Clinical and immunological studies in chronic dermatophytosis caused by Trichophyton rubrum

Twenty-six patients with chronic dermatophytosis (CD) by Trichophyton rubrum (TR) through one year were included in a double-blind clinical trial with Levamisole/Placebo. All patients were treated with griseofulvin concomitantly. Before, during and after the trial, studies of the cellular and humoral immune response were performed. The result of treatment with griseofulvin plus levamisole (62.5% cured or improved) did not differ from that of griseofulvin plus placebo (58% improved). All patients but one showed normal general cellular immune responses. Stimulation of lymphocytes with a specific TR antigen extract showed a significantly stronger response in the patient group than in the group of 39 controls (p = 0.01-0.00003) at all investigation dates. Immediate weal reactions to the TR extract were seen in 42% of the patients and increased concentration of IgE antibodies was demonstrated in 46%. Specific IgG antibodies towards TR were observed in 42% of the patients. The presence of specific IgG antibodies and a strong specific cellular immune response were related to the severity of clinical involvement. Environmental factors and atopy were associated disorders in 81% and 77% respectively.