title: Treatment of cutaneous sporotrichosis with itraconazole--study of 645 patients.
abstract: BACKGROUND
  Itraconazole has become the first choice for treatment of cutaneous sporotrichosis. However, this recommendation is based on case reports and small series. The safety and efficacy of itraconazole were evaluated in 645 patients who received a diagnosis on the basis of isolation of Sporothrix schenckii in Rio de Janeiro, Brazil.
  
  
  METHODS
  A standard regimen of itraconazole (100 mg/day orally) was used. Clinical and laboratory adverse events were assessed a grades 1-4. A multivariate Cox model was used to analyze the response to treatment.
  
  
  RESULTS
  The median age was 43 years. Lymphocutaneous form occurred in 68.1% and fixed form in 23.1%. Six hundred ten patients (94.6%) were cured with itraconazole (50-400 mg/day): 547 with 100 mg/day, 59 with 200-400 mg/day, and 4 children with 50 mg/day. Three patients switched to potassium iodide, 2 to terbinafine, and 4 to thermotherapy. Twenty-six were lost to follow-up. Clinical adverse events occurred in 18.1% of patients using 100 mg/day and 21.9% of those using 200-400 mg/day. The most frequent clinical adverse events were nausea and epigastric pain. Laboratory adverse events occurred in 24.1%; the most common was hypercholesterolemia, followed by hypertriglyceridemia. Four hundred sixty-two patients (71.6%) completed clinical follow-up, and all remained cured. Only 2 variables were significant in explaining the cure: patients with erythema nodosum healed faster, and lymphocutaneous form took longer to cure.
  
  
  CONCLUSIONS
  In the current series, the therapeutic response was excellent with the minimum dose of itraconazole, and there was a low incidence of adverse events and treatment failure.
authors.affiliation: Evandro Chagas Clinical Research Institute, Rio de Janeiro, Brazil. mblbarros@fiocruz.br
authors.forename: Mônica Bastos
authors.initials: MB
authors.lastname: de Lima Barros
authors.forename: Armando Oliveira
authors.initials: AO
authors.lastname: Schubach
authors.forename: Raquel
authors.initials: R
authors.lastname: de Vasconcellos Carvalhaes de Oliveira
authors.forename: Ezequias Batista
authors.initials: EB
authors.lastname: Martins
authors.forename: José Liporage
authors.initials: JL
authors.lastname: Teixeira
authors.forename: Bodo
authors.initials: B
authors.lastname: Wanke
mesh_terms: D000284:Administration, Oral; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001938:Brazil; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage* / Q000009:adverse effects; D013175:Sporothrix / Q000187:drug effects / Q000302:isolation & purification; D013174:Sporotrichosis / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole