Hair and groin problems
Manu Shah, Ariyaratne de Silva in The Male Genitalia, 2018
A number of inflammatory dermatoses and infective conditions commonly affect the groin areas, as well as the hair-bearing areas and peri-anal region. These problems may present to the sexual health clinic or may be seen in the general practice setting or the dermatology department. Intertrigo is a common condition, affecting all races, and is particularly found in old people and young children. The usual presenting symptoms are of chronic irritation of the skin folds with itching and burning being prominent symptoms. Candidosis (infection due to the yeast candida albicans) is the commonest cause of intertrigo. Clinical examination reveals red plaques in the skin folds, often with small erosions. The diagnosis of intertrigo can be made clinically but a cause must be sought. Wood's (ultraviolet) light examination of the groin area will exclude erythrasma. For infective problems antimycotic agents (e.g. topical clotrimazole, itraconazole) and anti-infective agents (antiseptics, topical antibiotics for short-term use) may prove useful.
Therapy For Skin, Hair and Nail Fungal Infections
Raimo E Suhonen, Rodney P R Dawber, David H Ellis in Fungal Infections of the Skin, Hair and Nails, 2020
Most of the fungi that affect the skin, hair and nails only proliferate under the ideal conditions of warmth, moisture and humidity. Topical therapy may be sufficient for dermatophytosis other than nail and scalp infections-for example, terbinafine topical formulations, tolnaftate, imidazole, amorolfine, cyclopiroxolamine, clotrimazole, miconazole, econazole, ketoconazole, bifonazole and tioconazole. It has been available for over 30 years and is still valuable for dermatophytic skin infection, in particular tinea capitis. Oral therapy using griseofulvin has been used extensively for the treatment of dermatophytosis. The duration of therapy varies from patient to patient and on the site and severity of the infection, with up to 12 weeks being required for skin and hair infections and approximately 12 months for nails. Oral ketoconazole has a high affinity for keratin and it has been used for dermatophytes, although the risk of hepatitis, albeit rare, makes this a secondary choice for therapy, especially now newer agents such as fluconazole, itraconazole and terbinafine are available.
Aspergillus fumigatus
Peter M. Lydyard, Michael F. Cole, John Holton, William L. Irving, Nino Porakishvili, Pradhib Venkatesan, Katherine N. Ward in Case Studies in Infectious Disease, 2010
A 68-year-old Caucasian man was diagnosed with B-cell chronic lymphocytic leukemia (B-CLL) and received various regimens of chemotherapy. As a patient with chronic leukemia he attended the CLL clinic regularly. Ten years later the patient presented with pneumonia symptoms and was examined by chest CT scan . The results were suggestive of aspergillosis and additional laboratory tests were done. Positive Aspergillus serology allowed the doctors in the clinic to give a diagnosis of A. fumigatus pneumonia. The patient was not neutropenic and his condition improved following an 8-month course of itraconazole followed by voriconazole for 6 months.
Effects of ketoconazole, voriconazole, and itraconazole on the pharmacokinetics of apatinib in rats
Published in Drug Development and Industrial Pharmacy, 2019
Dan Lou, Xiao Cui, Su-Su Bao, Wei Sun, Wen-He Pan, Meng-Chun Chen, Yao-Yao Dong, Guo-Xin Hu, Rui-Jie Chen, Zhe Wang
We investigated the effect of azole antifungal drugs (ketoconazole, voriconazole, and itraconazole) on the pharmacokinetics of apatinib in rats. The rats in ketoconazole, voriconazole, and itraconazole groups received single-dose apatinib 30 mg/kg after the oral administration of ketoconazole, voriconazole, and itraconazole, respectively. Co-administration of ketoconazole or voriconazole significantly increased the apatinib Cmax and AUC(0–t) and decreased the clearance. Co-administration of itraconazole did not significantly affect the pharmacokinetics parameters of apatinib. It could be concluded that both ketoconazole and voriconazole significantly increase the exposure of apatinib, and affect the pharmacokinetics of apatinib in rat. Apatinib can be co-administered with itraconazole, but ketoconazole and voriconazole should be avoided if possible or be underwent therapeutic drug monitoring of apatinib. A further clinical study should be conducted to investigate the inhibitory effect of azole antifungal drugs on the apatinib plasma concentration.
A meta-analysis comparing long-term recurrences of toenail onychomycosis after successful treatment with terbinafine versus itraconazole
Published in Journal of Dermatological Treatment, 2012
ZhiQiang Yin, JiaLi Xu, Dan Luo
As the most frequently used systemic antifungal agents for onychomycosis, terbinafine and itraconazole have both proved to have the conditions of recurrence in various degrees during follow-up period after end of therapy; very little is known about their comparative recurrences after long-term follow-up. We conducted a meta-analysis of available trials to compare the long-term recurrences of toenail onychomycosis after successful treatment with terbinafine versus itraconazole. Meta-analysis was performed by the Review Manager version 5.0.25. Risk ratio and 95% confidence intervals were calculated by the fixed effect model. Five trials and total 251 eligible patients were included in this meta-analysis. The combined risk ratio of the meta-analysis comparing terbinafine with itraconazole for mycological recurrence rate was 0.44 (95% CI 0.29–0.66), which suggests that itraconazole therapy is more likely to produce mycological recurrence compared with terbinafine therapy.
Itraconazole for severe asthma with fungal sensitivity
Published in Expert Opinion on Pharmacotherapy, 2009
Background: Severe asthma with fungal sensitivity (SAFS) is a recently described form of asthma that is difficult to treat with conventional inhaled corticosteroids. Antifungal therapies such as itraconazole might be an option. Objective: To discuss the data from a study evaluating efficacy and safety of itraconazole therapy in SAFS. Methods/results: Itraconazole therapy was found to improve quality of life and reduce immune response, with no impact on lung function. Conclusions: Itraconazole may be a promising therapy in SAFS, provided its potential of reducing airway inflammation is further documented.