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HWN Suggests

Avoid the use of combination topical steroid antifungals for tinea corporis, Candida skin infections, and diaper dermatitis

Although combination topical antifungal/corticosteroids have been approved for the treatment of tinea corporis, candidiasis, and diaper dermatitis, we recommend against use of these agents... In most patients, diaper dermatitis is an irritant contact dermatitis from stool that will usually respond to barrier diaper creams/ointments alone. Combination products, if applied with every diaper change, can result in skin atrophy, striae, and systemic absorption of the relatively high-potency topical steroids. It is instead recommended that barrier products be applied with every diaper change in this circumstance and a second low-potency topical steroid be applied as needed, no more than twice a…

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Articles of Interest

Topical Antifungals A Review and their Role in Current Management of Dermatophytoses

Topical antifungals are an important adjuvant in treatment of dermatophytosis. Also specific situations such as dermatophytoses in pregnancy and infants often warrant topical therapy. Several new topical antifungals and newer formulations hold out the promise of enhanced effectiveness of topical therapy in dermatophytosis.

A Closer Look At Topicals For Tinea Pedis

In selecting and instructing patients on the use of topical antifungal agents, it is helpful to be aware of the difference between fungicidal and fungistatic treatments.

Effective Use of Topical Antifungals

Topical antifungals need to be applied twice a day for four to six weeks or per the doctor’s advice. The treatment may vary as some fungal infections may take months to treat while others may take years. Fungal infections like athlete’s foot or ringworm infections take a minimum of two weeks when treated with cream.

Efficacy of Topical Antifungals in the Treatment of Dermatophytosis

Regarding the sustained cure outcome, butenafine hydrochloride and terbinafine hydrochloride were significantly more efficacious than were clotrimazole, oxiconazole nitrate, and sertaconazole nitrate.

Emerging Trends in the Use of Topical Antifungal-Corticosteroid Combinations

A broad range of topical antifungal formulations containing miconazole or terbinafine as actives are commonly used as efficacious choices for combating fungal skin infections. Their many benefits, owing to their specific mechanism of action, include their ability to target the site of infection, enhance treatment efficacy and reduce the risk of systemic side effects.

Oral Candidiasis and Treatment: Various Topical Antifungal Agents Compared

In adults with oral candidiasis, fluconazole exhibited a better clinical response rate than clotrimazole, but a similar mycological cure rate. There was no significant difference in clinical response and mycological cure rates in treatments with fluconazole and amphotericin B or with itraconazole and clotrimazole. For immunocompetent patients, fluconazole showed better results than clotrimazole in terms of clinical response rate. For immunocompromised patients, clotrimazole and itraconazole showed similar clinical response and mycological cure rates, but the relapse rate with itraconazole was lower than that developed with clotrimazole. In infants, miconazole and nystatin exhibited similar clinical response rates, while miconazole exhibited a higher mycological cure rate.

Resources

DermNet

Many antifungal medications are suitable for both dermatophyte and yeast infections. Others are more specific to one or the other type of fungus