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M94A0272.TXT
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1994-10-08
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Document 0272
DOCN M94A0272
TI Management of common superficial fungal infections in patients with
AIDS.
DT 9412
AU Elmets CA; Department of Dermatology, Case Western Reserve University,;
Cleveland, OH.
SO J Am Acad Dermatol. 1994 Sep;31(3 Pt 2):S60-3. Unique Identifier :
AIDSLINE MED/94358252
AB Cutaneous fungal infections are a major source of morbidity in
HIV-infected patients, and their management poses special challenges.
Superficial mycoses, such as tinea pedis, tinea cruris, tinea corporis,
and onychomycosis, are no more common in HIV-infected patients than in
the HIV-negative population but are of greater severity. Although they
respond to topical and systemic antifungal agents, HIV-positive patients
are predisposed to frequent recurrences. Unusual types of fungal
infections such as Majocchi's granuloma are more likely to develop in
HIV-infected patients and respond best to systemic antifungal therapy
with imidazoles or triazoles. Infections with Candida albicans develop
in virtually all HIV-positive patients. Although mucosal involvement is
the most common, patients may also develop superficial cutaneous
infections. Topical agents are frequently all that is necessary, but in
some, oral medications are required. Although fluconazole is effective,
an appreciable number of isolates are resistant. Patients with
pityriasis versicolor and seborrheic dermatitis, in which Pityrosporum
species are thought to be involved, respond well to short courses of
oral ketoconazole. Milder forms of seborrheic dermatitis can also be
treated with low-potency topical steroids or topical ketoconazole. The
oral triazole fluconazole is not particularly effective in the
management of seborrheic dermatitis. Although the cause of eosinophilic
pustular folliculitis, a common disorder in immunosuppressed
HIV-positive patients, is unknown, some can be cured with high doses of
itraconazole, suggesting that fungi are important in the pathogenesis of
the disease in some patients.
DE Acquired Immunodeficiency Syndrome/*COMPLICATIONS Administration, Oral
Administration, Topical Antifungal Agents/*THERAPEUTIC USE
Candidiasis/COMPLICATIONS/*DRUG THERAPY Dermatitis,
Seborrheic/COMPLICATIONS/*DRUG THERAPY
Dermatomycoses/COMPLICATIONS/*DRUG THERAPY
Eosinophilia/COMPLICATIONS/*DRUG THERAPY
Folliculitis/COMPLICATIONS/*DRUG THERAPY Human
Onychomycosis/COMPLICATIONS/DRUG THERAPY Tinea
Versicolor/COMPLICATIONS/DRUG THERAPY JOURNAL ARTICLE REVIEW REVIEW,
TUTORIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).