title: A prospective case series evaluating efficacy and safety of combination of itraconazole and potassium iodide in rhinofacial conidiobolomycosis.
abstract: BACKGROUND
  Rhinofacial conidiobolomycosis (RFC) is an uncommon subcutaneous fungal infection producing painless swelling with grotesque deformity of the face. Although there are case reports and small case series; there are very few prospective studies evaluating treatment outcome and long-term follow-up.
  
  
  OBJECTIVE
  To evaluate the safety and efficacy of combination of itraconazole (200 mg twice daily) and saturated solution of potassium iodide (SSKI) in patients with RFC.
  
  
  METHODS
  Ten patients of RFC were studied over a period of 5 years. Diagnosis was confirmed by clinical, histopathological, and microbiological evaluation. Conidiobolus was cultured in four cases and in the rest of the cases, the histopathology was suggestive of RFC. They were treated with itraconazole (200 mg twice daily) and SSKI and followed up for a minimum of 1 year after stopping treatment.
  
  
  RESULTS
  The mean age was 38.7 years and the mean duration of symptoms was 22.4 months. Males were predominantly involved (9 : 1). Seven patients responded to the combination treatment, five had complete resolution and two had good improvement (50-75%); however, in two patients the response was minimal (<25% regression of the swelling) and one patient did not show any improvement after 6 months of treatment.
  
  
  CONCLUSIONS
  Combination of itraconazole and SSKI is an effective treatment modality for RFC with relatively faster onset of action, low relapse rates, and minimal adverse effects. It can be considered as first-line treatment in patients with RFC.
authors.affiliation: Department of ENT, Gian Sagar Medical College & Hospital, Banur District, Patiala, Punjab, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Gupta
authors.affiliation: Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Narang
authors.affiliation: Department of Pathology, Gian Sagar Medical College & Hospital, Banur District, Patiala, Punjab, India.
authors.forename: Rupinder Jeet
authors.initials: RJ
authors.lastname: Kaur
authors.affiliation: Department of Microbiology, Gian Sagar Medical College & Hospital, Banur District, Patiala, Punjab, India.
authors.forename: Ashwani
authors.initials: A
authors.lastname: Manhas
authors.affiliation: Department of Histopathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Uma Nahar
authors.initials: UN
authors.lastname: Saikia
authors.affiliation: Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Dogra
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D020092:Conidiobolus; D004359:Drug Therapy, Combination; D005148:Facial Dermatoses / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017964:Itraconazole / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009668:Nose Diseases / Q000188:drug therapy / Q000382:microbiology; D011193:Potassium Iodide / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult; D020096:Zygomycosis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D011193:Potassium Iodide; D017964:Itraconazole