The prevalence of fungal infections has been increasing over the past few decades, suggesting a growing demand for antifungal therapy to treat such diseases. Fungal infections can be superficial, cutaneous, or systemic, and may be caused by dermatophytes, nondermatophyte molds, or yeasts. Both topical and systemic antifungal agents are being successfully used to treat these infections; however, development of newer antifungal agents is currently underway.
This issue of the Dermatologic Clinics discusses the management of fungal infections with emphasis on treatment—in particular, the treatment of various tinea infections, seborrheic dermatitis, pityriasis versicolor, and onychomycosis.
The US Food and Drug Administration has not yetapproved terbinafine, itraconazole, or fluconazole for the treatment of tinea capitis in children; however, published literature demonstrates that these antifungals are effective and safe when used for fungal infections and that physicians frequently use these agents to treat pediatric patients.
Studies have reported a variety of choices for the treatment of tinea pedis. Although oral treatments have generally demonstrated a greater ability to reach deeper layers of skin, topical agents have a lowerpotential for adverse events. Dermatophytosis complex infections may require treatment for both the fungal and bacterial components of an infection. The incidence of onychomycosis is increased in men, the elderly, diabetics, HIV-positive individuals, and other subgroups who may be immunocompromised. Treatment of onychomycosis begins with the proper diagnosis of the causative organism. Terbinafine, itraconazole (pulse and continuous), and fluconazole have been effective oral antifungal agents. For some conditions, such as superficial white onychomycosis, a topical agent may be sufficient, while other types of onychomycosis (eg, dermatophytoma) may require combined therapy (eg, surgical or topical and systemic). Nail lacquers may be effective in mild to moderate cases of onychomycosis.
As biotechnology and mycology advances, new antifungal agents are also being developed to combat fungal infections. Developments include modified versions of standard antifungal agents and the discovery of entirely new classes of agents for antifungal treatment.
This issue of the Dermatologic Clinics discusses the management of fungal infections with emphasis on treatment—in particular, the treatment of various tinea infections, seborrheic dermatitis, pityriasis versicolor, and onychomycosis.
The US Food and Drug Administration has not yetapproved terbinafine, itraconazole, or fluconazole for the treatment of tinea capitis in children; however, published literature demonstrates that these antifungals are effective and safe when used for fungal infections and that physicians frequently use these agents to treat pediatric patients.
Studies have reported a variety of choices for the treatment of tinea pedis. Although oral treatments have generally demonstrated a greater ability to reach deeper layers of skin, topical agents have a lowerpotential for adverse events. Dermatophytosis complex infections may require treatment for both the fungal and bacterial components of an infection. The incidence of onychomycosis is increased in men, the elderly, diabetics, HIV-positive individuals, and other subgroups who may be immunocompromised. Treatment of onychomycosis begins with the proper diagnosis of the causative organism. Terbinafine, itraconazole (pulse and continuous), and fluconazole have been effective oral antifungal agents. For some conditions, such as superficial white onychomycosis, a topical agent may be sufficient, while other types of onychomycosis (eg, dermatophytoma) may require combined therapy (eg, surgical or topical and systemic). Nail lacquers may be effective in mild to moderate cases of onychomycosis.
As biotechnology and mycology advances, new antifungal agents are also being developed to combat fungal infections. Developments include modified versions of standard antifungal agents and the discovery of entirely new classes of agents for antifungal treatment.