Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In an open study 58 patients with chronic dermatophytosis mainly caused by Trichophyton rubrum and five patients with Tinea capitis were treated with ketoconazole. The indications were ineffectiveness of or side effects to griseofulvin. Response to treatment varied from 1 week in scalp infections to 11 weeks in toe-nail lesions. Dermatophytosis of hands and feet were cured in 25%, marked improvement observed in further 30%. Toe- and finger-nail infections were cured in 20% and 43%, respectively, and marked improvement seen in further 36% and 14%, respectively. All scalp infections were cured without relapse. Recurrence of infections before 6 months after treatment was seen in 55-60% of hand and foot lesions and 33-38% of finger and toe-nail infections. In a double-blind study 20 patients with onychomycosis caused by T. rubrum the efficacy of ketoconazole was compared to that of griseofulvin. Cure rates in the griseofulvin group were 25% for finger-nails and zero for toe-nails, while 50% and 57% experienced marked improvement. In the ketoconazole group, 25% of finger-nail infections were cured and 75% markedly improved, while the corresponding figures for toe-nails were 11% and 89%, respectively. Adverse reactions to ketoconazole were seen in 29 (46%) of the patients in the open study and in 2 (20%) in the double-blind study and comprised mainly minor complaints. Side effects caused discontinuation in 12 patients, in two of whom due to toxic hepatitis.
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PMID:Oral ketoconazole as an alternative to griseofulvin in recalcitrant dermatophyte infections and onychomycosis. 240 17

The imidazoles have been appreciated for approximately fifteen years as a family of antifungals. Most derivatives, like the protype compounds, miconazole and clotrimazole, are effective only in a topical dose form. The topical imidazoles are generally thought to be superior to other topical antifungals. The first orally available imidazole, ketoconazole has ushered in a new era of potent, oral, broad-spectrum antifungal therapy. The imidazoles as a class are the treatment of choice for four dermatophyte infection syndromes. They are the preferred alternative therapy in another six syndromes. There is insufficient data to recommend one topical azole over the other. The topicals are inadequate for control of six clinical-anatomical infection syndromes. Griseofulvin remains the standard oral therapy in all situations except chronic, extensive dermatophytosis, where ketoconazole has proven to be more efficacious. The recognition of potential significant adverse effects, namely an idiopathic hepatitis and dose-dependent adrenal and testicular dysfunction have reduced ketoconazole's potential role in the dermatophytoses. Ketoconazole is a useful alternative to griseofulvin when oral therapy is required and the causative organism is insensitive to griseofulvin, or infection fails to respond to griseofulvin, or griseofulvin is contraindicated due to allergy, photosensitivity, porphyrinuria, intolerance, etc.
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PMID:Consensus of the role and positioning of the imidazoles in the treatment of dermatophytosis. 294 Jul 92

A 57-year-old Japanese woman developed multiple subcutaneous cysts located on the pubic region, thighs, back, and buttocks. She had been treated with systemic prednisolone and azathioprine for 3 years because of autoimmune hepatitis. Histologic examination revealed that the lesions were pseudocysts with numerous spores and hyphae. Trichophyton rubrum was identified in culture from the content of several examined cysts. The serum beta-D-glucan level was high (313 pg/mL), and a computed tomographic scan of the chest cavity showed infective embolism in the lung. To our best knowledge, this is the first reported case of multiple-cystic tinea profunda, presumably with systemic dermatophyte infection. Systemic T-cell immunosuppression, as represented by a relatively low percentage of memory T cells and negative delayed-type hypersensitivity tests, is considered to cause this rare manifestation of dermatophytosis.
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PMID:Tinea profunda cysticum caused by Trichophyton rubrum. 1642 83