Oral ketoconazole for dermatophyte infections.

Area of Science:

• Dermatology
• Mycology
• Pharmacology

Background:

• Chronic dermatophyte infections pose a significant therapeutic challenge.
• Previous treatments, such as griseofulvin, have shown limited efficacy in some patients.

Purpose of the Study:

• To evaluate the efficacy and safety of oral ketoconazole in treating chronic dermatophyte infections.
• To assess ketoconazole's effectiveness in patients refractory to other antifungal agents.

Main Methods:

• Nineteen patients with chronic dermatophyte infections received oral ketoconazole (200-400 mg/day).
• Dosage was escalated to 600 mg/day for non-responders.
• Outcomes included cure rates, clinical improvement, time to lesion clearing, and side effects.

Main Results:

• A 74% overall cure rate was achieved with oral ketoconazole.
• Sixty-three percent achieved complete cure, and 26% showed clinical improvement.
• Seventy-five percent of patients previously unresponsive to griseofulvin responded to ketoconazole.
• Four of eight patients with onychomycosis were cured, with others improving.
• One patient experienced a drug eruption; minor side effects were noted in five.

Conclusions:

• Oral ketoconazole is a potentially valuable treatment for chronic dermatophyte infections, including those resistant to griseofulvin.
• The drug demonstrated significant efficacy in clearing skin lesions and treating onychomycosis.
• Further investigation into long-term efficacy and management of side effects is warranted.