日本皮膚科学会皮膚真菌症診療ガイドライン改訂委員会：皮膚真菌症診療ガイドライン 2019．日皮会誌：129（13），2639-2673，2019.
L A Drake, S M Dinehart, E R Farmer, R W Goltz, G F Graham, M K Hardinsky, C W Lewis, D M Pariser, J W Skouge, S B Webster, D C Whitaker, B Butler, B J Lowery, B E Elewski, M L Elgart, P H Jacobs, J L Lesher, R K Scher
Guidelines of care for superficial mycotic infections of the skin: tinea corporis, tinea cruris, tinea faciei, tinea manuum, and tinea pedis. Guidelines/Outcomes Committee. American Academy of Dermatology.
J Am Acad Dermatol. 1996 Feb;34(2 Pt 1):282-6.
Abstract/Text
Almuth Dinkela, Julia Ferié, Marco Mbata, Marco Schmid-Grendelmeier, Christoph Hatz
Efficacy of triclosan soap against superficial dermatomycoses: a double-blind clinical trial in 224 primary school-children in Kilombero District, Morogoro Region, Tanzania.
Int J Dermatol. 2007 Oct;46 Suppl 2:23-8. doi: 10.1111/j.1365-4632.2007.03208.x.
Abstract/Text
BACKGROUND: Superficial dermatomycoses are a common problem in tropical regions. Due to limited resources, specific antimycotic therapy is often not available. The present study was performed to assess the clinical efficacy of the antimicrobial agent Triclosan in bar soap in comparison with regular soap against selected superficial dermatomycoses in Tanzanian schoolchildren.
METHODS: 820 primary school children were examined for skin disorders and 224 of these were included in the soap trial. The clinical presentation of dermatomycoses was recorded using a symptom score. Samples were taken for microscopic examination and mycological culture. The study participants received either bar soap containing Triclosan or a placebo for 2 months. They were re-examined at the end of this period.
RESULTS: The benefit achieved by the addition of Triclosan was not statistically significant. Overall cure rates for Triclosan and placebo groups taken together were 21.8% for tinea versicolor, 58.3% for tinea capitis, 55.5% for tinea corporis and 68.8% for tinea pedis. This was confirmed microscopically. For the majority of the children the dermatomycoses improved significantly.
CONCLUSIONS: The results strongly argue for regular soap use against common dermatomycoses as a low-cost and effective treatment. This promising finding should be considered in settings where dermatophyte infections represent a public health problem and where access to appropriate treatment and financial resources are limited.
A Alomar, S Videla, J Delgadillo, I Gich, I Izquierdo, J Forn
Flutrimazole 1% dermal cream in the treatment of dermatomycoses: a multicentre, double-blind, randomized, comparative clinical trial with bifonazole 1% cream. Efficacy of flutrimazole 1% dermal cream in dermatomycoses. Catalan Flutrimazole Study Group.
Dermatology. 1995;190(4):295-300.
Abstract/Text
BACKGROUND: Flutrimazole is a new imidazole derivate. Its antifungal activity has been demonstrated in in vivo and in vitro studies to be comparable to that of clotrimazole and higher than bifonazole.
AIM: To compare the efficacy and tolerability of flutrimazole cream 1% with a reference drug, bifonazole, in the treatment of dermatomycoses, eligible for topical treatment exclusively.
METHODS: A multicentre, double-blind, randomized, parallel-group clinical trial was conducted. Patients with clinically and mycologically (KHO and/or culture) diagnosed fungal infection of the skin were included in this study and were randomized into two treatment groups: 1% flutrimazole or 1% bifonazole, applied to the affected area (target lesion) once a day. The principal criterion of efficacy, 'cure', was based on clinical and mycological assessment.
RESULTS: Four hundred and forty-nine patients were included in the study (228 flutrimazole, 221 bifonazole). 'Intention-to-treat' analysis of the data showed a difference between the treatments in terms of the rate of cure (clinical and mycological) after 4 weeks: 73% in the flutrimazole group and 65% in the bifonazole group (p = 0.05). From a safety point of view, flutrimazole and bifonazole were well tolerated, and the overall incidence of adverse effects (mainly mild local effects like irritation or burning sensation) was 5%.
CONCLUSIONS: One percent flutrimazole applied topically once a day in the treatment of fungal infections of the skin presents a better efficacy than bifonazole and a good tolerability.
M V Shelanski, S B Phillips, C E Potts
Evaluation of cutaneous reactivity to recently marketed dermatologic products.
