Current possibilities of using antimycotic drugs in the treatment of various skin disorders.

The purpose of this article is to review the literature data on the therapeutic protocols and the results of using some antimycotics in different skin diseases. In addition to the antimycotic action, particular antifungal drugs such as itraconazole, ketoconazole and terbinafine exhibit anti-inflammatory activity by inhibiting the synthesis of 5-lipooxygenase metabolites. As these metabolites are involved in a number of inflammatory and immunoreactive processes the dual action of the drugs may be suitably exploited in the treatment of some skin diseases which are otherwise difficult to cure. Another rationale for the use of antimycotics in certain skin disorders is their action against Malassezia. It has been recently demonstrated that Malassezia, present as a commensal in the epidermis, may play an important role in inducing certain inflammatory processes by stimulating cytokine production by keratinocytes. The antimycotics proved to be useful in the therapy of the following skin conditions: seborrheic dermatitis, Malassezia folliculitis, perioral dermatitis and papulopustular rosacea, as well as adult atopic dermatitis. The use of antimycotic drugs in amicrobial palmoplantar pustulosis and sebopsoriasis remains controversial. These medications are also an alternative in the treatment of leishmaniosis