摘要:

SummaryTerbinafine (Lamisil®) is a new antifungal drug which is now available in many countries worldwide. This review seeks to summarize why terbinafine is of interest and how well it reaches its target sites–the stratum corneum and nail plate. The diseases in which it is potentially effective are described and evidence that terbinafine is of value in these diseases is cited. There are very few effective drugs which do not have some potential for producing side‐effects and these are discu

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1994.tb06082.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryNeutral red staining is a newly described method for evaluating the viability of fungal cells. Using this method, the antifungal effects of terbinatine and itraconazole were evaluated in vitro. When the number of neutral red‐positive Trichophyton mentagrophytes conidia treated with these two oral antifungals was compared with the number of culture‐proved viable T. mentagrophytes conidia, a strong positive correlation was found. This result confirms that neutral red staining is a useful method for evaluating the viability of T. mentagrophytes in vitro, and that it can be used for the evaluation of antifungal activity. We conclude that the effectiveness of an antifungal drug should not be evaluated by direct microscopic examination alone, but with the additional aid of mycological culture or neutral red stain

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1994.tb06083.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryThein vitrofungistatic and fungicidal activities of terbinafine, amorolfine and itraconazole against dermatophytes were compared. All three compounds showed very good activity against all dermatophyte species tested, but only terbinafine and amorolfine exhibited primary fungicidal activity. These two compounds were also activein vitroagainst other filamentous fungi which cause onychomycoses, such asScytalidiumandScopulariopsisspecies.

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1994.tb06084.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1994.tb06085.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryTerbinafine (Lamisil®) is a synthetic allylamine antifungal which has been shown to be fungicidal against dermatophytes and a number of yeasts and moulds. Topical application of terbinafine 1% cream has been shown to be a highly effective short‐duration therapy for dermatophytosis of the skin. The aim of this multicentre, double‐blind, parallel‐group study was to compare the safety and efficacy of terbinafine 1% cream, applied twice daily for 1 week, with clotrimazole (Canesten®) 1% cream, applied twice daily for 4 weeks, in the treatment of tinea pedis.One hundred and seven patients with mycologically proven tinea pedis received 1 week of terbinafine 1% cream, followed by 3 weeks of placebo, and 104 patients received clotrimazole 1% cream for 4 weeks. Mycological cure (negative microscopy and culture) and effective treatment (mycological cure with no or minimal signs and symptoms) were assessed 4 and 6 weeks after commencing therapy.Mycological cure rates were 93·5% for terbinafine and 73·1% for clotrimazole (p = 0·000l) at 4 weeks, and 97·2% for terbinafine and 83·7% for clotrimazole (P = 0·0001) at 6 weeks. Effective treatment rates at 4 weeks were 89·7% for terbinafine and 58·7% for clotrimazole (P = 0·0001), and 89·7% for terbinafine and 73·1% for clotrimazole (P = 0·002) at 6 weeks.The results show that 1 week of terbinafine b.d. is more effective than 4 weeks of clotrimazole b.d., in terms of both mycological cure and

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1994.tb06086.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryThe nails serve several important functions and, when they are infected by fungal organisms, these functions are severely impaired. In addition, the quality of life, in terms of self‐esteem and social interaction, is adversely affected when fungal nail infections are present. Finally, when finger and/or toenails are abnormal this may interfere with patients' occupation

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1994.tb06087.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummarySixty‐five patients with onychomycosis involving the yeastsCandida albicansorC. parapsilosis,or the mouldScopulariopsis brevicaulis,were treated for up to 48 weeks with terbinafine 250 mg daily. At the end of therapy mycological and clinical cure rates were 70% and 54% forC.albicans,and 85% and 63% forC. parapsilosis,respectively. Three out of sevenS. brevicaulisinfections were cured. Within 6 months of therapy, relapses occurred in 45.5% of the cured patients in the case of C.albicansinfections and in 12.5% of the cured patients in the case ofC. parapsilosisinfections. Treatment was generally well tolerated and, although adverse events occurred in 43% of the patients, they were responsible for cessation of therapy in only 8.6%. These results indicate that the use of terbinafine in onychomycosis is not restricted to dermatophyte infection

