ABSTRACT
In 1958, griseofulvin became the first significant oral antifungal agent available to treat cutaneous fungal infections.1•3 Anderson1 found that about 50% to 60% of patients with tinea corporis, tinea manuum, and tinea pedis were clinically cured with griseofulvin. With pedal onychomycosis however, cure rates were much lower, typical values being 3% to 38%.2 High relapse rates of 40% to 60% have been reported. c.s
Ketoconazole, introduced in the late 1970s was the next important antifungal agent.6-8 This imidazole was an effective treatment for chronic superficial candidiasis and chronic dermatophytosis.9 A few years after the introduction of ketoconazole several cases of symptomatic hepatitis were reported, estimated to be from 1 in 10,000 to 1 in 15,000 in frequency and occasionally fatal. 10•11 The reactions were felt to be an idiosyncratic drug-induced hepatitis, not necessarily associated with high doses of ketoconazole or duration of therapy. 12 As a consequence of these results the benefit/risk ratio of oral antifungal agents
The new generation of antifungal agents available for the treatment of dermatomycoses are itraconazole, fluconazole, and terbinafine. In this chapter we will present an overview of these agents, and examine their efficacy and adverse-effect profile.
