Fungal infections of the skin and mucous membranes: New therapies and the development of azole resistant yeasts

The treatment of dermatophyte infections of the skin, hair and nails has been considerably improved by the introduction of the new triazole, itraconazole (Sempera(R), Sporanox(TM), Janssen, Beerse, Belgium) and the allylamine, terbinafine (Lamisil(R), Sandoz, Basel, Switzerland). New evidence suggests that short-term and intermittant treatment is sufficient to cure onychomycosis. Fluconazole (Diflucan(R), Pfizer, UK) is also effective in dermatophyte infections. However, long-term fluconazole treatment of oropharyngeal Candida infection in HIV-infected patients has induced in-vivo and in-vitro azole resistant Candida albicans. Cutaneous and disseminated infections caused by opportunistic molds are increasing in immunocompromised patients. An effective treatment is not yet available.