BACKGROUND: Chromoblastomycosis is a chronic subcutaneous mycosis that occurs more frequently in tropical and subtropical areas and is caused by a group of dematiaceous fungi. It is a difficult-to-treat mycosis with low cure rates and a high rate of relapses. OBJECTIVE: The objective of this trial is to prove the efficacy and tolerance of oral terbinafine in four cases of chromoblastomycosis. METHODS AND RESULTS: We included four cases of chromoblastomycosis, proved clinically and mycologically, that are presented herein; three of them caused by Fonsecaea pedrosoi and one by Phialophora verrucosa. Two had a small extension and the other two were of medium and large extension. Oral terbinafine was administered at a dose of 500 mg/day, which was reduced to half in two of the cases once an 80% improvement had been reached; in the third case the initial dose was maintained, and in the fourth case the dose was increased to 750 mg/day. Three cases reached clinical and mycological cure in a mean treatment period of 7 months, the fourth case reached a significant improvement only after 1.2 years of treatment. The medication was well tolerated; no liver alterations occurred; only one patient suffered mild dyspepsia. CONCLUSION: Terbinafine at 500 mg/day doses represents one of the best treatments for chromoblastomycosis due to its efficacy and excellent tolerability.
BACKGROUND:Chromoblastomycosis is a chronic subcutaneous mycosis that occurs more frequently in tropical and subtropical areas and is caused by a group of dematiaceous fungi. It is a difficult-to-treat mycosis with low cure rates and a high rate of relapses. OBJECTIVE: The objective of this trial is to prove the efficacy and tolerance of oral terbinafine in four cases of chromoblastomycosis. METHODS AND RESULTS: We included four cases of chromoblastomycosis, proved clinically and mycologically, that are presented herein; three of them caused by Fonsecaea pedrosoi and one by Phialophora verrucosa. Two had a small extension and the other two were of medium and large extension. Oral terbinafine was administered at a dose of 500 mg/day, which was reduced to half in two of the cases once an 80% improvement had been reached; in the third case the initial dose was maintained, and in the fourth case the dose was increased to 750 mg/day. Three cases reached clinical and mycological cure in a mean treatment period of 7 months, the fourth case reached a significant improvement only after 1.2 years of treatment. The medication was well tolerated; no liver alterations occurred; only one patient suffered mild dyspepsia. CONCLUSION:Terbinafine at 500 mg/day doses represents one of the best treatments for chromoblastomycosis due to its efficacy and excellent tolerability.
Authors: S Deng; W Lei; G S de Hoog; L Yang; R G Vitale; H Rafati; M Seyedmousavi; A Tolooe; H van der Lee; W Liao; P E Verweij; S Seyedmousavi Journal: Antimicrob Agents Chemother Date: 2018-05-25 Impact factor: 5.191