Int J Dermatol. 1996 Feb;35(2):137-40.
Abstract/Text
BACKGROUND: Reports of purported sensitization reactions to widely used prescription dermatologicals have raised questions concerning the clinical significance of these reports. The current study was designed to compare irritant and sensitization potentials of such marketed products and to evaluate the risks involved in their usage.
METHODS: One hundred and eight healthy adult volunteers were evaluated for primary irritation and hypersensitivity following application under a double-blind paradigm of eight leading prescription dermatologic products and the vehicle cream of one product according to an intensified version of the Shelanski and Shelanski "Repeated Insult Patch Test."
RESULTS: No clinically significant irritant or sensitization reactions were associated with applications of topical formulations containing clobetasol propionate, doxepin hydrochloride, metronidazole, mupirocin, oxiconazole nitrate, and terbinafine hydrochloride. The doxepin hydrochloride cream vehicle was also found to be nonirritating and nonsensitizing. Both calcipotriene and ketoconazole were moderate irritants and possible sensitization reactions were also associated with ketoconazole.
CONCLUSION: Although every topically applied chemical has the potential to cause an adverse response in some individuals, the data obtained in this study for eight commercially available prescription dermatologic products indicate that most are quite safe and have very low risks of clinically significant irritation or sensitization.
A randomized trial to assess once-daily topical treatment of tinea corporis with butenafine, a new antifungal agent. - PubMed - NCBI [Internet]. [cited 2018 Nov 2]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/?term=9270509
U Budimulja, K Bramono, K S Urip, S Basuki, G Widodo, G Rapatz, C Paul
Once daily treatment with terbinafine 1% cream (Lamisil) for one week is effective in the treatment of tinea corporis and cruris. A placebo-controlled study.
Mycoses. 2001;44(7-8):300-6.
Abstract/Text
Duration of therapy is an important factor in determining patients' compliance in dermatomycosis. Terbinafine (Lamisil) is an allylamine antifungal agent. Its fungicidal properties against dermatophytes should allow physicians to reduce treatment duration without affecting the cure rate. This study was carried out to determine the efficacy and tolerability of terbinafine 1% cream, applied once daily for 7 days, in adult patients with tinea corporis/cruris. In a multicentre, randomized, double-blind, parallel-group study, patients with a clinical diagnosis of tinea corporis/cruris confirmed by microscopy and culture received treatment with either terbinafine 1% cream (n = 57) or placebo cream (n = 60). The patients applied the cream once daily for 7 days, and were then observed for a further 7 weeks. The efficacy was assessed at the end of the study by comparing the rates of mycological cure in the two treatment groups. Total clinical signs and symptoms scores, clinical response, and overall treatment efficacy were also measured and compared between the two groups. A 7-day once-daily course of terbinafine was significantly more effective than placebo in achieving and maintaining mycological cure (84.2 versus 23.3%, P< 0.001). Terbinafine was also significantly more effective than placebo in terms of clinical response, reduction in signs and symptoms scores, and overall efficacy. The short treatment regimen and the sustained high cure rate should contribute to making terbinafine a valuable treatment option in tinea corporis/cruris.
V Voravutinon
Oral treatment of tinea corporis and tinea cruris with terbinafine and griseofulvin: a randomized double blind comparative study.
J Med Assoc Thai. 1993 Jul;76(7):388-93.
Abstract/Text
Sixty-four patients with clinically and mycologically diagnosed tinea corporis and tinea cruris were randomly allocated to receive either 250 mg of oral terbinafine once daily or 500 mg of griseofulvin once daily for 2 wks. Patients in each group were well matched for age, gender, clinical features and type of dermatophytes. Clinical and mycological control tests (KOH wet mount and culture) were performed before treatment, at the end of treatment and 4 wks after stopping treatment. In the majority of cases, the infecting agent was identified as Trichophyton rubrum (53/64). The remainder comprised Trichophyton mentagrophytes (8/64) and Epidermophyton floccosum (3/64). After 2 wks of therapy, there was no significant difference in mycological response in the terbinafine group (90.3%) and griseofulvin group (80.7%). The clinical response in both groups was the same. At 6 wks' follow-up, the mycological cure in terbinafine and griseofulvin group was 87.1 and 54.8 per cent, respectively (P < 0.05). The clinical response of the terbinafine group was also significantly higher than in the griseofulvin group. A higher relapse rate was observed in the griseofulvin group than in the terbinafine group. No serious side effects were reported in either group. The result showed that oral terbinafine was more effective than oral griseofulvin in the treatment of tinea corporis or tinea cruris.
