Villaseñor OP, Rebollo DN, Fernández MR, Arenas GR, Magaña C, Soto NM

Language: Spanish
References: 7
Page: 168-171
PDF size: 163.62 Kb.

ABSTRACT

Introduction: Superficial mycoses are among the most frequent causes of consult in dermatology. The comparative efficacy and roll of traditional anti-mycotic drugs needs to be assessed.
Objetive: To compare head to head, the clinical and microbiological efficacy of topical bifonazole and ketoconazole in tinea pedis
Materials and methods: 46 patients with diagnosis of tinea pedis were studied. Diagnosis was based on clinical findings and KOH and culture. Following a randomization process, 23 patients received local bifonazole and 23 patients received ketoconazole; both drugs were applied twice daily for 2 weeks. Clinical evaluations and direct exam were performed on days 15 and 30 after initiation of therapy.
Results: 46 patients (27 women and 19 men) participated in this trial. Mean age, 62 years (range 23-89). Most patients had interdigital tinea (46.4%), while plantar tinea was observed in about a third of patients (37.7%); four patients (11.6%) had a mixed distribution. Eighteen patients (38.1%) had a positive culture, and the most frequent isolated fungi were: T. rubrum (26%), T. mentagrophytes (6.5%) and Candida spp (6.5%). Two weeks after therapy, the proportion of patients with a negative direct exam was higher in the bifonazole group (16%) as compared with the ketoconazole group (12%), without statistical significance. No differences in clinical improvement were observed at 2 weeks. At week 4 a statistically significant difference was recorded in the proportion of patients with improvement of hiperpigmentation favoring the bifonazole group (11% vs 18%, p = 0.03).
Conclusions: A similar therapeutic response was observed between bifonazole and ketoconazole in tinea pedis. An apparent tendency towards an earlier improvement based on direct exam favored the use of bifonazole .

REFERENCES

1. Rotta I, Sánchez A, Gonçalvez PR, Otuki MF, Correr CJ. “Efficacy and safety of topical antifungals in the treatment of dermatomycosis: A systematic review”. Br J Dermatol. 2012; 166(5): 927-933.

2. Baran, R, Kaoukhov A. “Topical antifungal drugs for the treatment of onychomycosis: An overview of current strategies for monotherapy and combination therapy”. J Eur Acad Dermatol Venereol. 2005; 19: 21-29.

3. Shemer A, Grunwald MH, Davidovici B, Nathansohn N, Amichai B. “A novel two-step kit for topical treatment of tinea pedis-an open study”. JEADV. 2010; 24: 1099-1101.

4. Arenas R, Bonifaz A, Padilla MC. Micosis superficiales. Tercera Revisión del Consenso Nacional de Prevención, Diagnóstico y Tratamiento. México, UNAM, 2006.

5. Arenas R. Micología médica ilustrada. 4ª ed.; México, McGraw-Hill, 2011: 61-91.

6. Bonifaz A, Araiza Santibáñez J, Ramírez Dovala Sa, Ponce Olivera RM. “Estudio de eficacia y seguridad de sertaconazol crema 2% en tratamiento de tiña de los pies”. Dermatología CMQ. 2011; 9(1): 10-15.

7. Manjunath Shenoy M, Teerthanath S, Karnaker VK, Girisha BS, Krishna Prasad MS, Pinto J. “Comparison of potassium hydroxide mount and mycological culture with histopathologic examination using periodic acid-Schiff staining of the nail clippings in the diagnosis of onychomycosis”. Indian J Dermatol Venereol Leprol. 2008; 74(3): 226-229.