Dermatology Book

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Topical AntifungalAka: Antifungal Agents for Superficial Skin Infections

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  1. Indications
    1. Cutaneous Fungal Infections (i.e. Tinea Corporis, Tinea Cruris, Tinea Pedis)
    2. Cutaneous Candidiasis (e.g. Intertrigo)
    3. Vulvovaginal Candidiasis
  2. Contraindications (due to lack of efficacy; these require systemic Antifungals)
    1. Tinea Unguium
    2. Tinea Capitis
  3. Preparations: Older, narrow spectrum fungistatic agents
    1. Tolnaftate (Tinactin, OTC)
      1. Narrow spectrum with no effect on candida species
      2. Fungistatic for dermatophytes and Tinea Versicolor
    2. Haloprogin (Halotex)
      1. Similar to Tolnaftate with added candida coverage
      2. Increased risk of irritant dermatitis
  4. Preparations: First-line fungicidal agents
    1. Polyene Antifungal (for Cutaneous Candidiasis)
      1. Nystatin
    2. Imidazole Antifungal (broad spectrum for Tinea Infection and Cutaneous Candidiasis)
      1. Clotrimazole (Lotrimin, OTC)
      2. Miconazole (Micatin, OTC)
      3. Econazole (Spectazole)
      4. Ketoconazole (Nizoral)
      5. Oxiconazole (Oxistat)
      6. Sulconazole (Exelderm)
  5. Preparations: Second line fungicidal agents for refractory Tinea Infection
    1. Ciclopirox (Loprox, Penlac)
    2. Butenafine (Mentax)
      1. Similar to allylamines
      2. Highly effective fungicidal agent
    3. Naftifine (Naftin)
    4. Terbinafine (Lamisil)
  6. Protocol
    1. See Vulvovaginal Candidiasis
    2. Cutaneous Candidiasis Management
      1. Polyene (e.g. Nystatin)
      2. Imidazoles (e.g. Clotrimazole)
    3. Dermatophyte Infections (e.g. Tinea Corporis)
      1. Imidazoles (e.g. Clotrimazole)
    4. Refractory Dermatophyte Infections
      1. Allylamines (e.g. Naftin, Lamisil)
  7. References
    1. Gupta (1998) Drugs 55:645
    2. Weinstein (2002) Am Fam Physician 65(10):2095

[DE102] ANTIFUNGAL, TOPICAL (C0973520)

ConceptsPharmacologic Substance (T121)
Parent ConceptsAnti-Infective Agents, Local (C0003205)
SourcesNDFRT
Derived from the NIH UMLS (Unified Medical Language System)



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