Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Ketoconazole is an anti-fungal medication in
the same family of drugs as fluconazole (Diflucan), itraconazole (Sporanox), and miconazole (Micatin, Monistat). It prevents growth
of several types of fungi by preventing production of the membranes that
surround fungal cells. The FDA approved ketoconazole in June 1981.
DOSING: Ketoconazole may be taken with or without food. The oral dose
range is 200-400 mg daily. Topical formulations are administered to affected
areas once or twice daily.
DRUG INTERACTIONS: There are no known drug interactions with topical
ketoconazole.
Ketoconazole tablets require stomach acidity to dissolve. Therefore,
ketoconazole should be administered at least two hours before taking antacids or
other acid reducing medications such as
cimetidine (Tagamet) or
ranitidine (Zantac). Combining
ketoconazole with alcohol may cause a very unpleasant reaction (disulfiram
reaction).
Rifampin (Rifadin,
Rimactane,
Rifamate,
Rifater) reduces the blood concentration of oral ketoconazole, probably by
increasing the elimination of fluconazole by the liver. This may reduce the
effectiveness of ketoconazole.
Ketoconazole may increase the concentration of
warfarin (Coumadin) in blood by reducing the elimination of warfarin. Therefore, the effect
of warfarin may increase, leading to an increased tendency to bleed.
Ketoconazole also increases the concentration of phenytoin,
(Dilantin) cyclosporine,
zidovudine (Retrovir), theophylline
(Theo-Dur, Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin), tolbutamide, glyburide
(Micronase, Diabeta, Glynase), glipizide
(Glucotrol), protease inhibitors [for example,
indinavir
(Crixivan), ritonavir
(Norvir), saquinavir (Invirase, Fortovase)],
midazolam (Versed) and triazolam
(Halcion).
Increased drug concentrations usually increase the incidence of side effects.
The term "ringworm" or "ringworms" refers to fungal infections that are on the surface of the skin. A physical examination of the affected skin, evaluation of skin scrapings under the microscope, and culture tests can help doctors make the appropriate distinctions. A proper diagnosis is essential to successful treatment. Among the different types of ringworm are the following: tinea barbae, tinea capitis, tinea corporis, tinea cruris, tinea faciei, tinea manus, tinea pedis, and tinea unguium.
Athlete's foot (tinea pedis) is a skin infection caused by the ringworm fungus. Symptoms include itching, burning, cracking, peeling, and bleeding feet. Treatment involves keeping the feet dry and clean, wearing shoes that can breathe, and using medicated powders to keep your feet dry.
Thrush is an infection of the mouth caused by the candida fungus. Symptoms of Thrush include pain or difficulty swallowing, a feeling that food gets stuck in the throat, and fever.
Jock itch is an itchy red rash that appears in the groin area. The rash may be caused by a bacterial or fungal infection. People with diabetes and those who are obese are more susceptible to developing jock itch. Antifungal shampoos, creams, and pills may be needed to treat fungal jock itch. Bacterial jock itch may be treated with antibacterial soaps and topical and oral antibiotics.
Folliculitis is a skin condition that causes small red bumps to form around the hair follicles. Skin bacteria such as Staphylococcus and Pseudomonas my infect the follicles. Treatment involves over-the-counter bacterial washes, topical antibiotics, and/or topical steroids.
Tinea versicolor is a fungus infection that mainly affects the skin of young people. Recognized by light or reddish brown spots, and areas lighter than the surrounding skin. Tinea versicolor is caused by yeast actually found in our skin. Factors like heat, humidity, and sweat help it proliferate in people, resulting in a rash that is not contagious to others.
Cushing's syndrome, sometimes referred to as hypercortisolism, is a hormonal disorder caused by prolonged exposure to high levels of the hormone cortisol. Symptoms may include obesity, thinning arms and legs, a rounded face, and increased fat around the neck. Some causes of Cushing's syndrome is from taking glucocorticoid hormones such as prednisone for inflammatory diseases. Treatment for Cushing's syndrome depends on the cause.
Dandruff (seborrhea) is a skin disorder that results from neither too much moisture nor too much oil. Dandruff can be treated with shampoos that contain tar, salicylic acid, zinc, selenium sulfide, or ketoconazole.
Yeast infections are caused by an overgrowth of a type of fungus called Candida. Oral thrush is a yeast infection of the mouth and throat. Oral thrush and yeast infections are treated orally or topically with an antifungal antibiotic called Nystatin.
Histoplasmosis is a disease caused by the Histoplasma capsulatum fungus. Symptoms and signs of this infection are fever, dry cough, chills, malaise, sweats, and abdominal pain. Transmission of the infection occurs when people inhale the spores. Most infections resolve on their own, and resistant infections are treated with itraconazole, ketoconazole, or amphotericin B.
Valley fever (coccidioidomycosis) is a disease caused by the inhalation of the Coccidioides immitis or C. posadasii fungus. Symptoms are flu-like and resolve over two to six weeks. Infection typically requires no treatment, though there are many antifungal drugs to treat valley fever.
Leishmaniasis is a disease caused by the bite of an infected sand fly. The most common types of leishmania infection are cutaneous and visceral leishmaniasis. Leishmaniasis is found mainly in the subtropics and tropics. Symptoms and signs of cutaneous leishmaniasis include skin sores with a raised edge and central crater, while those with visceral leishmaniasis usually have fever, weight loss, and an enlarged liver and spleen.
What is folliculitis? What are folliculitis symptoms? What does folliculitis look like?
Folliculitis is a common skin condition that appears as numerous small red or
pink little bumps at hair follicles. It can cause a "chicken
skin" appearance on the skin. Folliculitis can affect any part of the skin,
including the chest, back, arms, legs, buttocks, and cheeks. Often, 10-100 very small, slightly smooth
bumps are scattered in a body area like the back. Some of the bumps may be
slightly red or have an accompanying light-red halo indicating inflammation. Sometimes, scratching off the top reveals a small trapped or coiled hair within. Acne whiteheads, called milia, may also be in the same areas as
folliculitis. Although folliculitis is
primarily a skin condition of teenagers and younger adults, it is also
seen in all ages.
In general, folliculitis is often cosmetically displeasing and otherwise
medically harmless. Many cases of folliculitis may resolv...
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