Treatment of chromomycosis with terbinafine: preliminary results of an open pilot study

In an open trial, long courses (6-12 months) of terbinafine at a dosage of 500 mg/day were administered orally to 43 patients with a diagnosis of chromomycosis. Sixteen patients (37.2%) had previously relapsed after one or two courses of thiabendazole. A spectacular improvement in the lesions, including disappearance of bacterial superinfections and of associated oedema and elephantiasis, was observed as soon as 2-4 months after the beginning of treatment. The mean number of fungal cells in skin scrapings fell by about 70% in 4 months. Mycological cure, as judged by skin scrapings, was observed in 41.4, 74.1 and 82.5% of patients infected with Fonsecaea pedrosoi after 4, 8 and 12 months of therapy, respectively. For the first time with this disease, total cure was observed even in imidazole-refractory patients or chronic cases (47.2% with a lesion present for longer than 10 years). The efficacy of terbinafine in Cladosporium carrionii-infected patients seemed higher, as indicated by the examination at 4 months.