A double-blind clinical trial of griseofulvin in patients with Raynaud's phenomenon

Griseofulvin and its uses

Griseofulvin has been used in the treatment of dermatophyte infections for the past 30 years. The use of the drug in treating other medical conditions is reviewed.

Griseofulvin: a new look at an old drug

Griseofulvin is the oral antifungal agent of choice for the treatment of dermatophytoses. This article reviews the history, pharmacokinetics, adverse reactions, and traditional therapeutic applications of griseofulvin. In addition, reports since 1960 of the use of the drug in the treatment of Raynaud's phenomenon, progressive systemic sclerosis, lichen planus, mycosis fungoides, herpes zoster, eosinophilic fasciitis, and molluscum contagiosum are discussed, noting the varying degree of therapeutic success.

Plasma exchange in the treatment of nonadvanced stages of progressive systemic sclerosis

Ten patients suffering from progressive systemic sclerosis, who responded poorly to conventional therapy, underwent plasma exchange (PE) therapy in conjunction with drug therapy. The frequency of PE was twice weekly for 4-6 weeks, two or three times per year, with a summer interruption, when in our own experience a spontaneous relief of symptoms occurs. To judge the efficacy of our therapeutic device, we assessed several laboratory and clinical parameters before and after therapy. The changes in circulating immune complexes, in IgG and IgA, and in some functional indices were significant (P less than 0.001). Eight of 10 patients improved satisfactorily. The remaining two did not improve sufficiently to continue the apheretic treatment. In conclusion, our study suggests that the PE, together with conventional therapy, can be an effective therapeutic device in the treatment of progressive systemic sclerosis.

Long-term griseofulvin treatment for progressive systemic sclerosis

Thirty-three patients with progressive systemic sclerosis (PSS) (24 women and 9 men, 27 with diffuse scleroderma and 6 with CREST syndrome) were treated with griseofulvin alone (375-500 mg/day) for 12-84 months (mean 33). Clinical and functional assessment of the results included: a self-evaluation (general status, skin toughness, cold sensitivity, dysphagia), a physical examination (fingerprint areas, chest expansion, mouth widening, grip strength) routine laboratory tests, electrocardiogram, glomerular filtration rate (GFR), esophagus and chest X-rays. After griseofulvin, a significant improvement was noted in 28/33 patients (85%) regarding subjective condition and skin thickening and elasticity, particularly in the trunk and proximal limbs (p less than 0.05 for chest expansion), and of GFR (p less than 0.01). Lung and esophageal involvement, on the whole, remained unchanged during the treatment, which does not appear to modify the progression of PSS myocardiopathy. No patient stopped using griseofulvin because of side effects. The present results show that griseofulvin is a safe drug for PSS treatment and that it can influence the skin and renal involvement.