Disseminated superficial porokeratosis: Complete remission subsequent to discontinuation of immunosuppression

Abstract

agnosis should be reviewed. Other current topical antifungal products are more specific with regard to the impact of noncompliance, advising patients to use for the full treatmenteven though symptoms may have improved or continue for [some stated period of time] after manifestations have subsided to assure healing and to reduce the possibility of recur­ rence. The results of the current study confirm that the rapid and potent fungicidal action of terbinafine re­ sults in a high mycologic cure rate (>80%) and low relapse rate in interdigital tinea pedis with only 1 week of treatment. Effective short-course therapy with terbinafine may avoid treatment failure caused by noncompliance as illustrated by the relatively poor mycologic response when the 4-week course of therapy recommended for clotrirnazole is abbrevi­ ated to I week. Of those patients treated with the l-week clotrimazole regimen, only 38% converted from positive to negative mycology (KOB and cul­ ture) and did not experience relapse /reinfection (reversion to positive culture) within the 12-week study period. Thisphenomenon is likely due to the persistence of organisms that are only inhibited but not killed, that is, by virtue of the fungistatic prop­ erty of azoles. These organisms subsequently in­ crease in number and eventually result in the reemergence of signs and symptoms. Approximately 28% ofthe patients who received the recommended 4-week course of clotrimazole treatment had a relapse/reinfection within 8 weeks after treatment. By comparison, fewer than lO% of patients treated