WHO Model Prescribing Information: Drugs Used in Skin Diseases
(1997; 132 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentPreface
View the documentIntroduction
Open this folder and view contentsParasitic infections
Open this folder and view contentsInsect and arachnid bites and stings
Open this folder and view contentsSuperficial fungal infections
Close this folderSubcutaneous fungal infections
View the documentSporotrichosis
View the documentMycetoma
View the documentChromomycosis
View the documentSubcutaneous zygomycosis
Open this folder and view contentsBacterial infections
Open this folder and view contentsViral infections
Open this folder and view contentsEczematous diseases
Open this folder and view contentsScaling diseases
Open this folder and view contentsPapulosquamous diseases
View the documentCutaneous reactions to drugs
Open this folder and view contentsPigmentary disorders
Open this folder and view contentsPremalignant lesions and malignant tumours
Open this folder and view contentsPhotodermatoses
Open this folder and view contentsBullous dermatoses
View the documentAlopecia areata
View the documentUrticaria
Open this folder and view contentsConditions common in children
View the documentAcne vulgaris
View the documentPruritus
View the documentTropical ulcers
Open this folder and view contentsAntimicrobial drugs
Open this folder and view contentsAntifugal drugs
Open this folder and view contentsAntiseptic agents
Open this folder and view contentsKeratoplastic and keratolytic agents
Open this folder and view contentsScabicides and pediculicides
Open this folder and view contentsAnti-inflammatory and antipruritic drugs1
Open this folder and view contentsAntiallergics and drugs used in anaphylaxis
Open this folder and view contentsUltraviolet radiation-blocking agents (sunscreens)
Open this folder and view contentsMiscellaneous drugs
Open this folder and view contentsAnnex
View the documentSelected WHO Publications of Related Interest
View the documentBack cover
 

Mycetoma

Mycetoma, a chronic granulomatous infection which extends into the subcutaneous tissue and the underlying bone, is caused by a wide variety of fungi, including Madurella mycetomatis, M. grisea and Allescheria boydii (eumycetoma), and also by certain “actinomycetes” such as Actinomadura madurae, A. pelletieri and Nocardia asteroides (actinomycetoma). The lesions, which most commonly occur on the lower leg and foot (madura foot), are characterized by painless subcutaneous nodules and the subsequent formation, over several years, of multiple granulomatous draining sinuses. If left untreated, mycetoma may ultimately result in gross deformity of the lower leg.

Treatment

Small, localized lesions are best removed surgically. Eumycetoma infections are mostly resistant to chemotherapy, but oral administration of griseofulvin, 10 mg/kg daily as a single dose for up to 4 weeks, or ketoconazole, 200-400 mg daily for up to 2 weeks, or parenteral administration of amphotericin B, 0.25-1.0 mg/kg daily by infusion for 10-14 days, can be tried. Ketoconazole is effective in about 50% of infections caused by the fungus Madurella mycetomatis. In contrast, actinomycetoma is usually responsive to dapsone or sulfonamides administered over a period of 4-6 months either alone or in combination with rifampicin or streptomycin. Sulfamethoxazole/trimethoprim in combination with streptomycin has also been used. Advanced cases may need radical surgery.

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