Treatment of chromoblastomycosis with terbinafine: experience with four cases.
BACKGROUND
Chromoblastomycosis is a chronic subcutaneous mycosis that occurs more frequently in tropical and subtropical areas and is caused by a group of dematiaceous fungi. It is a difficult-to-treat mycosis with low cure rates and a high rate of relapses.


OBJECTIVE
The objective of this trial is to prove the efficacy and tolerance of oral terbinafine in four cases of chromoblastomycosis.


RESULTS
We included four cases of chromoblastomycosis, proved clinically and mycologically, that are presented herein; three of them caused by Fonsecaea pedrosoi and one by Phialophora verrucosa. Two had a small extension and the other two were of medium and large extension. Oral terbinafine was administered at a dose of 500 mg/day, which was reduced to half in two of the cases once an 80% improvement had been reached; in the third case the initial dose was maintained, and in the fourth case the dose was increased to 750 mg/day. Three cases reached clinical and mycological cure in a mean treatment period of 7 months, the fourth case reached a significant improvement only after 1.2 years of treatment. The medication was well tolerated; no liver alterations occurred; only one patient suffered mild dyspepsia.


CONCLUSIONS
Terbinafine at 500 mg/day doses represents one of the best treatments for chromoblastomycosis due to its efficacy and excellent tolerability.
Bonifaz
A
A
Mycology, General Hospital of Mexico, Mexico City, Mexico. a_bonifaz@yahoo.com.mx
Saúl
A
A
Paredes-Solis
V
V
Araiza
J
J
Fierro-Arias
L
L
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000382:Agricultural Workers' Diseases / Q000188:drug therapy*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002862:Chromoblastomycosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000008:administration & dosage / Q000627:therapeutic use*; D010676:Phialophora / Q000302:isolation & purification; D000077291:Terbinafine; D016896:Treatment Outcome
D000935:Antifungal Agents; D009281:Naphthalenes; D000077291:Terbinafine