Pulse itraconazole 400 mg daily in the treatment of chromoblastomycosis

Pulse itraconazole is effective in the treatment of chromoblastomycosis caused by Fonsecaea pedrosoi. Six patients, mean 62.3 years (range 45–79), mean duration 103 months (range 4 months to 30 years), were included in this study. F. pedrosoi was the only isolated organism. Four patients (66.7%) were cured by 12 months. Two patients (33.3%) failed to respond fully to treatment; however, one patient whose culture remained positive showed > 50% improvement at the end of study. Data showed that duration and severity were not predictive of treatment response. No side-effects were noted. Treatment should be continued until absence of organisms is proven by histology and tissue culture. Pulse regimen is more economical with better compliance than the conventional continuous 200–400 mg daily regimen, although optimum treatment duration depends on individual cases.