Selenium Sulfide, Ketoconazole and Ciclopirox Shampoo as Additional Treatments for Tinea Capitis (Scalp Ringworm) - Full Text View

Sponsors and Collaborators:	Chen, Catherine, M.D. Williams, Judith V., M.D. Hubbard, Thomas W., M.D. Eastern Virginia Medical School
Information provided by:	Chen, Catherine, M.D.
ClinicalTrials.gov Identifier:	NCT00127868

Purpose

Antifungal shampoos have been used as supplements to oral griseofulvin to help eradicate tinea capitis (also known as ringworm of the scalp) more quickly. While selenium sulfide shampoo has been the gold standard, its strong odor and its drying effect on the scalp discourage many patients from using it. Meanwhile, no other antifungal shampoo has been rigorously evaluated for efficacy. Therefore, while physicians are prescribing griseofulvin accompanied by any of a number of antifungal shampoos for tinea capitis, it is not known which antifungal shampoos (excluding selenium sulfide) actually significantly reduce time to cure, nor which do so the fastest.

Scalp ringworm can also re-occur in the same child. To date, no studies have been done to find out whether or not the use of antifungal shampoos can prevent the recurrence of scalp ringworm.

In this study, children ages 1-12 years old, who have clinically diagnosed tinea capitis, will all be prescribed oral griseofulvin for 8 weeks. In addition, they will be randomly assigned to use either selenium sulfide shampoo, ketoconazole shampoo, ciclopirox shampoo, or baby shampoo twice a week for 8 weeks. After 8 weeks, griseofulvin will be stopped. All patients will continue using the same assigned shampoo twice weekly for 24 weeks, while continuing to return to clinic every 4 weeks for scalp evaluation.

Condition	Intervention
Tinea Capitis	Drug: oral griseofulvin, selenium sulfide shampoo 1%, ciclopirox shampoo , ketoconazole shampoo 2%, baby shampoo

Study Type:	Interventional
Study Design:	Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator), Placebo Control, Parallel Assignment, Efficacy Study
Official Title:	A Randomized, Double-Blinded, Placebo-Controlled Study Observing the Efficacy of Selenium Sulfide 1% Shampoo, Ketoconazole 2% Shampoo, and Ciclopirox 1% Shampoo as Adjunctive Treatments for Tinea Capitis in Children

Resource links provided by NLM:

MedlinePlus related topics: Tinea Infections

Drug Information available for: Ciclopirox Ciclopirox olamine Ketoconazole Fungarest Griseofulvin Selenium sulfide Selenium disulfide Selenium

U.S. FDA Resources

Further study details as provided by Chen, Catherine, M.D.:

Primary Outcome Measures:

efficacy [ Time Frame: 9-10 months ] [ Designated as safety issue: No ]

Enrollment:	47
Study Start Date:	March 2005
Study Completion Date:	April 2008
Primary Completion Date:	April 2008 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
1: Active Comparator oral griseofulvin and selenium sulfide shampoo 1%	Drug: oral griseofulvin, selenium sulfide shampoo 1%, ciclopirox shampoo , ketoconazole shampoo 2%, baby shampoo
2: Active Comparator oral griseofulvin and ciclopirox shampoo	Drug: oral griseofulvin, selenium sulfide shampoo 1%, ciclopirox shampoo , ketoconazole shampoo 2%, baby shampoo
3: Active Comparator oral griseofulvin and ketoconazole shampoo 2%	Drug: oral griseofulvin, selenium sulfide shampoo 1%, ciclopirox shampoo , ketoconazole shampoo 2%, baby shampoo
4: Placebo Comparator oral griseofulvin and baby shampoo	Drug: oral griseofulvin, selenium sulfide shampoo 1%, ciclopirox shampoo , ketoconazole shampoo 2%, baby shampoo

Detailed Description:

Antifungal shampoos have been used as supplements to oral griseofulvin to help eradicate tinea capitis (also known as ringworm of the scalp) more quickly. While selenium sulfide shampoo has been the gold standard, its strong odor and its drying effect on the scalp discourage many patients from using it. Meanwhile, no other antifungal shampoo has been rigorously evaluated for efficacy. Therefore, while physicians are prescribing griseofulvin accompanied by any of a number of antifungal shampoos for tinea capitis, it is not known which antifungal shampoos (excluding selenium sulfide) actually significantly reduce time to cure, nor which do so the fastest.

