       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).

