Manish Gupta1, Tarun Narang2, Rupinder Jeet Kaur3, Ashwani Manhas4, Uma Nahar Saikia5, Sunil Dogra2. 1. Department of ENT, Gian Sagar Medical College & Hospital, Banur District, Patiala, Punjab, India. 2. Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education & Research, Chandigarh, India. 3. Department of Pathology, Gian Sagar Medical College & Hospital, Banur District, Patiala, Punjab, India. 4. Department of Microbiology, Gian Sagar Medical College & Hospital, Banur District, Patiala, Punjab, India. 5. Department of Histopathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Abstract
BACKGROUND: Rhinofacial conidiobolomycosis (RFC) is an uncommon subcutaneous fungal infection producing painless swelling with grotesque deformity of the face. Although there are case reports and small case series; there are very few prospective studies evaluating treatment outcome and long-term follow-up. OBJECTIVE: To evaluate the safety and efficacy of combination of itraconazole (200 mg twice daily) and saturated solution of potassium iodide (SSKI) in patients with RFC. METHODS: Ten patients of RFC were studied over a period of 5 years. Diagnosis was confirmed by clinical, histopathological, and microbiological evaluation. Conidiobolus was cultured in four cases and in the rest of the cases, the histopathology was suggestive of RFC. They were treated with itraconazole (200 mg twice daily) and SSKI and followed up for a minimum of 1 year after stopping treatment. RESULTS: The mean age was 38.7 years and the mean duration of symptoms was 22.4 months. Males were predominantly involved (9 : 1). Seven patients responded to the combination treatment, five had complete resolution and two had good improvement (50-75%); however, in two patients the response was minimal (<25% regression of the swelling) and one patient did not show any improvement after 6 months of treatment. CONCLUSION: Combination of itraconazole and SSKI is an effective treatment modality for RFC with relatively faster onset of action, low relapse rates, and minimal adverse effects. It can be considered as first-line treatment in patients with RFC.
BACKGROUND:Rhinofacial conidiobolomycosis (RFC) is an uncommon subcutaneous fungal infection producing painless swelling with grotesque deformity of the face. Although there are case reports and small case series; there are very few prospective studies evaluating treatment outcome and long-term follow-up. OBJECTIVE: To evaluate the safety and efficacy of combination of itraconazole (200 mg twice daily) and saturated solution of potassium iodide (SSKI) in patients with RFC. METHODS: Ten patients of RFC were studied over a period of 5 years. Diagnosis was confirmed by clinical, histopathological, and microbiological evaluation. Conidiobolus was cultured in four cases and in the rest of the cases, the histopathology was suggestive of RFC. They were treated with itraconazole (200 mg twice daily) and SSKI and followed up for a minimum of 1 year after stopping treatment. RESULTS: The mean age was 38.7 years and the mean duration of symptoms was 22.4 months. Males were predominantly involved (9 : 1). Seven patients responded to the combination treatment, five had complete resolution and two had good improvement (50-75%); however, in two patients the response was minimal (<25% regression of the swelling) and one patient did not show any improvement after 6 months of treatment. CONCLUSION: Combination of itraconazole and SSKI is an effective treatment modality for RFC with relatively faster onset of action, low relapse rates, and minimal adverse effects. It can be considered as first-line treatment in patients with RFC.
Authors: Rosane Orofino-Costa; Priscila Marques de Macedo; Anderson Messias Rodrigues; Andréa Reis Bernardes-Engemann Journal: An Bras Dermatol Date: 2017 Sep-Oct Impact factor: 1.896
Authors: Javier Ordoñez-Ortega; Ana María Borbolla-Pertierra; Yolotl Sánchez-Carrillo; María de Los Ángeles Costta-Michuy; Mónica Mirabal-García; Marlen Luengas-Bautista; Deborah Palacios-Reyes Journal: Med Mycol Case Rep Date: 2022-03-07