Kullavanijaya P, Rojanavanich V
Institute of Dermatology, Bangkok, Thailand.
Int J Dermatol. 1995 Nov;34(11):804-7. doi: 10.1111/j.1365-4362.1995.tb04404.x.
Many methods and medications had been tried for the treatment of chromoblastomycosis with unsatisfactory results. Recently, there were several reports showing a good response of chromoblastomycosis to itraconazole, but it took as long as 18-30 months for lesions to heal.
Itraconazole, 200 to 400 mg/day alone or in combination with monthly liquid nitrogen cryotherapy, was tried on 10 cases of chromoblastomycosis, caused by Fonsecaea pedrosoi in order to increase the potency of the drug and shorten the duration of treatment.
The 10 cases included five newly diagnosed and five recalcitrant cases. Two patients were cured by 200 mg/day alone within 3 months. Seven patients required itraconazole, 400 mg/day, with combined cryotherapy to cure the lesions within 5 to 10 months. One case showed marked improvement but no cure. After the period of 1-year follow-up, only one case had a recurrent infection.
Itraconazole was highly effective and may be useful in the treatment of chromoblastomycosis. A high dose is indicated in chronic fibrotic lesions in combination with liquid nitrogen cryotherapy, with higher efficacy and quicker healing than with medication alone.
治疗着色芽生菌病尝试过许多方法和药物，但效果均不理想。最近，有几份报告显示着色芽生菌病对伊曲康唑反应良好，但病变愈合需长达18至30个月。
对10例由裴氏瓶霉引起的着色芽生菌病患者试用伊曲康唑，剂量为每日200至400毫克，单独使用或联合每月一次的液氮冷冻疗法，以增强药物效力并缩短治疗时间。
10例患者中，5例为新诊断病例，5例为难治性病例。2例患者单用每日200毫克剂量在3个月内治愈。7例患者需要每日400毫克伊曲康唑联合冷冻疗法，在5至10个月内治愈病变。1例患者有明显改善但未治愈。经过1年随访，仅1例复发感染。
伊曲康唑治疗着色芽生菌病疗效显著，可能对其治疗有用。对于慢性纤维化病变，高剂量伊曲康唑联合液氮冷冻疗法疗效更佳，愈合更快，优于单纯药物治疗。