D M Pariser, R J Pariser, G Ruoff, T L Ray
Double-blind comparison of itraconazole and placebo in the treatment of tinea corporis and tinea cruris.
J Am Acad Dermatol. 1994 Aug;31(2 Pt 1):232-4.
Abstract/Text
BACKGROUND: Tinea corporis and tinea cruris are usually treated with a topical antifungal agent unless the infection is unresponsive, involves an extensive area, is chronic, or is in a difficult-to-access area. In these cases oral antifungals are frequently used.
OBJECTIVE: This double-blind study was undertaken to determine whether a 2-week course of oral itraconazole would produce statistically significant clinical and mycologic improvement in the treatment of tinea corporis, tinea cruris, or both, over the results obtained with placebo. A second objective was to determine the safety of itraconazole, through routine measurements of serum chemistry profiles.
METHODS: Sixty-seven patients were entered into a double-blind, multicenter study to compare the clinical and mycologic effects of itraconazole, 100 mg daily (45 patients), and placebo (22 patients) on tinea corporis and/or tinea cruris. The duration of treatment was 2 weeks. The investigators assessed signs and symptoms and performed a potassium hydroxide examination and culture at baseline, at termination of therapy, and 2 weeks after completion of treatment.
RESULTS: Twenty-two (96%) of 23 evaluable patients in the itraconazole group had healed or markedly improved lesions, as compared with 5 of 13 (39%) in the placebo group (p < or = 0.01). Similarly, the condition in 13 of 23 patients (57%) in the itraconazole group was mycologically cleared at the end of treatment whereas this result occurred in only 2 (17%) of 12 patients in the placebo group (p = 0.02). The prevalence of adverse side effects was lower for the itraconazole-treated group (20%) than for the placebo-treated group (36%).
CONCLUSION: Itraconazole 100 mg once daily is an effective agent for the treatment of tinea cruris and tinea corporis.
D Panagiotidou, T Kousidou, G Chaidemenos, G Karakatsanis, A Kalogeropoulou, A Teknetzis, E Chatzopoulou, D Michailidis
A comparison of itraconazole and griseofulvin in the treatment of tinea corporis and tinea cruris: a double-blind study.
J Int Med Res. 1992 Sep;20(5):392-400.
Abstract/Text
A total of 40 patients with clinically and mycologically documented tinea corporis or tinea cruris were treated with 100 mg/day itraconazole (n = 19) or 500 mg/day griseofulvin (n = 21) for 15 days. Of the itraconazole-treated patients, 83.3% were healed or markedly improved, i.e. 'responders', after 15 days compared with 85.7% of griseofulvin-treated patients. At 15 days after the end of treatment, 88.2% of itraconazole- and 80.9% of griseofulvin-treated patients were classed as 'responders'. The mycological cure rate (both microscopy and culture negative) was generally lower than the clinical response rate. Both treatments were equally effective at the end of 15 days' treatment with 66.7% of patients cured, but itraconazole was superior to griseofulvin at the 15-day follow-up visit (77.8% of itraconazole-treated patients compared with 66.7% of griseofulvin-treated patients were cured). Both therapies were well tolerated; only one patient treated with itraconazole reported minor side-effects (dizziness, headache and gastro-intestinal disturbances). The results confirm those of earlier comparative trials and suggest that griseofulvin-treated patients are more at risk of relapse than are itraconazole-treated patients.
A Bourlond, J M Lachapelle, J Aussems, B Boyden, H Campaert, S Conincx, J Decroix, C Geeraerts, L Ghekiere, J Morias
Double-blind comparison of itraconazole with griseofulvin in the treatment of tinea corporis and tinea cruris.
Int J Dermatol. 1989 Jul-Aug;28(6):410-2.
Abstract/Text
Seventy-eight patients with tinea corporis or tinea cruris participated in a double-blind study with either 100 mg itraconazole or 500 mg ultramicronized griseofulvin for 15 consecutive days. Clinical outcome was significantly in favor of itraconazole at completion of treatment (72% response rate vs. 51%) and at the follow-up visit (91% response vs. 64%). The most important difference between both treatments was the mycologic outcome, for which itraconazole showed a cure rate of 87% compared to 57% for griseofulvin 2 weeks after completion of therapy. It is suggested that 100 mg of itraconazole orally once daily is significantly more effective than 500 mg of griseofulvin once daily for 15 days in the treatment of glabrous skin infections. Both drugs were well tolerated.
