Tinea Nigra Medication
- Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD more...
Medication Summary
Because tinea nigra is caused by a superficial fungal infection of the skin, topical medicines designed to eradicate the dermatomycosis are used.
Dermatologic agents
Class Summary
These agents are used to treat tinea nigra because of their action on the skin. They may either aid in the removal of excessive keratin in hyperkeratotic skin disorders or increase epithelial cell turnover. These agents are used in conjunction with fungicidal or fungistatic medications.
Salicylic acid topical (Compound W, Salactic Film, Sal-Plant, Panscol)
Causes desquamation of the horny layer of skin by dissolving intercellular cement substance, while not affecting structure of viable epidermis. Hydrate skin and enhance effects of medication by soaking affected area in warm water for 5 min prior to use; remove any loose tissue with brush, washcloth, or emery board, and dry thoroughly. Improvement should occur in 1-2 wk.
Tretinoin topical (Avita, Retin-A)
Topical tretinoin decreases cohesiveness of follicular epithelial cells and stimulates their mitotic activity, resulting in quicker turnover of the epithelial layer.
Topical imidazoles
Class Summary
These medications are broad-spectrum antifungals that are commonly used in the treatment of tinea pedis, but they are also effective in the treatment of tinea nigra.[17, 18]
Clotrimazole (Lotrimin, Mycelex, Femizole-7)
Broad-spectrum antifungal agent that inhibits yeast growth by altering cell membrane permeability, causing death of fungal cells. Reevaluate diagnosis if no clinical improvement after 4 wk.
Ketoconazole topical (Nizoral)
Imidazole broad-spectrum antifungal agent; inhibits synthesis of ergosterol, causing cellular components to leak and resulting in fungal cell death.
Miconazole (Micatin, Femizol-M)
Damages fungal cell wall membrane by inhibiting biosynthesis of ergosterol. Increases membrane permeability, causing nutrients to leak out and resulting in fungal cell death.
Topical pyridones
Class Summary
Topical pyridones are broad-spectrum agents with antidermatophyte, antibacterial, and anticandidal activity.
Ciclopirox (Loprox)
Interferes with synthesis of DNA, RNA, and protein by inhibiting the transport of essential elements in fungal cells.
Topical allylamines
Class Summary
These drugs are effective in treating a variety of fungal infections. Because they have demonstrated potent activity against dermatophytes, they are often used in recalcitrant infections.[19]
Terbinafine topical (Lamisil)
Allylamine derivative that inhibits squalene epoxidase, a key enzyme in sterol biosynthesis in fungi. This effect results in a deficiency in ergosterol in the fungal cell wall, causing fungal cell death.
Fungistatic agents
Class Summary
These medications do not kill the fungus, but rather, they prevent their growth and replication.
Undecylenic acid & derivatives
Fungistatic agent.
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