Effective treatment for dermatophytoses of the foot: effect on restoration of depressed cell-mediated immunity

• Published in: Journal of the European Academy of Dermatology and Venereology Vol. 21; no. 8; pp. 1013 - 1018
• Main Authors: Schmid-Wendtner, M-H, Korting, HC
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.09.2007
• Subjects: Animals; Antifungal Agents - therapeutic use; cell-mediated immunity; chronic infection; delayed-type hypersensitivity; dermatophytoses; Fluconazole - therapeutic use; Foot Dermatoses - drug therapy; Foot Dermatoses - immunology; Humans; Immunity, Cellular - drug effects; Itraconazole - therapeutic use; Ketoconazole - therapeutic use; Mycoses - drug therapy; Mycoses - immunology; Naphthalenes - therapeutic use; terbinafine; treatment
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1111/j.1468-3083.2007.02364.x

Superficial infections caused by dermatophyte fungi are highly prevalent throughout the world. Modern antimycotic agents like the azole itraconazole or the synthetic allylamine terbinafine greatly improved treatment outcomes in comparison with former therapeutic options with griseofulvin or older azole preparations like ketoconazole or fluconazole. In randomized trials involving patients with dermotophytoses, a great effectiveness has been shown especially for terbinafine. Oral terbinafine in general is well tolerated, has a low potential for drug interactions and, therefore, may be the most often used therapeutic agent for dermatophyte onychomycosis. However, there is a group of patients suffering from chronic dermatophytoses or early reinfections after antifungal therapy. For these patients, a depression of the delayed‐type hypersensitivity reactivity was postulated. Just recently, effective antimycotic treatment, in particular with terbinafine, was shown to enhance and restore cell‐mediated immunity, which potentially improves the therapeutic outcome even for this group of patients.