| Background:Sporotrichosis is a kind of deep fungal infection which is causedby Sporothrix schenckii. At present,it is widely distributed in the world and popular innortheast China. In recent years, the incidence is rising.The most common types ofclinical manifestations of sporotrichosis are lymphocutaneous form and fixedform.Sporothrix schenckii can infect the population of all ages.It is also common thatsporotrichosis occurs in children in Jilin Province.Application of itraconazole (ITC)or potassium iodide (KI) or terbinafine (TBF) have exact efficacy and high safety intreatment for adults’ sporotrichosis in our country.Compared with adults, children arein poor compliance of treatment,and there are more restrictions on the route ofadministration.Also,the treatment requires higher security.At present,there are fewresearch on the treatment of children’s sporotrichosis with ITC or TBF therapy and onthe topic of the security assessment and comparative analysis of the two drugs.Subjective:To evaluate and compare clinical efficacy and safety of ITC and TBFin treatment of children’s sporotrichosis,so as to provide a scientific basis andreference for the effective treatment of children’s sporotrichosis.Methods:Randomized controlled study.From January2011to June2012,106patients who were diagnosed as confirmed sporotrichosis by fungal culture indermatology department of our hospital and who matched the inclusion standard wereincluded in this trial.They were divided into the ITC group and TBF group randomlyaccording to the random number table.Patients in ITC group were given oral ITC5mg/kg body weight once a day.Patients whose weight are above20kg in TBF groupwere asked to take TBF125mg once a day and whose weight are below20kg wereasked to take TBF62.5mg once a day orally.The results of efficacy and adversereactions of two groups were analyzed and compared.Results:There are106patients totally.52cases were included in the ITC group ofwhich49patients completed treatment,3cases were shedded.TBF group included54 cases and48patients completed treatment,6cases were lost.97cases finished theprocess of treatment completely in all and9cases were lost to follow-up.(1)General and clinical informations: A total of97cases of sporotrichosis in childrenwere aged from3months to12years(mean age:50.68±36.35months;53male,44female;male to female ratio of1:0.83).95cases lived in rural areas and cornstalks were used as the fuel of life in their family,accounting for97.94%.One case hada history of trauma which accounts for1.03%.The courses of this disease ranged fromtwo weeks to13months(average:2.88±2.20months).The onset of the lesion happenedmainly in winter and spring.35cases were infected in November and December,31cases were in January and February.17patients got this disease between March andApril and14patients between May and October.Totally,83cases were in November toApril.Fixed cutaneous and lymphocutaneous sporotrichosis were seen in8(8.25%)and89(91.75%) patients,respectively.A variety of types of lesions were mainly asnodules, papules and erythema.Lesion of one case occurred in hand,one in neck,and95cases had the facial involvement.Lesions located in different parts of the face:43cases on cheeks,27cases on eyelids,10cases on jaws,5cases on noses,4cases on thecorner of the eye,3cases on lips,2cases on the eyebrow,2cases on the front of theears and1cases on foreheads.Every aspect of general information in two groups hadno significant differences (p>0.05).(2)Clinical efficacy:49cases were cured in ITC group, the mean course of treatmentwas2.56±0.78months (range:2-6months),the cure rate of3rd,6th month were85.71%,100%respectively.48cases were cured in TBF group, the mean course oftreatment was2.88±1.00months (range:1-7months).The cure rate of3rd,6th monthwere80.41%,97.92%respectively.Regimen of two groups had no significantdifference(p>0.05).The cure rate in3rd,6th month of two groups had no significantdifference(p>0.05).(3)Adverse reactions:3cases had adverse reactions in all and the incidence is3.1%.Major of them were digestive symptoms.Adverse reactions were seen in2casesof ITC group (rate:4.1%) and major symptoms were nausea, stomach discomfort.Adverse reactions were seen in1cases of TBF group (rate:2.1%) and symptoms were mainly stomach discomfort.Incidence of adverse reactions of two groups had nosignificant difference (p>0.05).Conclusion:ITC and TBF are safe and effective in treatment of children’ssporotrichosis.The clinical efficacy and adverse effects of ITC and TBF are nosignificant difference in treatment of children’s sporotrichosis. |
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