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Long-term therapy of chronic mucocutaneous candidiasis with ketoconazole: experience with twenty-one patients

C R Horsburgh, C H Kirkpatrick

    The American Journal of Medicine
    |January 24, 1983
    PubMed

    Insights

    Ketoconazole effectively treats chronic mucocutaneous candidiasis, improving mucosal and skin lesions. While nail infections showed variable response, the drug was well-tolerated with infrequent adverse effects.

    Area of Science:

    • Mycology
    • Dermatology
    • Infectious Diseases

    Background:

    • Chronic mucocutaneous candidiasis (CMC) is an opportunistic fungal infection often associated with immunodeficiency and endocrine disorders.
    • Patients with CMC may present with concurrent fungal infections like dermatophytosis or chromomycosis.
    • Investigating effective treatments for CMC is crucial due to its persistent nature and potential complications.

    Purpose of the Study:

    • To review the clinical experience with ketoconazole in treating chronic mucocutaneous candidiasis.
    • To evaluate the efficacy and safety of ketoconazole in a cohort of patients with CMC.
    • To assess the response times for different types of lesions and identify potential factors influencing treatment outcomes.

    Main Methods:

    • A retrospective review of 21 patients diagnosed with chronic mucocutaneous candidiasis treated with ketoconazole.
    • Analysis of patient data including immune status, endocrine abnormalities, and concurrent infections.
    • Documentation of lesion response times (mucosal, cutaneous, nail) and adverse events.

    Main Results:

    • All 21 patients demonstrated a positive response to ketoconazole treatment.
    • Significant improvements were observed in mucosal lesions (6.7 days) and cutaneous lesions (22.7 days).
    • Nail lesions showed more variable response times (92.4 days), and concurrent dermatophytosis did not prolong treatment duration. Adverse effects were infrequent, with one case of hepatitis and two of hypertension.

    Conclusions:

    • Ketoconazole is an effective and generally well-tolerated therapeutic option for the infectious component of chronic mucocutaneous candidiasis.
    • The drug demonstrates efficacy across various lesion types, although nail involvement may require longer treatment durations.
    • Despite some cases of in vitro resistance, ketoconazole remains a valuable treatment choice for CMC, with careful monitoring for potential adverse events.

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