Itraconazole Pulse Therapy for Onychomycosis of Toenail: An Open Multicenter Trial
Abstract
BACKGROUND: Toenail onychomycosis still remains difficult to treat. Pulse therapy of itraconazole is frequently prescribed to lighten the patient's burden of economical problems, frequent side effects, resulting in good compliance.
OBJECTIVE: The purpose of this study is to evaluate the clinical efficacy and adverse reactions of pulse therapy of itraconazole.
METHODS: From March to September 1996, a total of 108 patients with onychomycosis of toenail diagnosed at Department of Dermatology of 5 university hospitals, were enrolled in a subject group for the study. Itraconazole was administered, 200 mg twice daily, in every first week of 3 consecutive months. Clinical symptoms and sings with or without mycologic findings were assessed at baseline, at the end of 4, 8, 12, 24, 36 and 48 weeks after the start of therapy.
RESULTS: Fifty six patients (male 22, female 34; mean age 44.0 ± 13.3) completed the follow-ups. As causative agents, Trichophyton(T.) rubrum was isolated in 51 of them, T. mentagrophytes 2, and yeast 3. Decrease in initial percentages of patients showing pathologic changes in target nail at the last follow-up 12 months after starting therapy : for onycholysis, from 51.8% to 21.4%; for subungual hyperkeratosis, from 96.4% to 39.3%; for nail discoloration, from 100.0% to 50.0%. Mycological cure rate was 82.1% at the last follow-up. Overall clinical responses evaluated at the last follow-up were cured in 28 patients (50.0%), 'markedly improved' in 15 (26.8%), 'moderately improved' in 9 (16.1%), and 'deteriorated' in 4 (7.1%), making a clinical response rate of 92.9%. During therapy, transient epigastric pain and indigestion developed in 2 patients (3.6%), respectively.
CONCLUSION: With these results, itraconazole pulse therapy is considered an effective and safe treatment modality for onychomycosis of toenail.
Keywords
Itraconazole Onychomycosis of toenail Pulse therapy
KJMM
1998 December;3(2):163-171(9). Epub 2016 February 24
Copyright © 1998 by Korean Journal of Medical Mycology
Language
Korean/English
Author
Jae Bok Jun; Department of Dermatology, Kyungpook National University School of Medicine, Korea
Kyung Sool Kwon; Department of Dermatology, Pusan National University College of Medicine, Korea
Jang Kyu Park; Department of Dermatology, Chungnam National University College of Medicine, Korea
Ki Hong Kim; Department of Dermatology, Yeungnam University College of Medicine, Korea
Sang Tae Kim; Department of Dermatology, Kosin Medical College, Korea
Sung Hoon Lee; Department of Dermatology, Kyungpook National University School of Medicine, Korea
Corresponding
Jae Bok Jun, Department of Dermatology, Kyungpook National University School of Medicine, Korea.
Publication history
Acknowledgements
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Jae Bok Jun
Department of Dermatology, Kyungpook National University School of Medicine, Korea
Kyung Sool Kwon
Department of Dermatology, Pusan National University College of Medicine, Korea
Jang Kyu Park
Department of Dermatology, Chungnam National University College of Medicine, Korea
Ki Hong Kim
Department of Dermatology, Yeungnam University College of Medicine, Korea
Sang Tae Kim
Department of Dermatology, Kosin Medical College, Korea
Sung Hoon Lee
Department of Dermatology, Kyungpook National University School of Medicine, Korea
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