Scalp ringworm can also re-occur in the same child. To date, no studies have been done to find out whether or not the use of antifungal shampoos can prevent the recurrence of scalp ringworm.

In this study, children ages 1-12 years old, who have clinically diagnosed tinea capitis, will all be prescribed oral griseofulvin for 8 weeks. In addition, they will be randomly assigned to use either selenium sulfide shampoo, ketoconazole shampoo, ciclopirox shampoo, or baby shampoo twice a week for 8 weeks. After 8 weeks, griseofulvin will be stopped. All patients will continue using the same assigned shampoo twice weekly for 24 weeks, while continuing to return to clinic every 4 weeks for scalp evaluation.

Eligibility

Ages Eligible for Study:	12 Months to 12 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Patients with clinically diagnosed tinea capitis.
Males or females, ages 1 through 12 years old.
Females of childbearing potential must have a negative pregnancy test.
Written Informed Consent must be obtained prior to performing any study- related procedure and according to local regulations.
Patients must be available for the entire study duration.

Exclusion Criteria:

Patients who are pregnant or breast-feeding.
Patients who have kerions requiring immediate treatment or treatment with systemic corticosteroids and/or systemic antibiotics.
Patients who have a skin disease involving the scalp, or any other condition or prior/present treatment which in the opinion of the investigator would interfere with evaluation of the treatment's effect. Examples include head lice, scalp psoriasis, atopic dermatitis of the scalp, or seborrheic dermatitis.
Patients with known liver disease.
Patients with non-acidic gastroduodenitis, malabsorption syndrome, chronic diarrhea, or any other serious gastrointestinal (GI) disease.
Patients who have received systemic antifungal treatment within 2 months prior to baseline.
Patients who have received the following topical treatments for their scalp within 1 week prior to baseline: antifungal agents, corticosteroids, zinc pyrithione, selenium sulfide, or tar-containing products.
Patients who have received immunosuppressant therapy, cytostatic therapy, or underwent radiation therapy within 1 month prior to baseline.
Patients who have been treated with any investigational agent within 8 weeks prior to baseline or who intend to use other investigational treatments during this study.
Patients with hypersensitivity to griseofulvin, selenium sulfide, or ciclopirox.
Patients who are known to miss appointments (per medical records), unlikely to follow medical instructions, or not willing to attend regular visits.
The following exclusion criteria are based upon the package insert for griseofulvin microsize suspension:
- Males planning to father children during their participation in the study or in the 6 months following their completion of the study.
- Patients taking substances known to interact with griseofulvin.
- Patients with systemic lupus erythematosus.
- Patients with porphyria.
- Patients with photosensitivity.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00127868

Locations

United States, Virginia
Children's Hospital of the King's Daughters
Norfolk, Virginia, United States, 23507

Sponsors and Collaborators

Chen, Catherine, M.D.

Williams, Judith V., M.D.

Hubbard, Thomas W., M.D.

Eastern Virginia Medical School

Investigators

Principal Investigator:

Catherine Chen, M.D.

Eastern Virginia Medical School

More Information

No publications provided

Study ID Numbers:	1-Chen
Study First Received:	August 5, 2005
Last Updated:	July 7, 2008
ClinicalTrials.gov Identifier:	NCT00127868 History of Changes
Health Authority:	United States: Institutional Review Board

Keywords provided by Chen, Catherine, M.D.:

Tinea Capitis
Children
Pediatric
Treatment
Therapy

Adjunctive
Selenium Sulfide
Ciclopirox
Shampoo

Study placed in the following topic categories:

Antioxidants
Skin Diseases
Trace Elements
Ketoconazole
Mycoses
Selenium
Anti-Bacterial Agents
Skin Diseases, Infectious

Ciclopirox
Antifungal Agents
Tinea Capitis
Griseofulvin
Micronutrients
Tinea
Dermatomycoses

Additional relevant MeSH terms:

Anti-Infective Agents
Antioxidants
Molecular Mechanisms of Pharmacological Action
Skin Diseases
Growth Substances
Physiological Effects of Drugs
Trace Elements
Infection
Ketoconazole
Protective Agents
Pharmacologic Actions
Mycoses

Selenium
Skin Diseases, Infectious
Ciclopirox
Therapeutic Uses
Antifungal Agents
Tinea Capitis
Antibiotics, Antifungal
Griseofulvin
Micronutrients
Scalp Dermatoses
Tinea
Dermatomycoses

ClinicalTrials.gov processed this record on July 06, 2009