Cutaneous sporotrichosis. Intermittent treatment (pulses) with itraconazole.
ABSTRACT Sporotrichosis is a subcutaneous and exceptionally deep mycosis caused by a dimorphic fungus, Sporothrix schenckii. Itraconazole is a triazole derivative leading to good results in the treatment of sporotrichosis. Patients with cutaneous sporotrichosis proven with mycological tests (direct examination and culture) were enrolled. All patients underwent laboratory tests (at baseline and on a monthly basis) and received oral itraconazole 400 mg/day for one week with a 3-week break (pulses); thereafter the drug was administered as pulses until clinical and mycological cure was achieved. Five patients with sporotrichosis were enrolled, 4 with cutaneous lymphangitic form and one with fixed cutaneous form. Clinical and mycological cure was achieved in 4/5 cases (80%), with a mean number of pulses of 3.5. No patient had side effects and no laboratory test abnormalities occurred. Intermittent or pulsed itraconazole was effective in treating cutaneous sporotrichosis. It may be considered as a new treatment choice that entails an important reduction in total medication use.
Article: Lymphocutaneous sporotrichosis in an immunocompetent patient: a case report from extreme southern Italy.[show abstract] [hide abstract]
ABSTRACT: Sporotrichosis is a mycotic infection rarely encountered in European countries, including Italy. We describe lymphocutaneous sporotrichosis in an immunocompetent 64-year-old male Italian mason. The patient had linear nodules along the right upper arm with severe lymphadenopathy in the same arm. Sporothrix schenckii was identified by phenotypic and molecular methods. Treatment with itraconazole and methylprednisolone followed by administration of itraconazole alone successfully cured the infection. To our knowledge, this is the first documented report of sporotrichosis from Calabria and Sicily, extreme southern Italy.Mycopathologia 05/2008; 166(3):159-62. · 1.65 Impact Factor
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ABSTRACT: Sporotrichosis, caused by several species from the genus Sporothrix, mainly affects men working in agricultural labor. It is reported mostly from endemic regions located in tropical and subtropical areas. Sporotrichosis usually affects subcutaneous tissue with no symptoms or mild symptoms, but it causes disseminated and even fatal disease if the patient is immunocompromised. Significant progress in the knowledge of etiologic agents of sporotrichosis has been achieved recently, but evaluations of treatment using well-designed clinical trials have been neglected. This article reviews the drugs currently used to treat subcutaneous disease, describing the differences in their efficacy, and reviews recent findings about the proposed new Sporothrix species of clinical interest, as well as the role of melanin as a virulence factor in Sporothrix schenckii. KeywordsSporotrichosis– Sporothrix schenckii –Fungal infection–Itraconazole–Potassium iodide–TerbinafineCurrent Fungal Infection Reports 04/2012; 5(1):42-48.