Ketoconazole treatment of 13 patients with chronic mucocutaneous candidiasis. A prospective 3-year trial

Long-term results of initial ketoconazole treatment were evaluated in 13 patients with chronic mucocutaneous candidiasis followed up for 3 years. Six of them shared 11 endocrine or autoimmune disorders. All patients responded well to treatment but 1 dropped out owing to anxiety. Clinical and mycological clearing was achieved in 1-2 months for the mouth, 2 months for the skin, 3-4 months for paronychiae and 4-14 months for the nails. Bacterial infections persisted in 2 cases. After withdrawal of ketoconazole, 2 patients have remained in remission. Continuous therapy was required in 2 cases and the others were treated intermittently owing to recurrences of Candida stomatitis. Ketoconazole was well tolerated. An asymptomatic reversible increase of serum hepatic enzymes occurred in 1 case. Oral ketoconazole is the drug of choice for treatment of chronic mucocutaneous candidiasis but long-term observation is required.