Ketoconazole in the Management of Fungal Disease

Abstract

This book is beautifully produced and is a pleasure to read.Ketoconazole is a major advance in the treatment of the mycoses.The first one-third of the book reviews the superficial and deep mycoses and their current treatment.All this information is available elsewhere, but it is well brought together and is a good 'back-drop' for the rest of the book which is devoted to the pharmacology and clinical experience with Ketoconazole.Ketoconazole is an exciting new drug and this excitement is evident in the book.It is emphasized how useful it is in some of the deep mycoses.For the dermatologist it has transformed the management of chronic mucocutaneous candidiasis.In the chapter on 'Ketoconazole in Perspective' I was disappointed that it was not recommended to keep the drug as a special one for defined clinical entities.Ketoconazole will rarely be required for dermatophyte infections when Griseofulvin is such a useful and well tolerated drug, or where topical treatment alone will suffice.Ketoconazole will rarely be required for cutaneous candida infections, where topical treatment will usually cure.It seems to be totally unjustified for the manufacturers to list pityriasis versicolor as an indication for its use, when this trivial infection can be treated with topical agents.The photographs are mostly good and some are excellent, but a few are grossly overexposed.In conclusion, a useful book and should be read by all clinicians who treat fungal infections.It is a pity that the authors have not given a stronger lead into when this drug is indicated.