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  In this article
   Abstract
   Introduction
   Materials and Me...
   Results
   Discussion
   Acknowledgement
   References
   Article Tables

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SHORT COMMUNICATION
Year : 1995  |  Volume : 61  |  Issue : 4  |  Page : 209-211

Itraconazole versus griseofulvine in the treatment of tinea corporis and tinea cruris




Correspondence Address:
K M Acharya


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Source of Support: None, Conflict of Interest: None


PMID: 20952956

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  Abstract 

126 patients (82 males and 44 females) aged above 12 years, suffering from tinea corporis and/or tinea cruris, were treated with either itraconazole (100 mg once a day for 2 weeks and then plecebo for 2 weeks) (63 patients), or griseofulvin (250 mg twice a day for 4 weeks). 90.47% of the patients treated with itraconzole improved whereas griseofulvin imporved 76.19% of patients, clinically. Mycological response was 72% with itraconazole and 57% with griseofulvin


Keywords: Tinea corporis, Tinea cruris, Itraconazole, Griseofulvin


How to cite this article:
Acharya K M, Mukhopadhyay A, Thakur R K, Me. Itraconazole versus griseofulvine in the treatment of tinea corporis and tinea cruris. Indian J Dermatol Venereol Leprol 1995;61:209-11

How to cite this URL:
Acharya K M, Mukhopadhyay A, Thakur R K, Me. Itraconazole versus griseofulvine in the treatment of tinea corporis and tinea cruris. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2019 Dec 13];61:209-11. Available from: http://www.ijdvl.com/text.asp?1995/61/4/209/4209



  Introduction Top


Infection of the skin by dermatophytes is a common problem. The distribution of tinea is world wide, but its incidence is higher in tropics and subtropics.[1]Since its introduction in 1958, griseofulvin has remained the mainstay of treatment for dermatophytosis. With the introduction of new triazole compounds, antifungal therapy has gained a new momentum. Itraconazole is a triazole with a potent antifungal spectrum (4-10 times greater than ketoconazole) and is the ideal treatment for dermatophytes, Candida etc.[2] In this present study efficacy of itraconazole was compared with that of griseofulvin in cases of tinea corporis and tinea cruris in 126 patients.


  Materials and Methods Top


Total 126 patients of more than 12 years of age with the complaints of tinea corporis or cruris or both, proved either by 10% KOH smear or by culture or by both, were taken for the study. Patients, who had taken any treatment, had any previous history of intolerance to the drugs under study, had any abnormality in the laboratory investigation or who were pregnant, were excluded. After taking detailed history, total haemogram, urinalysis, liver function tests, renal panel, blood sugar (random) were done before and after the study. Along with this 10% KOH examination and culture in the Sabouraud's media of the material from the lesions was done at the begining and end of the study. 63 patients chosen at random were given griseofulvin 250 mg with meals twice a day for 4 weeks and another 63 patients were given itraconazole, 100 mg orally once a day with meal for 2 weeks followed by placebo for another 2 weeks. Patients were followed up weekly and their clinical symptoms e.g., itching, burning, oozing etc were noted and rated as follows:



  1. 0, Not present


  2. 1, Present, but not distinct


  3. 2, Present and distinct


  4. 3, Very marked




Patients with scores 0 and 1 were held as clinically cured and those with scores 2 and 3 were assumed still affected. Results were compiled at the end of 4th week and patients were followed up in 6th week again.


  Results Top


There were 82 males (65%) and 44 females (35%). Maximum patients (62%) belonged to 21-40 years age group [Table - 1]. Tinea corporis alone was found in 44 (35%), tinea cruris alone in 49(39%) and mixed tinea corporis and tinea cruris were found in 33(26%) patients. Duration of infection is shown in the [Table - 2].

Itraconazole showed a clinical cure rate of 90.47%, whereas griseofulvin showed 76.19%; similarly mycological cure was found in the form of negative KOH smear and culture in 72% in case of itraconagole and 57% in griseofulvin [Table - 3].


  Discussion Top


The study showed a clear superiority of the itraconazole over the griseofulvin. Clinical improvement in patients treated with itraconazole occurred in 90.47%. Similar results of improvement were obtained by Pariser et al[3] (96%), by Degreef et al[4] (87%), by Panconesi et al[5] (96.6%) and De Doncker et al[6] (82%). Roberts has opined that it is superior to griseofulvin and ketoconazole in resistant dermatophytosis.[7]

Study by Cauwenbergh et al[8] has shown that itraconazole, in contrast to griseofulvin and ketoconazole, is extensively excreted in the sebum, apart from some excretion in the sweat and is incorporated in the basal layer. This later route gives a constant delivary of itraconazole to the skin surface even 3-4 week after the end of the treatment. Here mycological cure was obtained in 72% of cases at the end of the therapy. There may be increase in the cure-rate after few more weeks, as the drug will be there even after the stoppage of treatment.[3] Thus it may be concluded that itraconazole is a better drug against dermatophytes.


  Acknowledgement Top


We are grateful to Tide Pharmaceutical Ltd. for providing the drugs.

 
  References Top

1.Canizares O.Cosmopolitan superficial fungal infection of tropical importance. In: Clinical Tropical Dermatology (Canizares O, Harman RRM, eds). 2nd edn. Boston; Blackwell Scientific Publication, 1992;22-400.  Back to cited text no. 1    
2.Jacobs PH. New trends in antifungal therapy: Itraconazole. Ind J Dermatol Venereol Leprol 1992;58:365-7.  Back to cited text no. 2    
3.Pariser DM, Pariser RJ, Rouff G, et al. Double blind comparision of itraconazole and placebo in the treatment of tinea corporis and tinea cruris. J Am Acad Dermatol 1994;31:232-4.  Back to cited text no. 3    
4.Degreef H, Marienk, Veylder Hde, et al. Itraconazole in the treatment of dermatophytosis, A comparision of two daily dosages. Rev Infect Dis 1987;9(Suppl-I) S 104-108. In: Hay RJ, Clayton VM, Moore MK, et al. An evaluation of itraconazole in the management of onychomycosis. Br J Dermatol 1988;119:359-66.  Back to cited text no. 4    
5.Panconesi E, Dofonzo E. Treatment of dermatophytosis and pityriasis versicolor with itraconazole. Rev Infect Dis 1987:9(Suppl I): 5109-13.  Back to cited text no. 5    
6.De Doneker P, Cauwenbergh G. Management of fungal skin infections with 15 days itraconazole treatment: a worldwide review. Br J Clin Pharmcol 1990; Supp 71:118-22. In Gupta A K, Sauder D N, Sheon N H. Antifungal agents: An overview. Part II. J Am Acad Dermotol 1994;30:911-33.  Back to cited text no. 6    
7.Robers D T. Itraconazole in Dermatology. J Dermatol Treat 1992;2:155-58.  Back to cited text no. 7    
8.Cauwenbergh G, Degrdeef H, Heykants J, et at. Pharmacokinetic profile of orally administered itraconazole in human skin. J Am Acad Dermatol 1988;18:263-8.  Back to cited text no. 8    


    Tables

[Table - 1], [Table - 2], [Table - 3]

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2 Efficacy and safety of itraconazole use in children
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