Itraconazole pulse therapy in the treatment of disto-lateral subungual onychomycosis.
OBJECTIVE
To assess the efficacy of itraconazole pulse therapy in disto-lateral subungual onychomycosis.


METHODS
Quasi interventional study.


METHODS
The study was conducted at the Department of Dermatology, KEMC/Mayo Hospital, Lahore, during the period from 1996-1998.


METHODS
Sixty-seven patients, ages ranging from 19 to 55 years, with disto-lateral subungual onychomycosis were enrolled in the study period. Therapy was started with short pulse doses of itraconazole 200 mg twice daily for one week followed by a medicine-free interval of three weeks. Pulses were administered for two consecutive months in fingernail and three months for toenail onychomycosis. Patients were followed up to six months for fingernail onychomycosis and nine months for toenail onychomycosis.


RESULTS
Out of 67 cases, there were 62 evaluable patients. Trichophyton rubrum was the most common pathogen, isolated in 42 (67.8%) followed by Candida in 11 (17.8%), T. violaceum in 5 (8%), T. interdigitale in 3 (4.8%) and Epidermophyton floccosum in one (1.6%). Fingernails were affected in 46 cases whereas 16 had toenail infection. Clinical cure in finger and toenail onychomycosis was seen in 41 (89%) and 13 (81.2%) patients, respectively while mycological cure in 43 (93.5%) and 14 (87.5%) patients, respectively with itraconazole pulse therapy.


CONCLUSIONS
Itraconazole was found to be effective, well-tolerated and safe therapy for disto-lateral subungual onychomycosis.
Aman
Shahbaz
S
Department of Dermatology, KEMC/Mayo Hospital, Lahore. ddrema@paknet4.ptc.pk
Akbar
Talat Masood
TM
Hussain
Ijaz
I
Jahangir
Mohammad
M
Haroon
Tahir Saeed
TS
D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005533:Foot Dermatoses / Q000188:drug therapy / Q000382:microbiology; D006229:Hand Dermatoses / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D014009:Onychomycosis / Q000175:diagnosis* / Q000188:drug therapy*; D011446:Prospective Studies; D020551:Pulse Therapy, Drug; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome
D000935:Antifungal Agents; D017964:Itraconazole