Background: Tinea corporis and cruris are superficial fungal infections mainly caused by dermatophytes. The antifungal effect of carica papaya latex cream has been demonstrated in clinical studies, however, larger population and comparative studies to standard antifungal agents are needed to further strengthen this conclusion. This study determined the efficacy and safety of 1.5% carica papaya latex in cream base as treatment for tinea corporis and/or cruris compared to 1% terbinafine cream. Methods: This is a randomized, double-blind controlled trial wherein subjects with a clinical diagnosis of tinea corporis or cruris confirmed by microscopy applied terbinafine or carica papaya latex cream twice daily for 6 weeks. The efficacy and safety were assessed 2, 4, and 6 weeks using clinical and mycological cure parameters. The incidence of adverse effects was likewise evaluated. Results: 90 subjects were randomized, 45 in carica papaya group and 45 in the terbinafine group. Both groups had statistically comparable improvements based on symptoms and mycological cure rates. Adverse events are significantly higher in the papaya latex cream group. Conclusion Carica papaya latex cream is as effective as terbinafine cream in the treatment of tinea corporis and/or cruris, but it has a higher incidence of adverse events.
Terbinafine ; Tinea cruris ; Tinea

We report a case of chromoblastomycosis caused by , which was successfully treated by long-pulsed 1064 nm Nd: YAG laser combined with terbinafine. A 60-year-old man was admitted for the presence of a 30 mm×40 mm erythematous plaque on the dorsum of his right hand for about 10 months without any subjective symptoms. Both microscopic examination and tissue biopsy of the lesion showed characteristic sclerotic bodies of chromoblastomycosis. Lesion tissue culture on SDA at 26 ℃ for 2 weeks resulted in a black colony, and slide culture identified the isolate as Fonsecaea species. ITS sequence analysis of the isolate showed a 99% homology with strain KX078407. The susceptibility of the isolate to 9 antifungal agents was determined using the microdilution method according to the guidelines of CLSI M38-A2 protocol, and terbinafine showed the lowest MIC (0.125 μg/ml). We subsequently established a Wistar rat model of chromoblastomycosis using the clinical isolate and treated the rats with long-pulsed 1064 nm Nd: YAG laser (pulse width of 3.0 ms, fluence of 24 J/cm, spot size of 3 mm, frequency of 4 Hz, repeated 3 times at an interval of 30 s) twice a week for a total of 8 sessions. Although the laser treatment alone was not able to eliminate the fungi, histopathological examination showed the aggregation of numerous lymphocytes in the local affected tissue, indicating an immune response that consequently facilitate the regression of the lesion. The patient was successfully treated by long-pulsed 1064 nm Nd: YAG laser once a week combined with terbinafine (0.25 /bid) for 8 weeks, and follow-up for 20 months did not reveal any signs of recurrence.
Animals ; Chromoblastomycosis ; Humans ; Laser Therapy ; Lasers, Solid-State ; Male ; Middle Aged ; Rats ; Rats, Wistar ; Terbinafine ; Treatment Outcome