A Comparative Study of Single-Dose Treatment of Chancroid Using Thiamphenicol versus Azithromycin

A study was conducted in Sao Paulo, Brazil, to compare azithromycin with thiamphenicol for the single-dose treatment of chancroid. In all, 54 men with chancroid were tested. The etiology was determined by clinical characterization and direct bacterioscopy with Gram staining. None of the patients had positive serology or dark-field examination indicating active infection with Treponema pallidum. Genital infections due to Neisseria gonorrhoeae and herpes simplex virus were excluded by polymerase chain reaction testing. For 54 patients with chancroid, cure rates with single-dose treatment were 73% with azithromycin and 89% with thiamphenicol. HIV seropositivity was found to be associated with treatment failure (p=0.001). The treatment failed in all HIV positive patients treated with azithromycin (p=0.002) and this drug should be avoided in these co-infected patients. In the view of the authors, thiamphenicol is the most indicated single-dose regimen for chancroid treatment.13321822

Onychomatricoma: epidemiological and clinical findings in a large series of 30 cases

Made available in DSpace on 2019-09-12T16:53:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2015[Di Chiacchio, N.; Di Chiacchio, N. G.] Hosp Servidor Publ Municipal Sao Paulo, Dermatol Clin, Sao Paulo, Brazil[Tavares, G. T.; Alvarenga, L.; Stuhr, P.] Private Clin, Dermatol, BR-30110063 Belo Horizonte, MG, Brazil[Tavares, G. T.] Univ Fed Minas Gerais, Hosp Clin, Dermatol, BR-30130100 Belo Horizonte, MG, Brazil[Tosti, A.] Univ Miami, Miller Sch Med, Dept Dermatol & Cutaneous Surg, Miami, FL 33136 USA[Di Santi, E.] Hosp Universidade de Taubaté (Unitau), Dermatol[De Farias, D.] Univ Fed Santa Catarina, Dermatol, Florianopolis, SC, Brazi

A comparative study of single-dose treatment of chancroid using thiamphenicol versus Azithromycin

A study was conducted in São Paulo, Brazil, to compare azithromycin with thiamphenicol for the single-dose treatment of chancroid. In all, 54 men with chancroid were tested. The etiology was determined by clinical characterization and direct bacterioscopy with Gram staining. None of the patients had positive serology or dark-field examination indicating active infection with Treponema pallidum. Genital infections due to Neisseria gonorrhoeae and herpes simplex virus were excluded by polymerase chain reaction testing. For 54 patients with chancroid, cure rates with single-dose treatment were 73% with azithromycin and 89% with thiamphenicol. HIV seropositivity was found to be associated with treatment failure (p=0.001). The treatment failed in all HIV positive patients treated with azithromycin (p=0.002) and this drug should be avoided in these co-infected patients. In the view of the authors, thiamphenicol is the most indicated single-dose regimen for chancroid treatment

Intralesional steroid injections for inflammatory nail dystrophies in the pediatric population

Intralesional injections of triamcinolone acetonide are widely used to successfully treat several inflammatory nail conditions. This procedure is well described in adults, but less frequently reported in children and teenagers, being largely considered too invasive and fear-provoking for pediatric patients. Our report shows how this procedure is feasible and successful in children, even without a digital block. The step-by-step technique and tips to reduce pain should encourage clinicians to offer it as an alternative option to children with inflammatory nail disorders

Epidemiology and clinical classification of onychomycosis

Effendy I, Lecha M, de Chauvin MF, Di Chiacchio N, Baran R. Epidemiology and clinical classification of onychomycosis. Journal of the European Academy of Dermatology and Venereology . 2005;19(Suppl. 1):8-12.Objectives To review recent data - what is new in the epidemiology of onychomycoses? To identify the most relevant diagnostic criteria for effective therapy. Methods The preliminary results of the European Onychomycosis Observatory (EUROO) study were analysed. In this international study, physicians completed questionnaires concerning patient profile and the disease. Results One of the most interesting novel findings was that sampling requests were often not made [only 3.4% of general physicians (GPs) and 39.6% of dermatologists]. This means that no information about causative agent(s) was available, hindering appropriate treatment choice. Furthermore, contrary to previous findings, 70.7% of participants did not practice sports. Lastly, these preliminary findings showed that treatment strategy depends largely on the type of treating physician, with GPs preferring monotherapy and dermatologists preferring combination therapy. Conclusions A consensus was reached that treatment strategy should depend on the severity of nail involvement and the causative fungus. It is thus important to promote the importance of sampling. To simplify the choice of an appropriate treatment, onychomycosis may be divided into just two clinical groups: onychomycosis with and without nail matrix area involvement. However, the distinct clinical findings (number and type of affected nails, multimorbidity, drug interaction, etc.) in each individual case must be taken into account to ensure an appropriate treatment decision

Treatment options - development of consensus guidelines

Lecha M, Effendy I, de Chauvin MF, Di Chiacchio N, Baran R. Treatment options - development of consensus guidelines. Journal of the European Academy of Dermatology and Venereology . 2005;19(Suppl. 1):25-33.Background There are currently three main treatment strategies for onychomycosis: topical, oral and combination. Amorolfine nail lacquer appears to be the most effective form of topical monotherapy. However, the best mycological and clinical cure rates are obtained with combination therapy. Combination therapy increases antifungal spectrum, fungicidal activity and safety. New antifungals (triazoles and echinocandins) were recently developed, enabling new protocols. Objectives To review available therapies. To design an algorithm for the management of onychomycoses in daily practice. Results Therapeutic choice should be based on numerous factors including patient's age and health, aetiology, extent of involvement and clinical form. The consensus was that topical monotherapy is recommended when 50% of the nail, including the matrix area, is involved. Topical treatments should not be used alone when topical drug transport is suboptimal (i.e. when dermatophytoma, onycholysis or spikes are present). Chemical or mechanical removal should also be considered whenever applicable (interruption of drug transport). Conclusion In conclusion, treatment decision-making tools (e.g. an illustrated booklet or CD-ROM presenting each type of onychomycosis and criteria to be considered before selecting treatment regimen) would be valuable supports for the successful treatment of onychomycoses