S. Veraldi
2014
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Journal
Clinics in Dermatology
Abstract
Background/Purpose. This review discusses the treatment of cutaneous and vulvovaginal candidosis with topical fenticonazole, an imidazole derivative with a wide spectrum of activity against dermatophytes and yeasts. Data sources and study selection. Review of publishes studies. Data synthesis. The main mechanism of action of fenticonazole is based on the inhibition of the synthesis of aspartate acid proteinase, a virulence enzyme of Candida albicans correlated with the adherence of the yeast to epithelial cells. This activity is quite peculiar as it was not observed with fluconazole, ketoconazole and miconazole. Topical treatment (1 application/day for 4 weeks) is recommended, while in widespread or everlasting mycotic infections, fenticonazole must be associated with an oral antimycotic. Fenticonazole in monotherapy is also effective in treating vulvovaginal candidosis (ovules, cream or douche; 1 application/day for 7 days). In addition, all pharmaceutical formulations of fenticonazole are well tolerated. Limitations. Although fenticonazole is one of the earliest imidazoles developed in Europe, no experimental and clinical data on development of Candida albicans resistance have been published. Conclusions. Literature data demonstrated that fenticonazole is effective in Candida albicans infections of the skin and female genitalia.