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1994.tb06088.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryA spontaneously immortalized human keratinocyte line, HaCaT, was used as anin vitromodel to predict the cutaneous irritation of anionic surfactants. For this purpose, a number of sodium salts of N‐alkyl sulphates with hydrocarbon chain lengths varying between C8and C16were studied for possible cytotoxic effects. The endpoints used to assess toxicity were uptake of the vital dye neutral red (NR) and cell morphology criteria 24 h after dosing. A linear proportionality between keratinocyte number and NR uptake was established. All tested surfactants had cytotoxic effects as demonstrated by a decreased NR uptake, which showed a clear dose–response relationship. Concentrations resulting in 50% inhibition of NR uptake (IC‐50) ranged from 0·15 mmol (sodium lauryl sulphate, C12) to 1·23 mmol (sodium octyl sulphate, C8). Thein vitrocytotoxicity data were highly reproducible when the test was repeated after several weeks. The cytotoxicity data from these assays were compared with the irritant responses (as evaluated by measurement of erythema and transepidermal water loss) obtained after 24 h application of the same compounds (300 μ1 of 20 mmol aqueous solution) to the volar forearm of human volunteers. There were significant linear correlations between the IC‐50 values and both barrier damage (transepidermal water loss) and erythema (as evaluated by skin colour reflectance measurements). For the test substances, however, the sensitivity of thein vitrosystem was between 10 and 100 times higher than that observed in human skinin vivo.This quantitative difference can largely be ascribed to the effective permeability barrier of normal human skinin vivo,which protects living keratinocytes from the cytotoxic effects of surfactant molecules.The results indicate that normal human keratinocytes in culture are a promising screening method for predicting the irritation potential of anionic surfactants. Confirmation, however, has still to be obtained by appropriatein vivotesting in human

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1994.tb06876.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryIn this randomized double‐blind trial, two new antifungal compounds were compared in patients with interdigital or more extensive forms of tinea pedis. Two weeks of oral treatment with either terbinafine, an allylamine and new chemical entity, 250 mg daily, or itraconazole 100 mg daily, was given to 366 patients (184 terbinafine, 182 itraconazole). Of 13 patients who did not return after the first visit, 11 were lost to follow‐up (five on terbinafine, six on itraconazole) and two reported adverse events. Another nine patients (three on terbinafine and six on itraconazole) were excluded because it was uncertain to which group they were randomized. A central laboratory performed both the mycology and safety tests. In 355 patients who received the study medications and were available for analysis of side‐effects, 18 out of 179 (10·0%) in the terbinafine group and 10 out of 176 (5·7%) in the itraconazole group reported adverse events. No new clinically significant laboratory abnormalities were seen after treatment. At week 8 the efficacy analysis in 117 patients with mycologically confirmed dermatophyte infections (51 on terbinafine, 66 on itraconazole) showed that clinical symptoms were absent or minimal in 94·1% of the terbinafine and 72·7% of the itraconazole group (P=0·0095); mycology was negative in 86·3% of the terbinafine and 54·5% of the itraconazole group (P=0·0002). With terbinafine, negative mycology at week 8 was 81.3% in the interdigital and 88·6% in the more extensive forms of tinea pedis; with itraconazole mycology was negative in 65·0% and 50·0% of patients, respectively. This study demonstrates that the primary fungicidal action of terbinafine, i.e. its ability to kill fungi at minimal inhibitory concentrations, is of substantial clinical and economic benefit to patients with tinea pedis. After a 2‐week oral treatment period of any form of tinea pedis, terbinafine produced significantly higher mycological cure rates and significantly better clinical improvement

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1994.tb06089.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryThe cytotoxicity of irritants on human oral and skin keratinocyte culture models was compared. Keratinocytes were exposed to sodium lauryl sulphate and benzalkonium chloride at concentrations of 10–4–10–7M for 24 h. Cytotoxicity was evaluated by changes in niitochondrial metabolic activity (MIT assay) and plasma membrane integrity (LDH leakage). Our results showed that oral and skin keratinocytes are equally sensitive to the irritants tested. There were marked similarities in susceptibility between each cell type cultured from six individuals. The immunohistochemical staining pattern of both cell types resembled that of the basal cell.These observations suggest that the skin keratinocyte culture model may be useful in evaluating the cytotoxicity of agents which are irritants on either the skin or oral m

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1994.tb06877.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY