Effectiveness and safety of topical amphotericin B in 30% dimethyl sulfoxide cream versus 30% dimethyl sulfoxide cream for nondermatophyte onychomycosis treatment: A pilot study
Open Access
- 26 October 2021
- journal article
- research article
- Published by Scientific Scholar in Indian Journal of Dermatology, Venereology and Leprology
- Vol. 88 (4), 494-499
- https://doi.org/10.25259/ijdvl_359_2021
Abstract
Background: Although topical amphotericin B cream is effective for the treatment of nondermatophyte mold onychomycosis in vitro, studies of its effectiveness and safety in vivo are limited. Objectives: We studied the effectiveness and safety of topical 0.3% amphotericin B in 30% dimethyl sulfoxide cream (amphotericin B cream) in nondermatophyte mold onychomycosis using the vehicle cream 30% dimethyl sulfoxide cream as control. Methods: This randomized controlled study was conducted between January 2019 and November 2020. Patients diagnosed with nondermatophyte mold onychomycosis were randomly divided into two groups of ten patients each: one treated with amphotericin B cream and the other with the vehicle cream. Clinical and mycological cure as well as safety were evaluated. Results: Ten patients each treated with amphotericin B cream and the vehicle cream were included in the study, but only nine patients in the vehicle cream group were available for follow up. All the 19 evaluable patients had distal lateral subungual onychomycosis and the great toenails were affected in 18 (94.7%) of these. Mycological cure was achieved in 8 (80%) patients treated with amphotericin B cream and in 4 (44.4%) patients using the control (vehicle) cream. Clinical cure was achieved in 7 (70%) patients treated with amphotericin B cream, but only in 2 (22.2%) patients on the control cream. No adverse events were observed. Limitations: The small sample size and the fact that PCR fungal identification that provides accurate identification of fungal species was not performed are limitations of our study. Conclusion: Topical amphotericin B cream was both very effective and safe in the treatment nondermatophyte mold onychomycosis. The control (vehicle) cream containing 30% dimethyl sulfoxide also demonstrated some antifungal activity.Keywords
This publication has 28 references indexed in Scilit:
- Therapies for the treatment of onychomycosisClinics in Dermatology, 2013
- Onychomycosis Due to Neoscytalidium Treated with Oral Terbinafine, Ciclopirox Nail Lacquer and Nail Abrasion: A Pilot Study of 25 PatientsMycopathologia, 2012
- A New Classification System for Grading the Severity of OnychomycosisArchives of Dermatology, 2011
- Systematic review of nondermatophyte mold onychomycosis: Diagnosis, clinical types, epidemiology, and treatmentJournal of the American Academy of Dermatology, 2011
- Efficacious Treatment of Non-Dermatophyte Mould Onychomycosis with Topical Amphotericin BDermatology, 2011
- OnychomycosisClinics in Dermatology, 2010
- Genotyping and in vitro antifungal susceptibility of Neoscytalidium dimidiatum isolates from different originsInternational Journal of Antimicrobial Agents, 2009
- In vitro activity of amphotericin B, itraconazole, voriconazole, posaconazole, caspofungin and terbinafine against Scytalidium dimidiatum and Scytalidium hyalinum clinical isolatesJournal of Antimicrobial Chemotherapy, 2008
- Onychomycosis caused by nondermatophytic molds: Clinical features and response to treatment of 59 casesJournal of the American Academy of Dermatology, 2000
- Scytalidium hyalinumonychomycosis successfully treated with 5% amorolfine nail lacquerBritish Journal of Dermatology, 1999