John Libbey Eurotext

European Journal of Dermatology

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Short-term itraconazole versus terbinafine in the treatment of superficial dermatomycosis of the glabrous skin (tinea corporis or cruris) Volume 7, issue 5, July - August 1997

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Department of Dermatology and Venereology, Innsbruck, Austria.

The ability of itraconazole to inhibit the fungal cytochrome P450-dependent enzyme, 14a-demethylase and the rapid and persistent accumulation of itraconazole in the stratum corneum provide a rationale for the efficacy of a short-term, relatively high-dose treatment regimen in patients with superficial dermatomycosis. The aim of the present double-blind, multicentre trial was to compare the efficacy and safety of itraconazole, 200 mg/day for 7 days with that of terbinafine, 250 mg/day for 7 days in 230 patients with tinea corporis or cruris. Randomisation occurred at a 2:1 ratio. After 5 weeks of follow-up, 81 % of itraconazole-treated patients and 68% of terbinafine-treated patients were mycologically cured (p < 0.05). The clinical response rate was 84% in itraconazole-treated patients and 71 % in terbinafine-treated patients (p < 0.05). In the patient self-assessment analysis during treatment, the area under the curve analysis over the first 7 days, expressed as a percentage of the maximum possible value, showed that patients treated with itraconazole reported significantly less scaling (p = 0.035), redness (p = 0.052) and itching (p = 0.012) than patients treated with terbinafine. At the end of treatment, 84% of itraconazole-treated patients rated their treatment as good or excellent, compared with 56% of terbinafine-treated patients (p < 0.05). Both medications displayed good safety profiles, but tolerability was rated significantly higher in the itraconazole group than in the terbinafine group (p = 0.001). In conclusion, both 1-week treatment regimens were effective against superficial dermatomycosis (tinea corporis or cruris), but itraconazole achieved significantly better mycological and clinical results, was significantly better tolerated and received a significantly higher patient evaluation than terbinafine.