the market today that have proved to be useful in the typical dermatology practice: griseofulvin, ketoconazole, itraconazole, fluconazole, and terbinafine. These drugs may be used to treat commonly encountered superficial mycoses, such as fungal infections of the hair and nails, that do not respond to topical antifungals. Although many fungal infections of the skin do respond to topical antifungals, chronic dry forms of tinea cruris, extensive tinea corporis, or tinea pedis may require systemic antifungal treatment.^{40Degreef H.J., DeDoncker P.R.G. Current therapy of dermatophytosis J Am Acad Dermatol 1994 ; 31 : S25-S30

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For treatment of onychomycosis, properties that are desirable in an antifungal include favorable kinetics at the nail, high clinical cure rate, high mycologic cure rate, low incidence of relapse, and efficacy when used for short-term therapy. Low incidence of side effects, drug interactions, and cost-effectiveness are important. At present, itraconazole and terbinafine are the only oral antifungal agents approved for the treatment of onychomycosis in the United States.^{169Odom R.B. New therapies for onychomycosis J Am Acad Dermatol 1996 ; 35 : S26-S30

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Treatment for tinea capitis requires similar properties, usually tailored to the needs of the pediatric population. A good safety profile, high efficacy, less than 4-week treatment duration, a pleasant-tasting liquid formulation, and low cost are necessary in the successful treatment of tinea capitis. Griseofulvin is the only oral antifungal agent currently approved for the treatment of tinea capitis in the United States.^{54Elewski B.E. Treatment of tinea capitis: Beyond griseofulvin J Am Acad Dermatol 1999 ; 40 : S27-S30

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