Treatment of Chromoblastomycosis With Terbinafine: Experience With Four Cases

J Dermatolog Treat. 2005 Feb;16(1):47-51. doi: 10.1080/09546630410024538.

Abstract

Background: Chromoblastomycosis is a chronic subcutaneous mycosis that occurs more frequently in tropical and subtropical areas and is caused by a group of dematiaceous fungi. It is a difficult-to-treat mycosis with low cure rates and a high rate of relapses.

Objective: The objective of this trial is to prove the efficacy and tolerance of oral terbinafine in four cases of chromoblastomycosis.

Methods and results: We included four cases of chromoblastomycosis, proved clinically and mycologically, that are presented herein; three of them caused by Fonsecaea pedrosoi and one by Phialophora verrucosa. Two had a small extension and the other two were of medium and large extension. Oral terbinafine was administered at a dose of 500 mg/day, which was reduced to half in two of the cases once an 80% improvement had been reached; in the third case the initial dose was maintained, and in the fourth case the dose was increased to 750 mg/day. Three cases reached clinical and mycological cure in a mean treatment period of 7 months, the fourth case reached a significant improvement only after 1.2 years of treatment. The medication was well tolerated; no liver alterations occurred; only one patient suffered mild dyspepsia.

Conclusion: Terbinafine at 500 mg/day doses represents one of the best treatments for chromoblastomycosis due to its efficacy and excellent tolerability.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Agricultural Workers' Diseases / drug therapy*
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use*
  • Chromoblastomycosis / drug therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Naphthalenes / administration & dosage
  • Naphthalenes / therapeutic use*
  • Phialophora / isolation & purification
  • Terbinafine
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Naphthalenes
  • Terbinafine